Epiretinal Membrane
An epiretinal membrane is a thin layer of scar tissue that grows on the surface of the macula, causing central vision distortion and blur. When vision is significantly affected, epiretinal membrane surgery — a precise vitrectomy and epiretinal membrane removal procedure — can restore clarity and reduce distortion. Learn the symptoms, causes, diagnosis and when treatment is required.
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What a great experience! Very reassuring and I am very grateful for the consultation from Dr Musa he was so helpful in helping me make a decision to proceed to having eye correction surgery. I have the upmost confidence in him and the team at the Eye Doctor Clinic, Huddersfield.
Lozza 747I had implants with Dr Musa ten years ago. It was the best thing I've ever done. They are brilliant. My sight both near and distant was very poor but since the op I've had no glasses no lenses and my sight has been super. It remains really good to this day. Thank you Dr Musa. Brilliant consultations and treatment for glaucoma since.
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Carol PeelWhat Is an Epiretinal Membrane?
An epiretinal membrane (ERM), also called a macular pucker or cellophane maculopathy, is a thin sheet of scar tissue that forms on the surface of the macula, the central part of the retina responsible for sharp, detailed vision. As the membrane contracts, it causes the macula to wrinkle, leading to blurring and distortion of central vision.
ERMs are most common in people over the age of 50 and typically develop without a specific underlying cause, often following a posterior vitreous detachment. They may also occur after retinal surgery, inflammation, or vascular disease.
Many ERMs cause only mild symptoms and require monitoring rather than immediate treatment. When distortion or blurring significantly affects daily life, surgical removal by vitrectomy and membrane peel offers most patients meaningful improvement in vision.
Symptoms of an Epiretinal Membrane
Symptoms are typically confined to central vision and may progress slowly. Many patients are unaware of the membrane until it is detected on routine examination or begins to affect everyday tasks.
Causes & Risk Factors
Epiretinal membranes form when cells proliferate onto the macular surface. Identifying the underlying cause guides appropriate monitoring and treatment planning.
Idiopathic (Age-Related)
The most common cause. Epiretinal membranes form spontaneously in older adults, often after a posterior vitreous detachment, when cells migrate onto the macular surface and proliferate into a thin scar layer.
Posterior Vitreous Detachment
As the vitreous gel separates from the retina with age, cells can settle and proliferate on the macular surface, forming scar tissue that contracts and distorts the underlying retina.
Retinal Tears or Detachment
Previous retinal breaks or detachment trigger a healing response that can lead to epiretinal membrane formation, particularly after surgical repair of a retinal detachment.
Intraocular Surgery
Cataract surgery, glaucoma surgery, and other intraocular procedures can stimulate epiretinal membrane development as part of the post-surgical healing response.
Ocular Inflammation
Uveitis and other forms of intraocular inflammation can cause cellular proliferation on the macular surface, leading to epiretinal membrane formation and progressive macular distortion.
Retinal Vascular Disease
Diabetic retinopathy and retinal vein occlusion are associated with epiretinal membrane development, due to vascular disruption and secondary inflammation triggering cellular migration onto the macula.
Diagnosis and Assessment
Diagnosis combines clinical examination with OCT imaging to confirm the presence of the membrane, assess its impact on the macula, and determine whether monitoring or surgical treatment is the most appropriate course of action.
OCT Imaging
Optical coherence tomography is the gold standard for diagnosing and monitoring epiretinal membranes. It demonstrates the membrane's extent, thickness, and degree of macular distortion, guides surgical planning, and tracks changes over time.
Visual Acuity and Amsler Grid
Visual acuity measures the degree of central blur, while the Amsler grid detects metamorphopsia (distortion of straight lines). These simple tests quantify functional impact and help determine whether intervention is warranted.
Fundus Examination
Slit lamp biomicroscopy with a contact or non-contact lens visualises the macular surface, confirming the presence and extent of the membrane and identifying any associated pathology such as macular oedema or traction.
Assessment of Visual Impact
The effect on daily activities including reading, driving, and near-vision tasks is assessed clinically. The decision to proceed with surgery is guided by visual acuity, degree of distortion, rate of progression, and quality of life impact.
When to Seek Advice
Seek a specialist assessment if you notice any of the following:
- Central vision is becoming blurred or distorted
- Straight lines appear wavy or bent (metamorphopsia)
- Difficulty reading, regardless of your current glasses prescription
- A grey or hazy area has appeared in the central vision of one eye
- Visual symptoms are worsening or affecting your quality of life
- You have a history of retinal surgery or detachment and notice new central symptoms
“An epiretinal membrane often progresses slowly, but early assessment allows timely monitoring and surgical intervention before significant macular damage occurs. Treated early, most patients achieve meaningful improvement in distortion and clarity.”
Meet the Team
Where to Find Us
Three convenient locations across West Yorkshire. Visit us for consultations, diagnostics, and treatments.
Bolton
136 – 140 Newport St
Bolton, Greater Manchester
BL3 6AB
Huddersfield
Woodlands, 4 Longbow Close
Huddersfield, HD2 1GQ
Book an Epiretinal Membrane Assessment
If you are experiencing central vision distortion or blur, an early specialist assessment at The Eye Doctor Clinic will confirm the diagnosis and determine whether monitoring or surgical treatment is recommended.
