Epiretinal Membrane (Macular Pucker)

The macula is a portion of the retina responsible for our crisp central vision. The eye’s natural healing response can sometimes cause cells to be deposited on the retina. These cells can gradually settle and form a transparent layer over the macula causing an epiretinal membrane (ERM). In such instances, patients usually have no symptoms, or mild blurred vision. Epiretinal membranes occur in about 7% of the population. This scar tissue layer can tighten and create tension or puckering on the retina, pulling it out of shape. This macular pucker may also cause swelling or macular edema leading to blurred vision. Other causes of macular pucker development are inflammation inside the eye, posterior vitreous detachment, trauma, diabetes, prior ocular surgery, retinal occlusions, or torn/detached retina. Symptoms of a Macular Pucker include: 

  • Blurred central vision 
  • Distortion (wavy lines) 
  • Difficulty reading, threading a needle or any tasks for detailed vision 
  • Central blind spot 
  • Double vision 
  • Objects looking larger or smaller 

There are no eye drops, medications, or nutritional supplements to treat epiretinal membrane or macular pucker. Treatment options vary depending on the severity and impact on daily living. If vision is not severely affected, observation is very common as not all macular puckers progress to the point of vision loss or distortion. If vision is significantly affected, eye surgery called a vitrectomy is recommended. During a vitrectomy, our doctors remove all the vitreous gel from the eye and carefully peel the membrane causing the wrinkle or macular pucker away.  

Vitrectomy surgery for macular pucker has a very good success rate. During the three to six-month healing time after surgery the vision should progressively improve, although it does not usually return to normal. The level of vision a patient recovers will depend on many factors including, but not limited to, the severity of the macular pucker, how long it has been present, and the overall health of the eye. In most cases, distortion is significantly reduced. At Retina Specialist of Michigan, you alongside our doctors together will decide whether surgery is warranted. If you have questions regarding your vision or symptoms, speak with one of our staff at (616) 954-2020.