A wrinkled retina — also known as a macular pucker — is when fine wrinkles appear on the surface of the retina in an area called the macula. It’s a rare eye condition, according to the
The macula sits right in the middle of the retina and is responsible for central vision and the ability to see finer details when driving, reading, and more.
But it needs to sit flat against the back of the eye to function properly. If it wrinkles, it affects a person’s central vision.
The underlying cause of a wrinkled retina is still a mystery, though it’s thought that age plays a significant role.
As you get older, the vitreous — a gel that sits inside the eye — shrinks and starts to move away from the retina.
If the vitreous successfully pulls away, there’s usually no issue. But if it sticks to the retina, a membrane can appear on the retina’s surface, pulling on the macula and making it wrinkle over time.
It’s not just age that can cause this membrane to form. Eye surgery or eye inflammation can have the same effect.
A retina doesn’t wrinkle instantly, so symptoms may develop gradually.
Usually, you’ll start to notice differences in your central vision, such as blurriness when you look straight ahead.
People tend to notice such things when they’re reading or driving. Straight lines may look wavy, and some letters or words may seem as if they’re missing or crowded together.
One or both eyes can be affected — though one eye tends to be worse — and the severity of the symptoms depends on the severity of the wrinkling.
Older adults have a higher risk of their retina wrinkling — it’s most common in people over 50.
The following can also increase the risk of developing a wrinkled retina:
- eye injury or surgery
- inflammation or swelling in the eye
- vitreous or retinal detachment
- retinal tear
A dilated eye exam may be all that’s needed to diagnose this condition.
You’ll be given eye drops to widen your pupils so that the eye doctor can clearly see the retina.
If they believe you may have a macular pucker, they may also perform an optical coherence tomography using a special machine.
This procedure uses light waves to scan the back of your eye and take detailed photos of your retina and macula that the doctor can assess afterward.
After these exams, your eyes may be blurry for a few hours so you may need someone to drive you home.
If the wrinkled retina is mild, a doctor may recommend no treatment and instead advise regularly monitoring the eye.
Sometimes, glasses or a new prescription can improve vision. But your eye may naturally adjust to the change in sight.
For more severe cases where daily activities have become difficult, surgery is an option to reduce visual distortion. This will remove the membrane that’s formed and help smooth any wrinkles on the retina.
A surgical procedure can help a wrinkled retina.
A vitrectomy involves a doctor creating small keyhole incisions and using a suction tool to remove the vitreous gel, which is replaced with fluid.
The membrane is then removed from the retinal surface using small forceps in a process called a membranectomy.
A doctor will check the retina for any signs of damage or weakness. If any are found, they may be lasered or frozen to reduce the chance of the retina detaching.
The procedure usually ends with the doctor putting stitches that dissolve naturally on the surface of the eye.
You’ll be given a local anesthetic so you likely won’t feel any pain but may be aware of a little pressure, light, and shadow throughout.
As with any surgery, there are potential risks. These include:
- infection
- bleeding
- retinal detachment
- inflammation
- bruising
- recurrence of a macular pucker
There’s also a high risk of a cataract forming after the procedure, which will likely need to be treated in time.
While vision can improve with surgery, it often doesn’t return to the way it was before the retina wrinkled. On average, about half of lost vision recovers after surgery, but vision distortion is significantly improved.
At the end of the eye operation, a pad and shield will be placed over your eye to protect it. These can often be removed the day after surgery.
You’ll be given eye drops to use for a number of weeks and will be advised when and how to apply them to help reduce inflammation and avoid infection.
You’ll also be advised on how long to avoid the following activities:
- driving
- intense exercise
- heavy lifting
- swimming
- air travel
If stitches are placed, these will dissolve by themselves over 4 to 6 weeks. But you may feel a gritty sensation inside your eye, and it may look red while the stitches are present.
The full recovery process can take several months, so you may need to wait to see the final results.
If you experience severe pain or other side effects that concern you, consult with a doctor or another healthcare professional as soon as possible.
If your wrinkled retina or macular pucker is only mild, your eye may adjust to the changes over time.
Your symptoms may worsen over time, so continuing to have regular eye exams is the best way to stay on top of things.
But surgery may be the best option if your symptoms are interfering with your daily life. A significant reduction in vision distortion is expected, but the exact outcome is difficult to predict.
If surgery is recommended, but you choose not to have it, there’s a chance that severe vision loss or a hole in the macula
Many wrinkled retinas seem to occur with age or have an unknown cause, so there isn’t a way to stop them from happening.
Having an annual eye exam will assist with the prompt diagnosis and treatment of any eye conditions.
If a doctor diagnosed a wrinkled retina and mentioned treatment, you’ll likely have lots of questions.
Here are some more of the most commonly asked ones.
Is a wrinkled retina the same as a tear?
A macular pucker — or wrinkled retina — is different from a retinal tear, although the same pulling of the vitreous can result in a tear if it’s particularly severe.
A tear in the retina can also put you at a
How long does it take to recover from treatment?
Swelling and redness of the affected eye are
You’ll likely have to take 2 to 4 weeks off work or school to recover and may have to avoid things like lifting heavy objects and intense exercise for a while. Your doctor will let you know exactly how long to avoid these activities.
As for your vision, it can take a few months for the full effects of surgery to be seen.
Do you have to sleep a certain way while you recover?
Some types of retinal surgery require you to stay facedown for a few days, but this is usually while you’re awake.
If you have a vitrectomy, you’ll usually only be told to do this if the doctor had to insert a gas bubble into your eye in place of the vitreous and needs that bubble to remain in a certain place for your eye to heal.
You may also be advised to avoid sleeping on your back to keep the gas bubble in place.
Can you drive or fly after treatment?
As your vision is likely to be somewhat blurry after surgery, you won’t be able to drive until your doctor says you can meet the minimum standard that’s needed to get behind the wheel.
It may be easier to start driving in the day on quieter roads before trying busier places and at night.
If a gas bubble was put in your eye, you won’t be able to fly until it’s dissolved. That’s because high altitudes can increase pressure inside your eye and potentially make the bubble bigger.
Is it possible to develop this again in the same eye or in your other retina?
Yes, it is possible for a macular pucker to recur in the same eye, and you can experience one in the other eye.
Staying on top of your eye exams is a great way to keep track of your eye health.
A wrinkled retina is a rare condition that can cause significant vision distortion, but it does not lead to full blindness.
If it does occur, it may not need treatment, and you may learn to live with it.
But if your vision is making it difficult to carry out daily tasks, book an eye exam as soon as possible to find out the best way forward.
Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.