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What It Means to Have a Wrinkled Retina

Medically reviewed by Katherine E. Duncan, MD — By Lauren Sharkey on October 10, 2022Share on PinterestFG Trade/Getty Images

What is a wrinkled retina

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 National Eye Institute. 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.

How does a wrinkled retina happen

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.

What does a wrinkled retina feel like

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.

Are some people more prone to this condition than others

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 surgeryinflammation or swelling in the eyevitreous or retinal detachmentretinal tear

How is a wrinkled retina diagnosed

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.

What treatment options are available for a wrinkled retina

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:infectionbleedingretinal detachmentinflammationbruisingrecurrence 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.

What is the recovery process for repairing a wrinkled retina like

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:drivingintense exerciseheavy liftingswimmingair 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.

What s the outlook for someone with a wrinkled retina

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 can occur. You won’t experience full blindness, as a wrinkled retina only affects central vision.

Is there anything you can do to prevent a wrinkled retina from forming

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.

Other frequently asked questions

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 heightened risk of the retina wrinkling.

How long does it take to recover from treatment

Swelling and redness of the affected eye are common for a few weeks after surgery, along with some degree of discomfort and blurry vision. 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.

The bottom line

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. Last medically reviewed on October 10, 2022

How we vetted this article

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Boyd K. (2020). Face-down recovery after retinal surgery.
aao.org/eye-health/treatments/face-down-recovery-after-retinal-surgeryBoyd K. (2022). What is a macular pucker?
aao.org/eye-health/diseases/what-is-macular-puckerEpiretinal membrane. (n.d.).
moorfields.nhs.uk/condition/epiretinal-membraneKaiser P, et al. (2021). Retinal fluid and thickness as measures of disease activity in neovascular age-related macular degeneration.
journals.lww.com/retinajournal/Fulltext/2021/08000/Macular pucker. (n.d.).
downstate.edu/patient-care/find-treatment/areas-of-care/ophthalmology/eye-disorders/macular-pucker.htmlMacular pucker. (2022).
nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/macular-puckerPatient information instructions following retinal surgery. (n.d.).
health.ucdavis.edu/eyecenter/pdf/post_op_instructions.pdfYuan A. (2013). Update on surgery for macular hole and pucker.
retinalphysician.com/issues/2013/july-aug/update-on-surgery-for-macular-hole-and-puckerOur experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Oct 10, 2022 By Lauren Sharkey Edited By Tess Catlett Medically Reviewed By Katherine E. Duncan, MD Copy Edited By Anne Arntson Share this articleMedically reviewed by Katherine E. Duncan, MD — By Lauren Sharkey on October 10, 2022

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