During your annual eye exam, our optometrist will assess the health of your eyes. This will include a check of your glasses prescription and the condition of the inside and outside of your eyes. At the very back of the eye is the retina, a layer of nerves that is responsible for sending visual information to the brain.
The health of this nerve layer is key for proper vision and clarity of images. A variety of changes to the retina can affect your vision and an epiretinal membrane is just one example. Below is a quick summary of the condition and the treatment options available.
What is an Epiretinal Membrane?
A epiretinal membrane (ERM), also known as macular pucker, develops as a sheet of fibrous material that overlays the retina. The most concerning is when the material builds up on the fovea, a specific area of the retina responsible for the clarity of an individual’s central vision. About 7-12 % of the population has this condition and it usually occurs in individuals over 50 years of age. In 20 % of cases, the ERM is in both eyes.
What Causes an Epiretinal Membrane?
There are a variety of causes for an ERM. Unfortunately, not all of the causes are known as a portion of individuals with this condition have unknown underlying causes. In some cases, it can be secondary to trauma, inflammatory events, vascular disorders or traction from the vitreous (the gel-like substance that fills the eye) pulling on the retina. It could also be the result of surgery within the eye such as retinopexy, a procedure completed for retinal breaks or tears.
What are the Symptoms of Macular Pucker?
As mentioned above, if the ERM is located right on the fovea, it can cause a decrease in the clarity of vision as well as metamorphopsia, a distortion of one’s field of view. It also has the potential to cause double vision.
In some cases, an ERM can also develop in other parts of the retina, which correspond to the periphery of the visual field. This is often not noticeable by the patient but could cause mild blur or metamorphopsia.
Our optometrist will monitor the ERM using optical coherence tomography (OCT) and view it with fundus photography and through a slit lamp microscope and lens.
How is Macular Pucker Treated?
Depending on the severity of the ERM, the treatment will vary. In many cases, the ERM is observed and if it is stable, no treatment will be needed. If the ERM causes severely decreased vision or distortion of one’s visual field, a referral will be made to an ophthalmologist for surgery. The procedure involves removing the vitreous that fills the eye then peeling off the ERM from the retina.