For PatientsFor Referring ProvidersPay My BillCall (720) 828-3937
Front Range Retina, Steven M. Christiansen, MD
Request an appointment

Epiretinal Membrane (Macular Pucker)

An epiretinal membrane is an abnormal sheet of tissue that forms on the surface of the retina. The membrane has some similarities to scar tissue, and as the membrane contracts, it causes wrinkling and disruption of the delicate structure of the retina beneath it.

Many epiretinal membranes are mild and need only monitoring, but occasionally, the membrane induces damage to the retina that can cause blurry central vision. Surgery to peel the epiretinal membrane can improve the anatomy of the retina and improve the vision.

Retina photograph showing an epiretinal membrane

Symptoms of an epiretinal membrane

Symptoms range from none at all to significant distortion:

  • Wavy or distorted lines, especially when reading
  • Blurry vision in one eye that does not improve with glasses
  • Images looking different and asymmetrically blurry between the two eyes
  • Gradual worsening over months to years

Causes & risk factors

The most common cause is posterior vitreous detachment, the normal age-related separation of the vitreous gel, which stimulates a fine layer of cells to grow on the macula’s surface. Membranes can also form after having a retinal tear or retinal detachment, retinal surgery, or inflammation inside the eye.

How we diagnose an epiretinal membrane

A dilated eye exam identifies the membrane, and OCT imaging demonstrates the degree to which the epiretinal membrane is disrupting the normal contour and anatomy of the retina. Comparing OCT scans over time helps determine whether the epiretinal membrane is stable or worsening, and how it may be affecting your vision.

Retina photograph showing the glistening sheen of an epiretinal membrane over the macula
From our clinic: the subtle glistening sheen and fine wrinkling of an epiretinal membrane over the macula.

How is an epiretinal membrane treated?

There are no drops or injections that remove a membrane. The choice is between monitoring and surgery:

Monitoring
Many membranes stay mild for years. If your vision is stable and the epiretinal membrane is not worsening, monitoring without surgery is a reasonable approach.
Vitrectomy with membrane peel
When distortion or blur starts interfering with reading, driving, or other daily activities, surgery may be performed to remove the vitreous gel and gently peel the membranes off the retina, which allows the retina to return to a more normal contour.

What to expect

After a membrane peel, the vision gradually improves over the coming 6-12 months as the retina returns to a more normal contour.

Common questions

Do I need surgery?

Epiretinal membrane peeling surgery is an elective surgery and does not have to be performed. However, the epiretinal membrane does usually get worse over time. Surgery helps prevent further worsening, typically improves distortion you may be experiencing, and in most cases, does improve the vision by a line or two on the reading chart.

Will the membrane come back?

Recurrence of the membrane after surgical peeling is very uncommon.

Can I do anything to keep the membrane from getting worse?

No, we are not aware of any eye drops or treatments to prevent the epiretinal membrane from developing or from worsening once it is present. Fortunately, progression is typically very slow and surgery is very successful.

Sources & review

This page is educational and is not a substitute for an examination. Content follows guidance from the American Academy of Ophthalmology and the American Society of Retina Specialists.