Both macular degeneration and glaucoma can lead to vision loss and blindness. But they have different causes and treatments.
Age-related macular degeneration (AMD) and glaucoma are two of the
Macular degeneration results from a wearing down of the eye’s macula, which is near the center of the retina. AMD has two types — wet and dry — and causes central vision loss over time, which can result in blindness.
Glaucoma occurs as a result of damage to the optic nerve, often due to pressure in the eye. It often begins as peripheral vision loss and can also lead to blindness.
This article explores the differences between macular degeneration and glaucoma, what to expect if you have either of these conditions, and how they can be treated or prevented.
Key statistics
Vision loss affects many people in the United States, especially older adults:
11 million people live with AMD3 million people have glaucoma- over
20 million people over age 40 have cataracts in one or both eyes
Age can naturally cause many changes in your eyes. While it’s not unusual for your vision to change over time, some health conditions can affect your vision’s overall health and even cause blindness if untreated.
Macular degeneration causes
AMD can develop as your macula changes over time. The macula is a part of the retina, which is tissue at the back of your eye. It controls the sharpness of your central vision, allowing you to accurately see shapes and details.
There are two types of age-related macular degeneration: dry and wet.
Dry macular degeneration occurs as the macula thins due to natural wear and tear as we age.
Wet macular degeneration happens when abnormal blood vessels leak fluid into the macula. This can be due to a buildup of drusen, or lumps of fatty proteins called lipids, under the macula. This creates bleeding and scarring.
Many people develop drusen in their eyes with age. Most drusen don’t cause serious vision problems. However, having large, central drusen is a risk factor for AMD.
Glaucoma causes
Glaucoma can also develop with age, but even babies and children can have glaucoma. There are many different types, with open-angle glaucoma being the most common.
Although experts aren’t really sure why glaucoma develops in the first place, what’s clear is that damage occurs from a buildup of pressure within the eye.
Sometimes, this pressure happens because your eye doesn’t drain its natural fluid properly. In other cases, it could be due to other health conditions like high blood pressure or diabetes.
Over time, this high pressure within the eye affects the optic nerve, disrupting the signals between your eye and brain about what you’re seeing.
Glaucoma can also develop even if eye pressure is normal.
Vision loss occurs with both macular degeneration and glaucoma, but the specific type of vision loss and its symptoms are different.
Macular degeneration symptoms
There are typically three stages of macular degeneration:
- Early AMD: This stage usually has no symptoms.
- Intermediate AMD: This might also not appear with noticeable symptoms, but people who do have them notice things like mild blurred vision and difficulty seeing in low light.
- Late AMD: This is the most severe stage. What you see can appear crooked or wavy, and you may lose sight in the center of your visual field. You may even see blank spots at the center of your eye. Peripheral vision is often more clear in people with AMD.
A simple dilated eye exam at your ophthalmologist’s office can often detect AMD. Other tests, called optical coherence tomography and fluorescein angiography, provide a more detailed look.
Your doctor may use a tool called the Amsler grid, which can identify vision changes due to later stage AMD. The Amlser grid can also help people notice early changes so they know to contact their eye doctor.
Glaucoma symptoms
Glaucoma symptoms vary depending on the type. In general, while you may not notice changes initially, you’ll likely begin to lose peripheral vision, which is sight around the edges of your eye. This could feel like tunnel vision, or patches of vision loss.
In severe cases, the loss of peripheral vision may eventually lead to blindness.
Acute-angle glaucoma is different than the primary form and is a
Regular eye examinations to track gradual changes in your vision are an important step in the treatment process. While exams may not seem like a treatment, they’re crucial to identifying problems early on, which can sometimes help slow or stop the progression of your vision loss.
A peripheral visual field test, which is usually part of a routine eye exam, is an important tool doctors use to detect vision changes due to possible glaucoma or other conditions.
Macular degeneration treatment
Treatment for AMD depends on the type.
Dry AMD is the
As of 2023, the FDA has approved two new injectable medications, Syfovre (pegcetacoplan) and Izervay (avacincaptad pegol), for the treatment of dry AMD. An eye doctor administers these drugs as an injection into the eye.
Injectable anti-VEGF drugs and laser therapies can help slow down and sometimes partially reverse vision loss due to wet AMD.
Glaucoma treatment
Laser treatments may also be an option to drain fluid from your eye and help lower eye pressure. In severe cases, a surgical procedure called a trabeculectomy may be necessary to remove fluid and relieve pressure buildup.
These treatments focus on alleviating the pressure in your eye and preventing further damage to the optic nerve. However, different types of glaucoma cause this pressure to build in different ways. Talk with your doctor about the right treatments for your specific type of glaucoma.
While age is the biggest risk factor for both AMD and glaucoma, researchers have identified other risks.
Macular degeneration risk factors
The top
- being age 55 years and older
- being white
- smoking cigarettes
- having a family history of AMD
- having obesity
Glaucoma risk factors
Top
- having a family history of glaucoma, which can lead to glaucoma at any age
- being over 60 years of age
- being Hispanic, Latino, or Black
There are many risk factors for both AMD and glaucoma that you can’t control, and it’s not possible to entirely prevent either condition. However, you can take steps to help improve your overall eye health.
These include:
- quitting smoking, if you smoke
- attending routine eye exams
- getting regular
physical activity - eating a balanced diet
- maintaining stable blood pressure
Glaucoma and macular degeneration are common eye conditions that can develop with age in some people. Both conditions can lead to vision change and loss.
In the early stages of these conditions, there are often no symptoms. As glaucoma progresses, it will cause loss of peripheral vision, while AMD affects central vision first. Severe cases of either condition can cause blindness.
Vision loss due to dry AMD is permanent, while wet AMD can be slowed and sometimes reversed with medications and laser therapy. Glaucoma is usually treated with eye drops or surgery to relieve pressure on the optic nerve.
Talk with your doctor about your family history and other risk factors for both AMD and glaucoma. Prioritize yearly eye exams, especially once you turn 40, to catch any signs of a chronic eye condition before they affect your vision.