Epiretinal Membrane

What is an Epiretinal Membrane?

The macula is part of the retina of the eye. When it is pulled and puckered by an epiretinal membrane, vision can become distorted.

The eye is often compared to a camera. The front of the eye contains a lens that focuses images onto the inside of the back of the eye. This area, called the retina, is lined with special nerve cells that react to light. These nerve cells sit very close together in the middle of the retina, where the eye focuses the images we see. This small part of the retina is called the macula.

The macula normally lies flat against the inner back surface of the eye. Sometimes, however, cells can grow on the inside of the eye and contract, pulling on the macula. Occasionally, an injury or a medical condition creates patches of scar tissue inside the eye. These are called epiretinal membranes, and they can pull on the macula, distorting vision.

Before surgery

After surgery

Why do people develop epiretinal membranes?

Sometimes an epiretinal membrane is the result of an injury or of a medical condition, such as diabetes, that affects the eye. Epiretinal membranes can also form after eye surgery, including cataract surgery. In most cases, however, the cause is not known.

How can the doctor tell if someone has an epiretinal membrane?

It is not unusual to have an epiretinal membrane and still have normal vision. Membranes tend to change over time, however, and the following symptoms may appear:

• The ability to see fine detail when looking directly at an object, no matter how near or far it is, begins to decline.
• Vision changes so that straight lines appear wavy or broken.

If either of these symptoms appears, it is important to book an appointment with your ophthalmologist as soon as possible. The ophthalmologist will use a slit lamp to examine the inside of your eye for epiretinal membranes, and may also use specialised imaging, including optical coherence tomography, to assess the membrane.

Is there any treatment for an epiretinal membrane?

If an epiretinal membrane is not causing significant problems with your vision, your ophthalmologist may recommend leaving it untreated. Instead, you may simply be advised to have eye examinations more often than usual, to make sure the membrane is not changing and causing problems. An epiretinal membrane that does affect vision can be treated with surgery.

What happens during surgery to treat an epiretinal membrane?

Surgery to remove an epiretinal membrane is usually performed under local anaesthetic, so the patient is awake but does not feel the procedure.

The first part of the operation is the removal of the gel-like material that fills the back of the eye. This fluid is called the vitreous, and the procedure to remove it is called a vitrectomy.

The surgeon makes small incisions in the eye and inserts specialised surgical instruments to remove the vitreous. The surgeon will also remove the epiretinal membranes affecting the macula. This allows the macula to settle flat against the back of the eye and improves the problems with vision.

How successful is surgery to treat an epiretinal membrane?

In most cases, surgery allows the macula to lie flat against the back of the eye and brings a partial improvement in vision. The best way for a patient to avoid problems, and to have the best chance of recovering vision, is to follow the surgeon’s advice, use all medication as directed and keep every post-operative appointment.