Vision

The Epiretinal Membrane of the Eye



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"The Epiretinal Membrane of the Eye"
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If you are young and discovered that one of your eye has blur vision, you probably has got epiretinal membrane, also known as macular pucker. ERM is seen in old people of age 70 and above and is thus very rarely seen in young adults. If you went for your normal eye checkup by using only one eye to see certain wordings/letters and noticed that one eye is causing the blur vision, you could have ERM. Sometimes you can feel a cellophane type film at the back of the eyeball.

There is usually no known cause for ERM. However, it is basically caused by an injury to the affected eye. It could also be caused by trauma, diabetic issues. There is currently no cure or medication for ERM. The option is either surgery or nothing at all.

Of course you could go for a second opnion from another eye specialist. The eye doctor will usually recommend surgery when the affected eye has a degree higher than 18 and especially since you are in your thirties where recuperation and full recovery has a higher chance and to do it as soon as possible since the condition may deteriorate.

If your eyesight is about 6/30 (perfect eyesight is 6/6) for the affected eye, it is advisble to ask for further monitoring one month, two month and three month to come to a total of six months monitoring. If the condition remain at about 6/30...sometimes it depends on how hard you try at the letters and at different angles... and the doctor cannot detect any difference from the light microscope asfrom the first observation, the condition should be stable enough and does not require any surgery at all. You should still monitor six months down the road or longer period or when you feel that the condition has worsened.

The reason why I advise against surgery are many. The surgery involves vitrectomy together with the epiretinal membrane (ERM) peeling. However, to do this, the vitreous gel in the eye has to be cut up and sucked out before the surgeon could reached for the membrane with the fine tweezers. This operation is a short operation completed in about three hours. The vitreous gel however cannot be replaced since it has been cut up, instead a saline salt solution was used in place of it. There are chances of eye infection and risk involved as in any operation. On top of that, there are high chances of encountering cataracts after the surgery as seen in patients who has undergone this surgery. Moreover, there are many cases that the eyesight did not improve at all. The reason was because the film(ERM) contracts and wrinkled the macular region at the back of the eye. It is this wrinkling that causes the blur vision, not the film. And removal of the film (ERM) does not warrant full recovery as the macular has already been wrinkled. Of course, the surgeon will try to 'flatten' the wrinkled portion but again the word is 'try'. Why pay $7000-$10000 for a surgery that removes your natural vitreous gel and does not guarantee improvement in the eyesight when you could actually live with it. The surgeon will say the chances is that your eyesight will at least improve by half i.e. from 6/40 to 6/20 at least and say you still have a long way to go and the the condition will only worsen and what if your other eye also gets it...

This scar membrane has a minute chance of being dislodged from its original location so that the macular is no longer covered by it and hopefully the macular can then naturally flattens out to re-focus your images sharply as before. Word of advice - watch your ways.

 

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