Epiretinal Membrane Treatment and Management

By John Choi, MD

The retina is the “wallpaper” lining the inside of the back of the eye and contains the vision machinery. The center of the retina is called the macula. The macula enables you to focus and perform tasks such as reading and driving.

An epiretinal membrane is a layer of scar tissue that forms inside the eye on top of the macula. It can affect your vision and make performing your daily activities more difficult.

What Causes It?

This is most often an aging change of the eye. The average age at diagnosis is 65. Men and women are equally affected. There is no way to prevent an epiretinal membrane due to aging from forming. Epiretinal membranes can occur in both eyes 20% of the time.

Other eye conditions can predispose a person to developing an epiretinal membrane. The most common is posterior vitreous detachment.

How Does It Affect Vision?

Most patients have no symptoms. However, membranes can worsen with age and then affect vision by pulling and wrinkling the macula. Patients may have a vague visual distortion. Straight lines like window blinds or a door frame may look wavy or crooked. In severe cases, vision can be very blurry. Other symptoms are double vision, light sensitivity or images looking larger or smaller than they actually are. Activities such as reading and driving may be more difficult.

How Is It Diagnosed?

Eye doctors can diagnose membranes with an eye exam and pictures. Membranes are often found incidentally in patients without symptoms. Often an epiretinal membrane is masked by the other “good” eye, so closing one eye then the other while looking at any straight line may reveal waviness from a membrane. If you notice this, you should see an eye doctor.

What Can I Do If I Have It?

After diagnosing an epiretinal membrane, your eye doctor should refer you to a retina specialist for further evaluation and management. Membranes can be monitored if vision is not affected.

Treatment is recommended for those patients whose vision is worsened. Medicine eye drops may rarely improve symptoms. A surgical procedure called vitrectomy is the best treatment option. The retina specialist enters the eye with instruments and peels the epiretinal membrane, allowing the macula to relax.

This surgery has a good success rate, and most patients experience improved vision and decreased symptoms afterward.