Epiretinal membrane (ERM), sometimes called ‘Macular Pucker’, is a thin sheet of fibrous (scarlike) tissue that grows on the surface of the macula – the most central and sensitive part of the retina.
When the membrane becomes thicker, it reduces the quality of vision. The wrinkling of the retina causes the most obvious effect, which can result in twisted or distorted vision. For some, it will distort straight lines or cause letters on a page to look jumbled when they try to read.
However, while this is naturally a real cause for concern, ERM doesn’t result in total blindness. It typically affects the most important vision – the central area of vision – but doesn’t cause a loss of peripheral (side-to-side) vision.
If an epiretinal membrane is laying dormant, it can be observed for a period of time until it proves that it is progressing. Once it declares itself as progressive (decreased vision, increased thickening on OCT tests, fluid leakage on Fluorescien angiogram) there is just one treatment available – a vitrectomy operation (the removal of some or all of the vitreous humor from the eye), which is typically highly successful. In fact, over 80% of patients find their overall quality of vision improved, and 70-80% can see better centrally. The longer an epiretinal membrane has been present, the lower the chance of a successful outcome following surgery and the less the improvement in vision is likely to be.
New techniques and instrumentation allow faster healing these days, with minimal post-operative ocular irritation. An eye patch is be required for 24 hours or so, followed by eye drops or ointment to facilitate healing. Overall, most patients can resume non-strenuous activities after a day, but the time required to fully recover to be able to work, play sports or drive can vary from person to person.
While the treatment is usually very effective, it’s vital to avoid delay. The symptoms of ERM generally worsen over time, even if they appear to stabilise. So, it’s important to do something about it because early surgery will ensure improved results. While it’s not an emergency, it’s still vital to arrange treatment as soon as possible.
ERM can produce different symptoms in different people and the only way you can determine your condition is to consult your eye doctor. There are charts that are indicative of how ERM is affecting your vision, although your perception of visual difficulty, and the amount of distortion or blurring you notice in your everyday life will all be taken into account. By carefully tracking the symptoms, it will be possible to decide how much ERM is affecting your quality of life and what can be done to control it.