Date issued: May 2021
Review date: May 2023
Ref: A-462/WS/Ophthalmology/Epiretinal Membranes
PDF: Epirentinal membranes final May 2021.pdf [pdf] 469KB
How to contact
The Royal Eye Infirmary
Switchboard: 01752 202082
Eye Ward: 0845 439348
What is the macula?
Lining the inside of your eye is a thin sheet of nerves called the retina. The retina acts like the film in a camera by turning light entering your eye into a picture for your brain. The central part of the retina is called the macula. The macula is the most important part of the retina and is responsible for your best vision.
What is an epiretinal membrane?
An epiretinal membrane is when you develop a thin sheet of scar tissue on the surface of the macula. The membrane is initially very thin, then gradually becomes thicker and wider.
Who is at risk of developing an epiretinal membrane?
Epiretinal membranes are most frequently seen in people over the age of 50 years, and may possibly be more common in women. In 20-30% of cases this condition is seen in both eyes.
Overall up to 12% of people may be affected.
Epiretinal membranes may also occasionally be caused by other conditions such as: retinal tears, retinal blood vessel problems, eye inflammation and eye injuries.
What are the symptoms?
Patients with epiretinal membranes most commonly experience blurred central vision. They also commonly notice that things are distorted near the centre of their vision. These changes develop slowly causing a gradual deterioration in the quality of their vision. In some cases the epiretinal membrane is not initially noticed by the patient and is only picked up on a routine visit to the optician.
Although the central vision may be severely reduced, not all your vision will be lost because of an epiretinal membrane.
What are the main risks of the operation?
All patients who have not previously had cataract surgery will develop a cataract more rapidly.
One in a thousand chance of loss of vision from a severe eye infection.
One in a thousand chance of loss of vision from severe eye bleeding.
One in twenty chance of developing a retinal detachment.
One in twenty chance of the membrane forming again.
How much vision can I expect after a successful operation?
There is an up to 80-90% chance of an improvement in vision of up to 2 lines on the vision test chart. Your near vision would also improve, and there would be less distortion of your vision.
It may take up to a year of gradual improvement until your sight gets to the best that it is capable of.
What can I expect after the operation?
Your vision will be more blurred for approximately one month following surgery. And it will take up to a year to achieve the best possible vision.
There will be a number of eye drops that you will have to regularly put into your eyes for about one month.
The 20% of people who need a gas bubble placed in the eye are required to posture. Posturing means that you will have to spend all day keeping your head in a position as instructed by your surgeon. You are only allowed 10 minutes break in each hour. You will need to do this for 10-14 days. Please ask the nurses on the ward for advice on posturing.
Some important points to remember about the gas you may have in your eye
There are three very important things to remember during the two to six weeks that you have gas in your eye:
Do not lie on your back, unless instructed.
Do not go flying in an aeroplane.
If for any reason you require a general anaesthetic you must let the anaesthetist know that you have gas in your eye.
What is the treatment?
Surgery is the only treatment that we can offer for an epiretinal membrane. The operation can be carried out under a local anaesthetic or a general anaesthetic.
The jellylike fluid is removed from the eye and replaced with clear fluid. Finally the membrane is gently removed from the surface of the retina. There is a 20% chance that we will need to leave a bubble of special gas inside your eye.
Though your eye may feel sore after the operation, there should be little or no pain. As long as there are no problems you can go home on the day of surgery.
What happens if the epiretinal membrane returns?
It is not common for this condition to return, and if so, rarely significantly affects the vision. If necessary, surgery can be repeated.
Can epiretinal membranes be prevented?
Apart from avoiding injury to your eyes, there is no obvious preventative action that can be taken.
What about my other eye?
There is approximately a 20-30% chance that you could develop an epiretinal membrane in your other eye.
What if my sight remains poor?
You can be helped to see many of the things you used to by making use of your remaining sight. Low vision services can help. They can help you find the best magnifiers for you, and can give advice and training about the many often simple ways that can make the most of your sight. Ask the eye specialist, optometrist (ophthalmic optician), GP, social worker or local voluntary organisation about low vision services near you. RNIB can also advise on the help that is available.