What is an epiretinal membrane?
An epiretinal membrane is a thin layer of fibrous, scar-like tissue that forms on the surface of the macula. It is sometimes called a macular pucker because it can wrinkle or distort the retina.
The macula is responsible for detailed central vision, including reading, recognising faces and seeing fine detail. Changes in its shape can therefore affect the clarity or quality of central vision.
Some epiretinal membranes are mild and remain stable. Others can gradually cause increasing distortion or blurred vision.
What symptoms can it cause?
An epiretinal membrane may cause:
- Blurred central vision
- Distorted vision
- Straight lines appearing wavy
- Difficulty reading
- Objects appearing smaller or larger when viewed with the affected eye
- Reduced clarity despite updated glasses
Symptoms vary. Some patients notice very little change, while others find that distortion interferes with reading, work or other daily activities.
Why does an epiretinal membrane form?
Epiretinal membranes often develop as part of natural ageing changes inside the eye. They may also be associated with a posterior vitreous detachment, previous retinal tears, retinal detachment, inflammation, diabetes or previous eye surgery.
A specialist retinal assessment helps establish whether the membrane is isolated or associated with another retinal condition.
How is it diagnosed?
The most important imaging test is OCT imaging. Optical coherence tomography, known as OCT, is a non-invasive scan that produces detailed cross-sectional images of the retina.
OCT allows the consultant to see the membrane in detail, assess its effect on the macula and look for retinal thickening, traction or distortion.
At The Retina Clinic London, OCT is combined with a detailed retinal examination and additional imaging. Together, these investigations provide a detailed assessment of the macula and surrounding retina.
Does every epiretinal membrane need treatment?
No. Mild epiretinal membranes that are not significantly affecting vision may simply be monitored with examinations and OCT imaging.
Treatment may be considered when symptoms become intrusive, vision is worsening or the membrane is significantly affecting visual function.
The decision is individual and takes into account the patient’s symptoms, visual needs, retinal appearance and overall eye health.
What treatment is available?
The main treatment is vitrectomy surgery with membrane peeling.
During the procedure, the vitreous gel inside the eye is removed. The surgeon then uses microsurgical instruments to carefully peel the fine membrane away from the surface of the macula.
The aim is to release traction and allow the retina to settle into a more natural shape. Visual recovery is usually gradual and may continue over several months.
The degree of improvement varies and can depend on how long the membrane has been present, the severity of the retinal distortion and the health of the macula. Vision may not return completely to how it was before the membrane developed.
As with any eye surgery, there are potential risks. The surgeon will explain these carefully, together with the expected benefits, limitations and recovery process, before treatment is considered.
Our approach
Patients with an epiretinal membrane receive detailed retinal imaging, careful explanation and a personalised management plan.
Where surgery is appropriate, it is performed by specialist vitreoretinal surgeons using advanced microsurgical techniques in our dedicated onsite surgical theatre.
Just as importantly, patients are guided through the decision-making process so that they understand the potential benefits, limitations and recovery expectations before deciding whether to proceed.
The next step
If you have been told that you have an epiretinal membrane, or you are experiencing distorted central vision, a specialist retinal consultation can help determine whether monitoring or treatment may be appropriate.
To book your consultation, please call us on +44 (0)20 4548 5310 or visit https://www.theretinacliniclondon.com/book-a-consultation/
We’ll be glad to guide you through the next steps.