Vitreomacular Traction

Symptoms | Treatments

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What is

Symptoms

How to prevent

Causes and Risk Factors

Diagnosis

Treatment

Post-Surgery

What is - Vitreomacular Traction

Vitreomacular traction (VMT) is a condition in which the vitreous (the clear gel-like substance in the eye) pulls abnormally on the retina (the innermost layer of the eye responsible for sensing light and forming visual images) and the macula (the region of the retina that is most important for central vision). When this distorts and stretches the macula, it can cause symptoms of blurred central vision and distortion of images.

Symptoms of Vitreomacular Traction

Symptoms of vitreomacular traction (VMT) include a gradual worsening of central vision or distortion of images (seeing straight lines as abnormally curved or "wavy").

Vitreomacular Traction - How to prevent

There are no proven preventive measures.

Vitreomacular Traction - Causes and Risk Factors

When we are young, the clear gel-like vitreous in the eye is attached to the retina and macula. As we age, at some point in our lives, the vitreous will usually detach from the macula and the posterior retina, which is called a posterior vitreous detachment (PVD). PVD can cause symptoms of floaters and flashes for a few weeks, but in most cases does not cause any major problems. However, in a small proportion of patients, the vitreous remains stuck on the macula during the process of PVD, and pulls abnormally on the macula, causing VMT with distortion and stretching of the macula.

Vitreomacular traction

OCT scan showing VMT casuing distortion of the retina

Diagnosis of Vitreomacular Traction

The best way to diagnose the problem is through an eye examination. Your ophthalmologist will administer eye drops to enlarge (dilate) the pupils temporarily so that they can examine the retina and macula. Usually, you will also undergo an optical coherence tomography (OCT) scan, which will provide a detailed cross-sectional image of the macula, which confirms the diagnosis of VMT. An OCT scan is very fast and convenient. The light beam used for scanning is painless, and unlike X-rays, does not involve any radiation.

Treatment for Vitreomacular Traction

Vitreomacular traction (VMT) does not always require treatment. In many cases, VMT is mild, or gets better on its own, as the vitreous completes its separation from the macula. However, in some cases, if the VMT is severe with significant symptoms, causes a macular hole, or does not get better on its own, then surgery may be required.

Surgery for VMT usually involves a vitrectomy, a form of "keyhole" surgery that uses small instruments to enter inside the eye to remove the vitreous gel. In some cases, a gas bubble is injected into the eye at the end of surgery, to replace the vitreous and prevent it from pulling on the retina gel.

VMT can be successfully relieved with surgery in the large majority of cases. Surgery helps to stabilise and prevent deterioration of vision, and in most cases also improves symptoms of blurred vision and distortion. The success of improving the vision varies from person to person and ranges from 60% to 80%. Some distortion may persist, depending on how long the symptoms and VMT have been there for, prior to surgery.

Post-Surgery Care for Vitreomacular Traction

Following surgery, if a gas bubble was injected, your doctor may instruct you to maintain a specific head position (usually face-down) for up to two weeks after surgery, and you would also need to avoid air travel until the gas bubble dissolves. The eye will refill naturally with fluid over time.

Eye drops will be dispensed after surgery and should be used as prescribed. Good eye hygiene and avoiding injury to the operated eye are important to reduce infection and problems after surgery.