Macular pucker is caused by a transparent membrane of scar tissue that grows over the surface of the central retina. The eventual contraction and shrinkage of this membrane can wrinkle and distort the underlying macula, impairing central vision. Macular puckers usually arise from age-related changes in the vitreous gel but can result from any type of eye injury, inflammation, disease, or surgery.
Treatment is not necessary if symptoms are mild. However, if there is significant metamorphospsia or visual loss, vitrectomy may be performed. During this procedure, after the vitreous gel is removed, the membranous tissue that is causing the macular distortion is peeled off the retinal surface and removed from the eye.