Vitreomacular traction (VMT) happens when the vitreous gel inside the eye stays abnormally attached to the macula and tugs on it as it tries to separate, distorting central vision. Mild VMT often releases on its own and is simply monitored with OCT scans. When traction persists, worsens vision, or threatens to form a macular hole, treatment options include a keyhole vitrectomy with membrane peel, or in selected cases an enzyme (ocriplasmin) or expanding-gas injection to release the gel. Private vitrectomy fees start from £6,500 per eye, all-inclusive, while monitoring consultations start from £240.
What is vitreomacular traction?
The vitreous is the clear gel that fills the back of the eye. With age it naturally shrinks and peels away from the retina — a normal process called posterior vitreous detachment. In vitreomacular traction, the gel separates everywhere except over the macula, where it stays firmly stuck and pulls on the central retina. This tugging distorts the macula and can blur and warp central vision.
VMT is closely linked to macular hole and epiretinal membrane — persistent traction can progress to a hole if it is not released. It is more common with age, in short-sighted eyes and in people with diabetic eye disease. Diagnosis and monitoring rely on OCT scanning, which shows the traction in cross-section.
Symptoms of VMT
- Distorted central vision — straight lines look bent or wavy (metamorphopsia)
- Blurred reading vision in the affected eye
- Objects appearing smaller (micropsia) or a different size
- Flashes of light as the gel pulls on the retina
- Side vision remains unaffected
New distortion or a central blur? An OCT scan shows whether the vitreous is pulling on your macula and tracks whether it is releasing or progressing — the key to timing any treatment.
Book a macular assessmentTreatment options
Treatment is tailored to how much the traction is affecting your vision and whether OCT shows it releasing or worsening. Many mild cases need no surgery at all.
Surgery is performed by our vitreoretinal surgery team, who also treat the closely related macular hole and epiretinal membrane.
What happens during surgery
When a vitrectomy is needed, it is a day-case keyhole procedure under local or general anaesthetic, usually taking 45–60 minutes:
- Anaesthetic is given and three tiny ports are made in the white of the eye (pars plana).
- A vitrectomy removes the vitreous gel, directly releasing its pull on the macula.
- The surgeon peels the internal limiting membrane from the macula with a contrast dye to ensure the traction is fully relieved.
- If a macular hole has started to form, a gas bubble is added and you posture as instructed.
- The ports are closed and the eye is shielded. You go home the same day.
Recovery week-by-week
Recovery depends on whether a gas bubble was used. Without gas, recovery is gentle; with gas, posturing and a longer settling period apply (as for macular hole surgery).
First few days
The eye is gritty and a little red. Use prescribed drops. If a gas bubble was used, follow posturing instructions and expect dark, blurred vision from the bubble.
Weeks 1–2
First review and OCT confirm the traction is released. Light activities resume; any gas bubble begins to shrink.
Weeks 2–8
Distortion settles and central vision sharpens. No flying while any gas remains. A cataract may progress and can be treated later.
Months 2–6
Vision continues to improve as the macula recovers its normal contour. Follow-up OCT confirms a stable result.
Cost & insurance
Our VMT treatment fees are all-inclusive of the consultant, theatre, anaesthetic and a structured follow-up:
- Vitrectomy + ILM peel: from £6,500 per eye.
- Phacovitrectomy (with cataract): £8,500–£11,500 per eye.
- Monitoring: consultation and OCT from £240 for mild VMT under surveillance.
- Insurance: recognised by Bupa, AXA, Aviva, Vitality, Cigna and WPA — VMT treatment is functional and usually covered. We handle authorisation.
- Finance: 0% options available to spread the cost.