Macular Pucker

Epiretinal membrane (ERM) or macular pucker is the result of semitranslucent membrane on the inner retinal surface. ERM can be idiopathic and is relatively common in patients over age 50, and both sexes are equally affected. Secondary ERM occur regardless of age and sex due to inflammation, retinal tears/detachment or bleeding in the vitreous gel.


Many epiretinal membranes do not disrupt vision. Affected patients may report distortion of vision such as bowing of straight lines or objects looking different in size and a variable degree of visual loss ranging from 20/20 to 20/200. Continued traction on the retina can lead to fluid accumulating in the retina, which is evident clinically and on other tests.


After a thorough examination of the eye, the physician will perform a series of diagnostic tests. These tests may include a dilated eye examination, fluorescein angiography and optical coherence tomography.


Surgery is usually recommended in cases where there is significant distortion or decreased vision. Usually a vitrectomy is performed as an outpatient under local anesthesia. During the procedure, the vitreous gel is removed and the membrane is peeled from the retinal surface.