Patient Education
Epiretinal Membrane (Macular Pucker)
An epiretinal membrane (ERM) — also called a macular pucker — is a thin layer of scar-like tissue that forms on the surface of the macula. As it tightens, it can wrinkle or pucker the underlying retina, distorting central vision.
Typical Symptoms
- Blurry or mildly distorted central vision
- Straight lines appearing wavy or irregular
- Difficulty reading small text
- A gray or cloudy haze in the center of vision
- Monocular double vision (objects appearing doubled in one eye)
- Many patients have only mild symptoms initially
How It's Diagnosed
OCT
The key diagnostic test. OCT shows the membrane as a bright, reflective layer on the retinal surface and reveals whether it is distorting the underlying macula.
Dilated Eye Exam
The membrane may appear as a cellophane-like sheen over the macula during examination.
How It Affects Vision
The degree of vision impairment varies widely. Some epiretinal membranes cause only subtle distortion and never progress significantly. Others tighten over time and cause worsening blurring and distortion. Surgery can reduce distortion significantly, though complete restoration of vision is not always possible.
Treatment Options
Observation
Many patients with mild symptoms and stable vision can be monitored without intervention. Regular OCT imaging tracks any progression.
Vitrectomy with Membrane Peel
Surgical removal of the epiretinal membrane under a microscope. The vitreous is removed first, then the membrane is carefully peeled away from the retinal surface. Recovery takes weeks to months.