The first symptom of an epiretinal membrane generally involves distortion of objects in the field of view of one eye. These distortions cause vertical and horizontal lines to appear wavy – especially in the center of the field of vision. Color perception may also change in the same area.
There is no pain or discomfort associated with the membrane, but it can be confused with macular degeneration; however, epiretinal membranes can be successfully treated.
What is an Epiretinal Membrane and how is Visual Health Affected
With age, fluid in the eyeball – the vitreous – shrinks somewhat in volume and pulls away from the retina causing the retina to form scar tissue in the macula – the region of the retina more or less directly behind the pupil where vision is best. The scar tissue is very thin and virtually transparent, but with time it shrinks and pulls on the retina causing a wrinkling or macular pucker which results in distortion.
An epiretinal membrane is not an indication that blindness or macular degeneration is impending, and individuals with the condition may have only minimal changes in vision. However, if the membrane continues to grow, the unaffected eye many not compensate well for the distortions in the affected eye and loss of visual detail may become chronically annoying affecting the quality of life.
The discovery of a membrane is not a medical emergency and surgery is typically elective based on how the patient’s vision is eventually affected. In some cases, surgery is not necessary if the condition stabilizes.
How is an Epiretinal Membrane Treated?
Eye surgery is the only treatment for macular pucker. The surgery involves removal of the membrane by careful peeling and replacement vitreous humor with a saline solution.
The procedure – a vitrectomy – is an outpatient procedure and takes about an hour. The patient reports to a hospital or surgical center and is prepped as for most surgeries – including a gown, IV, etc. Because there is potential for substantial pain, the patient is put to sleep briefly while access ports are made in the eyeball. These allow for the insertion of surgical tools and a light source. Local anesthesia is also injected while the patient is anesthetized.
Once the patient awakes, there is little sensation in the eye and the surgeon can proceed quickly. Patients are watched for a short time in a recovery area and sent home with a patch over the eye.
When the local anesthesia wears off, the eyeball may feel slightly irritated, but significant pain is not generally a problem, although the eyeball will be very red. This condition disappears over a period of about two weeks.
The eye patch can be removed the next day. But care must be taken to avoid risky activities and lifting. Simple rest and frequent application of eye drops for the prevention of swelling and infection are prescribed.
The exact length of time needed for complete healing differs according to general health, age, and other factors, but patients should expect recovery in a safe environment of at least a week before resuming normal activities. The surgeon will schedule several follow-up visits.
There can be Complications from the Surgery
The most serious possible complication is a detached retina. The incidence, however, is low – about one or two percent. If the retina becomes detached, the surgeon will inject a gas bubble into the eye to help hold the retina in place, but the patient must recover in a head-down position so that the bubble will float to the top – or back – of the eyeball.
Cataracts are the most common complication, and patients will frequently develop a cataract in the affected eye within a year or two after surgery. Fortunately, this surgery has become almost routine for good ophthalmologists, and cataract removal can often restore perfect vision.
Other less common complications include an increase in pressure in the eyeball or infection. An ophthalmologist can advise patients who might be considering eye surgery for a membrane pucker.
There is comfort in knowing that the surgery is common and typically results in significantly improved vision, although improvement in not usually immediate as it may take the retina months to return to its pre-pucker shape.
Sources:
“Epiretinal Membranes,” eyeinstitute.co.nz (Accessed: November 10, 2010)
” Epiretinal Membrane,” themedicineprogram.com (Accessed: November 9, 2010)
Harvey Craft - I am a retired educator with diverse experience. I read anything science, education, and history. I write to share what I learn.
