Vitreoretinal diseases are a group of eye conditions concerning the retina and the vitreous in your eye. These structures can become damaged, often with age, and lead to eye problems that can affect your vision. (Learn More)

Age-related macular degeneration is a common vitreoretinal condition that occurs in people over the age of 50. The macula becomes damaged, and central vision is impaired. Fortunately, symptom management and surgical treatment options are available. (Learn More)

Posterior vitreous detachment occurs naturally in everyone, and it usually happens over the age of 60. With age, the vitreous gradually detaches from the retina, usually without any problems. Complications, such as retinal tear or detachment, can sometimes occur during this process. (Learn More)

Retinal tears can be caused by injury to the eye, but they are primarily the result of posterior vitreous detachment. For some people, retinal tears are mild and don’t present with any serious symptoms. Severe retinal tears, however, can lead to retinal detachment. In such a case, surgical treatment is necessary. (Learn More)

patient receiving cataract surgery

A vitreoretinal surgery is any type of surgical intervention performed on the vitreous or the retina. With modern advances in eye surgery, vitreoretinal surgeries are minimally invasive, highly effective, and have relatively quick recovery times. (Learn More)

Not all vitreoretinal diseases require surgical intervention, but for those that do, there are many surgical treatment options available. Vitrectomy, laser therapy, cryotherapy, photodynamic therapy, and traditional eye surgery are all surgical treatment options for various vitreoretinal conditions. (Learn More)

If you are experiencing symptoms of a vitreoretinal disease, speak with your eye doctor about your treatment options. In mild cases, surgery may not be recommended, as many vitreoretinal symptoms clear up on their own over time. In more severe cases, vitreoretinal surgery may be a good treatment option. (Learn More)

 

What Are Vitreoretinal Diseases?

Vitreoretinal diseases are a type of eye condition that affect the retina and the vitreous, a gel-like substance in the eye that helps it keep its round shape.

The retina is the layer on the back of your eye that is sensitive to light. It focuses images you see and transmits that information to the brain.

When these two structures are damaged for any reason, your eye health and vision can be compromised.

Types of vitreoretinal diseases include:

  • Age-related macular degeneration.
  • Diabetic retinopathy.
  • Flashes and floaters (posterior vitreous detachment).
  • Macular holes.
  • Macular pucker.
  • Retinal tears or detachments.
  • Retinoblastoma.
  • Stargardt disease.
  • Uveitis.

Many of these vitreoretinal diseases get progressively worse with age. Weakening of structures in the eye can lead to complications, such as retinal detachments or holes. Likewise, the vitreous in the eye tends to shrink as you get older, and this can cause problems like macular pucker.

eye anatomy

Age-Related Macular Degeneration

Age-related macular degeneration (AMD) happens when the macula, which is part of your retina, is damaged. AMD causes you to lose your central vision and makes you unable to see fine details, though your peripheral vision will still be intact.

AMD is a very common eye condition. It is the primary cause of vision loss in people over the age of 50.

There are two types of AMD: dry and wet. Dry AMD occurs in about 80 percent of people who have AMD.

With dry AMD, the macula thins with age. Small clumps of proteins, or drusen, grow on the macula, which lead to impaired central vision.

Unfortunately, there is no current known treatment for dry AMD. Studies have found, however, that a daily intake of the following eye-healthy foods and vitamins can help to slow the progression of dry AMD:

  • Vitamin C
  • Vitamin Ediagram of Macular Degeneration
  • Lutein
  • Zeaxanthin
  • Zinc
  • Copper
  • Dark leafy greens
  • Yellow fruits and vegetables
  • Fish

Wet AMD is less common in people with AMD, but it is more serious. With wet AMD, new and irregular blood vessels develop under the retina. These blood vessels can leak blood and other fluids that cause scarring on the retina.

Vision loss occurs more quickly with wet AMD. Many people don’t realize they have the condition until their vision is already blurry.

Medical treatment options have been developed for wet AMD. Anti-vascular endothelial growth factor (anti-VEGF) and laser therapy have been developed in order to target abnormal blood vessels on the retina and reduce leakage.

 

Posterior Vitreous Detachment

Posterior vitreous detachment (PVD) occurs when the vitreous gel separates from the retina. It is a natural change that happens to everyone in adulthood and rarely causes problems, explains the American Society of Retina Specialists (ASRS). PVD primarily occurs over the age of 60 and once in each eye.

Usually, PVD is not sight-threatening. It’s possible that complications from it, such as retinal detachment or macular hole, can create a more serious threat to your vision.

The two primary symptoms of PVD are:

  • Floaters. These small shadows are caused by particles or debris in the eye that obscure vision.
  • Flashes. These are streaks of light that typically occur in your peripheral vision.

ASRS notes that mild floaters in your vision are normal, and many people are able to ignore them before they settle out of their field of vision. However, a sudden increase in floaters is a common first symptom of PVD.

