QUESTION: Are there other retinal and macular disorders I might have?
AMD is a form of macular degeneration that occurs in people 50 and older. There are other changes that occur as we age, so it’s not uncommon for people with AMD to have other age-related disorders.
Changes in the Vitreous As We Age
The vitreous is the jelly-like fluid (99% water) that fills the eye between the lens in the front of the eye and the retina in the back of the eye. It is firmly attached to the inside. The shape of the eye is maintained by long collagen fibers connected to the front and to the back. Problems occur when the vitreous changes due to the natural aging process or from an eye disease. As we age, it becomes more fluid and tugs where it is connected including at the retina. In most people, the vitreous eventually detaches completely from the retina in a process called a Posterior Vitreous Detachment (PVD). PVDs sometimes occur after cataract surgery. People with myopia (nearsightedness or shortsightedness) are prone to PVDs. Watch this short video for a simple explanation of this process.
Another consequence of the aging process is that the collagen fibers start to ‘clump’ and cast shadows on the retina that we see as floaters. When a PVD occurs, we may see an increase in floaters and also flashing lights in our peripheral vision. The collagen fibers that cause the floaters tend to sink to the bottom of the vitreous with time.
How long do these symptoms last? In this video ‘How long do symptoms of posterior vitreous detachment last?’, we find out that a PVD may occur over time (several weeks or even several months) with symptoms such as an increase in floaters and flashes of light. The flashes of light are caused by the tugging at the retina which causes a ‘mechanical’ light – the same reaction as when light hits it.
As long as there is no retinal detachment, there is no reason for concern. It is recommended, however, that you see your eye doctor when this occurs to make sure that there isn’t anything that may signal a more serious problem. The symptoms of a full retinal detachment, which requires immediate attention, are below.
Possible Consequences of Vitreous Traction
If the vitreous does not completely detach, it can tug at the retina. That’s called Vitreous Traction (VT). That tugging can create flashing lights.
The vitreous is attached to the macula. When it tugs on it, it is called Vitreomacular Traction (VMT). This can cause damage, sometimes vision loss, if not treated quickly. The consequences of VMT can be macular hole, epiretinal membrane/macular pucker/macular wrinkle, and retinal detachment.
The Vitreous Video Series
This video series goes through the entire process of possible changes in the vitreous and the consequences of some of them. These are short videos. The longest is 10 minutes:
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Vitreous 1: Vitreous Aging and Floaters
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Vitreous 2: Vitreous and Trouble
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Vitreous 3: Vitrectomy
Retinal Detachment – Emergency!!
One serious possible consequence of the vitreous tugging at the retina is a retinal detachment which can occur gradually or suddenly. In either case, call your eye doctor as soon as possible. What are the symptoms? The most common one is having part of the visual field blocked with what might be called a curtain that can come down from the top or up from the bottom. You might also see something that looks like a ‘sticker’ blocking your vision.
This video is a good one to describe what goes on with a retinal detachment:
‘Retinal Detachment Symptoms and Treatment | How Retinal Detachment is Treated’
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