Epiretinal membrane
An epiretinal membrane is a very thin layer of scar-like tissue that can form on the surface of the retina, usually over the macula. You can imagine it like a fine sheet of cling film lying across the retina. If this sheet tightens or wrinkles, it can pull on the retina and cause vision to appear blurred, distorted, or wavy. Epiretinal membrane is also called macular pucker.
What causes epiretinal membrane?
Epiretinal membrane often develops as part of the natural ageing process. As the vitreous gel inside the eye changes with age, it can pull slightly on the retina, leading to the growth of scar tissue. Other possible causes of epiretinal membrane include:
- Previous eye surgery, such as cataract removal
- Retinal tears or detachment
- Inflammation inside the eye (uveitis)
- Conditions such as diabetic retinopathy or vein occlusions
In some cases, no clear cause is found, and it develops spontaneously.
Stages of epiretinal membrane
Epiretinal membrane can vary in severity, and eye specialists often classify it by stages:
- Mild: The membrane is thin, with minimal effect on vision. Many people don’t notice symptoms.
- Moderate: The membrane begins to contract, causing distortion such as straight lines appearing wavy, or mild blurring of central vision.
- Severe: The membrane thickens and pulls more strongly on the retina, leading to significant vision distortion, blurring, or difficulty with daily activities like reading and driving.
How serious is epiretinal membrane?
Epiretinal membrane rarely causes complete blindness. The main issue is central vision becoming blurred, cloudy, or distorted. For some, it is only a nuisance. For others, it can seriously affect quality of life, especially if both eyes are involved.
How fast does epiretinal membrane progress?
Progression is usually slow. Some membranes remain stable for years without causing significant problems. Others may gradually worsen over months or years. Rapid progression is uncommon. Regular check-ups and eye scans are important to track changes.
Should I have surgery for epiretinal membrane?
Not everyone with an epiretinal membrane needs surgery. The decision depends on:
- Severity of symptoms: Are daily activities like reading, driving, or recognising faces affected?
- Progression: Is the membrane worsening over time?
- Your overall eye health: Other eye conditions may influence the benefit.
If your vision is only mildly affected, your specialist may recommend regular monitoring instead of immediate surgery. If distortion is interfering with your quality of life, surgery can offer meaningful improvement.
What is surgery for epiretinal membrane like?
If an epiretinal membrane is affecting your sight significantly, it is possible to operate to remove it. The procedure is called a vitrectomy with membrane peel.
- Vitrectomy: The surgeon removes the vitreous gel (the clear jelly inside the eye) to gain access to the retina.
- Membrane peel: Using very fine instruments under a microscope, the surgeon delicately peels the thin layer of scar tissue away from the retinal surface. This helps release the traction that causes distortion and blurring.
What is the success rate of epiretinal membrane surgery?
Vitrectomy surgery with membrane peel has high success rates:
- Around 85% of patients experience clearer, less distorted vision.
- Distortion often improves, though perfect vision may not return.
- The longer the membrane has been present, the less likely full recovery will be.
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