Vitreomacular traction (VMT) develops when the vitreous — the clear gel that fills the eye — separates from the retina with age but remains firmly attached at the macula, the small central area responsible for fine detail. The persistent pulling distorts the macula and blurs central vision. Some cases release naturally; those that don’t are treated with a vitrectomy (from £6,100) to relieve the traction and protect sight.
What is vitreomacular traction?
As we age, the vitreous gel gradually liquefies and peels away from the retina — a normal process called posterior vitreous detachment. Usually it separates cleanly. In VMT, the gel stays abnormally adherent to the macula — the centre of the retina that gives you sharp, detailed vision — and continues to tug on it. This mechanical pull wrinkles and thickens the macula, distorting the images it sends to the brain.
VMT sits on a spectrum of conditions caused by abnormal vitreous adhesion, which also includes epiretinal membrane and macular hole. Mild traction may cause few problems and can release by itself; persistent or worsening traction needs treatment to prevent lasting damage.
Symptoms
VMT affects central, detailed vision in the affected eye. Common symptoms include:
- Distorted vision (metamorphopsia) — straight lines such as door frames look bent or wavy
- Blurred central vision that makes reading and recognising faces harder
- A change in the size of objects — they may appear smaller or larger than in the other eye
- A grey or missing patch in the very centre of your vision in more advanced cases
Symptoms often come on gradually and affect one eye, so they may be noticed only when the other eye is closed.
Noticing distortion or central blur? An OCT macular scan shows exactly how the vitreous is pulling on your macula and whether treatment is needed.
Book a macular assessmentCauses & risk factors
VMT is caused by an incomplete posterior vitreous detachment, where the gel stays stuck to the macula. Contributing factors include:
- Increasing age — vitreous changes are part of normal ageing
- Female sex — VMT and related macular conditions are a little more common in women
- Short-sightedness (myopia)
- Other macular conditions such as macular degeneration or diabetic eye disease
- Previous eye surgery or inflammation affecting the vitreous
How it is diagnosed
VMT is diagnosed with detailed imaging of the macula:
- Optical coherence tomography (OCT) — the key test, providing a cross-sectional scan that shows the gel pulling on the macula and measures the traction.
- Dilated retinal examination — the consultant examines the macula and the rest of the retina.
- Amsler grid testing — a simple chart that helps detect and monitor distortion.
- Visual acuity testing — measures how much central vision is affected.
Treatment options
Treatment depends on how much the traction is affecting your vision — see our VMT treatment overview.
- Monitoring — mild VMT with good vision is often watched with regular OCT scans, as a proportion releases spontaneously.
- Vitrectomy — the definitive treatment when traction persists or vision worsens. The vitreous gel is removed to release the pull on the macula, allowing it to flatten and recover. See vitreoretinal surgery pricing.
Treating VMT promptly when vision is deteriorating reduces the risk of it progressing to a macular hole.