The retina is a thin layer of nerve tissue that lines the back of the eye. When light from an object is focused onto the retina, information is sent to the brain and an image of the object is formed. The macula is the most sensitive portion of the retina and is responsible for fine-detail vision such as reading.
An epiretinal membrane is a layer of nearly transparent tissue that can form on the surface of the macula. Most often, this occurs due to age, but sometimes it can result from trauma or inflammation. The membrane can contract and lead to wrinkling or puckering of the underlying macula. This may result in painless distortion and blurring of vision. A change in eye glasses cannot overcome this physical change.
Visual change from a macular pucker may not be noticeable to the patient. This is because with both eyes open, we use the best information coming from both eyes to produce an image. It is sometimes only when we cover the better seeing eye that we become aware of a difference between the eyes. Often, the change in vision may only be detected at the eye doctor’s office when you are asked to view the eye chart with only one eye at a time.
If the macular pucker is mild and does not affect vision, the situation can be monitored without intervention. In addition, patients can test themselves at home by reading with one eye at a time. First, cover your right eye and read a few lines with only your left eye open. Next, cover your left and read with only your right eye open. If you have significant blurring or distortion in either eye you should be evaluated by your eye doctor. When significant blurring or distortion occurs due to macular pucker, a surgical procedure called a vitrectomy can be utilized to remove the membrane and relieve the wrinkling of the macula. A successful procedure can limit further worsening and in most cases improve central vision.