Cataracts and AMD: Where Each One Starts
Two eye conditions that become common with age begin in different parts of the eye. One starts in the lens, near the front. The other starts at the back, in the part of the retina that handles straight-ahead vision.
A cataract is a cloudy area in the lens of the eye, the clear part that helps focus light. Age-related macular degeneration is damage to the macula, the part of the retina that controls sharp, straight-ahead vision. Both can sit there for a long stretch without producing a single symptom.
Where a Cataract Begins: The Lens
Most cataracts happen because of normal changes in the eye with age.
Around age 40, the proteins in the lens start to break down and clump together. That clump makes a cloudy area on the lens. Over time the cataract gets worse and makes more of the lens cloudy.
More than half of all Americans age 80 or older either have cataracts or have had surgery to get rid of them, according to the National Eye Institute. The figure counts people who no longer have a cataract alongside people who still do.
Age is not the only route. A cataract can also come after an eye injury, or after surgery for another eye problem such as glaucoma.
Where AMD Begins: The Macula
Age-related macular degeneration is a disease of the macula, the part of the eye that controls sharp, straight-ahead vision. The macula sits inside the retina, the light-sensitive tissue at the back of the eye, and AMD happens when aging causes damage there.
That location shapes the loss. Central vision is what blurs.
AMD is common, and a leading cause of vision loss for older adults. It moves very slowly in some people and faster in others. Someone with early AMD may not notice vision loss for a long time.
The Quiet Stretch
At first, a person may not notice they have a cataract.
Early dry AMD causes no symptoms. In intermediate dry AMD, some people still have none, while others notice mild blurriness in central vision, or trouble seeing in low lighting.
In late AMD, wet or dry, many people notice that straight lines start to look wavy or crooked. The National Eye Institute calls wavy straight lines a warning sign for late AMD.
Other changes may or may not turn up. A person may notice a blurry area near the center of their vision, and over time that area may get bigger, or blank spots may appear.
Colors may seem less bright than before. Low light may be harder than it was.
Stages of AMD, and the Two Conditions Side by Side
Dry AMD happens in three stages: early, intermediate, and late. It usually progresses slowly over several years.
Wet AMD is a less common type of late AMD, and it usually causes faster vision loss. Any stage of dry AMD can turn into wet AMD. Wet AMD is always late stage.
Cataracts and AMD side by side, as described by the National Eye Institute (cataracts page last updated August 19, 2026; AMD page last updated June 22, 2021)
| Question | Cataracts | AMD |
|---|---|---|
| What part of the eye is affected | The lens, the clear part of the eye that helps focus light | The macula, the part of the eye that controls sharp, straight-ahead vision, within the retina at the back of the eye |
| What happens early | A person may not notice it at first | No symptoms in early dry AMD, and some people still have none in intermediate |
| What is noticed when symptoms appear | Vision cloudy or blurry; colors look faded; poor night vision; lamps, sunlight, or headlights seeming too bright; a halo around lights; double vision, which sometimes goes away as the cataract gets bigger; needing to change a glasses or contact-lens prescription often | In late AMD, straight lines looking wavy or crooked; a blurry area near the center of vision, which over time may get bigger, or blank spots; colors seeming less bright; more trouble seeing in low lighting |
| What raises the risk | Age; certain health problems, like diabetes; smoking; drinking too much alcohol; a family history of cataracts; an eye injury, eye surgery, or radiation treatment on the upper body; having spent a lot of time in the sun; taking steroids | Age, with people age 55 and older more likely to have AMD; a family history of AMD; being Caucasian; smoking |
| What can be done | Surgery is the only way to get rid of a cataract; early on, brighter lights at home or work and a new prescription for eyeglasses or contact lenses can help a person see better with a cataract | No treatment for early AMD; for intermediate AMD in one or both eyes, special dietary supplements may be able to stop it from turning into late AMD; for wet AMD, anti-VEGF drugs injected in the eye and photodynamic therapy; no treatment for late dry AMD |
AMD does not cause complete blindness, but losing central vision can make it harder to see faces, read, drive, or do close-up work like cooking or fixing things around the house.
What Treatment Looks Like for Each
Surgery is the only way to get rid of a cataract. During cataract surgery, the doctor removes the clouded lens and replaces it with a new, artificial lens, also called an intraocular lens, or IOL. The National Eye Institute states that 9 out of 10 people who get it can see better afterwards.
Before that point there is management rather than removal. Brighter lights at home or work, and a new prescription for eyeglasses or contact lenses, can help a person see better with a cataract early on.
AMD runs the other way. There is currently no treatment for early AMD.
For intermediate AMD in one or both eyes, special dietary supplements — vitamins and minerals — may be able to stop it from turning into late AMD. Where late AMD is in only one eye, those supplements may slow down AMD in the other eye.
Wet AMD has treatments that may be able to stop further vision loss: medicines called anti-VEGF drugs that the doctor injects in the eye, and photodynamic therapy, a combination of injections and laser treatment.
There is currently no treatment for late dry AMD.
The two conditions are not symmetrical. Cataracts have a procedure that ends them. AMD has no treatment at its earliest stage and none at late dry AMD, and in between only measures that may slow what is already underway.
The Dilated Eye Exam
Both conditions get checked for during a dilated eye exam.
The exam includes a visual acuity test, which checks how clearly a person sees, and a visual field test for peripheral vision. There is an eye muscle function test for the muscles around the eyeballs, and a pupil response test that checks how light enters the eyes.
A tonometry test measures the pressure in the eyes. That one uses a machine to blow a quick puff of air onto the eye, or gently touches the eye with a special tool.
Then dilation itself: eye drops that widen the pupil, so the doctor can check the inner parts of the eye. Depending on a person’s needs, a doctor may include other tests too.
Dilating the pupil lets more light into the eye, the way opening a door lets light into a dark room. That extra light is what lets the doctor check for eye problems including diabetic retinopathy, glaucoma, and age-related macular degeneration.
For AMD, a doctor may also do a test called optical coherence tomography, which takes pictures of the inside of the eye with a special machine.
The dilation wears off. For a few hours after the exam, vision may be blurry and the eyes may be sensitive to light.
On frequency, the National Eye Institute gives an interval of every 1 to 2 years for people over age 60, for African Americans over age 40, and for people with a family history of glaucoma. For people with diabetes or high blood pressure, most need an exam at least once a year, and the interval itself is a question for their own doctor.
Two conditions, two starting points. The lens clouds from the front; the macula takes damage at the back. Neither announces itself while it is starting, and that silence is a property of the diseases, not a sign that nothing is happening.
This article is general information, not professional advice. For decisions about your money or health, consult a qualified professional.