Dr. Walter Moscoso, MD.
Fellowship-trained retina specialist

The inner wall of the back of the eye is lined by a layer of tissue called the retina. The center of vision is served by the center of the retina, which is the macula. The macula is used to look at someone dead in the eye, for reading and very fine detailed work. The center of the eyeball is filled with a gel-like substance called vitreous. The vitreous undergoes changes with age that allows a sheet of cells to grow on top of your retina. The sheet of cells is called an epiretinal membrane (ERM). This can cause a decrease of vision. As light enters in the eye through the front, it penetrates the cornea and the lens and these structures focus the light on to the macula. In order for the macula to see the light, the light must penetrate this sheet of cells (ERM) which grows on the surface of the macula. The ERM acts as a filter to the light and may decrease vision on this basis.

The other way that blurred vision can result is by the pulling of this sheet of cells upon the surface of the retina, causing it to distort or become "wrinkled." An ERM has the appearance of wrinkled cellophane paper and consequently this condition is sometimes called cellophane/wrinkling retinopathy. The distortion in the retina can cause blurred vision, but it can also cause distortion in images that your eye perceives. Sometimes there can be swelling that occurs in the retina from this distortion. When the vision is significantly affected by this membrane the surgeon may recommend "a membrane peeling." The surgery consists of an operation being performed called a vitrectomy. The vitrectomy removes part of the vitreous that is inside the middle of the eye. It is then followed by peeling away of the membrane that is living on the surface of the macula. It is performed under the microscope and a variety of specialized microscopic instruments are used to remove or peel the membrane from the surface of the macula. This usually results in improved visual acuity and may also resolve much of the distortion that people may experience as a result of this condition.

Learn more about Retinal Vein Occlusions and Macular Holes.