Lattice degeneration

Lattice degeneration is a thinning of the peripheral retina. This condition does not interfere with central vision or cause any symptoms, so it is often undetected unless a patient undergoes a thorough peripheral retinal exam.

Lattice degeneration occurs in about 7% to 8% of the general population, and of those affected, about 45% have lattice degeneration in both eyes.

This condition is often inherited and is found more commonly in people who are myopic (nearsighted).

In many cases, no treatment is needed. The physician will most likely recommend observation and discuss the symptoms that could suggest the development of complications related to lattice. These include:

• The sudden onset of a “shower” of constant floaters

• Frequent light flashes

• Loss of peripheral vision, like a curtain or veil covering a part of the visual field

Complications of having thin areas may include the presence of small holes within the areas of lattice. There is also an increased risk of developing larger tears in the retina due to the vitreous gel pulling on the thin areas. In certain circumstances, such as when other surgical procedures are planned for the eye (such as cataract surgery or Lasik surgery), the risk of holes or tears associated with lattice may be further increased.

In certain cases, when retinal holes or tears are present, recommendation for either laser photocoagulation or cryotherapy may be made. The decision for mode of treatment depends upon the location of the tear and whether there is fluid associated with the tear.

The goal of treatment is to seal the area surrounding the tear. With laser photocoagulation, a bright, highly focused beam of light is used to seal the area. In cryotherapy, the area surrounding the tear is frozen. In both cases, this induces the eye to form a localized scar, which prevents fluid from getting beneath the retina and causing a retinal detachment.

After treatment, the eye may be a bit sore for a couple of days. Usually Tylenol® or Advil® and the application of a cold compress are sufficient to relieve any discomfort.

Vision may be somewhat blurred and “floaters” may be more obvious in the days following treatment. The treatment does not “cure” the floaters, but most patients report that they become less noticeable with time. The goal of the treatment is to seal the holes or tears and/or lattice to prevent retinal detachment.

Warning signs that a retinal detachment has occurred can include:

• Loss of side vision, like a curtain or shadow coming from your periphery and moving toward the center

• A significant overall decrease in vision

These warning signs or any significant decrease in vision should be reported to your physician immediately.