What is an Epiretinal Membrane (Macular Pucker)?

The retina is a layer of light-sensing cells lining the back of your eye. As light rays enter your eye, the retina converts the rays into signals, which are sent through the optic nerve to your brain where they are recognized as images.

The macula is the central portion of the retina responsible for clear, detailed vision which is needed for activities such as reading and driving.

Damage to your macula causes blurred central vision, making it difficult to perform tasks such as reading small print, threading a needle, or reading a street sign. Straight lines can often appear wavy. Vision loss can vary from barely noticeable to severe.

The macula normally lies flat against the back of the eye. An epiretinal membrane (macular pucker) is when wrinkles, creases, or bulges form on the macula.

What Causes an Epiretinal Membrane?

As you age, the vitreous clear gel-like substance that fills the middle of your eye begins to shrink and pull away. Once the vitreous starts to shrink, scar tissue may develop on the macula. Sometimes the scar tissue can shrink and contract, causing the retina to wrinkle or bulge. Eye conditions that are associated with macular pucker include:

Vitreous detachment (separation of gel inside eye)
Torn or detached retina
Inflammation inside eye
Severe injury to the eye
Occlusions of the retinal blood vessels

A diagnosis for epiretinal membrane or macular picker is not usually related to any medical problem outside the eye. Our staff of ophthalmologists offer eye surgery and treatment options to clients that are encountering the symptoms of macular pucker.

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What Are the Symptoms of Macular Pucker?

The symptoms of macular pucker or epiretinal membrane range from mild to severe and may involve one or both eyes. Symptoms may include:

Blurred central vision
Distorted or wavy vision
Gray and/or cloudy areas in central vision
Central blind spot
Difficulty reading or performing tasks that require detailed vision

How is Macular Pucker Detected?

Our staff of ophthalmologists detect macular pucker by examining your retina. A test called a fluorescein angiogram, a procedure that takes special photographs of the eye may be performed. These photographs show if an abnormality exists in your retina. In addition, a specialized type of ultrasound called an OCT may be performed to diagnose epiretinal membrane.

How is Macular Pucker Treated?

For mild symptoms, you may not be required to treat epiretinal membrane. Updating your eyeglass prescription or wearing bifocals may improve vision. Eye drops, medicines or laser surgery do not improve vision. If you are experiencing severe symptoms, a surgery called vitrectomy is recommended to treat macular pucker. The surgery is usually performed as an outpatient procedure in an operating room.

During surgery, your retina specialist uses tiny instruments to remove the wrinkled tissue on your macula. After the tissue is gone, the macula flattens and vision slowly improves, though it usually does not return all the way to normal. This is an elective procedure and should be considered if your blurred vision is interfering with your daily activities.

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What Are the Potential Risks of Vitrectomy Surgery?

As with any surgical procedure, rare complications that can occur while you are treating macular pucker include infection, bleeding, retinal detachment, recurrence of macular pucker after surgery, and cataracts. Be sure to discuss potential complications with your ophthalmologist before surgery.