Epiretinal Membrane (ERM)
Epiretinal membrane[ERM] is common and occurs in approximately 6 - 15% of people, sometimes resulting in blurred or distorted central vision. Many patients however are completely asymptomatic, or only have very mild symptoms, such as slight blur, jumbling of / missing letters whilst reading, or mild distortion noticed when covering the other eye. Some patients can be very symptomatic, especially if they have significant distortion in their dominant eye. Epiretinal membrane can progress, with further reduction in vision over time, or remain fairly static. However, peripheral vision is never affected.
Symptoms can resemble macular degeneration, which can require urgent treatment, so it is important that should you develop any of these symptoms, you contact your optician or eye care provider for an urgent assessment.
If caught relatively early, surgery can offer a good outcome for patients with symptomatic epiretinal membrane. The amount of visual recovery does tend to depend on how much vision has been lost and the duration of symptoms.
Even with prompt surgery, because the condition affects the most delicate part of the retina, full recovery of vision is rarely possible, and some blurring / distortion of vision often remains. However, around three-quarters of patients do have a significant improvement in quality of vision, and find that vision with both eyes working together (binocular vision) is improved. The surgery can also prevent the condition from getting worse.
What does the surgery involve?
The surgery is performed via a procedure called a vitrectomy and is often under local anaesthetic as a daycase. The vitreous gel at the back of the eye is removed using tiny instruments and the membrane over the macula is removed using very fine forceps. Typically taking around 45 minutes – 1 hour, it is sometimes combined with cataract surgery and lens implantation at the same time if there is significant cataract.
Occasionally an air bubble is introduced into the eye at the end of the surgery, which can blur the vision significantly for a couple of days, but gradually dissipates by itself. Your surgeon will inform you if this has been used.
Aftercare
With modern vitrectomy surgery, the eye generally heals fairly rapidly with minimal discomfort. Occasionally there is some mild irritation, especially if sutures are used, but your surgeon will inform you if this is the case.
You will be prescribed drops post-surgery, and it is important you follow the relevant directions.
It is important that you avoid getting water directly into the eye for the first week after surgery, and swimming needs to be avoided for 3 months.
Normally patients are reviewed approximately at 2 weeks and then 2 months after the procedure to ensure everything is settling well.
If there are any unexpected symptoms, in particular increasing pain or dramatic drop in vision, or you have any other postoperative concerns, it is very important that you contact your surgeon. Emergency contact details will be provided upon discharge from the hospital.