Treatment of PVD varies depending on the severity of your case. For many people, the symptoms of PVD go away after three months or so, and no medical or surgical intervention is needed. If floaters persist, vitrectomy surgery is an option to effectively remove them.

Although rare, complications from PVD can happen. In the case of retinal tear or detachment following PVD, laser surgery may be necessary.

 

Retinal Tears or Detachment

Retinal tears are small tears that form in the retina. They can lead to retinal detachment and vision loss if not treated promptly.

Retinal tears can occur as a complication of PVD. In some people, the vitreous is sticky and pulls on the retina as it is separating from it, resulting in a tear. Retinal tears can also be caused by injury to the eye, though they are primarily due to PVD.

Symptoms of an acute retinal tear include:

  • Sudden appearance of floaters.
  • Flashes of light.
  • Bleeding in the eye due to vitreous hemorrhage.

If a retinal detachment occurs, additional symptoms include:

  • Blurred vision.
  • A shadow over peripheral vision.

When addressed early, retinal tears are easily treated. Laser surgery and cryotherapy are two safe and effective treatment options. For low-risk tears that don’t present with any disrupting symptoms, treatment may not be necessary.

Once retinal detachment has occurred, surgical intervention is likely needed. Laser surgery, cryotherapy, and traditional eye surgery are all used to treat retinal detachment.

Depending on the severity of your retinal detachment, multiple treatment methods may be used at the same time. Although you may need a second treatment for a retina that detaches again, surgery is a successful treatment method for about 90 percent of patients, explains the National Eye Institute.

 

Vitreoretinal Surgerylaser eye surgery

Vitreoretinal surgery refers to operations performed on the vitreous or retina. Many diseases and age-related changes that impact the retina and vitreous can be treated with surgery.

Most vitreoretinal surgeries are performed primarily under local anesthetic. They are usually relatively quick and have short recovery periods.

Many types of vitreoretinal surgeries begin with removing the vitreous from your eye. Though it is essential for the formation of babies’ eyes in utero, the vitreous can safely be removed later in life.

Advancements in vitreoretinal surgeries allow for the use of special lens attachments to microscopes and specialized vitrectomy machines to increase precision and reduce the risk of traditional eye surgeries.

Risks of vitreoretinal surgeries include:

  • Eye infection.
  • Bleeding in the eye.
  • Detached retina.
  • Cataract.
  • Recurrence of the problem.

Although there are risks associated with vitreoretinal surgeries, they are highly effective and correct most eye problems in just one operation. Most operations have a short recovery period of a few days to a week. It can take longer, however, for vision to completely return to normal.

 

Surgical Treatment Options

There are many different surgical options available for treating vitreoretinal diseases.

Experts from the UT Southwestern Medical Center explain how different surgical procedures can be used, depending on which vitreoretinal disease you have.

Surgical treatment options include:

  • Traditional surgery. Traditional eye surgery can be performed to repair retinal detachment or retinal tears.
  • Vitrectomy. In order to better reach the retina, the vitreous is removed from the eye and replaced with an artificial gel-like substance.
  • Laser therapy. In order to treat damaged blood vessels in the eye, laser therapy offers a blade-free surgical option.
  • Cryotherapy. Targeted cold therapy is used to freeze cells in order to repair damaged areas in the eye.
  • Photodynamic therapy. Abnormal blood vessels in the retina are sealed off with photodynamic therapy through the use of a laser and special light-sensitive medication.

Ophthalmologist doctor with the snellen chart

Is Vitreoretinal Surgery for Me?

A discussion between you and your ophthalmologist will help you decide if vitreoretinal surgery is right for you. Depending on your condition, there are many different treatment options available that come with varying degrees of risks and potential side effects.

Medical, nonsurgical treatment options are also available for some vitreoretinal diseases. Anti-VEGF therapy, for example, utilizes medications to treat conditions in the eye by reducing swelling and the growth of blood vessels.

If you are experiencing symptoms of any kind of vitreoretinal disease, it is important to see your ophthalmologist as soon as you can. Many vitreoretinal diseases are relatively harmless at first and can be successfully addressed with minimal surgical intervention.

Some conditions, such as retinal detachment, can progress quickly and lead to more serious complications, like vision loss. If detected and treated early, serious eye and vision complications can be avoided. With prompt care, you can quickly return to your daily life with healthy and clear vision.

 

References:

Posterior Vitreous Detachment. (2016). American Society of Retina Specialists.

Retinal Detachment. (June 2019). National Eye Institute.

Retinal Tears. (2016) American Society of Retina Specialists.

Vitreoretinal Disease. Milford Eye Clinic.

Vitreoretinal Diseases and Surgery. UT Southwestern Medical Center.

Vitreo Retinal Diseases. (June 2018). National University Hospital.

What Is Macular Degeneration? (February 2020). American Academy of Ophthalmology.

Age-Related Macular Degeneration. (August 2019). National Eye Institute.