Vitreomacular traction syndrome (VMT) is an eye condition that involves the jelly-like substance that fills the eye (vitreous humour) and the macula (the area found in the centre of the retina that is responsible for our central vision, our ability to see colour & fine detail).

Here, we’ll go into some more detail about vitreomacular traction syndrome and how OCT (optical coherence tomography) scans can be helpful in spotting the condition during an eye test.

What is vitreomacular traction syndrome?

Our eyes are filled with a clear, jelly-like substance known as the vitreous humour that sits behind the lens at the front of the eye and the retina at the back of the eye – its role is to keep the spherical shape of the eye.

The vitreous is attached to the retina (the light-sensitive layer at the back of the eye) by lots of tiny fibres, but over time, the vitreous starts to shrink and pull away from the retina. This is a normal part of the ageing process that typically happens some time after the age of 50, known as posterior vitreous detachment.

Sometimes, the vitreous doesn’t detach itself completely from the retina, and part of it can remain stuck to the macula, found in the middle of the retina – this is vitreomacular traction. ‘Traction’ refers to the process of the vitreous essentially tugging on the macula as it tries to detach itself, which can damage the macula and cause partial vision loss if left untreated.

There are several symptoms of vitreomacular traction syndrome to look out for, including:

  • Distorted vision (straight lines can look wavy, bent, blank or blurry)
  • Appearance of flashing lights
  • Objects looking smaller than their actual size

VMT can also lead to other conditions, such as:

  • Retinal tears (a tear in a part of the retina)
  • Retinal detachment (when the retina separates from the back of the eye)
  • Macular pucker (also known as epiretinal membrane, a thickening of the inner layer of the retina)
  • Macular hole (when the vitreous tugs enough to form a small hole)

You can learn more about what macular conditions OCT can detect here.

What causes vitreomacular traction?

Vitreomacular traction syndrome is usually caused by ageing, where the vitreous humour starts to become watery, rather than its usual gel-like substance.

Not all cases of posterior vitreous detachment result in this way, but there are some factors that could put you at a higher risk of developing VMT, including:

  • Being very short-sighted (high myopia)
  • Diabetic retinopathy (damage to the blood vessels that supply the retina)
  • Retinal vein occlusion (a blockage in the veins of the retina)
  • Age-related macular degeneration (a condition affecting your central vision)

How OCT can detect vitreomacular traction

OCT (optical coherence tomography) is a quick, non-invasive scan that can be a useful tool in diagnosing and monitoring vitreomacular traction syndrome. An OCT scan can be done during an eye test and uses light waves to create a 3D image of the eye. This allows your optometrist to see the retina and all its layers in great detail, so they can spot signs of anything out of the ordinary.

They’ll also be able to assess how the vitreomacular traction is affecting the retina, in order to make a judgement about possible treatment or onward referral. In some cases, treatment might not be necessary, but monitoring with regular OCT scans may be needed to keep an eye on retina health.

When to book an OCT scan

If you ever have any of the symptoms mentioned here, it’s important that you book an appointment with your optician as soon as possible. 

If you’re over 25 or have a family history of eye conditions, your optician might recommend that you add an OCT to your routine eye test. Having your images on file helps the optician to track any potential changes over time, or spot anything suspicious.