What is premacular fibrosis?

Quite simply it is wrinkling and thickening of the retina caused by a membrane that grows on the surface of the retina. The retina is normally smooth and flat like a sheet of paper, but in this condition it becomes more like a corrugated iron roof. In most cases the membrane forms after ageing changes occur in the vitreous gel of the eye. Occasionally, the membrane forms after other eye diseases. Premacular fibrosis is completely different to macular degeneration.

Above: The left macula affected by a white fibrotic membrane causing distortion and thickening of the retina

What are the symptoms of premacular fibrosis?

The wrinkling causes distortion of vision and the thickening makes things blurry. Confusingly, these symptoms are very similar to those experienced by people with macular degeneration as well.

How is the condition diagnosed?

Typically the eye doctor will measure the vision, examine the eye, and usually carry out a test known as OCT. Another test, fluorescein angiography, may also be done. OCT scans show a cross section of the retina.

How is premacular fibrosis treated?

The only way it is treated is by surgery. An operation known as vitrectomy is carried out. Using small incisions in the white part of the eye, tiny instruments are used to remove the membrane from the retina. It takes about an hour and is done with local anaesthetic, mostly as a day only procedure. Sometimes sutures are used, sometimes the surgery may be sutureless. The surgery is routine and very safe. Rarely complications can occur, such as retinal tears or detachments. These are usually treated at the time but occasionally do not appear until later on. Further treatment would be needed in that eventuality. Late complications can include formation of cataract,  regrowth of the membrane, macular oedema. Severe problems such as infection and bleeding are fortunately very uncommon.

What can I expect from surgery?

The eye will be initially red and somewhat sore. Most of this is resolved by six weeks. You will be required to use eyedrops during this time. Recovery of vision is very slow. It may take 6-12 months for vision to be maximized following the surgery. It takes this long for the retina to remodel itself. Eyesight normally returns halfway back to normal from wherever the starting point was.