What is an epiretinal membrane?
An epiretinal membrane is a thin layer of fibrous tissue that grows on the surface of the macula — the central part of the retina. It is sometimes called a macular pucker or cellophane maculopathy because of how it can wrinkle the underlying retina as it contracts. Most epiretinal membranes develop with age, often after the natural separation of the vitreous gel from the retina. They can also occur after retinal tears, retinal detachment surgery, intraocular inflammation, or eye injury.
Symptoms
Many epiretinal membranes cause no symptoms at all and are simply monitored. When symptoms do develop, they may include:
- Blurred central vision
- Distortion of straight lines, similar to other macular conditions
- Mild double vision in the affected eye
How we diagnose it
An epiretinal membrane is identified on a dilated examination and confirmed with optical coherence tomography (OCT) imaging.
When to consider surgery
Most epiretinal membranes do not need treatment. Surgery is considered when the membrane is causing visual distortion or blurring significant enough to affect daily life — reading, driving, or working. The decision is individualized; we discuss expected benefits and risks based on your symptoms and your individual case.
The procedure
Surgery involves a small-gauge vitrectomy. The vitreous gel is removed, and the membrane is gently peeled off the surface of the retina with fine instruments. The procedure is performed in the operating room as outpatient surgery.
Recovery
Vision improves gradually after surgery, usually over a period of weeks to months. Some distortion or blur may remain, particularly if the membrane was longstanding before surgery. Most patients return to normal activities within a few days, with restrictions on heavy lifting and strenuous exercise for one to two weeks.