Vitreomacular Traction Syndrome

When vitreous contraction distorts the center of the macula, vision becomes distorted and hazy


Vitreomacular traction (VMT) is a condition that occurs in the eye and is closely related to a posterior vitreous detachment (PVD). In a PVD, the vitreous, a gel-like substance that fills the inside of the eye, separates from the retina, which lines the back of the eye. In some cases, during this separation, a part of the vitreous remains adhered to the macula, the central part of the retina responsible for detailed and central vision. This residual attachment creates tension and traction on the macula, leading to vitreomacular traction.

VMT can have detrimental effects on vision, causing various issues such as vision loss and macular swelling. The continued tugging of the vitreous on the macula can distort its shape and cause fluid accumulation in the macular area, leading to macular edema. This, in turn, can result in decreased visual acuity and distortion in one’s central vision. Prompt diagnosis and appropriate treatment are essential in managing vitreomacular traction to mitigate potential vision impairment and improve visual outcomes.

Below is a video that reviews the anatomy of the eye, information on vitreomacular traction, and an example of vitrectomy surgery:


The most common symptoms of vitreomacular traction are distortion and vision loss. In is important to realize that other, more serious and more acute disorders can also cause distortion. If you experience new distortion in your vision, DO NOT ASSUME YOU HAVE VITREOMACULAR TRACTION. You may have something more serious. You should consult a physician as soon as possible (less than a week) if you have new onset distortion and vision loss in either eye. Sometimes when one eye has a serious vision problem the other eye will take over and you may not notice the problem. Therefore, it is important to check your eyes separately every day to make sure that each eye is seeing well.


The diagnosis of vitreomacular traction is established by an eye examination and confirmed with ancillary testing. A dilated examination of the macula using a silt lamp (microscope) can usually establish the diagnosis of vitreomacular traction. Optical coherence tomography (OCT) is a useful tool for assessing the microstructure of the macula. A low energy laser is swept across the macula and a computer uses the reflected light to reconstruct the layers of the retina. An OCT scan will also show details of how the vitreomacular traction is affecting the layers of the retina and also can be used to follow the course of the disease.


If you have been diagnosed with vitreomacular traction you can follow without treatment, treat with Jetrea, treat with an intra-ocular gas bubble, have surgery, or if applicable, seek treatment of other disease affecting your vision.

Observation: Vitreomacular traction is not uncommon. As the vitreous contracts it usually pulls free of the fovea and vitreomacular traction is transient. Spontaneous resolution of vitreomacular traction occurs in about 10 to 30 percent of cases and usually takes about 18 months to occur. The smaller the area of attachment of the vitreous the center of the macula (on OCT scanning) the more likely the vitreomacular traction is to spontaneously resolve. In cases where the vitreomacular traction is symptomatic, spontaneous resolution can occur if the vitreous further contracts and pulls free of the fovea.

Pneumatic vitreolysis: This is a therapy that is new as of this writing in 2017. By injecting a small gass bubble in the eye and allowing it bounce around for a few weeks, there is a fairly high rate of release of vitreomacular traction. The release usually occurs in an average of 13 days. Small studies have shown a success rate of 80 to 90 percent. There is a small risk of retinal tear and retinal detachment with this treatment.

Vitrectomy: Vitrectomy is highly effective for vitreomacular traction. This therapy has been in widespread use since 1980. The success rate of relieving the traction is nearly 100 percent. Their are risk of vitrectomy surgery like infection, bleeding, and retinal detachment. Therefore it is best to discuss surgery and other treatment options with an experienced vitreoretinal specialist who can outline the risk and benefits of all the possible management options currently avialable.

A 70 year old woman presented with minimal blurring and distortion of vision due to vitreomacular traction syndrome (VMT). As she tolerated the symptoms well, she was observed without surgery. Over a period of four years, the traction released itself and the vision remained stable.

This 63-year-old female had 20/30 vision and mild vitreomacular traction.  Then over 6 months her vision declined.  She failed treatment with posterior subtenon’s kenalog and was offered vitrectomy.  With surgery,  her vision improved from 20/200 to 20/30.