Updated: Is there a relationship between cataracts and macular degeneration?

Disclaimer: I’m NOT a medical person & this isn’t advice. I do research on topics & summarize what I find to try to make it more understandable. –Linda…

What is a cataract?

“A cataract is a cloudy or opaque area in the normally clear lens of the eye. Depending upon its size and location, it can interfere with normal vision. Most cataracts develop in people over age 55, but they occasionally occur in infants and young children. Usually cataracts develop in both eyes, but one may be worse than the other.” From Glossary of Eye and Vision Conditions

Here’s a good video from the National Eye Institute “Cataracts”

Here’s a very comprehensive website section with not only statistics from the UK but also sections on what they are, what medications are used with them, and where you can get more information.

Cataract removal in someone with AMD

Question is how much of one’s poor vision is from the cataract & how much from the AMD? Depends on the severity of the cataract & stage of the AMD.

Possible Benefits

From Cataracts & Age-Related Macular Degeneration

  • if it’s mild AMD, cataract removal may improve acuity even of central vision.
  • if more advanced AMD, removal may help with color discrimination, contrast, clarity or peripheral vision.
  • if it’s wet AMD which hasn’t been stabilized, see ‘Risks’ below.
  • if it’s a thick cataract that prevents the doctor from seeing the macula clearly especially if there’s a high risk for wet AMD, removal may aid the doctor in accurate diagnosis of condition of the macula.
Risks of cataract removal in someone with AMD

Basically the same as those without AMD except when the AMD is not stabilized – more below.  In general, it’s considered to be a low-risk procedure.

Considerations:
  • the natural lens (that’s what turns yellow and is called a cataract) filters blue light but you can get an IOL (Intraocular Lens) that will help to filter some of it out (no evidence this reduces vision).
  • risk of Posterior Vitreous Detachment (PVD) which can result in floaters or retinal holes or retinal detachments (holes or detachments can occur in the macula).
  • inflammation related to AMD. Solution: pre-op NSAIDS (anti-inflammatories).
    • From Cataract Surgery in the Patient with AMD
      “Additionally, growing evidence supports a pathogenic role for inflammation in AMD, and the normal inflammatory response that accompanies cataract surgery, even when uncomplicated, may be deleterious to at-risk eyes. However, epidemiologic studies to date have failed to prove definitively that cataract surgery is associated with AMD progression. “
    • From Cataract Surgery in the Patient with AMD “In summary, in the patient with a visually significant cataract, AMD should not be considered a contraindication to cataract surgery, and surgery need not be delayed for fear of causing advanced AMD. Factors such as IOL selection and peri-operative management may optimize visual outcome and reduce the risk of AMD progression.

Other references:

Cataracts and Macular Degeneration from WebRN-MacularDegeneration.com

The Impact of Cataract Surgery on Pre-existing Retinal Disease

updated 1/27/2017

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