Home Treatments Eye Treatments Epiretinal Membrane (ERM): Symptoms, Causes & Treatment Options

Epiretinal Membrane (ERM): Symptoms, Causes & Treatment Options

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The eye is a complex system of components. They all exist in harmony, but it is easy for that delicate harmony to be disrupted. A range of conditions can impact individual parts of the eye, which then impair its entire function. Epiretinal membrane is one such condition, reasonably common in individuals over 50.

This condition affects the retina, the part of the eye that takes in light and sends visual signals to the brain. In a sense, it is the part of the eye that processes information and makes it possible for us to see. So it plays a very crucial role. However, a membrane, or layer of scar tissue, can form on top of the retina.

Over time, this can lead to the retina getting wrinkled or scrunched up. This can sometimes have a negative impact on how it works, leading to distorted or blurred vision. It is not painful but can alter a person’s ability to see and interact with the world. Luckily, treatment options exist, which we will explore below.

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What is an Epiretinal Membrane?

An epiretinal membrane is an eye condition most prevalent in older people. It is also called macular pucker. Most often, it only affects a single eye, but there is a chance of it impacting both.

Sufferers of this condition have a thin layer of fibrous tissue (the epiretinal membrane) forming over the middle part – the macula – of their retina. It forms for various reasons, which can be age-related or health-related. It does not cause pain when it forms, and many people do not know they have it.

However, the membrane may eventually contract or shrink as the condition progresses. When it does that, it also moves the retina into an unusual, unnatural position. This changes the way the retina absorbs and interprets light. As such, the patient can end up with blurry or distorted vision.

Symptoms of Epiretinal Membrane

A lot of patients have symptomless cases of epiretinal membrane at first. However, if the condition worsens and the membrane contracts, some people can develop visual problems. These can include unclear vision, making it difficult to distinguish faces or details in the world.

Another common symptom is metamorphopsia. This is when shapes that are usually straight or have straight edges begin to look curvy or crooked. Often, the symptoms are more pronounced and noticeable if the patient shuts their other eye and tries looking solely through the problematic eye.

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Causes and Risk Factors

Often, epiretinal membrane is simply a result of the ageing process. Specifically, it is linked with posterior vitreous detachment (PVD), which often occurs in older people. PVD causes the vitreous gel inside the eye to detach from the retina, which can lead to membrane formation.

There are also idiopathic cases of epiretinal membrane, with no clear, known cause, and cases where the condition results from retinal tears, retinal laser treatment, surgery, inflammation of the eye, or some other condition impacting the retina. Diabetes has also been identified as a risk factor.

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Diagnosis & Tests for Epiretinal Membrane

A lot of cases of the epiretinal membrane are diagnosed almost by accident. They are spotted during routine eye or visual acuity tests, as the patient may not have noticed any symptoms at the time.

In cases where the condition is suspected, specialists may conductOCT (optical coherence tomography) scans. These scans generate a cross-sectional picture of the retina, making the membrane easy to spot.

Treatment Options for Epiretinal Membrane

Treatment plans for epiretinal membrane cases have to be managed and tailored according to the severity of the condition. In mild cases, without any pronounced symptoms, no intervention is needed.

Patients may also have to make some lifestyle adjustments if symptoms present themselves. You may find it harder to read, for example, and could switch to audiobooks to continue enjoying books without straining your eyes. Some may have to drive less if the condition worsens and makes it unsafe to be behind the wheel.

If the symptoms become more prominent and problematic, surgery for the epiretinal membrane may be the best option. An operation for an ERM is called a vitrectomy and membrane peel and takes around 45 minutes in total. The patient will typically be kept awake, but with their eye numbed. Very fine surgical instruments are used to remove the eye’s vitreous gel, access the retina, and peel away the membrane.

Full recovery can take several months, but many patients experience visual improvements within the first weeks. It is important to note that surgery is not usually able to restore entirely normal vision, though it is about 90% successful in improving visual quality. Surgery is best at improving the symptoms of distortion, with blurring improving slightly less well.

Living with Epiretinal Membrane

Many patients live with symptomless epiretinal membranes for many years, and the condition may never pose much of a problem for them. They can continue living their usual lives, and monitoring by an eye doctor is not essential. Eating a balanced diet, staying hydrated, and shielding the eyes against sun damage are all healthy lifestyle habits.

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FAQs about Epiretinal Membrane

Occasionally, a membrane can peel off the retina spontaneously, and symptoms can improve, although this is not very common. Most often, the membrane remains stable and causes no visual problems for the patient.

Some risks include bleeding, infection, temporary or permanent visual changes, cataract development, and retinal detachment. However, these are rare possibilities, and most operations are successful and problem-free.

No. These are two separate conditions. Macular degeneration is a disease in which the macula (part of the retina) degrades over time. Epiretinal membrane is the formation of a layer of tissue on top of the macula.

It varies. A full recovery can take up to half a year, though patients may notice visual improvements much earlier, within a few weeks of surgery.

Yes. Lifestyle adjustments will not cure or reverse the condition, but can make it more manageable. Avoiding smoking, eating a healthy diet, and managing other health conditions that may affect eye health, like diabetes, are good ways to start.

Roughly 90% of patients experience improved vision after this surgery.

It is not a painful or life-threatening condition. It does not tend to produce serious visual problems, however, occasionally the symptoms are significant enough to impact a person’s quality of life.

Usually, you will need at least a few weeks of recovery before your doctor will allow driving.

No, this is not a blinding condition.

Most of the time the vision is unaffected or minimally affected by the ERM. In the first year or two after initial formation, the ERM can thicken, producing increasing symptoms in some individuals. After that time, the ERM generally remains stable.

Conclusion: Contact Clinica London for More Information About Epiretinal Membrane

Overall, epiretinal membrane is a relatively common condition that is often symptomless but sometimes requires surgery. This is why patients should take steps to prioritise their eye health and seek specialist checkups at least once a year. Contact our clinic today if you have any suspicions about possible epiretinal membranes or want to discuss treatment options.

Our clinic operates as a private surgery and is not affiliated with the NHS (National Health Service)

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Getting the right treatment for myopia now could prevent serious eye problems later in your life. To find out more about the available treatments for myopia, book a consultation.

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Ms Evgenia Anikina

Consultant Ophthalmic Surgeon
Cataract, Surgical Vitreoretinal (VR) and Medical Retina Specialist

Mr Julian Robins

Consultant Ophthalmic Surgeon
Cataract, Vitreoretinal (VR) and Medical Retina Specialist