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Epiretinal Membrane (Macular Pucker)

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What is an Epiretinal Membrane?

An epiretinal membrane is a thin layer of tissue that forms on the surface of the macula.  The macula is in the center of your retina and is responsible for you being able to see objects in clear detail.  When the macula is compromised, your central vision is affected.  When an epiretinal membrane forms over the macula, it may contract and wrinkle the retina, causing blurred and distorted vision.    

Symptoms of an epiretinal membrane usually include difficulty seeing detail, wavy vision, or cloudy central vision.  Epiretinal membranes do not affect your peripheral vision.

 

 

 

 

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What causes epiretinal membranes?

An epiretinal membrane is most commonly caused by the aging process.  As we age, our vitreous shrinks and pulls away from the surface of the retina.  This is a normal aging change that usually happens without affecting vision.  However sometimes the vitreous can stick to the retina causing scar tissue to form.  This scar tissue causes the macula to swell and wrinkle.

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Who is at risk of epiretinal membranes?

Although age is the most common risk factor, people who have other underlying eye problems may also develop an epiretinal membrane.  The other risk factors include:

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• Posterior vitreous detachment

• History of retinal detachment

• History of laser treatment to the eye

• History of damage/trauma to the eye (either from injury or surgery)

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How is epiretinal membrane diagnosed?

Dr. Varma will dilate your eye with eye drops and use a lens to look at your macula through your pupil.  Scans will be taken of your macula using optical coherence tomography (OCT).  This provides a detailed image of the layers of the retina.

    

How is epiretinal membrane treated?

Treatment depends on your symptoms.  If your symptoms are mild and your visual acuity is 20/40 or better, Dr. Varma may recommend observation.  You will be able to continue regular follow-up with your optometrist and have your glasses or contacts updated to help optimize your vision. 

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If you are bothered by your symptoms and they are severe enough, you may be offered vitrectomy surgery.  Surgery is the only way to treat an epiretinal membrane.  There are no eye drops, medicines, or laser treatments that can help your vision if you have an epiretinal membrane.  A vitrectomy is a surgery where the jelly is removed from the center of your eye and then the epiretinal membrane is peeled from the surface of your retina.  Over time, the wrinkles will disappear and the retina will gradually return to its normal position.  Your vision will slowly improve as your eye heals from surgery however your vision usually does not return to the level it was at prior to developing the epiretinal membrane. 

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What are the risks of vitrectomy surgery?

Like all surgery, vitrectomy has associated risks.  Dr. Varma will go over the risks and benefits of surgery with you at the time you give consent.  Some of those risks are as follows:

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• Eye infection (endophthalmitis)

• Bleeding in your eye

• Retinal detachment

• Reoccurrence of the epiretinal membrane

• Development of a cataract

• Glaucoma

• Loss of the eye

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