Published: 16 October 2023

A wrinkle on the retina -- which is also known as an epiretinal membrane (ERM) or a macular pucker -- is a thin, translucent tissue that develops on the surface of the retina. The retina is the inner layer that lines the inside of the back of the eye and is responsible for converting the light image into an electrical impulse that is then transmitted to the brain. An epiretinal membrane that forms on the retina goes unnoticed by the patient many times, and is only noticed during a dilated eye exam by an eye doctor. Epiretinal membranes can become problematic if they are overlying the macula, which is the part of the retina that is used for sharp central vision. When they become problematic they can cause distortion of your vision, causing objects that are normally straight to look wavy or crooked. Causes of a wrinkle on the retina The most common cause is age-related due to a posterior vitreous detachment, which is the separation of the vitreous gel from the retina. The vitreous gel is what gives the eye its shape, and it occupies the space between the lens and the retina. When the vitreous gel separates from the retina, this can release cells onto the retina's surface, which can grow and form a membrane on the macula, leading to an epiretinal membrane. ERMs can also be associated with prior retinal tears or detachments, prior eye trauma, or eye inflammation. These processes can also release cells onto the retina, causing a membrane to form. Risk factors Risk for ERMs increases with age, and males and females are equally affected. Both eyes have ERMs in 10-20% of cases. Diagnostic testing Most ERMs can be detected on a routine dilated eye exam. An optical coherence tomography (OCT) is a noninvasive test that takes a picture of the back of the eye. It can detect and monitor the progression of the ERM over time. Treatment and prognosis Since most ERMs are asymptomatic, no treatment is necessary. However, if there is significant visual distortion from the ERM or significant progression of the membrane over time, then surgical intervention is recommended. There are no eye drops, medications, or nutritional supplements to treat or reverse an ERM. The surgery is called a vitrectomy with membrane peeling. The vitrectomy removes the vitreous gel and replaces it with a saline solution. The epiretinal membrane is then peeled off the surface of the retina with forceps. Surgery has a good success rate and patients in general have less distortion after surgery. Article contributed by Dr. Jane Pan

Published: 09 October 2023

Costume Contacts Can Make Halloween a Scary Time Fall brings a lot of fun, with Halloween playing a big part in that. But did you know that some Halloween practices could harm your vision? Take Halloween contacts, for instance. Costume contacts vary widely, with everything from monster eyes to goblin eyes to cat eyes to sci-fi or glamour looks. They can be just the added touch you need for that perfect costume. However, some people do not realize that the FDA classifies contact lenses as medical devices that can alter cells of the eye and that can damage the eye if they are not fit properly. Infection, redness, corneal ulcers, hypoxia (lack of oxygen to the eye) and permanent blindness can occur if the proper fit is not ensured. The ICE, FTC, and FDA are concerned about costume contacts from the illegal black market because they are often unsafe and unsanitary. Proper safety regulations are strictly adhered to by conventional contact lens companies to ensure that the contact lenses are sterile and packaged properly and accurately. Health concerns arise whenever unregulated black-market contacts come into the US market and are sold at flea markets, thrift shops, beauty shops, malls, and convenience stores. These contacts are sold without a prescriber's prescription, and they are illegal in the US. There have also been reports of damage to eyes because Halloween spook houses sometimes ask employees to share the same pair of Halloween contact lenses as they dress up for their roles. So the take home message is, have a great time at Halloween, and enjoy the flare that decorative contacts can bring to your costume, but get them from a reputable venue using a proper legal prescription. Don't gamble with your eyes for a night of Halloween fun!