An epiretinal membrane, also known as macular pucker, is the formation of a thin membrane over the macula, the area of the retina that gives us clear central vision. Eyes with epiretinal membrane which are long standing may not be treated with surgery if the vision is unlikely to improve after surgery. Some epiretinal membranes may present in the early stages which are less serious. They may just be followed up by an ophthalmologist.
An epiretinal membrane often develops with age, as the vitreous gel that makes up most of the eye’s volume thins and pulls away from the retina. The damage caused to the retina leads to the formation of scar tissue on the retina. When the scar tissue contracts, the retina wrinkles, or puckers, causing blurry or distorted central vision. Deterioration of the vitreous can also cause other problems such as floaters and flashes, retinal tears, vitreomacular traction and retinal detachment.
Epiretinal membrane cause a mild decline in vision. Some signs include gradual loss of central vision or vision distortion (seeing straight lines as wavy). The best way to detect the condition is through an eye examination. Your eye doctor will administer eye drops to enlarge the pupils temporarily and check your eyes retina. The eyes are also painlessly scanned with optical coherence tomography (a light used to check the different layers of the retina).
An epiretinal membrane can be treated with a vitrectomy, a form of keyhole surgery that uses small probes to enter inside the eye to remove the vitreous and peel off the epiretinal membrane. A gas is then injected into the eye to replace the vitreous and prevent it from pulling on the retina. Following surgery, the patient will need to lie in a face-down position for one to two days to allow the gas bubble to press against the macula to smoothen it. The eye will refill naturally with fluid. This surgery is usually done as a day (outpatient) surgery using a local anesthesia, and takes up to an hour.