Epi-retinal Membrane (Macular Pucker)

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Epi-retinal Membrane

(Macular Pucker)
What is it?

Epi-retinal membrane or ERM is a thin membrane or scar tissue similar to cellophane the covers the macula in the back of the eye. Typically progresses very slowly and is diagnosed most often in individuals over 75. Notice the position of the retina and macula in the diagram below.



Age is a factor with the gradual loss of inner eye fluid which causes the vitreous fluid in the eye to detach from the retina. In some individuals this causes scar tissue to develop over the macula. Other conditions that may contribute to ERM include detached retina, eye inflammation, and diabetic retinopathy.


Blurred vision

Double Vision

Vision may appear distorted or wavy

Central vision blind spot in severe cases

Swelling of the macula may occur over time. Severe vision loss in uncommon


ERM is detected by your eye doctor during the inspection of the retina while the pupil is dilated. The membrane has a glistening appearance. Further testing of the individual’s central visual acuity will be assessed to determine the severity of the condition and the affect on ERM on the individual’s vision. An Ocular Coherence Tomography or OCT scan may be performed to scan your retina. This test uses light rays to see each layer of the retina for close examination.


This condition generally does not require treatment as vision is only mildly affected with blurriness. Sometimes it may even go away. A membrane peel may be surgically performed under general or local anesthesia. A vitrectomy is also possible. This is a procedure where the vitreous (inner fluid) of the eye is removed and the eye is then filled with a new liquid or gas bubble to maintain the eyes shape and keep the retina intact. Recovery from this procedure is slow and there are many possible complications. Typically patients are cautioned to wait until their vision has deteriorated to the point that their lifestyle is affected and the benefits strongly outweigh the risks.



Center for Sight. (2009). Macular Pucker or Epi-retinal Membrane. Retrieved on July 2, 2010 from http://www.center-for-sight.com/macular-disease/macular-pucker-retinal-membrane.html

Eye Centers of Florida. (2006-2008). Epiretinal Membranes/Macular Pucker. Retrieved on July 2, 2010 from http://www.ecof.com/florida-lasik-fort-myers/epi_retinal_membranes_macular_pucker_retina_center/epi-retinal-membranes-macular-pucker.html

Kaufman Eye Institute. (2009). Epi-Retinal Membrane (or Macular Pucker). Retrieved on July 2, 2010 from http://www.kaufmaneyeinstitute.com/epiretinal.html

National Eye Institute. (2010). Macular Pucker. Retrieved on July 2, 2010 from http://www.nei.nih.gov/health/pucker/index.asp

Prasad, S. (May 2010). Epi-retinal membrane. Retrieved on July 2, 2010 from http://sight2020.co.uk/erm.aspx
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