Macular Degeneration vs. Cataracts

If you’ve noticed changes in your vision or the feeling in your eyes, reach out to a doctor. Vision changes may be particularly noticeable when driving, watching TV, or reading.

A primary care doctor can provide an evaluation, but you may need an appointment with an ophthalmologist, a doctor who specializes in eye health.

Macular degeneration symptoms

Macular degeneration is sometimes referred to as age-related macular degeneration (AMD). According to the National Eye Institute, AMD is broken down into two main types: wet and dry. Dry macular degeneration (dry AMD) is more common than wet macular degeneration (wet AMD).

The symptoms of AMD vary depending on the type and how the condition is progressing. The progression of dry AMD is divided into three stages: early, intermediate, and late. Wet AMD has a much more sudden onset and causes a severe loss of central vision.

In late-stage dry or wet AMD, the following symptoms may occur:

• seeing straight lines as crooked or wavy
• seeing a blur at the center of your vision
• developing blank spots in your vision
• difficulty seeing in low light
• noticing that colors are faded

Dry macular degeneration

According to the Centers for Disease Control and Prevention (CDC), 70 to 90 percent of people with macular degeneration have dry AMD.

This form occurs when the macula thins and small collections of yellow protein and lipid deposits called “drusen” grow under the retina. Over time, people with dry AMD will slowly lose their central vision.

In the early and intermediate stages, dry AMD often does not cause any noticeable symptoms. However, some people experience mild symptoms, like central vision blurriness or difficulty seeing in dim light. Sometimes dry AMD leads to wet AMD, but not always.

There is no treatment for late-stage dry AMD. But research is underway into the immune system’s role in dry AMD and whether stem cell treatments might help. A high antioxidant vitamin preparation has been found to slow down the progression of dry AMD.

Wet macular degeneration

Wet AMD is usually more serious than dry AMD, and it occurs when atypical blood vessels start to grow under your retina. This can lead to scarring on your macula, especially when these blood vessels leak. Wet AMD leads to a much quicker loss of vision than dry AMD, and it’s always considered late-stage.

Wet AMD can be treated with photodynamic therapy and anti-vascular endothelial growth factor (anti-VEGF) drugs, which are injected into the affected eye. We’ll discuss these approaches in more detail below.

Cataracts symptoms

Cataracts are also a progressive condition that tends to be mild at first but worsens over time. As cataracts grow, your vision will change.

The following symptoms are common to cataracts:

• cloudy or blurry vision
• seeing faded colors
• difficulty seeing at night
• feeling that light from lamps, sunlight, or headlights is too bright
• seeing a halo around lights
• seeing double, which is a symptom that might disappear as a cataract grows
• frequent change in glasses prescription
• vision loss

Macular degeneration causes

The key contributor to macular degeneration is age. The condition occurs due to the wearing down of the eye’s macula. This can happen naturally as your body gets older, but it can also be worsened by certain risk factors.

Cataracts causes

Most cases of cataracts are also caused by typical age-related changes in the eyes. A young person has a clear lens on their eye, but by the time they reach age 40, the proteins that make up the lens break down and clump together.

These proteins are what form the cloudiness in your eye’s lens. The cloudy lens is a cataract. Without treatment, cataracts typically become denser and lead to more vision loss.

Macular degeneration risk factors

The American Optometric Association identifies the following risk factors for AMD:

• a family history of any kind of macular degeneration
• excessive UV light exposure
• smoking
• nutritional deficiencies
• lack of exercise

Cataracts risk factors

Your risk for cataracts increases if you:

• smoke
• have diabetes
• drink heavily
• have family members who have had cataracts
• had an eye injury, eye surgery, or upper body radiation treatment
• spend or have spent a lot of time in the sun
• take or have taken steroids

AMD and cataracts can both cause vision change and loss, and the chance of developing each increases with age. Smoking, sun exposure, and genetics are shared risk factors. However, while vision loss due to cataracts is often reversible, this is not true for AMD.

