Macular pucker, also known as epiretinal membrane, is caused by scar tissue that grows over the center of the retina (macula). Epiretinal membranes develop as part of aging and are observed in over 70% of patients over the age of 80.  Typically, an epiretinal membrane is mild and does not cause visual symptoms.  However, sometimes the scar tissue can grow to the point where it contracts the retina causing decreased vision and distortion of central vision.  Any prior ocular history, such as inflammation, retinal tears, or trauma, increase the risk of epiretinal membrane formation.

If the patient is symptomatic from the epiretinal membrane, then vitrectomy surgery may be recommended.  In this surgery, the scar tissue is peeled off the retina removing traction from the retina, and allowing for visual recovery.  Around 70% of patients will have a 3 line improvement in vision after vitrectomy peeling surgery for macular pucker.