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Reston   (703) 485-2148 Leesburg   (703) 777-1244
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Macular Holes and Puckers banner

Macular Holes and Puckers

Your macula is the part of your eye that allows you to have central vision. Located in the center of the retina, this collection of nerve cells is the location where the eye focuses on images. If there is any break in the nerve cell fibers, you can develop what is called a macular hole. If scar tissue begins to grow over this same area, it is called a macular pucker. 

Symptoms of Macular Holes and Puckers

  • Loss of central vision 
  • Distortion of central vision
  • Straight lines appear wavy 
  • Gray spot or blind spot in central vision

Macular holes can cause more serious vision problems or vision loss over time than macular puckers. The severity of the hole (partial thickness or full thickness) will have a big impact on your vision. Neither condition is typically associated with pain, but if you notice any of these symptoms, it is important to see an eye doctor to get the condition under control. 

Causes of Macular Holes and Puckers

Macular holes are more common in women, especially those over age 60, but they can occur in men as well. A macular pucker can cause a hole to develop. This condition can also be caused by:  

  • Diabetic eye disease
  • Detached retina
  • Eye trauma or injury
  • Extreme myopia (nearsightedness)

Your eye is filled with a jelly-like substance called the vitreous. If this substance shrinks, it can detach from the retina surface, leading to the formation of scar tissue. When this occurs on the macula, you develop a macular pucker and your central vision will be disrupted. 

Treatment for Macular Holes and Puckers

The common treatment for a macular hole is vitrectomy surgery. During this procedure, the retina doctor removes the vitreous gel from your eye and replaces it with an air or gas bubble. The bubble allows the edges of the holes to come together, allowing it to heal. The bubble evaporates naturally and the eye refills itself with its own saline fluid. 

Macular puckers often do not require any treatment unless the condition is seriously affecting your vision. If treatment is necessary, the vitreous gel is removed and replaced with a saline solution. Scar tissue can also be removed. 

If you are having vision problems, don’t wait to schedule a comprehensive eye exam. Our retina specialist in Reston, VA, can diagnose your condition and provide treatments to preserve your vision.

Our Locations


12110 Sunset Hills Rd., Suite 50 LL
Reston, VA 20190

Jacqueline Deneen Griffiths, MD


20 Davis Ave. SW
Leesburg, VA 20175

Claiborne M. Callahan, MD

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