Definition: Epi-retinal membrane (ERM), also called macular pucker, is a cellophane-like membrane that forms over the macula. It’s typically a slow-progressing problem that affects central vision by causing blur and distortion. As it progresses, traction of the membrane on the macula may cause swelling.


ERM is seen most often in people over 75 years of age. It usually occurs for unknown reasons, but may be associated with certain eye problems such as: diabetic retinopathy, posterior vitreous detachment, retinal detachment, trauma, and many others.


  • Blurred vision
  • Double vision that is noticeable even with one eye covered
  • Distorted vision (straight lines may appear bent or wavy)

Doctors are able to detect ERM with a dilated eye exam. It has a glistening, cellophane-like appearance. When detected, your doctor may order an ophthalmic coherence tomography (OCT) and / or a fluorescein angiography to measure and monitor swelling caused by the ERM. The affect of ERM on the patient's central vision is assessed with a visual acuity HYPERLINK "file:///U:/Web%20Development/stlukeseye/eyeq/vision.htm" test and the Amsler Grid.

Treatment: A procedure called a membrane peel is performed when vision has deteriorated to the point that it is impairing the patient's lifestyle. Most vitreo-retinal surgeons recommend waiting for treatment until vision has decreased to the point that the risk of the procedure justifies the improvement.

The membrane peel is performed under anesthesia in an operating room. After making tiny incisions, the membrane peel is done in conjunction with a procedure called a vitrectomy.Vision usually improves slowly after surgery, with most improvement coming within the first three months. In rare cases, the vision may not improve at all. The chance that vision will improve following surgery is about 75%. On an average, patients regain approximately half of the vision that was lost because of the epi-retinal membrane.

Complications of surgery include retinal tears and detachments, cataract formation, infection, and regrowth of the membrane. These complications may result in mild to total loss of vision, though vision- losing complications are extremely rare.