What is vitreomacular adhesion/traction?

Vitreomacular adhesion is the attachment of the vitreous, the gel space in the back of the eye, to the macula, the center of the back layer of the eye. Traction occurs when the vitreous pulls on the macula.

What are the causes and risk factors for developing an adhesion or traction?

Usually these form as a person gets older and the vitreous gets stuck to the macula. Risk factors include being very nearsighted and having diabetic eye disease or macular degeneration.

What are the symptoms?

The most common symptom is blurry central vision. Distortions in the vision and difficulty with fine details can also occur. Flashes of light are also possible.

How is vitreomacular adhesion/traction diagnosed?

A comprehensive exam including checking the vision and dilating the eyes is needed. An optical coherence tomography (OCT) photo can show if there is any damage or swelling in the layers in the macula.

The arrow in this photo points to where the vitreous is attached to the macula. Image Source ¹

The arrow points to where the vitreous is causing traction on the macula. Image Source ¹

How are these treated?

Many patients do not require any treatment. If it does not affect the vision, it is safe to have regular exams and photos to monitor the adhesion or traction. In some cases, this condition will resolve on its own.

Vitreomacular traction can cause vision changes especially if it is associated with a macular hole, epiretinal membrane, or edema. If the vision is affected, surgery can be done to relieve the traction on the macula and restore its natural contour. This surgery should be discussed with your retinal specialist to ensure that it is the best option.