WHAT WE TREAT
Epiretinal Membrane
An epiretinal membrane is a thin, transparent layer of fibrous tissue that can form on the surface of the macula.
About Epiretinal Membrane
Overview
An epiretinal membrane (ERM) is a thin, transparent layer of fibrous tissue that can form on the surface of the macula—the central portion of the retina responsible for detailed, sharp vision. When this membrane contracts or ‘wrinkles,’ it can cause distortion, blurring, or waviness in central vision.
Epiretinal membranes are sometimes called macular puckers, cellophane maculopathy, surface wrinkling retinopathy, or macular fibrosis. They do not cause total blindness but can affect tasks requiring fine vision such as reading, driving, and recognizing faces.
Causes
Epiretinal membranes develop when cells on the inner surface of the retina begin to grow and form a thin sheet of tissue over the macula. This can occur spontaneously (idiopathic) in otherwise healthy eyes, most often in people over age 50.
Other causes include:
In the United States, about 25–50% of uveitis cases are linked to autoimmune or inflammatory diseases such as:
- Posterior vitreous separation (PVS)—a natural aging process where the clear gel in the eye (vitreous) detaches from the retina
- Eye trauma or surgery (e.g., cataract surgery)
- Inflammation or infection inside the eye
- Vascular disease of the retina, such as diabetic retinopathy or retinal vein occlusion
In most cases, the membrane remains thin and stable, causing little or no change in vision. However, in some cases, it can thicken or contract, leading to visual symptoms such as blurred, distorted, or ‘wavy’ vision in one eye.
Treatment Options From LRR
Treatments
Not all epiretinal membranes require surgery. If the membrane is mild and not affecting daily activities, careful observation with periodic eye exams is appropriate. There are no medications, drops, or laser treatments that can remove or shrink an epiretinal membrane.
When vision distortion or blurring becomes significant, vitrectomy surgery may be recommended. Vitrectomy is a microsurgical procedure performed on an outpatient basis under local anesthesia with mild sedation.
Vitrectomy Surgery:
During surgery:
- Tiny incisions are made in the white part of the eye (sclera).
- The epiretinal membrane is gently peeled from the surface of the macula using delicate microsurgical instruments.
Modern vitrectomy techniques use very small, self-sealing incisions that often do not require sutures, allowing faster healing and minimal discomfort. An eye patch is typically worn overnight, and postoperative drops are prescribed to aid healing.
Recovery and Visual Results:
After surgery, patients typically use eye drops for several weeks. Most can resume light, non-strenuous activities the next day. Vision improvement occurs gradually over several months as the macula heals and swelling subsides. Most patients experience meaningful improvement in visual clarity and distortion, though some degree of residual distortion may persist.
Visual outcomes vary depending on:
- The severity and duration of the membrane
- Preoperative visual acuity
- The presence of other eye conditions (e.g., macular degeneration or diabetic retinopathy)
More To Know
Risks and Complications
Vitrectomy surgery is highly effective and generally safe, but—as with any operation—there are potential risks, including:
- Infection (endophthalmitis)—rare, about 1 in 1,000 cases
- Retinal detachment—occurs in 1–2% of cases
- Cataract progression—often accelerated following vitrectomy in patients who still have their natural lens
- Bleeding or loss of vision
- Double vision or eyelid drooping (ptosis)
- Anesthetic complications
Symptoms
Patients with epiretinal membranes may notice:
- Blurred or hazy central vision
- Straight lines appearing bent or wavy (metamorphopsia)
- Difficulty reading fine print or recognizing faces
- A gray or cloudy area in central vision
Prognosis
With timely evaluation, surgical precision, and proper follow-up, most patients with epiretinal membranes achieve significant improvement in visual quality and stability. Ongoing monitoring is recommended to ensure optimal long-term retinal health.
Prepare For Your Visit
If you already have an appointment made, we look forward to providing your care! If you need an appointment or have questions, please reach out to the Lakes Region Retina care team.
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