Vitreomacular adhesion (VMA)—also known as sticky eye—is an eye condition in which adhesions pull on the macula, potentially leading to vision problems. Since the condition, which is common among older individuals, can affect the central vision you need to perform everyday tasks, it's important to gain fuller knowledge of the condition, its diagnosis, and the treatment options available.
Understand the Cause
VMA can occur when the vitreous, or gel, inside your eye begins to shrink and liquefy as you get older. If the vitreous doesn't separate completely and some of it remains attached to the retina, you may experience vision problems.
As the vitreous gel pulls away from the retina at the back of the eye, it sticks to the macula—the part of the retina responsible for central vision and seeing fine details. Consequently, the pull of the gel on the macula can cause central vision impairment.
Identify the Symptoms
Although you may not experience symptoms at first, eventually your vision can become wavy or distorted. Decreased visual acuity or blurred central vision may occur as well. Your vision may become less sharp, and objects may look smaller and farther away. In some cases, the condition can cause significant and permanent vision loss.
Know the Risk Factors
Although the condition usually occurs in individuals over age 50, VMA is common in people age 70 and older. Women are more likely than men to suffer the condition, as are individuals who are nearsighted.
Get a Diagnosis
If you are having problems with your vision, an eye care specialist will dilate your pupils and physically examine your eyes. Pupil dilation allows the doctor to get a better look at the back of your eye, particularly the retina and optic nerve.
An ophthalmologist may do a test called an optical coherence tomography (OCT) that takes pictures of your retina to see whether there is fluid or swelling present. Fluorescein angiogram is another diagnostic tool doctors use to examine the blood vessels in the eye.
Watch for Potential Complications
Individuals with VMA can develop eye disorders such as macular edema, retinal tears or detachment, or macular hole—a small break in the macula. Shrinking vitreous that pulls away from the surface of the retina can also cause scar tissue on the macula. Known as macular pucker, the condition doesn't usually get worse over time but may eventually affect the other eye.
Learn the Treatment Options
While VMA is treatable, sometimes symptoms improve on their own. In the meantime, your eye doctor may schedule frequent eye examinations to monitor your symptoms and watch for complications that may develop. In cases where a shrinking vitreous pulls too hard, the condition can become more serious. If left untreated, symptomatic VMA can lead to blindness.
Your ophthalmologist may recommend injecting medication into the affected eye if the symptoms you experience become severe. This helps to release the adhesion between the vitreous and macula, leading to improved visual acuity. Pharmacologic treatment generally is effective for individuals with small focal adhesions or small macular holes.
Surgery is another option when medication does not dissolve the adhesion and vision fails to improve. A procedure known as a vitrectomy involves removing the vitreous from your eye and replacing it with fluid or a temporary gas bubble that the eye will reabsorb within a few weeks.
Following surgery, your doctor may instruct you to lie face down to allow the fluid or gas bubble to push against the detachment at the back of your eye. If you have other complications, you may need additional treatments to repair large tears in the retina or stop blood from leaking into the vitreous gel.
If you are worried that eye symptoms you have are related to vitreomacular adhesion, the eye care professionals at Absolute Vision Care can perform diagnostic tests and recommend the appropriate treatment option.