Epiretinal membrane or macular pucker is a disease of the eye in response to changes in the vitreous humor or more rarely, diabetes. Sometimes, as a result of immune system response to protect the retina, cells converge in the macular area as the vitreous ages and pulls away in posterior vitreous detachment (PVD). PVD can create minor damage to the retina, stimulating exudate, inflammation, and leucocyte response. These cells can form a transparent layer gradually and, like all scar tissue, tighten to create tension on the retina which may bulge and pucker, or even cause swelling or macular edema. Often this results in distortions of vision that are clearly visible as bowing and blurring when looking at lines on chart paper (or an Amsler grid) within the macular area, or central 1.0 degree of visual arc. Usually it occurs in one eye first, and may cause binocular diplopia or double vision if the image from one eye is too different from the image of the other eye. The distortions can make objects look different in size (usually larger = macropsia), especially in the central portion of the visual field, creating a localized or field dependent aniseikonia that cannot be fully corrected optically with glasses. Partial correction often improves the binocular vision considerably though. In the young (under 50 years of age), these cells occasionally pull free and disintegrate on their own; but in the majority of those affected (over 60 years of age) the condition is permanent.
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).