Signs of VMT will arise when the vitreous inside of the eye tugs on the macula, which is the part of the eye responsible for sharp central vision.
Signs of VMT will commonly include blurred vision, straight lines appearing wavy or distorted, loss of vision acuity, and objects appearing smaller than they really are. Symptoms could progress if the traction grows or complications arise.
If suddenly reading one eye is more difficult than usual, or straight lines appear bent, this should not be dismissed; this could be an early symptom of vitreomacular traction.
Introduction
The lines, straight and true, suddenly appear wobbly and distorted; letters in a book run together, and your central vision starts to blur for no apparent reason; this may lead to confusion or even panic.
But this visual change may not just be a normal sign of aging; it may be a symptom of vitreomacular traction (VMT), a condition in which the retina’s macula can be threatened and, consequently, your sharp central vision put at risk.
Fortunately, the signs of VMT begin to appear long before central vision loss develops. This information on recognizing symptoms may enable you to make the appropriate and timely call to a retina specialist.
What Is Vitreomacular Traction?
The way that you understand the condition makes you understand what happens in terms of symptoms. Let’s consider what occurs in the eye during vitreomacular traction.
The vitreous is a gel-like substance that fills the space within the eye. When people get older, it is natural for the vitreous to pull away from the retina, becoming smaller.
However, in this condition, the vitreous is pulled away from parts of the retina yet remains attached to the macula. This creates a pull or tension on the macula, which leads to central vision becoming distorted.
Often, the amount of traction, or pull, depends on how significant the symptoms are perceived to be.
For more on the condition, read our guide to vitreomacular traction.
Early Vitreomacular Traction Symptoms
Often, symptoms start very mildly. Most patients can point to slight changes in vision long before they suspect that these changes are caused by a retinal disease process.
Common early symptoms include:
- Mild blurred central vision.
- Mild distortion of straight lines.
- Reduced ability to read small print.
- Reduced contrast sensitivity.
- Difficulty focusing on fine details.
- Slight size difference between images in both eyes.
These changes usually occur gradually, so when progress is so slow, they often go undetected.
What Patients Commonly Notice First?
Visual descriptions in medicine are not always accurate reflections of how real life feels. The type of visual changes patients generally describe before diagnosis is:
- Letters look funny on the page.
- Phone text looks lopsided.
- The door frame looks crooked.
- Blinds look wobbly.
- Face appears warped.
- The object in one eye appears smaller.
- Reading is becoming more strenuous.
These real-life situations are often the first visual indicators of vitreomacular traction.
1. Blurred Central Vision
Your central vision is crucial to most daily activities. Slight changes can lead to reading, driving, or facial recognition challenges.
Blurry central vision is one of the most common symptoms of VMT.
Your central vision aids in:
- Reading
- Driving safely
- Recognizing faces
- Operating digital devices
- Fine motor skills
When your macula is subjected to traction, these activities often become challenging.
Typically, peripheral vision will be preserved at first.
2. Distorted or Wavy Vision (Metamorphopsia)
Distorted vision is usually the first symptom noticed and can occur before significant visual decline. This can manifest as:
- Straight lines appear bent.
- Writing looks distorted.
- Grids do not appear flat.
- Objects appear misshapen.
- Corners are perceived as curves instead of right angles.
The distortion is thought to be caused by traction altering the shape of the macula. Cover tests of the affected eye can help detect the distortion.
3. Objects May Appear Smaller Than They Really Are
A sensation of changing image size can also appear unusual or confusing. It is a symptom that may impact your sense of space and visual comfort in everyday tasks.
A symptom called micropsia may arise.
This symptom can cause your:
- Objects appear smaller.
- Letters to appear reduced in size.
- The difference in the size of the images seen with each eye.
- Problems with the estimation of distances.
While a rare symptom compared to blurred vision or distortion, it is a significant warning sign to monitor.
4. Difficulty Reading and Seeing Fine Details
The macula is essential for sharp, detailed vision. Precision-demanding tasks usually become harder to perform as the amount of traction grows.
Reading difficulty is usually the most frustrating VMT symptom.
You can experience:
- Blurred vision when reading.
- Words that appear to “jump” on the page.
- Slower reading speeds.
- Difficulty seeing small print.
- Rapid eye fatigue.
Many patients present to their doctor when it becomes progressively difficult to read and perform tasks requiring fine visual discrimination.
Symptoms of Worsening Vitreomacular Traction
VMT is not always stationary. Knowing how to recognize evidence of progression allows patients to receive timely care to prevent complications.
Symptoms will often become more pronounced as traction worsens. Symptoms of progression are generally indicated by a change and/or worsening of:
- Perception of visual distortion increases.
- Central blur worsens.
- Trouble reading increases.
- The apparent size of images becomes more evident.
- Visual sharpness declines.
- Difficulty recognizing faces.
Some patients may also experience complications that warrant intervention.
Vitreomacular Traction Symptom Progression Timeline
A patient may not suddenly develop symptoms but may instead progress over time. Knowledge of this pattern helps patients to identify which vision changes are significant.
Early Stage
- Slight blurring
- Intermittent distortion of vision
- Trouble reading
- Mild visual discomfort
Intermediate Stage
- Chronic wavy vision
- Worsening central vision changes.
- More prominent visual distortion.
