It’s common for our vision to become less clear with age.

Macular degeneration and cataracts are very common eye conditions in the U.S., each with more than three million new cases every year. They are different conditions, but both share some symptomatic similarities. Our risk for both increases with age.

The macula is an extremely small, oval-shaped region in the center of the retina at the back of the eye. When healthy, the macula provides central (reading) and color vision with clear resolution. In macular degeneration, the macula is damaged or worn, which leads to permanent central vision loss and blurred vision.  Macular degeneration causes permanent vision loss.

In contrast, a cataract is a clouding of the eye’s lens, causing blurred vision. As opposed to cataracts, this vision loss caused by cataracts can be reversed with a very reliable and relatively quick surgical procedure.  Complications and permanent vision loss are very rare with cataract surgery.

Symptoms of Macular Degeneration

Macular degeneration, also called age-related macular degeneration (AMD), consists of dry and wet AMD. The type and progression of AMD determine symptoms. Dry AMD has no known FDA-approved therapies to date.  Wet AMD has multiple possible therapies which can sustain visual function. 

The Centers for Disease Control and Prevention estimate 70%-90% of people with AMD have the dry type. In dry AMD, the macula thins, and small deposits of yellow protein and fat (drusen) build beneath the retina. A person gradually loses central (reading) vision. Early on and as dry AMD progresses, people typically don’t experience noticeable changes. But central vision blurriness, problems with dim light, and other mild symptoms may occur.

Wet AMD involves unusual blood vessel formation underneath the macula. This can cause visual distortion and permanent scarring of the macula, particularly when vessel leakage occurs. Wet AMD commonly leads to much more rapid loss of vision.

Symptoms of late-stage dry AMD and wet AMD include:

• Straight lines appearing crooked or wavy
• A blur in one’s center of vision
• Development of blank areas of vision within one’s central vision

Symptoms of Cataracts

Like AMD, cataracts cause gradual vision loss. Symptoms include:

• Cloudy or blurred vision
• Fading colors
• Impaired night vision
•  Light sensitivity
• A halo appearing around lights
• Double vision (which can disappear as a cataract evolves)
• Frequently needing new glasses or needing less power for reading
• Loss of vision

What Causes Macular Degeneration and Cataracts?

Aging and years of wear and tear on the macula are the chief causes of macular degeneration, though other risk factors (genetics, eye injury, lifestyle, etc.) can exacerbate the condition.

Cataracts are also mostly due to age-related wear and tear. By age 40, the proteins in a person’s lens begin to deteriorate and cluster, causing cloudiness in one’s vision. Treatment is needed to avoid further cloudiness and vision loss.

What Increases Risk?

According to the American Optometric Association, risk factors for AMD include:

• Family history of macular degeneration
• Too much UV exposure
• Smoking history
• Nutrient deficiencies

Risk factors for cataracts include:

• Smoking 
• Family history of cataracts
• Previous eye injury, surgery, or upper body radiation exposure
• History of sun exposure
• History of steroid use

Treating Macular Degeneration

Vision loss from dry AMD is irreversible, and treatment is instead aimed at slowing progression and symptom management.

The American Academy of Ophthalmology (AAO) suggests people with significant vision loss from dry AMD consider taking the following nutritional supplements every day to help preserve vision called the AREDS vitamins. These are only effective if certain preliminary findings are seen in the retina.  Please see your eye M.D. regarding appropriate therapy. 

Remember to consult your doctor before taking any dietary supplements.

For wet AMD, anti-VEGF (vascular endothelial growth factor) medications may help. These meds are delivered by eye injection and work to prevent further atypical vessel growth and slow leakage. The AAO says these drugs work in about one-third of people and stabilize eyesight in 90% of people.

Treating Cataracts

Surgery is the main treatment for cataracts, while low vision aids can also help. The aim of surgery is to replace the clouded lens with an artificial intraocular lens (IOL). The surgery is safe, commonplace, and quick, taking roughly an hour. People are typically awake for the procedure, and over 90% have better vision following surgery.

That said, complications from surgery can occur. Furthermore, surgery isn’t always the best option for early-stage cataracts, as new glasses or contacts may improve vision. Discuss available options with your doctor.

Quick Comparison

See a Doctor If Your Vision Changes

A person can have both AMD and cataracts occurring together, since each disease affects a different part of the eye. Permanent vision loss can be expected from AMD. It’s important to see an ophthalmologist to determine which condition is responsible for the majority of vision loss so appropriate action can be taken.

Likewise, with any changes in vision or feeling in the eyes, usually noticeable when driving, reading, or watching television, it’s advisable to schedule an appointment with an ophthalmologist for an expert evaluation and tailored action plan.

*Cirino, E. (2022, March 16). Macular Degeneration vs. Cataracts. Healthline. https://www.healthline.com/health/macular-degeneration-vs-cataracts

This article was reviewed and edited for accuracy by Alan Robin, M.D., a Responsum Health Advisory Council member, ophthalmologist, glaucoma treatment specialist, and leader in the clinical management and scientific study of the disease.