How The Eye Functions

The structure of the eye is similar to the camera with lenses in front and film in the back.  The film, which lines the back of the eye is called the retina.  The area in front of the retina is normally filled with a jelly-like material called vitreous.  At birth, the vitreous is quite firm and has thin fibrous strands running through it and a clear fibrous skin on the back.

As the vitreous ages, it becomes more liquid.  This can be compared to gelatin that has been removed from the refrigerator and put in a warm room, becoming more liquid as it is left to stand.  Eventually, the fibrous skin peels partially or totally away from the retina.  This process, called vitreous detachment, increases the number of floaters but does not cause damage to the retina.

What Is Macular Pucker?

Occasionally, the retinal surface can form a thin sheet of scar tissue over the macula (the reading portion of the retina) which can distort the vision.  This distortion is called macular pucker.  In order to study the distortion of the retina caused by puckering, a fluorescein angiogram is done.  This photographic test provides useful information about distortion, damage and swelling that has resulted from the macular pucker.  If the pucker is severe enough to cause visual problems, scar tissue may be surgically removed.  This operation is called a vitrectomy and includes the delicate peeling of the abnormal tissues from the retinal surface as well as removal of the central vitreous from the eye.  The vitreous is then replaced with a clear fluid.

Treatment

Visual recovery may take weeks to months, but the eye will feel relatively comfortable within days of the surgery.  The patient can usually resume normal activities within two or more weeks after surgery.