Macular Pucker is a condition also referred to as pre-retinal fibrosis, cellophane retinopathy, or epiretinal membrane. It is a condition where a thin membrane of scar-like tissue covers the surface of the macula. Such membranes glisten when examined giving the appearance of cellophane. Macular pucker occurs typically after age 50 after a posterior vitreous detachment (PVD) has occurred. The membrane alone may not cause any significant vision problems and is not necessarily progressive.

The action of the PVD may release fibrous tissue, which settles upon the macula in the back of the eye, and begins the formation of the membrane. Macular puckers may also occur after retinal tears or detachments, severe trauma affecting the back of the eye, or previous retinal surgery. Some cases have no obvious preceding event and are considered idiopathic. Nevertheless, in all these cases fibrous tissue is released within the vitreous cavity of the eye and settles upon the macula.

The membrane may contract and can cause wrinkling of the retina which can, in turn, cause distortion in vision. The distorted retina looks wrinkled and may looked "puckered". Generalized blurring may also occur, especially if there is associated macular edema caused by the traction of the contracting membrane upon the retina. The most specific visual symptom is visual distortion, especially of straight lines into wavy lines.

When the vision is affected causing distortion surgery may be recommended. Vitrectomy surgery with peeling of the membrane is highly effective and very successful. If visual symptoms become progressively worse and intolerable, the membrane may be carefully "peeled" off the retina during a surgical procedure called a vitrectomy. Membrane peeling allows the retina to return to a more normal shape, and allows for improved visual function (especially a reduction of the distortion). Visual improvement after surgery is slow and gradual as the sensitive nerve tissue recovers and may take 12 to 16 weeks.