Two eyes visible through a pair of binoculars, one has more visible damage than the other

Macular Degeneration or Macular Pucker?

Last updated: May 2023

About a year ago, my beautiful daughter started asking more questions about my macular degeneration. She was beginning to have symptoms in one eye which concerned her. And me, as well! My mother had lost her vision to dry macular degeneration, and my present journey with the scotoma in my dry eye and injections in my wet didn’t bode well for her chance of avoiding it. She has occasionally been my drive home after an injection and she knows she’s at higher risk of developing this sight-stealing disease.

A macular pucker diagnosis

She had originally gone to her optometrist hoping she just needed a new prescription for glasses. But no, that was not to be. She was referred to a retinal specialist with a diagnosis of an epiretinal membrane, or macular pucker. This usually occurs when the vitreous begins to shrink with age, and causes scar tissue to form on the retina. This is something that normally happens in people over 75, and she’s not yet fifty! It could also be caused by inflammation or trauma which she doesn’t recall happening.

Macular pucker vs. macular degeneration

Although macular pucker and macular degeneration have very similar symptoms, they are completely separate conditions. Both can cause a distorted, wavy or blurred central vision. But macular pucker normally only affects one eye.

I had been worried my daughter was following in my footsteps, not really believing that it wasn’t macular degeneration. So I offered to drive her to the specialist appointment and was allowed in the exam room with her. Thinking about how if it started in her forties, what would it be like when she was my age? The doctor examined her eye, looked at the OCT pictures, and told us it was definitely macular pucker, not macular degeneration. He sent her for an MRI, just in case there was something going on behind the eye. Thankfully there was nothing else there.

Treating macular pucker

This retina specialist told her the only treatment was surgery which is not recommended unless or until it causes significant distortion or vision loss. It’s called a vitrectomy, where they remove the vitreous and peel away the scar tissue. Then replace the gel with a form of saline solution. It could take three to four months for vision to return to normal, and may never return to where it was before the macular pucker.

Learning to live with it

I asked my daughter today for an update on her vision hoping it would be no worse. This was her reply:

The whole vision in my left eye is blurry. The middle is worse. With glasses on it's still blurry. I close my left eye if I really need to concentrate on small writing. I'm just learning to live with it. I was considering buying binoculars to bird watch in our backyard but I recall using them at the Paul McCartney concert last year and having to close my left eye to be able to focus on him. It’d be the same for the birds, so is it really worth it?

By the way, she treated me to that concert, and it was amazing!

Worries about my duaghter's vision

Why do our minds always go to the worst? Which in my case would be macular degeneration in my children. At least with this, we know there’s some hope for her, in the form of surgery, if it worsens. Not so curable if it was AMD.

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