Epiretinal membrane treatment

Many people with epiretinal membrane do not experience symptoms, especially in the early stages, and the condition is often picked up during a routine eye exam.

If you do have symptoms of epiretinal membrane they are often mild and may include:

• Blurred central vision
• Distorted vision - straight lines appear wavy or crooked
• A grey area in the centre of your vision
• Double vision
• Sensitivity to light
• Images appearing smaller or larger than they actually are
• Difficulty reading
• Difficulty recognising faces

Epiretinal membrane, often called macular pucker, occurs when a membrane of cells forms over the macular and shrinks, pulling away from the retina and causing puckering and distortion of the retinal shape.

The most common cause is an eye condition called posterior vitreous detachment (PVD), which is where the gel that fills the back of the eye separates from the retina. Sometimes epiretinal membrane has no apparent cause. This is known as idiopathic retinal membrane.

You are at higher risk of developing epiretinal membrane if you:

• Are over fifty years of age
• Have posterior vitreous detachment (PVD)
• Have had previous eye surgery
• Have a retinal tear or detachment
• Have retinal vascular disease - diseases affecting the blood vessels in the eyes such as diabetic retinopathy
• Have an epiretinal membrane in your other eye

Mild cases of epiretinal membrane do not normally need treatment and your condition will be monitored to make sure it is not getting worse. In rare cases, the epiretinal membrane may spontaneously release from the retina, which can cause symptoms to resolve on their own.

If your epiretinal membrane is causing severe blurred or distorted vision that makes it difficult to perform daily tasks, your consultant may recommend surgery called a vitrectomy. This is the only treatment available for epiretinal membrane.

At your first consultation, you will be seen by a consultant ophthalmologist, a doctor specialising in conditions affecting the eye. Your consultant will ask you about your symptoms, medical history, and general health. They will perform a thorough eye examination to check for any other eye conditions.

Most cases of epiretinal membrane can be diagnosed during a standard eye examination. A test called ocular coherence tomography (OCT) can also be used to measure how severe your epiretinal membrane is. OCT is a non-invasive imaging test that uses light waves to take cross-section images of your retina.

At the end of your appointment, your consultant will decide whether a vitrectomy is right for you based on your symptoms, diagnosis, and general health. They will explain what happens during the surgery as well as any possible risks and complications and what to expect during your recovery.

It is important to us that you are as well-informed and comfortable as possible before, during, and after your surgery, so please ask your consultant any questions you may have.

The main benefit of vitrectomy surgery is an improvement in your vision. Most people experience a complete reversal or significant improvement in distorted or blurred vision after surgery and around 80% of patients also experience an improvement in their level of vision (how much of the letter chart they can read during an eye test).

How much your sight improves after your vitrectomy depends on several factors including:

• How severely your vision was affected
• How long you have had problems with your vision
• Whether there were any complications during your surgery
• Whether your epiretinal membrane is idiopathic (of unknown cause) or secondary to another eye condition such as retinal detachment or retinal vascular disease

The length of the surgery will depend on the complexity of your case, but typically it can last from two to four hours. You will be given either local anaesthesia (where you'll be awake) or general anaesthesia (where you'll be asleep) to ensure your comfort throughout the procedure.

During the surgery, your surgeon will make small incisions in your eye, and then use specialised instruments to remove the vitreous gel and any other material that may be causing issues in your eye. Once the surgery is complete, your surgeon may place an eye patch over the treated eye to protect it and promote healing.

Recovering from surgery for macular pucker

After the procedure, you should plan on having someone else drive you home. You may also need to use eye drops and avoid certain activities for a while as instructed by your surgeon. It's important to follow all post-operative instructions carefully to ensure the best possible outcome.

As with any surgery, there are risks and potential complications associated with vitrectomy. Your surgeon will discuss these with you in detail prior to your procedure and answer any questions you may have to help you make an informed decision.

As with all types of surgery, a vitrectomy carries a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure.

It’s important that you are well informed about the possible risks and complications of your surgery and can make an informed decision.

Possible complications of any surgery include:

• Bleeding
• Infection
• Blood clots
• Adverse reactions to the anaesthetic

Possible complications specific to vitrectomy include:

• Development of cataracts (clouding of the lens of the eye) —many patients with epiretinal membrane develop cataracts in the same eye. Cataracts can be removed during the same procedure or in a separate operation
• Retinal detachment
• Infection
• Bleeding inside the eye
• High pressure inside the eye
• Inflammation inside the eye
• Bruising in and around the eye 

Call the hospital immediately if you experience:

• Severe pain or pain that isn’t relieved by medication
• Vision loss
• Worsening eye redness
• Discharge from your eye

We answer some of your most commonly asked questions about epiretinal membrane.

What is epiretinal membrane surgery?

Epiretinal membrane surgery is an operation called a vitrectomy that involves removing the vitreous gel from inside the eye and peeling away the epiretinal membrane. The surgery is usually performed as a day case, and can be performed under local or general anaesthetic.

Can epiretinal membrane disappear?

Rarely, the epiretinal membrane can spontaneously separate from the retina resulting in improved symptoms.

How serious is epiretinal membrane?

Epiretinal membrane is not usually serious, and in most cases has mild or no symptoms. If your condition is so severe that it distorts your vision and makes it difficult to perform daily activities, surgery may be recommended. Epiretinal membrane does not cause blindness.

Can cataract surgery cause epiretinal membrane?

Eye surgery including cataract surgery can increase your risk of developing epiretinal membrane. It can also make existing epiretinal membrane worse. Many people develop cataracts following surgery for epiretinal membrane (vitrectomy). Cataract removal can be performed at the same time as a vitrectomy or later in a separate procedure.

Can epiretinal membrane cause blindness?

No. Epiretinal membrane can cause blurred and distorted vision but is not known to cause blindness.

Can epiretinal membrane cause retinal detachment?

While epiretinal membrane doesn't cause retinal detachment, the condition can occur following a retinal tear or detachment. Retinal detachment is also a possible complication of epiretinal membrane surgery (vitrectomy).

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about epiretinal membrane treatment, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in April 2023. Next review due April 2026.

1. Epiretinal membrane, Moorfields Eye Hospital NHS Foundation Trust
2. Epiretinal membrane, RNIB
3. Epiretinal membrane, NIH
4. Epiretinal membranes, American Society of Retina Specialists