In 50% of the population, by the age of 50, the vitreous, the jelly inside the eye, begins to detach from the retina. This is known as vitreous detachment.
In some cases, however, the adhesions of the vitreous to the retina are very strong, resulting in partial detachment of the vitreous and traction on the retina. This is a very undesirable condition because this traction causes a decrease in central vision and can lead to further problems such as macular hole, macular membrane and cystoid edema.
Patients with vitreous traction should be thoroughly examined by a specialist ophthalmologist because they often have peripheral retinal tears that go undiagnosed and can lead to retinal detachment. Retinal detachment is very dangerous, because it can lead to blindness.
The most common symptoms patients present are:
1) reduced visual acuity and blurred vision
2) illuminations, i.e. flashes
3) micropsia, where objects appear smaller than the pathological eye
4) metamorphosis, where lines appear distorted instead of straight.
In some cases, metamorphopsia is the first symptom and the most important before the decrease in visual acuity.
Optical coherence tomography (OCT) is the most common examination performed for the diagnosis and monitoring of patients. This is a technology that provides us with cross-sections of the retina and the vitreous surface. Thus, in great detail we can examine abnormalities on the vitreoretinal surface.
Figure 1. OCT of a patient with severe vitreous traction and cystic retinal edema.
There are 3 main treatment options for vitreous traction syndrome.
Most patients with vitreous traction maintain good vision even if treatment is needed. Contact specialist ophthalmic surgeon Georgios Trichonas to learn more about your treatment options.