Macular Pucker Surgery

Macular pucker (also knows as Epiretinal Membrane or ERM) happens when wrinkles, creases or bulges form on your macula. The macula must lie flat against the back of your eye to work properly. When the macula wrinkles or bulges, your central vision is affected. With macular pucker, things can look wavy, or you may have trouble seeing details. You might notice a gray or cloudy area in your central vision. You may even have a blank spot in your central vision.

Aging is the most common risk factor for macular pucker. People who have other eye problems may also get a macular pucker.

  • Causes of MP

Age is the most common cause of macular pucker. As you get older, the vitreous begins to shrink and pull away from the retina. People who have other eye problems may also get a macular pucker. These problems include:

  • Vitreous detachment, where the eye’s vitreous pulls away from the retina
  • Torn or detached retina
  • Swelling inside the eye
  • Serious damage to the eye (from surgery or injury)
  • Problems with blood vessels in the retina
  • Learn more here


Macular pucker is diagnosed through a dilated eye exam by an ophthalmologist and can be confirmed using optical coherence tomography (OCT). With OCT, a machine scans the back of your eye. This provides very detailed pictures of the retina and macula. If symptoms are severe the best course of action will be to get macular pucker surgery.


If your symptoms are mild, you might not need any treatment. Instead, you may need to change your glasses or contact lens prescription to improve your vision. Eye drops, medicine, and laser surgery do not help vision if you have macular pucker. Macular pucker surgery called vitrectomy is the best way to treat macular pucker patients with severe symptoms. We remove the vitreous gel that is pulling on your macula and scar tissue on your macula. This flattens the macula, returning it to its proper position. It is likely your vision will slowly improve. However, your sight may not be as good as it was before macular pucker.



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Dr. Malihi has 15 years experience.


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