Retinal Support - Surface of the Retina

Causes   Treatment   Nutrients   About the vitreous
Photoreceptors   Connective   Hole / Wrinkle in the macula   Sugar balance   Vitamin A

Epiretinal Membrane

Retinal damage can occur in the form of a pucker or wrinkle caused by an epiretinal membrane. Under adverse conditions such as an immune response, a thin layer of cells covering the retina surface forms and may draw together pulling the vitreous away from the retina and creating a wrinkle in the retina surface. Wikipedia reports that not only can a pucker result, but swelling such as macular edema may occur as well.

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Epi Retinal Support Package 1 Epi Retinal Support Package 1
Nutrients to support retina health, reduce inflammation & help eliminate waste
Epi Retinal Support Package 2 (3 month supply)Epi Retinal Support Package 2 (3 month supply)
Natural supplements to help nourish the retina, reduce inflammation and eliminate waste.
Advanced Eye & Vision Support Formula (whole food) 60 vcapsAdvanced Eye & Vision Support Formula (whole food) 60 vcaps
Whole food, wild crafted herbal vegetarian formula with vision antioxidants, chemical- and preservative-free.
Carlsons Super Omega-3 Gems 1000 mg 250 softgelsCarlsons Super Omega-3 Gems 1000 mg 250 softgels
High quality omega-3 fatty acids
Retinal Support (wild-crafted herbal formula) 2 ozRetinal Support (wild-crafted herbal formula) 2 oz
This wild-crafted herbal formula by Dr. Grossman based on classic Chinese patent formulas to help support the retina and reduce general inflammation.
Very Important
Dr. Grossman's Bilberry/Ginkgo Combination 2oz (60ml)Dr. Grossman's Bilberry/Ginkgo Combination 2oz (60ml)
Bilberry/Ginkgo Wild crafted extract formula.
Very Important
Total Ocular Function Oral Spray 30mlTotal Ocular Function Oral Spray 30ml
Spray formula of vision nutrients

Such damage effects vision similarly to that brought about by macular degeneration; both can arise due to changes in the vitreous. If the retina is damaged, the process of healing may leave a scar in the form of the epiretinal membrane.


Often, the membranes are seen following a posterior vitreous detachment (where the vitreous gel that fills the eye becomes more liquid, causing a strain on tissues that in turn causes a separation from the retinal lining of the eye). Occasionally an epiretinal membrane can appear without any obvious underlying cause.

Non-nerve retinal cells (glia) multiply along the inner surface of the retina lining. Small defects allow them to push through to the inner surface between the retina and the vitreous fluid and build a thin wall of tissue that can fold and pucker, distorting the macula. Membranes are seen with many retinal vascular conditions, retinal detachments and breaks, trauma to the eye, inflammation of the uvea (uveitis), and following retinal and intraocular surgery.

macular pucker


This condition has been generally considered to be 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.

For severe cases, your doctor may recommend one of several procedures for different types of macular puckers.

IEMM peeling. A procedure called internal limiting membrane peeling is commonly used in the idiopathic form of ERM. It is considered safe and effective.

Vitreous traction related. Though often not requiring any medical intervention, sometimes vision deteriorates due to the pulling on the retina, to the point where it affects daily routine activities. In these cases, a surgical procedure called a vitrectomy may be recommended. The retinal surgeon removes the vitreous gel to prevent it from further pulling on the retina and replaces it with a salt solution (because the vitreous is mostly water, you will notice no change between the salt solution and the normal vitreous). The surgeon also removes the scar tissue causing the wrinkling. Usually half of the vision lost can be restored and the vision distortion improved.

Cataracts often develop as a result of the surgery within a few years afterward. Less common complications are retinal detachment either during or after surgery, and/or infection after surgery.

Recurring pucker. The macular pucker may grow back, but this is rare.

Complementary Approach

We believe that vision conditions like epiretinal membrane are a reflection of the health of the entire physiology and vision system. Lifestyle choices, including a high-quality diet and taking targeted supplements can make a big difference in preventing and managing this condition. Proper nutrition is essential for eye health, as it promotes proper circulation, bringing nutrients to, and removing toxins from, the eyes. Also, getting daily exercise, avoiding smoking, and avoiding other toxins such as food additives are crucial.

Carotenoids (especially lutein, zeaxanthin, astaxanthin, and vitamin C), omega-3 fatty acids, vitamin D, and trans-resveratrol are important aids to good macular health.

Related conditions

Membrane   Causes   Nutrients   About the vitreous