Epiretinal membrane

What it is

The retina is the light-sensing layer at the back of the eye. An epiretinal membrane (ERM) forms when cells multiply on the inner surface of the retina over the macula, gently pulling and wrinkling it. It is sometimes called macular pucker or cellophane maculopathy. It is different from a macular hole, though both affect central vision.

Symptoms

Symptoms depend on how much the membrane contracts.

• Straight lines looking wavy, bent or smaller (metamorphopsia)
• Blurred or misty central vision
• Difficulty reading small print or seeing fine detail
• A central blind spot in more advanced cases
• Usually painless and gradual, often in one eye

Causes and who it affects

Many ERMs have no clear cause and are found at routine eye checks in older adults. They can follow posterior vitreous detachment, retinal tears, laser treatment, inflammation, or retinal vein occlusion. Diabetes and eye injury are occasional associations. Most people with an ERM do not have another serious eye disease.

Diagnosis

Optometrists or ophthalmologists see membrane shine and retinal wrinkling during dilated examination. OCT scanning confirms thickness and how much the macula is distorted. An Amsler grid at home can help you notice new waviness between visits.

Treatment

Mild ERMs with little symptom impact are monitored every six to twelve months. If central vision limits reading, driving or work, vitrectomy surgery can peel the membrane. Surgery improves distortion in many cases but does not always restore normal vision; risks include cataract formation and rare complications, which your surgeon will discuss.

When to seek care

Book assessment for new central distortion or blur, especially if sudden — that can signal wet macular degeneration or other treatable problems. Stable mild distortion found at a routine test can usually be monitored on a planned schedule.