Changes in the macula – the central part of the retina responsible for detailed, central vision – can lead to serious visual distortion and blurring. Two of the most common macular conditions are macular holes and epiretinal membranes. Though they affect the same area of the eye, they differ in cause, symptoms, and treatment.
At the ELZA Institute in Zurich, we specialize in diagnosing and treating these macular disorders using advanced imaging, surgical techniques, and patient-centered care.
The macula is the central part of the retina and allows you to see fine details such as reading text, recognizing faces, or driving. Damage or traction in this area can lead to loss of central vision, while peripheral vision usually remains unaffected.
A macular hole is a small break or defect in the macula. It can develop due to age-related changes in the vitreous – the gel-like substance inside the eye. As the vitreous shrinks and pulls away from the retina (a process called posterior vitreous detachment, or PVD), it may cause traction strong enough to create a hole.
Symptoms of a macular hole may include:
Macular holes do not heal on their own and typically require surgical repair to restore vision.
An epiretinal membrane – also known as macular pucker or cellophane maculopathy – is a thin layer of scar-like tissue that forms on the surface of the macula. This membrane may contract and distort the retinal surface, leading to visual symptoms.
ERM often develops slowly and can be mild. In many cases, no immediate treatment is needed, but when vision becomes impaired, surgery can improve visual function.
At ELZA, we use high-resolution optical coherence tomography (OCT) to image the macula in fine detail. This allows us to distinguish between macular holes, epiretinal membranes, and other macular disorders. Accurate diagnosis is essential in deciding whether surgical intervention is needed and in selecting the appropriate approach.
Amsler grid – on screen or on paper (A), or as seen by people with macular disease (B).
For both macular holes and significant epiretinal membranes, the standard treatment is vitrectomy – a microsurgical procedure in which the vitreous gel is removed. During surgery:
Surgery is typically performed as a day procedure and has a high success rate, especially when conducted early. Postoperative positioning (face-down) may be recommended in some macular hole cases to help the gas bubble press against the retina.
If you’re experiencing visual distortion, difficulty reading, or changes in your central vision, don’t delay evaluation. Macular disorders can often be treated successfully – especially when caught early.
Book your consultation at ELZA Institute and take the first step toward clearer vision.
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