What Happens if VMA Is Left Untreated?

If you have symptoms of vitreomacular adhesion (VMA) but you don’t have it treated, you could end up with permanent vision problems that can affect your ability to read, drive, or recognize faces.

If you have VMA, your vitreous -- that’s the gel-like substance in the middle of your eyeball -- hasn’t separated properly from the retina as it shrinks naturally with age. This causes a pull on the retina that can affect your vision.

What Can Happen

The damage that pull brings can distort and blur what you see. It could even cause permanent vision loss.

Your doctor may recommend surgery or an injection before it causes lifelong damage.

Thankfully, the symptoms often go away on their own. The vitreous separating from the retina takes time. That’s why doctors generally recommend a wait-and-see strategy when they find VMA.

If you’re lucky, you’ll have nothing more serious than “floaters” or “flashes” when your vitreous has finished its normal, age-related shrinking.

If the problem hangs around, the force of your vitreous pulling away can damage the central part of the retina, which is called the macula. That’s a small oval-shaped area of your retina that you use to read and recognize faces. Basically, it does detail work.

What It Leads To

Retinal tears: The vitreous contains millions of fibers attached to your retina. As it detaches from the retina, it can create tears or holes. If a tear happens near a blood vessel, blood that spills into your vitreous can hamper your vision.

Retinal detachment: Half of retinal tears from VMA lead to a retinal detachment. That’s when your retina pulls away from the wall at the back of your eye. Typically, you’ll first notice a shadow at the edge of what you see. That shadow can move to the center. Without prompt surgery or laser treatment, it can cause permanent vision loss.

Macular pucker: Scar tissue on the macula “puckers” or wrinkles as it shrinks. If you have a macular pucker, your central vision may be distorted or blurry. You may have trouble seeing fine details. You could see a gray area or blind spot in it. 

Macular hole: This is a small hole in the macula that can cause what you see to become blurred and distorted. This can make it tough to read or see fine details. It often starts gradually. But it can lead to permanent vision loss in the eye it’s in. It’s important to treat a macular hole early.

Macular edema: This is a buildup of fluid in your macula. It causes swelling or thickening, which can distort your vision.

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

Sources

SOURCES:

Sebag, J. Retina Today, April 2012.

Pritchard, E. Clinical Ophthalmology, published online Jan. 12, 2016.

Dimopoulos, S. British Journal of Ophthalmology, published online Oct. 23, 2014.

Matthew Wood, MD, Eye Surgical Associates, Lincoln, NE.

Association for Research in Vision and Ophthalmology 2014 annual meeting, Orlando, FL.

National Eye Institute: “Facts About Vitreous Detachment,” “Facts About Macular Edema,” “How is Macular Edema Diagnosed?” “Retina / Macular Edema,” “Retina/Macular Pucker,” “Macular Pucker Defined,” “Retina/Retinal Detachment,” “Retina/Macular Hole.”

American Academy of Ophthalmology: “What is Macular Edema?”  "Retina / Posterior Vitreous Detachment,” “What is Optical Coherence Tomography?” "Vitreomacular Traction Syndrome.”

Bascom Palmer Eye Institute: “Vitreoretinal Diseases.”

Wills Eye Hospital: “Macular Pucker.”

Cleveland Clinic: “What is Posterior Vitreous Detachment?”

U.S. National Library of Medicine: “Retinal Detachment.”

Royal National Institute of Blind People: “How does PVD change with time?”

American Society of Retina Specialists: “Posterior Vitreous Detachment.”

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