Do Objects Look Distorted? Understanding Epiretinal Membrane, a Condition That Can Lead to Vision Loss
Many people dismiss symptoms such as seeing objects appear bent or letters look distorted as simple eye strain. However, these symptoms may be a sign that structural changes have occurred in the macula, the central part of the retina. One of the most common conditions associated with these changes is epiretinal membrane (ERM). Epiretinal Membrane (ERM)is.
Today, we will take a closer look at the causes, symptoms, diagnostic methods, treatment options, and postoperative prognosis of epiretinal membrane (ERM).
What Is Epiretinal Membrane (ERM)?
Epiretinal membrane (ERM) is a condition in which a thin fibrous membrane forms on the surface of the retina, especially over the macula, which is responsible for central vision.
The macula is a very important part of the retina that is responsible for sharp central vision, such as reading text and recognizing people's faces. When a thin membrane forms in this area and begins to contract, it can pull on the retina, causing wrinkles and distortion on the retinal surface.
As a result, symptoms such as reduced vision or seeing objects appear distorted or wavy may develop.
Simply put, it can be understood as a condition in which a thin membrane forms on the retina, which should normally be smoothly spread out, and contracts, causing the retina to wrinkle.
Causes of Epiretinal Membrane (ERM)
Epiretinal membrane can be broadly classified into Idiopathicand Secondaryare classified into
1. Idiopathic Epiretinal Membrane (ERM)
It is the most common type and occurs without any specific cause.
It is mainly associated with age-related changes in the vitreous gel inside the eye, and is unlikely to be caused by lifestyle habits such as smartphone use or eating certain foods.
Therefore, there is no need to worry excessively that this condition was caused by poor eye care or something you did wrong.
2. Secondary Epiretinal Membrane (ERM)
It occurs as a result of other eye diseases or changes within the eye.
The main causes are as follows.
- Diabetic Retinopathy
- Retinal Vascular Diseases
- Ocular Inflammation
- Eye Trauma
- Retinal Tear
- Retinal Detachment
- Inflammatory reactions following certain eye surgeries
Regardless of the cause, the decision on whether treatment is necessary is based on the degree of retinal distortion, the extent of vision loss, and the level of difficulty experienced in daily life.
Main Symptoms of Epiretinal Membrane (ERM)
The representative symptoms of epiretinal membrane are as follows.
Decreased Vision
In the early stages, it may simply feel like your vision is blurry or less sharp than usual.
Metamorphopsia (Visual Distortion)
It refers to a phenomenon in which straight lines appear bent or distorted.
For example,
- For example, a door frame may appear bent or warped.
- For example, a window frame may appear bent or warped.
- For example, letters or text may appear distorted or warped.
- For example, the grid lines on a checkerboard or Amsler grid may appear bent or distorted.
These are some of the representative examples.
When it occurs in only one eye, some people may not notice the symptoms when using both eyes together.
Therefore, if letters or straight lines appear distorted in only one eye when you cover each eye alternately, it is advisable to undergo an ophthalmologic examination.
Diagnosis of Epiretinal Membrane (ERM)
Fundus Examination (Fundoscopy)
This is an examination in which the retina and macula are directly observed through the pupil.
The examination can identify the following changes.
- A shiny membrane on the retinal surface
- Traction of the macular blood vessels
- Presence of retinal folds (wrinkling of the retina)
Optical Coherence Tomography (OCT)
It is the most important examination for diagnosing retinal diseases.
Using light, cross-sectional images of the retina are obtained to assess the following information.
- Presence or absence of an epiretinal membrane
- Degree of retinal traction (how much the retina is being pulled)
- Changes in macular thickness
- Degree of structural distortion
It causes little to no pain, and because the examination is quick, it is very helpful for accurate diagnosis and follow-up monitoring.
Additional tests, such as fluorescein angiography, may be performed if necessary.
Epiretinal Membrane (ERM): Is Surgery Always Necessary?
To begin with the conclusion, Not all patients require surgery.
Even if an epiretinal membrane is present, in many cases vision loss is minimal and the condition shows little or no progression over many years.
In such cases, the condition is monitored through regular vision tests and OCT examinations.
Many patients wonder whether eye drops or oral medications can treat the condition, but it is difficult to remove an already formed epiretinal membrane with medication alone.
Cases Requiring Surgical Treatment
Surgery may be considered in the following situations.
- Vision decreases
- When objects appear severely distorted or warped
- When reading becomes difficult
- When driving becomes difficult or uncomfortable
- When the condition interferes with work performance
- When retinal distortion is found to be progressing on OCT examinations
Surgery is generally performed through a procedure called vitrectomy. Vitrectomy and Epiretinal Membrane PeelingIt is performed through vitrectomy and epiretinal membrane peeling.
The goal of treatment is to remove the epiretinal membrane that is pulling on the retina and prevent further damage.
What about vision recovery after epiretinal membrane surgery?
Vision and visual distortion may improve after surgery, but symptoms do not completely disappear in every patient.
Although removing the epiretinal membrane reduces the traction pulling on the macula, retinal folds or some structural distortion may remain if the condition has been present for a long time.
Therefore, vision does not usually improve immediately after surgery. Instead, it gradually recovers over time as the retina stabilizes and heals.
In particular, if the disease has been present for a long time or retinal distortion is severe, the degree of visual recovery may be limited.
Importantly, the goal of surgery is not to restore the retina perfectly to its original state, but rather to preserve as much of the current vision as possible and prevent further damage.
Can Epiretinal Membrane (ERM) Be Prevented?
There is currently no known way to completely prevent epiretinal membrane (ERM).
Because most cases are related to the aging process, it is difficult to prevent the condition or stop its progression through lifestyle habits alone.
However, the following measures may be helpful.
- Regular eye examinations
- Monitor for changes in vision
- Check for visual distortion by covering one eye at a time
- Seek prompt medical attention if any abnormal symptoms occur.
- Monitor the condition with OCT examinations
Epiretinal membrane is not simply a result of eye strain, but a condition caused by structural changes in the macula. If you experience decreased vision or symptoms such as objects appearing distorted, it is important not to ignore them and to undergo a proper eye examination. In particular, early diagnosis and regular follow-up play an important role in determining the appropriate timing of treatment and preserving vision.
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