Eyes Home > Macular Pucker Causes

Scientists are still trying to determine the exact cause of macular pucker (scar tissue on the retina). While not specific causes of the condition, vitreous pulling and certain eye conditions -- including inflammation of the eye and vitreous detachment -- put people at a greater risk for developing a macular pucker. Other potential macular pucker causes include diabetic retinopathy and eye surgery.

An Introduction to Macular Pucker Causes

Doctors are not sure of the specific macular pucker causes. Similar to a macular hole, a macular pucker (scar tissue on the retina) is believed to be the result of:
  • The vitreous pulling on the retina
  • Certain eye conditions.

Macular Pucker Causes: Vitreous Pulling

Most of the eye's interior is filled with vitreous, a gel-like substance that fills about 80 percent of the eye and helps it maintain a round shape. The vitreous contains millions of fine fibers that are attached to the surface of the retina. As we age, the vitreous slowly shrinks and pulls away from the retinal surface. This is called vitreous detachment, and it is normal. In most cases, there are no adverse effects, except for a small increase in floaters -- little "cobwebs" or specks that seem to float about in your field of vision.
However, sometimes when the vitreous pulls away from the retina, there is microscopic damage to the retina's surface. When this happens, the retina begins healing the damaged area and forms scar tissue, or an epiretinal membrane, on the surface of the retina. This scar tissue is firmly attached to the retina surface. When the scar tissue contracts, it causes the retina to wrinkle, or pucker, usually without any effect on central vision. However, if the scar tissue has formed over the macula, sharp, central vision becomes blurred and distorted.
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Last reviewed by: Arthur Schoenstadt, MD
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