Epiretinal Membrane (macular pucker)
Epiretinal membrane (ERM) is identified with many different terms, including cellophane maculopathy and macular pucker. It 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.
This condition is seen most in elderly persons over 75. The cause is often associated with eye problems such as vitreous or retinal detachment, diabetic retinopathy, trauma to the eye, and other conditions.
At first symptoms may not be noticeable, or a very modest reduction in vision acuity may occur. Progression can give rise to distorted vision in which lines in a grid may appear wavy, or parts of the grid may be blank, gradually worsening until there may be distortion and impairment. In some cases macular edema may occur (in which fluid is retained in a cyst under the macula, or retinal detachment (in which the retina separates from the lining of the eye) may develop.
This condition is generally considered difficult to treat or untreatable. Fortunately, most patients experience only a minor reduction of acuity or slight distortion. Eye doctors usually simply reassure patients as to what has happened and provide periodic follow-up, suggesting an Amsler grid for monitoring vision changes at home. In very severe cases, vision might deteriorate to 20/100 or worse. At this point the eye doctor usually suggests surgery to remove some of the vitreous fluid and peel off the membrane. As you can imagine, this an intricate, delicate procedure and is used only when there are no other alternatives. Development of cataracts is a complication from vitrectomy surgery.
Self Help and Prevention
We believe that vision conditions like epiretinal membrane are a reflection of the health of the entire physiology and vision system. Lifestyle choices, nutrition and diet can make a big difference in preventing and managing this condition. Daily exercise, avoiding smoking, and toxins in food additives is important. Providing proper nutrition for the eye and supporting circulation to bring nutrients and remove toxins is essential. See our general good vision protocol.
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.