Cataracts vs. Macular Degeneration: How to Spot the Difference

Vision changes due to age-related cataracts and macular degeneration (ARMD) generally progress slowly. But this is where the similarities end.  To understand and compare the two, we need to look at three distinct areas: the causes, the symptoms, and the treatments. 

Eye Disease Comparison: Causes, Symptoms, and Treatments 

The cause

Cataracts are the result of proteins clumping together on the eye lens. With age-related cataracts, this happens over many years—often decades. While some things are believed to potentially speed up the progression, such as smoking, poor nutrition, excessive UV exposure, and certain medications, cataracts will affect everyone in the happy event of living to old age.

Age-related macular degeneration, on the other hand, isn’t something that everyone gets. It’s estimated to affect around one in eight people aged 60+. It happens when the central part of the retina, known as the macula, begins to deteriorate. While the exact cause is unknown, elements like obesity, smoking, hypertension, and cardiovascular disease are believed to be a factor. However, aging and genetics are thought to play the largest part.

The symptoms

There are significant differences in the symptoms of cataracts vs. macular degeneration. This is because a different area of the eye is affected. In cataracts, the gradually increasing clouding of the lens impacts the passage of light through the eye. This can cause:

• Blurring.
• Double vision.
• Seeing halos around lights.
• Poor low light vision.
• Muting or yellowing of colors.
• Light sensitivity.

ARMD affects the light-sensitive cells of the macula (a central area in the retina), which are also responsible for fine vision clarity. This leads to symptoms like:

• Blurred or distorted areas in central vision. This can progress to areas that are completely blacked out.
• Straight lines appear to be crooked.
• Difficulty in seeing detail, leading to problems with reading, watching TV, or recognizing faces.
• Light sensitivity.

The treatments

The treatments for the two conditions are also very different.

Cataracts are cured by removing the diseased lens and replacing it with an artificial intraocular lens (IOL). This is a quick, well-proven treatment carried out by a specialist ophthalmologist. The success rate is around 99%, with most people experiencing what are often positively life-changing results post-surgery.

ARMD is not a curable condition. However, treatments can slow it down. Exactly how will depend on the type of disease you have: dry or wet macular degeneration. The former is the most common, affecting around 80% of those with the disease. 

Until recently, dry ARMD had no specific treatments. Instead, antioxidant vitamin supplements support eye health at a cellular level and day-to-day living is improved through visual aids and lifestyle adjustments.

But this is set to change with some revolutionary new treatments for dry ARMD.

• Drug therapy: Two new drugs have been approved by the FDA for treating dry ARMD. Pegcetacoplan (SYFOVRE) and avacincaptad pegol (Izervay) are given by injection and, while they don’t cure the symptoms of macular degeneration, they have been proven to effectively slow its progression.
• Stem cell replacement: This is still very much in the early research stages, but small clinical trials are proving very positive in replacing the damaged macular cells. However, it’s expected to be another decade or so before stem cell treatment is approved for general human use.

Wet ARMD does have some treatments. Again, these slow down the pathway, rather than being a definitive cure.

• Anti-VEGF injections: These are administered every 1-2 months under local anesthetic. The success rate of slowing progression is high (around 90%) and around 30% of people also experience visual improvement.
• Laser therapy: Either a standalone treatment or in conjunction with injections, this is usually performed every couple of months. It seals and/or destroys the leaky blood vessels that are the hallmark of wet ARMD.

When it comes to understanding cataracts vs. macular degeneration it can’t be overstated how important it is to have regular eye exams. This applies to everyone, no matter what your age, even if you have zero problems with your vision.

At the West Boca Eye Center, we specialize in cutting-edge care for cataracts and macular degeneration—and our eye doctors are some of the best in the world at diagnosing and instigating the very latest treatment.

Discover more at https://www.westbocaeyecenter.com/