Epiretinal Membranes and Macular Holes
When light enters your eye’s lens, cells within your retina, a thin tissue layer on the back wall of your eye, convert it into electrical signals. These signals travel along the optic nerve to your brain, where they’re converted into images. At the center of the retina is the macula, which is responsible for tasks involving fine vision and attention to detail, such as reading or seeing faces.
At Retina Consultants of Charleston, we treat multiple conditions and concerns involving the retina, macula, and vitreous. Two conditions we work on are epiretinal membranes, or macular puckers, and macular holes. While they may sound similar, their only connection is that both target your macula. While these conditions may not require any treatment, if they worsen, you may lose your central vision, and surgery may be required.
What Is An Epiretinal Membrane?
An epiretinal membrane, or macular pucker, involves a thin, semi-transparent layer of scar tissue growing over the macula. This scarring clouds your vision and makes it difficult to see, although it may not be immediate. As the pucker grows and spreads, it may contract, and this can cause the retina to become very “puckered,” or wrinkled.
While you may have no interference with your ability to see, your vision can become distorted and blurred. But typically, these membranes only affect central vision and leave peripheral vision intact, and total blindness typically doesn’t develop. And while rare, a macular pucker can develop into a macular hole.
What Is A Macular Hole?
When we refer to a macular hole, that’s just what it is, a hole in the macula. A rare condition, these openings typically develop after the macula’s been stretched or pulled. You may not notice any symptoms, especially if your other eye is healthy.
Should you experience any symptoms, they may start slowly. As the hole develops, your peripheral, or side vision remains normal, but the center will be blurry, and visual details may become fuzzy. While a pucker narrows your scope of vision, a hole doesn’t change the outside border, but instead, takes away your vision from the inside out.
Macular holes are similar to another retinal condition, age-related macular degeneration (AMD). They both have similar symptoms and affect people over the age of 60. But they’re two unique conditions, and your ophthalmologist can provide a proper diagnosis.
What Causes Epiretinal Membranes and Macular Holes?
While epiretinal membranes and macular holes are different conditions, aging plays a role in the development of both. Epiretinal membranes typically develop due to natural changes with the vitreous, or vitreous gel or humor, a clear gel making up most of your eye’s total volume. The vitreous gel maintains the eye’s shape and provides a clear pathway for light to reach the retina.
Over time, the vitreous shrinks and loses its viscosity, or thickness, causing it to stick to and pull on the retina. While you may not experience any vision problems, this pulling can damage the retinal and macular tissues. Gradually, cellular debris accumulates in the vitreous, forming an epiretinal membrane.
Epiretinal membranes can affect anyone, even if you’ve never had eye or vision issues. But they may also be associated with underlying problems, such as eye disease or trauma. Macular holes also stem from normal aging, as the pulling and stretching of the vitreous on the retina can cause holes to develop.
Diagnosing And Treating Epiretinal Membranes And Macular Puckers
For both of these conditions, you will require a comprehensive dilated eye exam. With this exam, your ophthalmologist applies special eye drops to widen your pupil to provide an unobstructed retinal view.
To diagnose epiretinal membranes, you can use an Amsler grid, a simple paper tool you can use at home every day. This grid helps you to determine if you have specific types of visual distortions, such as straight lines appearing wavy, which may indicate macular issues. For macular holes, your ophthalmologist may use optical coherence tomography (OCT). With this painless, non-invasive test, your eyes are dilated, and then infrared light waves are used to capture cross-sectional retinal images.
How Are Epiretinal Membranes And Macular Holes Treated?
Most often, these conditions don’t cause any vision problems, and as such, treatment may not be needed. But you will need to have your vision regularly checked to monitor the health of the macula. However, if epiretinal membranes significantly interfere with your vision, you may require a vitrectomy, a surgical procedure in which part or all of your vitreous is removed.
If macular holes hinder your vision, the (only) treatment option involves the implantation of a bubble inside your eye, which pushes the hole to keep it closed. Should it be successful, you can expect your vision to return slowly, but if not, the hole may grow over time.
Schedule a Consultation for Epiretinal Membranes and Macular Holes in South Carolina
Do you have any questions about epiretinal membrane and macular hole treatment options? If so, contact us at Retina Consultants of Charleston for an appointment.