Question: Dear Dr. Misra,

Thanks a lot for your earlier reply to my questions in the thread

https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=389732

I have done ERM surgery to my right eye in end May and now is two weeks after. Visual acuity has improved a bit from about 20/30 pre-operation to 20/20 - . Distortion (eg, larger image, wavy lines, wavy edges of objects, spatial and location disparity with left eye ) no apparent improvement. Entoptic phenomenon (image of branches which look like blood vessels in the eye) Intraocular pressure has fluctuated from 6 the day after surgery to 21 yesterday and so doctor has prescribed eye drop to lower the pressure.

Just before right eye surgery, my left eye started to show symptoms of ERM (floating feeling for some images, like having cellophane in front) and OCT in early XXXXXXX confirmed ERM with fovea thickness of 318. (My earlier OCT done in end March this year show normal result for left eye without ERM findings

My questions
1.     What can I expect about the improvement to my vision acuity and distortion as well as any possible complications in the next two or three months and the longer term?
2.     Why is entoptic phenomenon still present after the surgery?
3.     Why my left eye also has ERM so soon after onset of the disease in the right eye and also quickly progress to a fovea thickness of 318? I am worried that there are other underlying pathology or eye disease causing these conditions in both eyes.


Grateful for your expert advice. Many thanks in advance.

Dear Dr. Misra,

Thanks a lot for your earlier reply to my questions in the thread

https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=389732

I have done ERM surgery to my right eye in end May and now is two weeks after. Visual acuity has improved a bit from about 20/30 pre-operation to 20/20 - . Distortion (eg, larger image, wavy lines, wavy edges of objects, spatial and location disparity with left eye ) no apparent improvement. Entoptic phenomenon (image of branches which look like blood vessels in the eye) Intraocular pressure has fluctuated from 6 the day after surgery to 21 yesterday and so doctor has prescribed eye drop to lower the pressure.

Just before right eye surgery, my left eye started to show symptoms of ERM (floating feeling for some images, like having cellophane in front) and OCT in early XXXXXXX confirmed ERM with fovea thickness of 318. (My earlier OCT done in end March this year show normal result for left eye without ERM findings

My questions
1.     What can I expect about the improvement to my vision acuity and distortion as well as any possible complications in the next two or three months and the longer term?
2.     Why is entoptic phenomenon still present after the surgery?
3.     Why my left eye also has ERM so soon after onset of the disease in the right eye and also quickly progress to a fovea thickness of 318? I am worried that there are other underlying pathology or eye disease causing these conditions in both eyes.


Grateful for your expert advice. Many thanks in advance.

Dear Dr Misra,

Thanks for your reply.

Is entoptic phenomenon due to the ERM? I wonder why entoptic phenomenon is still present after ERM surgery. Or is entoptic phenomenon due to other disease or pathology? Is it worrisome?

In my case my ERM developed rapidly in right eye ( operated eye) and now ERM is also developing in my left eye. Is it common to develop ERM for both eyes at nearly the same time? Do I need to worry about the pathology or any other eye disease underlying? Do I need to ask my doctor to do any other tests or examination? I have only done OCT for both my right and left eyes.

Given my rapid progression of ERM in my right eye before the surgery, does it have implications on ERM recurrence? What can be done if it really recur some time in future? Do the surgery again?

Thanks in advance for your expert advice.

Dear Dr Misra,

Thanks for your reply.

Is entoptic phenomenon due to the ERM? I wonder why entoptic phenomenon is still present after ERM surgery. Or is entoptic phenomenon due to other disease or pathology? Is it worrisome?

In my case my ERM developed rapidly in right eye ( operated eye) and now ERM is also developing in my left eye. Is it common to develop ERM for both eyes at nearly the same time? Do I need to worry about the pathology or any other eye disease underlying? Do I need to ask my doctor to do any other tests or examination? I have only done OCT for both my right and left eyes.

Given my rapid progression of ERM in my right eye before the surgery, does it have implications on ERM recurrence? What can be done if it really recur some time in future? Do the surgery again?

Thanks in advance for your expert advice.

Dear Dr Misra,

Thanks much for your advice. What about the chance of recurrence for my operated eye? My doctor said with internal limiting membrane removed, the chance of recurrence is very low. He also advised me to sleep on my side rather than sleeping on my back to avoid fibres/tissues in my eye depositing at the macular area. My question/conscern is that despite low chance of recurrence, , what happen if it really recurs? Do surgery again?

Will I have a higher chance of macular hole after this ERM surgery? Does the fact that I had ERM surgery will make it more complicated to treat macular hole if it does arise in future?

With ERM surgery done, apart from cataract, in the longer term, will I have a greater chance of other eye disease such as retinal detachment, glaucoma, machular degeneration etc.?

I had complete vitrectomy for my RE. But I still see many floaters (transparent dots and lines) especially when the background is bright or light colour. Why?

Thanks again for your advice

Dear Dr Misra,

Thanks much for your advice. What about the chance of recurrence for my operated eye? My doctor said with internal limiting membrane removed, the chance of recurrence is very low. He also advised me to sleep on my side rather than sleeping on my back to avoid fibres/tissues in my eye depositing at the macular area. My question/conscern is that despite low chance of recurrence, , what happen if it really recurs? Do surgery again?

Will I have a higher chance of macular hole after this ERM surgery? Does the fact that I had ERM surgery will make it more complicated to treat macular hole if it does arise in future?

With ERM surgery done, apart from cataract, in the longer term, will I have a greater chance of other eye disease such as retinal detachment, glaucoma, machular degeneration etc.?

I had complete vitrectomy for my RE. But I still see many floaters (transparent dots and lines) especially when the background is bright or light colour. Why?

Thanks again for your advice

Dear Dr Misra,

Thanks much for your expert advice which is very informative and useful. For floaters, do you mean that my floaters in the operated eye will eventually disappear in a few months? Or will floaters continue to persist permanently despite having performed vitrectomy?

I wonder whether having had ERM is associated with a higher chance of macular degeneration or glaucoma in future? Any research or studies on this? Can you share your clinical experience also?

Thanks much for your advice.

Dear Dr Misra,

Thanks much for your expert advice which is very informative and useful. For floaters, do you mean that my floaters in the operated eye will eventually disappear in a few months? Or will floaters continue to persist permanently despite having performed vitrectomy?

I wonder whether having had ERM is associated with a higher chance of macular degeneration or glaucoma in future? Any research or studies on this? Can you share your clinical experience also?

Thanks much for your advice.