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Epi-retinal Membrane (Macular Pucker)
Epi-retinal
membrane (ERM) or macular pucker is a cellophane-like membrane that
forms over the macula. It 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.
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.
SIGNS
AND SYMPTOMS
•Blurred vision
•Double vision that is noticeable
even with one eye covered
•Distorted vision (straight lines may
appear bent or wavy)
DETECTION AND DIAGNOSIS
The doctor is able to
detect ERM with ophthalmoscopy during an examination of the retina. It
has a glistening, cellophane-like appearance. The affect of ERM on the
patient's central vision is assessed with a visual acuity test and the
Amsler Grid. If the doctor suspects macular swelling, he may order
fluorescein angiography.
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 a local anesthesia in an
operating room. After making tiny incisions The membrane peel is often
done in conjunction with a procedure called a vitrectomy.
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