Macular Holes and Puckers

About Macular Holes and Puckers

The macula is in the center of the retina and controls central vision or straight-ahead vision used in driving and ready and seeing fine detail. A macular pucker is an extra layer of tissue that forms on the surface of the macula. Both macular holes and puckers can cause blurry and distorted vision and are related to aging.


The vitreous is a gel-like substance inside the eye that helps keep its round shape. With age, the vitreous can shrink and pull away from the retina tissue, causing a hole in the macular area of the retina. A macular pucker may develop if scar tissue forms where the hole is.


Since these conditions usually happen slowly, symptoms are often subtly at first. Some symptoms may include:

  • Blurriness in straight-ahead vision.
  • Straight lines or objects appear bent or wavy.
  • Difficulty reading or driving.
  • Gray area in the center of vision, or even a blind spot.

Treatments We offer

A macular hole can lead to a detached retina if left untreated, so receiving the proper care is critical. In most cases, a surgery called a vitrectomy is recommended. In a vitrectomy, the vitreous gel is removed to prevent it from pulling on the retina and is replaced with a mixture of air and gas that acts as a bandage to heal the hole. For macular puckers, the vitreous gel is removed, and then a “membrane peel” is performed to remove the scar tissue on the retina.

Why Choose Columbia?

Columbia is the birthplace for several vitreoretinal surgical techniques. Minimally invasive vitreoretinal surgery within the Tri-state area was first applied at Columbia. Several innovative treatments were first developed her, such epiretinal human amniotic membrane grafting for complex macular pathologies. This, the tradition of innovation, surgical excellence and scientific developments all make Columbia a unique place for the treatment of macular pathologies. In short, Columbia ophthalmologist retinal specialists are uniquely skilled in treating this eye structure, which is critical to vision. We have world-renowned experts in treating problems affecting the retina and are leaders in the research of retinal diseases.