Epiretinal Membrane (Macular Pucker)

Epiretinal membrane (ERM) (also known as Cellophane Maculopathy or Macular Pucker) is a thin, almost transparent layer of fibrous cellular material which grows over the surface of the retina. Like a layer of plastic wrap or cellophane, it can be basically transparent. In some cases contracture of this thin fibrous tissue can cause wrinkling of the retina, like wrinkles on a bedspread. This condition is typically a slow-progressing problem that affects the central vision by causing blur and distortion. As it progresses, the traction of the membrane on the macula may cause swelling.

Learn about self help and prevention
Learn about vision products that may help

This condition is seen most in elderly persons over 75. While the cause is usually unknown, it may be associated with eye problems such as vitreous or retinal detachment, diabetic retinopathy, trauma to the eye, and other conditions.

Symptoms

In early stages, epiretinal membrane may be asymptomatic, or it may create only a mild reduction in acuity. Its progression may cause metamorphopsia and lead to severe visual impairment.

In very severe cases, macular edema and even retinal detachment have been known to occur.

Nutritional Supplements

These are the most important supplements and recommendations.

Shopping Tips

On a tight budget?

Here's our single most important recommendation:
Doctor's Choice: Advanced Eye and Vision Support Formula - Dr. Grossman's Advanced Eye & Vision (whole food) Support Formula - 60 vcaps per bottle Promotes clear vision and healthy eyes, including macula, retina and lens, supports healthy eye growth, and rejuvenation, and supports the body's natural detoxification processes with targeted, quality antioxidants for vision.

Essential: Advanced Eye and Vision Support Formula - Dr. Grossman's Advanced Eye & Vision (whole food) Support Formula - 60 vcaps per bottle Promotes clear vision and healthy eyes, including macula, retina and lens, supports healthy eye growth, and rejuvenation, and supports the body's natural detoxification processes with targeted, quality antioxidants for vision.

Essential: MacuHealth with LMZ - 90 capsules (3 mo. supply) with10mg of meso-zeanthin per capsule. Meso-zeanthin is an essential antioxidant found in the macula (center of the retina).

Essential: Carlsons Super Omega-3 Gems 1000 mg 130 softgels / 250 softgels - Super Omega-3 Gems 1000 mg 130 softgels / 250 softgels - Fish body oil is the only major source of the polyunsaturated Omega 3's EPA and DHA

Very Important: Microcurrent Stimulation 100ile Purchase Option - Microcurrent Stimulation helps stimulate energy production (ATP) in the retina, improve circulation & reduce waste build-up.

Very Important: Glucosamine Chondroitin 90 caps (GLU89) - Glucosamine Chondroitin may be helpful for osteoarthritis.

Very Important: Retinal Support 2 oz - Retinal Support is based on classic Kidney & Spleen Chinese medicine formulas to help support the retina by building blood, improving circulation, eliminating dampness, & strengthening overall energy.upport based on classic Kidney & Spleen Chinese medicine formulas to help support the retina by building blood, improving circulation, eliminating dampness, & strengthening overall energy.

Helpful: Vitamin C Complex 1000mg 120 vcaps - Vitamin C Complex 1000 mg 120 vtabs with natural buffers to help the body utilize the vitamin C more efficiently,

Causes

Often, the membranes are seen following posterior vitreous detachment, or they may occur idiopathically in patients over 50 years of age.

Epiretinal membrane formation occurs as a result of retinal glial cell proliferation along the surface of the ILM. Small, focal defects in the ILM allow these cells to "break through" to the retinal-vitreous interface and reproduce, creating a thin veil of tissue. Epiretinal membranes have been found in association with retinal vascular diseases, retinal breaks and detachments, ocular trauma, uveitis, and following retinal cryopexy, laser photocoagulation, and intraocular surgery.

Conventional Treatment

In most cases, little can be done to improve acuity. Most patients, fortunately, suffer only a minimal reduction of acuity or slight metamorphopsia. Doctors reassure patients as to the nature of the disorder and follow up periodically, using an Amsler grid for home monitoring of progression. In severe cases, vision may drop to 20/100 or worse; this may indicate the need for vitrectomy and surgical peeling of the membrane. This procedure is, as one might imagine, very intricate, and is reserved for those patients for whom there are no alternatives.

Self Help and Prevention

Since we consider most eye conditions to be a reflection of the health of the whole body, lifestyle choices and diet can play a major factor in getting and maintaining good vision. Below are some recommendations:

Diet & Nutrition

Supplement your diet with a good multivitamin such as Dr. Grossman's Whole Food Multivitamin and/or a good green drink such as Renewal Greens.
The Vision Diet - recommended in Natural Eye Care: An Encyclopedia on CD. This CD covers 29 major eye conditions with specific nutrient, diet, exercise and juicing instructions by eye condition, plus much more.
Eliminate deep fat fried foods
Avoid monosodium glutanate (MSG) used as a flavor enhancer which is a potential retinal toxin (Inv Oph 1996; 37: 1618-24)
Avoid fat blockers like Olestra which impair the absorption of carotenoids (Argus, August 1996;19:18:July 1996;19:22). Eating greater amounts of saturated fat and cholesterol also appear to increase the risk of age-related macular degeneration.
Limit your alcohol consumption to 1 glass of red wine at night. Alcohol interferes with liver functions, reducing protective glutathione levels (Alcohol 1993;10;469-75).

Lifestyle & General Health

Eliminate smoking. Smoking among other things produces cyanide, a retinal toxin.
Limit the amount of medications (both prescription and non-prescription as much as possible. Make sure to work closely with your doctor.
Exercise daily - do at least 20 minutes of aerobic exercise daily. Walking and swimming are two excellent forms of exercise.
Manage your emotional health, which is very important in maintaining physical health. Fear (fear of failure, responsibility, of being alone, of death, etc.) is at the root of many of life's problems, and is a major factor in many diseases. Take up the practice of meditation, yoga, tai chi, walks in the woods or prayer on a daily basis.

Research

Although the underlying physiological cause may be unique, there may be similarities in terms of nutritional, diet and lifestyle recommendations made by Dr. Grossman for eye conditions that result in similar vision symptoms to those of epiretinal membrane (macular pucker).

See also research for macular degeneration.

Back to Top