macular traction syndrome vs. macular pucker

Hi. I"m 49  and in Oct. was diagnosed with a macular pucker. Since my acuity was good at 20/25-2 letters, a vitreous peel surgery was not suggested and I figured I had time. However, someone else looked at my optomap and said it showed internal retinal derangements (derangements not word used) and was consisitent with macular traction syndrome and it looked from the scan like there was already a partial thickness macular hole or impending hole. My visual field test ("fast" test) shows 4 blind spots, one big, all in the same quadrant.

my questions are 1) if i am a poor candidate for surgery (I cannot lie face down for more than 5 minutes), does that mean I will go blind in the macular region in that eye? Its my understanding that  70% of partial thickness holes go on to destroy vision 1b) is there at least a chance that despite what the optomap looks like, there isn't a macular hole and the traction isn't bad enuf to lead to blindness? (I had an oct, but they took the wrong scan and I will get another this week. No retinal specialist yet). Though even if there isn't a hole yet, if I can't have surgery and the traction continues, does that means a high probabilty of  destroyed vision eventually no matter what(?)

2) I know causes are usually listed as "aging" and unknown, but is there a chance that getting away from my very dry climate ASAP would at least prevent it from happening to the other eye (which is now bothering me), if not slow down the traction force in the affected eye?. I have sjogren's syndrome as well, and the dry climate of the desert I am in puts me in constant eye pain; i do not use drops. Just seems hard to believe its a coincidence - woudln't  dryness cause shrinkage, which could in turn cause traction?even if this is not established would it be sensible to nonetheless try an immediate move?

incidentally, I'm a professor of higher-level vision, so please don't spare any technical details. thanks much.

[Houman Vosoghi, MD]

Go see a retina specialist.  They will tell you what is going on and what the chances of it worsening are.  There is a chance you may not need to lay face down if there is a simple membrane peel and the hole is not full thickness.  If your vision is better than 20/50, most retina specialist would not operate unless there is some other circumstance that requires it (traction from the vitreous etc).  Go see a specialist and put all questions to rest.

HV