ConditionEyes & vision
Lattice Degeneration of the Retina
Lattice degeneration is a thinning of the outer edge of the retina, the light-sensitive layer at the back of the eye. It is found in about 6% to 10% of people, more often in those who are nearsighted, and usually causes no symptoms. Most people with lattice never have problems, but the thin areas are prone to holes and tears, and it is linked to about a third of retinal detachments. Regular dilated eye exams and knowing the warning signs of a tear are the key. Laser treatment is used only in selected cases.
Also called: Lattice degeneration of the retina, peripheral retinal degeneration, lattice retinal degeneration
At a glance
- What it is
- Areas of thin, weak retina in the far periphery, often with a criss-cross "lattice" pattern.
- How common
- About 6% to 10% of the population; often in both eyes.
- Risk factors
- Nearsightedness, family history, Stickler and Marfan syndromes.
- Symptoms
- None by itself.
- Management
- Periodic dilated eye exams; laser only for high-risk situations.
When to get help
Call 911 or go to the ER
- A sudden shower of new floaters, flashes of light, or a shadow or curtain moving across your vision
- Sudden loss or blurring of vision in one eye
See a doctor within a day or two
- A single new large floater or new flashes without vision loss, especially if you have lattice degeneration or high myopia
- Eye injury in someone with known lattice degeneration
Book a routine appointment
- Lattice degeneration found on an eye exam: follow-up as advised, usually every 1 to 2 years
- Planning cataract or refractive surgery with known lattice
What lattice degeneration is
The retina lines the inside back wall of the eye. In lattice degeneration, oval or linear patches near its outer edge become thin. Small blood vessels in these areas can turn white, creating the crisscross pattern that gives the condition its name. The vitreous gel that fills the eye is often firmly stuck to the edges of these patches.
When the vitreous shrinks and separates from the retina with age, a normal event called posterior vitreous detachment, it can pull on these sticky edges and tear the retina. Fluid can then pass through the tear and lift the retina off, causing retinal detachment.
Risk factors
- nearsightedness, especially moderate to high
- family history of lattice or retinal detachment
- Stickler syndrome, Marfan syndrome and Ehlers-Danlos syndrome
- previous retinal detachment in the other eye
Symptoms
Lattice degeneration itself causes no symptoms and does not affect vision. It is usually found during a routine dilated eye exam. Symptoms appear only if a complication occurs:
| Complication | Warning signs |
|---|---|
| Retinal tear | Sudden new floaters, flashes of light |
| Retinal detachment | A shadow, curtain or veil spreading across vision; blurred vision |
| Atrophic holes | Usually no symptoms; slow, small detachments may cause gradual peripheral loss |
Diagnosis
An eye doctor finds lattice degeneration by dilating the pupils and examining the far edges of the retina with an indirect ophthalmoscope, sometimes pressing gently on the eyelid (scleral depression) to bring the edge into view. Wide-field retinal photos may document it.
Treatment
Observation
Most people with lattice degeneration need only monitoring. The overall risk of retinal detachment is low for any one person. Guidelines generally do not recommend preventive treatment for lattice without symptoms.
Laser or freezing treatment
Prophylactic laser (laser retinopexy) or freezing (cryotherapy) creates scars around weak areas to "weld" the retina down. It may be considered for:
- new symptomatic retinal tears, which are treated routinely
- lattice in a fellow eye when the other eye had a detachment from lattice
- lattice with high-risk features, such as in Stickler syndrome
- sometimes before cataract surgery or in very high myopia, on a case-by-case basis
Laser does not eliminate the risk of detachment, since new tears can form elsewhere.
Surgery
Retinal detachment needs surgery: pneumatic retinopexy, scleral buckle or vitrectomy, depending on the type.
Living with lattice degeneration
- learn the warning signs of a tear and act on them the same day
- keep regular eye appointments, typically every 1 to 2 years or as advised
- wear protective eyewear for sports with a risk of eye injury
- there is no evidence that normal daily activities, reading or screens worsen lattice; ask your eye doctor about high-impact contact sports or activities with rapid pressure changes
Frequently asked questions
Is lattice degeneration serious?
Usually not. Most people with lattice degeneration never develop problems. However, it does increase the risk of retinal tears and detachment, so it is important to have regular eye exams and to know the warning signs.
Does lattice degeneration always need laser treatment?
No. Most cases are simply monitored. Laser is used for symptomatic retinal tears and selected high-risk situations, such as when the other eye has had a detachment. Your eye doctor will advise based on your individual risk.
What are the warning signs of a retinal tear with lattice degeneration?
Watch for a sudden increase in floaters, flashes of light in the side of your vision, or a shadow or curtain moving across your vision. These need an urgent same-day eye exam.
Can lattice degeneration get worse?
Lattice patches can enlarge slowly over many years, and atrophic holes can develop within them. Most changes are gradual and harmless, which is why periodic checkups are recommended rather than immediate treatment.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Ophthalmology: Posterior vitreous detachment, retinal breaks and lattice degeneration Preferred Practice Pattern
- American Society of Retina Specialists: Lattice degeneration
- National Eye Institute: Retinal detachment
- MedlinePlus: Retinal detachment
- Cleveland Clinic: Lattice degeneration