Features include a thickening of the nerve fiber layer, a serrated appearance to the surface of the retina just beneath a thickened layer of glial tissue at the retinal-vitreous interface. Prevention
There is no good evidence for any preventive actions, since it appears this is a natural response to aging changes in the vitreous. It has been estimated that Posterior vitreous detachment (PVD) occurs in over 75 percent of the population over age 65, that PVD is essentially a harmless condition (although with some disturbing symptoms), and that it does not normally threaten sight. However, since epiretinal membrane appears to be a protective response to PVD, where inflammation, exudative fluid, and scar tissue is formed, it is possible that NSAIDs may reduce the inflammation response. Usually there are flashing light experiences and the emergence of floaters in the eye that herald changes in the vitreous before the epiretinal membrane forms. Treatment
Surgeons can remove or peel the membrane through the sclera and improve vision by 2 or more Snellen lines. Usually the vitreous is replaced at the same time with clear (BSS) fluid, in a vitrectomy. Surgery is not usually recommended unless the distortions are severe enough to interfere with daily living, since there are the usual hazards of surgery, infections, and a possibility of retinal detachment. More common complications are high intraocular pressure, bleeding in the eye, and cataracts, which are the most frequent complication of vitrectomy surgery. Many patients will develop a cataract within the first few years after surgery.
In fact, the visual distortions and diplopia created by cataracts may sometimes be confused with epiretinal membrane. Epidemiology
This ocular pathology was first described by Iwanoff in 1865, and it has been shown to occur in about 7% of the population. It can occur more frequently in the older population with postmortem studies showing it in 2% of those aged 50 years and 20% in those aged 75 years. Culture
In 1996, Spalding Gray (June 5, 1941 – ca. January 10, 2004), an American actor, screenwriter and playwright, released Grays Anatomy, a film monologue describing his experiences dealing with a macular pucker and his decision to undergo surgery. In the 2011 film Paul, Ruth had Epiretinal membrane complicated by macular edema in her left vitreous cavity. See also
Eye surgery

References
Additional references
de Wit GC (2007). "Retinally-induced aniseikonia". Binocul Vis Strabismus Q. 22 (2): 96–101. PMID 17688418. Benson WE, Brown GC, Tasman W, McNamara JA (1988). "Complications of vitrectomy for non-clearing vitreous hemorrhage in diabetic patients". Ophthalmic Surg. 19 (12): 862–4. PMID 3231410. Suami M, Mizota A, Hotta Y, Tanaka M (2007). "Pattern VEPs before and after idiopathic epiretinal membrane removal". Doc Ophthalmol. 114 (2): 67–73. doi:10.1007/s10633-006-9039-4. PMID 17216518. S2CID 22039065. Dev S, Mieler WF, Pulido JS, Mittra RA (1999). "Visual outcomes after pars plana vitrectomy for epiretinal membranes associated with pars planitis". Ophthalmology. 106 (6): 1086–90. doi:10.1016/S0161-6420(99)90247-6. PMID 10366075. Johnson MW (2005). "Perifoveal vitreous detachment and its macular complications". Trans Am Ophthalmol Soc. 103: 537–67. PMC 1447588. PMID 17057817. External links

Macular Pucker Resource Guide from the National Eye Institute (NEI).