What is it?
The retina is a light-sensitive layer of tissue that lines the inner surface of the eye. It captures light and sends signals to the brain that result in vision. The macula is a very small area at the centre of the retina. It is the macula that is responsible for your pinpoint vision, allowing you to read, sew or recognise a face.
Epiretinal Membrane
An epiretinal membrane is a layer of scar tissue that grows on the macula. It develops because of the vitreous gel in the eye shrinking as we age. As it pulls away from the macula, scar tissue develops over the macula. This scar tissue causes a wrinkle in the macula, and distorts the central vision.
Macular Hole
As we age, the jelly-like vitreous body in the middle of the eye shrinks and pulls away from the macula. Occasionally the vitreous gel sticks to the macula rather than pulling away. As it shrinks, it stretches the macula. The macula eventually tears, forming a hole. You may notice blurring or loss of your central vision when this occurs.
Treatment
Generally both these conditions require surgery if we want to improve vision.
Vitrectomy
This is the commonest procedure for epiretinal membranes and macular holes. It is a day surgery procedure, similar to cataract surgery. Dr Sharma removes some of the fluid and vitreous gel from the inside of the eye. The membrane on the macula that is causing the problem is carefully and precisely removed. Following this, air or a gas bubble is infused into the eye to support the retina during recovery.
Occasionally we may need additional procedures in the same surgery, such as combined cataract surgery.
After surgery you may need to keep your head in a certain position for a few days. We will give you detailed instructions to get the best results.
When should I have surgery?
Epiretinal Membrane
Vitrectomy for this condition is often dependent on how blurred and distorted your vision is, and how much it affects your daily activities, especially driving or reading. In this condition, you have to decide when it’s troubling you enough that you want to proceed with surgery for the benefits it may provide. We do advanced imaging including OCT to determine whether you are eligible for, and will benefit from, the operation.
Macular hole
There is evidence that the earlier a macular hole is treated, the better the end outcome of your vision is. Certain types, when caught early, are suitable for an injection of a medication into the eye rather than surgery. The majority of patients require surgery for this condition.
Dr Sharma will go through in detail with you the risks, benefits and limitations of any management option, including waiting versus proceeding with surgery.