What Are Macular Holes and Puckers?
The macula is a structure that helps form the central part of the retina. In this area, it has a high level of photoreceptor cells that sense light and send the messages back to the brain, which interprets the information as images. If you have certain conditions that damage the macula, you may experience blurred or fuzzy vision. Two very common conditions that can greatly impact the macula include macular holes and macular puckers. Our ophthalmologists at Ophthalmology Associates of the Valley in San Fernando Valley of Los Angeles, CA have years of experience diagnosing and treating these conditions and can help improve your vision.
What Are The Signs?
A macular pucker is a thin line of scar tissue that forms over the retina. Scar tissue may be mild or severe, and in some cases, it tends to look like plastic during an eye exam. For more severe cases of macular pucker, it may cause the macula to wrinkle or look distorted. Compared to a macula pucker, macular holes look like a micro-injury or hole that goes all the way through the macula. If you suffer from either of these conditions, you may experience a few common symptoms, including:
- Blurred central vision
- Wavy or distorted vision, such as straight lines that appear to bend
- Difficulty seeing detail
- Trouble reading small print
- A blind spot or gray area in your central vision
- Blurred vision and distortion
- Occurrence of blind spots
What Causes Them?
Generally, the most common reason for a macular pucker is because of age-related deterioration of the structures within the eye. As you start to age, the vitreous gel starts to shrink. If it shrinks enough, this gel can break away from its normal spot and create damage or swelling, which results in a macular pucker. In other cases, the vitreous gel does not detach without harming the delicate structure of the retina, which creates a macular hole. A macular pucker can also be caused by an injury or trauma to the eye, which causes scar tissue. Certain medical conditions, such as diabetes, may create a macular pucker because of the impact it has on retinal blood vessels.
Treatment is based on the severity of each condition. If a macular pucker begins to affect everyday activities, we may perform vitrectomy using local anesthesia. While performing this procedure, we use fine instruments to gently remove the scar tissue from your macula. Afterward, you should experience relief from blurry and distorted vision once your eye starts to heal over the next couple of months.
For macular holes, we will monitor the severity of your condition because some holes may close without the need for professional treatment. However, for larger holes, we offer two options. We may inject a medication into the eye to reduce the pulling of vitreous gel on the macula so it releases without causing any damage. For more severe cases, we may recommend a vitrectomy. As we perform this surgery, we reduce any pulling on the macula and place a temporary gas bubble in the eye, which enables the hole to close. Depending on the type of bubble selected, it will naturally absorb into the body, or we may need to surgically remove it.
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Macular hole and pucker FAQs
When should I seek help for a macular hole or pucker?
If you experience any type of vision loss or changes in your vision, you should seek medical attention from an ophthalmologist right away. This is especially true if symptoms are sudden or interfere with daily activities. Our staff will perform an exam and make recommendations so you can make the best decision for your eye health.
How do I prepare for treatment?
OAV will provide a detailed list of instructions based on the type of treatment chosen and your individual case. In general, you should plan to have someone drive you home after the procedure and stay with you for at least 24 hours. We also provide a list of activities to avoid during the recovery process.
What should I expect after treatment?
Again, this will vary depending on the type of treatment you receive. It is normal to experience some blurry vision after addressing a macular hole or pucker, but any side effects are manageable and temporary. Our team at OAV will schedule regular follow-up appointments to monitor your progress and ensure you are on the road to recovery.
Macular puckers and macular holes can cause a variety of uncomfortable symptoms, such as blurry and distorted vision. It is extremely important to attend yearly eye exams so we can detect these issues for you and prevent long-term damage. To learn more, please schedule an appointment with Ophthalmology Associates of the Valley in San Fernando Valley of Los Angeles, CA.