Doctor insights on:
Alternative Treatments For Macular Pucker
How problematic is macular pucker in both eyes for prognosis & treatment. 1 eye advanced from mild to moderate in few mos. but no visual effects yet.
Macular pucker: Bottom line: observe only unless affecting vision significantly. Pars plana vitrectomy with membrane peel is a major surgery and not to be taken lightly even though results are much better than they once were. Keep follow up appointments and do Amsler grid testing at home. Many cases do not advance, so be patient. Many cases have no known cause. ...Read more
Usually: If one has Medicare as insurance, macular pucker is usually a covered diagnosis, and surgery is considered medically necessary if the patient is symptomatic or has vision deterioration from the pucker. People are Medicare eligible at age 65 years, or with certain chronic illnesses. ...Read more
Very small%: Macular pucker is very rare condition , I have seen only 3 times in thirty nine years of office practice. ...Read more
Yes: If the cornea is of normal curvature and health and the tear is sufficient to support a lens, then a contact can be worn. The vitrectomy will not affect the front of the eye unless the need for the vitrectomy included pathology of the front of the eye. Ask your ophthalmologist about your corneal health. ...Read more
Macular pucker causing objects & letters to appear larger. Doesn't bother me & I see 20/20. Dr doesn't recommend surgery. Sound reasonable?
Have macular pucker. Doorways wavy, objects larger but see 20/20. Could difficulty seeing curbs and turn lanes when driving at night be a symptom?
Hard to say: Getting the opinion of a retina specialist that can examine the eye carefully and see what other, if any, eye problems might contribute, would be most appropriate. If there are no other problems and the pucker is identified as the cause symptoms, then the risk of surgery must be weighted against the magnitude of the problem and visual acuity, for surgical decision making. ...Read more
Vision disturbed: Macular pucker is when the vitreous gel atop the macula developed a membranous layer with attachments to the macula and with some degree of condensation and contraction will wrinkle a little and disturb the vision. It can occur after trauma, retinal surgery but also can be spontaneous. If progressive and threatening the vision a procedure called membrane peel can improve things. ...Read more
How effective is jettrea injection for macular pucker. Should it be tried before the decision to have vitrectomy?
Ask ophthalmologist.: Contact your ophthalmologist who does the procedure. He/she is the best person to comment on this. ...Read more
After vitrectomy for macular pucker, how does the patient function in daily living activities during the recovery process. ?
Post surgery: You should receive specific instructions from your doctor and follow them very closely. Report to your doctor asap. ...Read more
In moderate macular pucker with no progression of disease is it likely. the pucker will continue to wrinkle in the coming months or years.
Not necessarily: Not all macular puckers, or epiretinal membranes continue to advance. I have watched patients for 15-20 years without worsening. This is, however, not the usual clinical picture. Most patients progress at usually a SLOW rate, with many patients never developing enough symptoms to need surgery. Fortunaltely there is a n intevention, allbeit surgical to fix this condition. ...Read more
Yes: Yes, both terms describe the same condition. This condition results from a membrane forming from a remnant of vitreous that stays adherent to the retina after the vitreous separates from the retina. This condition may never cause visual issues, but in some people the membrane will wrinkle and may need to be surgically removed. ...Read more
Does having drusins have any effect on having a vitrectomy for macular pucker due to scar tissue? Vision progressively getting worse.
Drusen: Do you have a photo or the fluorescein (FA) or your macular area? Were you told you have early macular degeneration? Usually drusen does not make vision worse on its own unless there is a clumping of drusen with new blood vessels growing underneath. A photo/FA would help. Consult with us to provide a more complete answer to your excellent question. ...Read more
Have macular pucker with some distortion & macropsia but see 20/20. Can symptoms make it more difficult to use monovision. I get headaches.
Yes: Monovison (using one eye for distance and and another for near) may be difficult with a macular pucker. Metamorphopsia( distortion) will make the one eye function less than optimally for the task ...Read more
Vitrectomy macular pucker Surgeon said 90% chance all mp removed,75% chance 20/20 vision or close, 25% chance better vision. 2% chance none. Right?
Optimistic: it all depends on the starting vision before pucker surgery. I generally quote patients a 2 out of 3 chance of improving 2 or more lines on the eye chart, and a 1 in 3 chance of minimal improvement, though stabilization (no more worsening). Of course there are rare cases of poorer vision following surgery as well. Regarding distortion, it is almost always improved, but rarely completely gone. ...Read more
Have Macular pucker causes white to appear gray. Also have glaucoma. Will visual field test be inaccurate because background is gray instead of white.
Likely to be fine: There can be multiple conditions in an eye at one time, and when this is the case a visual field may be a bit off from it's full potential. But it can still give useful information. In your case, if it is inaccurate, some changes can be made to the settings of the test to make it easier. If still inaccurate, there are still other parameters/tests of your eye that can be utilized to follow it. ...Read more
Have moderate macular pucker. 1 retina specialist said it will affect my vision within 5 yrs. & another said It may never cause problem. Any opinions?
Does it bother?: Macular puckers have a wide range of effect on vision. If the vision is mildly affected and it does not bother, I generally recommend observation. If there is significant distortion that affects a persons vision performance, I often recommend surgery, regardless of visual acuity. So the key is how much does it affect a person either from poor acuity (blurriness) or distortion. ...Read more
No: A macular scar is a replacement of the rod and cones (photoreceptors) in the macula. The normal tissue is no longer present, and one cannot expect a return of function, when the retinal cells no longer exist. A macular pucker refers to a loss of the smooth surface of the retina.The photoreceptors are present, but perceive images incorrectly because of the altered angle they project on the retina. ...Read more
Several Causes: Macular pucker or epiretinal membrane results in formation of a thin layer of scar tissue which distorts the retina. It is caused by cells migrating through a tiny hole or from inflammation. If the symptoms of blurring and distortion are severe enough, then surgery may be needed. ...Read more
Vitrectomy: If the symptoms are severe enough, a retinal surgeon can perform a vitrectomy operation which involves delicately peeling the wrinkled membrane from the surface of the retina. Over time, this allows the retina to flatten out and assume a more normal shape. Cataract if a common complication of this operation. ...Read more
If it were to become necessary for me to have vitrectomy for macular pucker, how long should I plan to be off work. I am a paralegal.
Pucker: Only your ophthalmologist who is familiar with what exactly needs to be done can give you the answer. ...Read more
I heard that in surgery for macular pucker, 2 out of 3 people have improved visual accuity. Is there any research being done to improve those odds?
Macular pucker moderate stage w/mild distortion & objects larger. I see 20/20 but Dr said in 2 yrs. vision will deteriorate. Any opinions about that?
Have macular pucker for 1 yr. & each week notice steady increase in wavy lines, but yet I see 20/20. Why has distortion not stabilized & will it ever?
Unfortunately: there is no way to predict stabilization. In some it does and in some it doesn't. Typically if it doesn't and progresses to a certain extent surgery can be performed to help. In your case of progressive change, make sure you are seeing a retinal specialist regularly to make sure your visual changes are not related to something else, like cataract or glaucoma. Hope this helps! ...Read more
Possibly: You most be carefully followed by your ophthalmologist at least every 6 months. ...Read more
Moderate macular pucker & didn't think I had distortion but now not so sure. Is seeing objects, faces & letters larger in that eye distortion?
See eye doctor: you need fundoscopic , slit lamp and retinal scan. Get into your doctor soonest ...Read more
If macular pucker in both eyes that may need surgery at different times, would it be difficult for the corrected vision in both eyes to work together?
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