Epiretinal Membrane

Epiretinal Membrane

At Sapphire, we often describe the eye as being like a camera.

The eye lens is like the camera’s lens, receiving light rays. The retina is more like the photographic film inside it, capturing the light in order to transform it into images. At the heart of this film-like layer is the macula, an area that allows us to see objects in sharp detail. An epiretinal membrane (ERM) is what happens when a thin layer of scar tissue forms across this macular area. Your vision might not be affected as it forms, but if the tissue later contracts, it may pull on the retina and distort your central vision. This can make reading difficult. It may also cause straight lines to appear wavy. The best way to ‘fix’ epiretinal membranes is with a procedure called a vitrectomy. But not everyone who develops ERM will necessarily opt to have surgery. ERM treatment is often a matter of choice – and that’s something we can help you with when you come in to the clinic.

Epiretinal membrane (ERM) is a condition characterised by the growth of abnormal tissue across the surface of the macula, the central part of the retina. It is very important as it is responsible for our central vision. It allows us to see fine detail for activities such as reading, recognising faces, watching television, and driving. It also enables us to see colour.

An epiretinal membrane behaves like scar tissue. As the tissue contracts, it “puckers” the underlying macula. This can cause distortion and visual loss.

The cause of most epiretinal membranes is unknown (idiopathic), but the condition is frequently associated with previous Posterior Vitreous Detachment (PVD).

It is more common when vitreous detachment has resulted in retinal tearing (which requires laser or freezing therapy) or retinal detachment. Less commonly, ERM is associated with previous occlusion (blockage) of retinal blood vessels, or with inflammation in the eye.

Comparison of a healthy eye and an eye with epiretinal membrane.

Common symptoms of epiretinal membrane or macular pucker are:

  • distortion of straight lines
  • blurred central vision
  • disparity in image size between the two eyes.
OCT image of a normal macula and a macula with epiretinal membrane

In order to treat an epiretinal membrane, we need to remove the scar tissue from the retina. This procedure is known as Epiretinal Membrane Peeling and it requires a vitrectomy operation.

Whether or not you decide to opt for surgery depends largely on the level of distortion or visual interference you are experiencing. Developing an epiretinal membrane in your eye does not automatically mean that you will need to have an operation for it. The decision to treat depends on both the progression of symptoms in the affected eye and your ability to use the two eyes together.

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