Here’s a breakdown of key features for comparison:

Macular degeneration treatment

There is no way to reverse the vision loss a person experiences with dry AMD. Instead, treatment for this condition focuses on slowing vision loss and managing symptoms.

Nutrition

For dry AMD, the American Academy of Ophthalmology suggests people with serious vision loss may slow continued loss of vision by taking the following supplements and minerals every day:

• Copper: 2 milligrams (mg)
• Lutein: 10 mg
• Vitamin C: 500 mg
• Vitamin E: 400 international units (IU)
• Zeaxanthin: 2 mg
• Zinc: 80 mg

Always consult a doctor before adding supplements to your diet. In addition to adjusting nutritional intake, aiming to quit smoking and eating a rich, balanced diet can help.

Learn more about the best foods for healthy eyes.

Medications and procedures

People with wet AMD may benefit from anti-VEGF drugs. The American Academy of Ophthalmology explains that these medications improve vision in a third of people who receive them and stabilize vision in the majority.

Anti-VEGF medications are delivered through the eye by injection. They block a certain protein that causes blood vessels to grow in the eye. This can reduce the number of atypical blood vessels below the macula and slow leaking.

Rare cases of wet AMD may benefit from photodynamic therapy in addition to anti-VEGF medications. During photodynamic therapy, doctors use lasers alongside a light-sensitive medication called “verteporfin” to target and break down blood vessels causing vision loss. The process may need to be repeated.

Before any of these procedures, a doctor will clean your eye and apply a numbing medication.

Mental health support

Loss of vision can have serious psychological effects, as it can impact independence and quality of life. It’s important to look after your mental health if you’re experiencing vision changes.

Seeing a therapist can provide a safe space to work through any emotions you may feel or want to share. You’re not alone and support is available.

Learn more:

• 9 Tips for Finding the Right Therapist
• Benefits and Options for Therapy
• A Guide to Different Types of Therapy

Low vision aids

There are tools and coping strategies you can use to maximize the vision you have.

These include:

• wearing sunglasses or UV glasses for protection
• using magnifiers when reading
• using brighter overhead lights or lamps to improve visibility
• using screen readers or other assistive technologies
• making sure your home is easy to navigate

Some people also benefit from online or in-person support groups.

Cataracts treatment

Aside from using low vision aids, the main treatment for cataracts is surgery. During cataract surgery, a doctor will remove your clouded lens and replace it with a new, artificial lens known as an intraocular lens (IOL).

Cataract surgery is considered routine and safe. It takes around 1 hour, and people are usually awake during the procedure. For those who receive the surgery, 9 out of 10 experience improved vision.

As with any surgical procedure, there can be complications. These include:

• bleeding
• pain
• certain types of edema, which is swelling due to fluid buildup

New glasses or contacts can also improve your vision early in cataract development. It’s not always advisable to have surgery right away. Talk with your doctor about what options are available to you.

It is possible to have both AMD and cataracts at the same time, as they affect two different parts of the eye.

However, while cataracts are treatable with surgery, AMD is progressive. People with both conditions can expect certain vision loss due to the AMD component.

It’s important for an ophthalmologist to determine whether the majority of your vision loss stems from AMD or cataracts before pursuing any surgery for the latter.

Clear vision often diminishes over time with age. Your sight can be affected by a host of other factors, like genetics, injuries, and lifestyle.

Macular degeneration (or AMD) and cataracts are two common, age-related chronic eye conditions. Both cause vision change and loss. Low vision aids can help maximize the vision you have and help you cope with both. Preventive measures include eating a balanced diet, not smoking, and wearing sunglasses.

Cataracts can be treated with surgery, and wet AMD can be treated with medications and laser therapies. However, the most common form of macular degeneration, dry AMD, causes permanent vision loss.

If you’ve recently noticed changes in your vision or how your eyes feel, seek an appointment with an ophthalmologist. An eye expert can investigate the root cause of your vision loss and help you come up with an individualized, actionable plan.