Scar Tissue in the back of my Eye

This post is a response by a doctor to a question one of our community members asked.

Marian Asks:

My doctor told me that i have scar tissue in the back of my eye and that right now he doesn’t want to do anything to my eye until it bleeds. When will it bleed I’m confused.

Dr Alejandro’s reply:

Hello Marian,

Let me start by explaining some basic concepts of the eye, its structure and function.

The eye is formed of several tiny structures, (cornea, lens, retina, etc.) which are contained in three fluid-filled chambers: the anterior chamber, the posterior chamber and the vitreous chamber. The first two are contained within the anterior segment of the eye, and the vitreous chamber, is localized in the posterior segment of the eye (the back of the eye).

The vitreous chamber, is filled with a thick, clear gel-like substance called the vitreous humor (also known as vitreous body), and is composed of 99% water and contains no cells, so that the light perceived by the eye can effectively pass through, without it being deflected, reaching the retina, which transforms the received image into electrical impulses that are then carried to the brain.

A scar tissue in the back of the eye, medically known as macular pucker or epiretinal/preretinal membrane, is a scar tissue that has formed on the eye’s macula, located in the center of the light-sensitive tissue called the retina (contained in the posterior segment of the eye, within the vitreous chamber). It is caused by a microscopic damage to the retina’s surface. When this happens, the retina begins a healing process to the damaged area and forms scar tissue, on the surface of the retina.

Symptoms of a macular pucker include vision loss that can vary from no loss to severe loss, although severe vision loss is uncommon. People with a macular pucker may also notice that their vision is blurry or mildly distorted, and straight lines can appear wavy. They may have difficulty in seeing fine detail and reading small print. There may be a gray area in the center of your vision, or perhaps even a blind spot.

A macular pucker usually requires no treatment, since in most cases the symptoms of vision distortion and blurriness are mild, and people usually adjust to the mild visual distortion, since it does not affect activities of daily life. Neither eye drops, medications, nor nutritional supplements will improve vision distorted from macular pucker. However, when vision deteriorates to the point where it affects daily routine activities, or a hemorrhage occurs (since it changes the composition of vitreous humor thereby affecting light passage through it), surgery may be recommended. This procedure is called a vitrectomy, in which the vitreous gel is removed to prevent it from pulling on the retina and replaced with a salt solution, while on regional anesthesia.

I think that what your doctor tried to say was that surgery would only be needed if your symptoms get worse or if you have a complication like a hemorrhage (which is not that common). So, it does not necessarily mean that it will bleed, it is only a possibility. There’s no need to be worried about it.

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