Epiretinal Membrane and Distorted Vision

An epiretinal membrane is a thin layer of fibrocellular tissue that forms on the inner surface of the retina. When it develops over the macula—the central area responsible for reading, recognising faces and seeing fine detail—it may contract and distort the underlying retinal tissue.

The condition is also called a macular pucker. Many remain mild and stable, but some cause progressively blurred or distorted central vision.

Symptoms of an epiretinal membrane

Straight lines may appear bent, wavy or uneven. Words can look crowded on a page, and fine detail may be harder to see. Some people notice that objects appear slightly different in size between the two eyes or that one eye produces a ghosted image.

Changes can be easier to recognise when each eye is checked separately because the clearer eye may compensate. An Amsler grid can help monitor distortion, but it does not establish the diagnosis.

Why the membrane develops

Most epiretinal membranes are associated with age-related change in the vitreous, the clear gel filling the eye. As the vitreous separates from the retina, cells can grow across the retinal surface and form a very fine membrane.

It can also develop after a retinal tear or detachment, retinal vein occlusion, diabetic retinopathy, inflammation or eye surgery. Examination of the entire retina is therefore important.

Retinal examination and OCT imaging

Our eye specialists assess visual acuity and examine the retina after dilating the pupil. Optical coherence tomography (OCT) uses light to produce detailed cross-sectional images of the macula and vitreoretinal interface. It can show the membrane, retinal thickening and the degree of traction or distortion.

Comparing OCT and retinal imaging over time helps determine whether the appearance is stable and whether the structural change corresponds with the person’s visual symptoms.

Epiretinal membrane treatment

A mild membrane that is not interfering with useful vision can usually be monitored. Glasses may improve any accompanying focusing error, but eye drops, medicines and supplements do not remove the membrane itself.

When distortion or reduced vision is affecting reading, driving, work or other important activities, vitrectomy with membrane peel may be considered. During this operation, the vitreous is removed and the membrane is carefully peeled from the retinal surface, allowing the macula to relax. Improvement is generally gradual rather than immediate, and the likely benefit depends on the retinal findings and duration of the condition.

As with any surgery, vitrectomy carries risks. Individual outcomes vary, and the potential benefits, limitations and risks should be discussed with the treating vitreoretinal surgeon.

When visual distortion needs prompt assessment

Epiretinal membrane symptoms usually develop gradually. New distortion should be assessed promptly because wet macular degeneration and other macular conditions can produce similar symptoms. Sudden substantial loss of vision, new flashes or floaters, or a dark shadow in the field of vision requires urgent same-day assessment.

At Eye and Retina Specialists Sydney in Green Square/Waterloo, our ophthalmologists Dr Neil Sharma, Dr Cheryl Au and Dr Linda Zheng provide comprehensive retinal and ophthalmic assessment. If straight lines have become distorted or central vision has changed, our team can examine the macula, perform OCT imaging and discuss whether monitoring or vitreoretinal surgical review is appropriate.