Vitreomacular Adhesion: What Happens?

Vitreomacular adhesion (VMA) can be serious, but it’s treatable.

It involves two parts of your eye. One is the vitreous, or the “jelly” part that fills the eyeball. The other is the macula, a small area on the retina responsible for the central part of your field of vision.

The macula is important in seeing fine details, such as when you're reading. It’s considered the most sensitive part of the retina.

As we grow older, the jelly in our eyes begins to shrink. That’s mainly because of age and regular wear and tear. It eventually pulls away from the retina. That’s the light-sensitive tissue on the back of your eye that includes the macula.

Sometimes the jelly doesn’t completely separate. It sticks -- or adheres -- to the macula. This is vitreomacular adhesion. It can hold on so strongly, it pulls on the macula (your eye doctor may call this “traction”). When that happens, it can affect vision -- what doctors call symptomatic VMA.

VMA usually happens in folks older than 50. It’s pretty common for those over 70. It’s more likely to happen to women than men and to people who are nearsighted.

It can lead to distorted or blurry vision. It rarely causes a permanent loss of sight.

 

Symptoms

If you have VMA:

  • Your vision could become less sharp.
  • You could have wavy vision, or things could look distorted.
  • You also could see things smaller than they actually are, which is called micropsia.

If any of these are happening, see your eye doctor right away.

Diagnosis

Your doctor will give you special eye drops to dilate your pupils and a complete eye exam.

Part of that will be something called optical coherence tomography (OCT). The test uses light to take pictures of your retina and map the layers of your eye.

Treatment

If your eye doctor says you have VMA but your symptoms aren’t severe, she may want to wait and see if your vision gets better by itself.

If things become serious, you have treatment options. The goal is to break the adhesion so that the vitreous no longer pulls on the macula.

Continued

One is surgery called a vitrectomy, which relieves the pulling on the macula by removing the jelly and replacing it with fluid or a temporary gas bubble.

After the surgery, you may be asked to lie facedown so the bubble or fluid floats to the back of your eye, lessening the pull and hopefully allowing any damage to the macula to get better.

How well your vision gets better depends on:

  • If you keep that face-down position while you’re healing
  • The amount of eye damage that you had
  • How long the damage was there

Another type of treatment is medication that’s injected into your eye. It can lead to the release of the adhesion between the vitreous and macula, beginning the process of healing.

Getting older has its challenges. Keeping your vision as sharp as possible is one of them. Regular eye exams can help spot early signs of vitreomacular adhesion.

WebMD Medical Reference Reviewed by Alan Kozarsky, MD on June 17, 2019

Sources

SOURCES:

American Academy of Ophthalmology: “What is Macular Degeneration?” “What is Optical Coherence Tomography?” “What Happens During OCT?” “Macular Hole Treatment.”

Prevent Blindness: “Symptomatic Vitreomacular Adhesion.”

American Society of Retina Specialists: "Vitreomacular Traction Syndrome.”

National Eye Institute.

National Institutes of Health: “Healthy Eyes.”

Carpineto, P. European Ophthalmic Review, March 2011.

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