Macular holes most commonly develop spontaneously during the natural aging process, when the vitreous (the gel that fills most of the eye) becomes more like a watery liquid and separates from the retina. Less commonly, macular holes are caused by direct, blunt eye injury or can occur with intraocular inflammation, macular pucker, or retinal detachment. Most cases occur in people over the age of 60.

An epiretinal membrane, also called macular pucker, is a thin layer or sheet of scar tissue that forms and grows over the macula, the area of the retina that gives us clear central and reading vision. Idiopathic or primary epiretinal membranes often develop on their own as a part of the natural aging process.

Many epiretinal membranes do not affect vision. Thicker membranes, however, can create a wrinkle or pucker of the macula as they grow over the surface of the retina. The retina can swell leading to macular edema. As this occurs, small blurry or distorted areas in the center of vision may develop.

While many epiretinal membranes don’t progress enough to require treatment, surgery is recommended for those patients who experience troublesome vision loss. Surgery involves vitrectomy to remove the vitreous gel and membrane stripping to delicately peel the sheet of scar tissue away from the macular surface using tiny, specially designed instruments. The surgery is performed as an outpatient procedure with local anesthesia.

Diabetes mellitus causes a persistent elevation of blood sugar which eventually results in damage to the blood vessels within the retina. These damaging changes are known as diabetic retinopathy. Dr. Pappas provides assessments and personalized treatments for diabetic retinopathy, including laser treatments, intra-vitreal injections, and in severe cases, vitrectomy, to stabilize and improve vision.

Macular degeneration, also known as age-related macular degeneration (AMD) is a common condition in older adults and the leading cause of vision loss in people over the age of 65. Macular degeneration affects the macula, the part of the retina responsible for sharp, detailed vision needed for reading or driving. As one ages, the retinal tissue responsible for central vision slowly begins to deteriorate, and this change can significantly affect a patient’s quality of life. Dr. Pappas provides evidence-based diagnostic scanning and ongoing management and monitoring of macular degeneration.

If you have been experiencing vision loss or other changes in your vision and would like to see a specialist, please consider calling the Krieger Eye Institute at 410-601-8145 to schedule a consultation.