- More profound trouble with detailed work.
Advanced Stage
- Profound loss of central vision.
- Extreme visual distortion.
- Possible macular hole.
- Major interference with everyday activities.
Not all patients follow this developmental sequence; some cases remain stable, while others progress relatively rapidly.
Vitreomacular Traction vs Other Eye Conditions
Many diseases of the retina share many symptoms. A discussion on diseases and their differences can provide insight into the importance of a comprehensive retinal examination.
|
Condition |
Common Symptoms |
|
Vitreomacular Traction |
Distorted central vision, blur, micropsia |
|
Macular Hole |
Central blind spot, severe central blur |
|
Epiretinal Membrane |
Wavy vision, image distortion |
|
Age-Related Macular Degeneration |
Central vision loss, difficulty recognizing faces |
|
Retinal Detachment |
Curtain-like shadow, flashes, sudden vision loss |
When Should You See an Eye Doctor?
Is my condition serious enough for an eye examination? Some signs should always warrant an examination:
- Visual distortions that are new.
- Blurriness centrally.
- Problems with reading.
- Changes in the size of images.
- Loss of vision in one eye.
- Symptoms that are worsening.
It is important to have this assessed early so that any signs of vitreomacular traction are detected before they affect vision.
Symptoms That Require Immediate Medical Attention
Though not all of the VMT signs appear suddenly, they can occur as a sign of a retinal emergency, and prompt treatment could preserve your sight.
Go for immediate treatment if you notice the following:
- Sudden, unexpected flash of light in the peripheral vision.
- Sudden, marked increase in floaters in your field of vision.
- A curtain of darkness is moving across your visual field.
- Sudden loss of vision.
- Rapid progression of symptoms.
These can be signs of a retinal tear or detachment, and you need to see a doctor quickly.
How Doctors Diagnose Vitreomacular Traction?
A standard vision test will not provide the right diagnosis. A retina specialist uses sophisticated imaging techniques to identify whether the macula is being pulled.
These diagnostic tests can include:
1. Optical Coherence Tomography (OCT)
OCT is a non-invasive imaging test that produces high-resolution images of the retina and macula. The OCT may identify:
- Vitreomacular traction areas.
- Macular distortion.
- Swelling of the retina.
- Development of a macular hole.
- Progress over time of treatment effects.
2. Dilated Retinal Examination
A retina specialist examines the back of the eye to evaluate retinal health and identify associated retinal conditions.
3. Treatment Options for Vitreomacular Traction
Management depends on the degree of symptoms and signs observed in the retina, and on the interference of symptoms with daily functioning. A retina specialist would be able to suggest the best management strategy.
4. Observation
Mild presentations can sometimes be observed as spontaneous resolution may occur.
An ophthalmologist with periodic OCT scans may monitor these cases.
5. Medications
There is now a treatment available that aims to release the vitreomacular adhesion, thereby decreasing the traction. A patient can be a candidate for this medication.
6. Vitrectomy surgery
During vitrectomy surgery, the vitreous is removed, thereby reducing traction on the macula.
Retinal specialists generally recommend surgery when the patient’s daily vision is affected or complications arise.
Can Vitreomacular Traction Resolve on Its Own?
Not all cases can be treated as readily. The vitreous can separate spontaneously in some patients, thereby relieving the traction.
Yes. Some cases of macular traction can be managed conservatively with spontaneous vitreous separation.
Spontaneous separation does not occur in all cases.
It is still important to monitor patients, as symptoms may progress if traction is not released.
Retina Vitreous Associates of Florida — Preserving Vision. Protecting Quality of Life.
Vision distortions, central blur, and reading difficulties may appear insignificant at first. Still, they could be signs of vitreomacular traction and other underlying retinal pathologies. Detecting any visual problems early offers the best chance to save your vision and prevent further damage in the long run.
It is important to promptly attend to any changes you notice in your central vision rather than wait for further deterioration. Consult our Retina Vitreous Associates of Florida specialists for a thorough retinal examination and to discuss the recommended management strategy.
Frequently Asked Questions
1. What Is Usually The First Symptom Of Vitreomacular Traction?
A common initial symptom is minor visual distortion. For instance, straight lines may seem to meander, writing may appear irregular, or the center of the field of vision can become blurred during activities such as reading.
2. Can Vitreomacular Traction Symptoms Come And Go?
Yes. Early symptoms may be quite variable, particularly when the distortion is minimal. Nevertheless, it’s important that any progression of distortion, blur in central vision, or worsening of visual symptoms be assessed by a retina specialist.
3. Can Vitreomacular Traction Cause Floaters?
Significant floaters are typically not associated with a condition such as vitreomacular traction alone. Changes within the vitreous, which occur concurrently with VMT, can contribute to the formation of new floaters and are concerning enough to seek medical attention.
4. How Do VMT Symptoms Differ From A Macular Hole?
The characteristic symptom of VMT is central vision, which becomes blurry or distorted. Macular hole symptoms can lead to more severe visual impairment and enlargement of the blind spot, causing trouble with reading and facial recognition.
5. When Should I Worry About Vitreomacular Traction Symptoms?
New or distorted vision, increased blurring at the center, reading difficulty, and a change in the perceived size of an image should prompt immediate attention from an eye doctor. If you experience vision loss, go to an emergency room immediately.