Visual impairment is a national health problem that negatively impacts physical and mental health. In the United States, macular degeneration is the leading cause of vision loss in people age 50 and older. Glaucoma affects fewer people, but it can also lead to complete loss of vision and is the second leading cause of blindness worldwide.
Both conditions are considered degenerative eye diseases, and it is possible for people to be affected by both. In this article, we will discuss the characteristics of the conditions and vision changes they can cause.
There are two basic types of age-related macular degeneration (AMD), wet and dry. About 80%–85% of people with macular degeneration have dry macular degeneration. In dry macular degeneration, the part of the macula at the center of the eye’s retina becomes thinner and protein clumps grow. Dry macular degeneration often affects both eyes, and there is currently no treatment or cure.
Although less common, wet macular degeneration is considered more severe than dry macular degeneration. In wet macular degeneration, new, abnormal blood vessels grow under the retina, projecting light to the back of your eye. These vessels often leak blood or blood products, which can scar the macula. Vision loss occurs faster than in dry macular degeneration. Treatment is available for wet macular degeneration, which slows or stops the growth of blood vessels and slows vision loss.
Macular Degeneration: A Timeline of Vision Loss Progression
Certain common risk factors cannot be changed, such as a family history of macular degeneration and whiteness. However, lifestyle choices such as smoking, high intake of saturated fat, overweight and high blood pressure can be addressed. Managing these factors can help reduce your likelihood of developing dry AMD.
The eye is constantly producing a fluid called the aqueous humor, the clear fluid in the front of the eye. It nourishes your eyes and keeps them puffed up.
As fluid drains from the eye through the drainage horn, new fluid is created to replenish the eye. If the drainage angle is blocked, aqueous humor can remain in the eye and pressure can increase. As the pressure inside the eye rises, it can compress and damage the optic nerve. This can lead to a condition called glaucoma.
Glaucoma is divided into open-angle glaucoma (the most common type) or angle-closure glaucoma. In open-angle glaucoma, the aqueous humor drains slowly, causing a gradual increase in pressure. This type of glaucoma is usually painless, and people with glaucoma experience no vision changes initially. However, people eventually notice blind spots in their peripheral vision.
Angle-closure glaucoma occurs when the iris (the colored part of the eye) suddenly blocks the draining angle completely. In this type of glaucoma, stress can rise rapidly and cause symptoms such as:
- blurred vision
- severe eye pain
- nausea and vomiting
- halos around lights or iridescent rings
What to Know About Sudden Blurred Vision
Risk factors for glaucoma include:
- over 40 years old
- family history of glaucoma
- African, Spanish or Asian ancestry
- history of ocular hypertension
- farsighted or nearsighted
- history of eye trauma
- long-term steroid use
- central thin cornea
- optic nerve thinning
- History of diabetes, high blood pressure, migraines, poor circulation, or other medical conditions affecting the whole body
Located in the central part of the retina, the macula is the structure of the eye that makes up the central visual field and finer visual details. In people affected by macular degeneration, central vision is lost. Fine details, regardless of distance, are difficult to see, but peripheral or side vision usually remains normal.
People affected by open-angle glaucoma may not notice any visual changes initially. However, as damage to the optic nerve continues to increase, people will begin to notice blind spots in peripheral vision. Eventually, complete blindness may occur.
People affected by angle-closure glaucoma often experience sudden eye pain, see halos around lights, or blurred vision. Other symptoms may include headache, nausea and vomiting.
Minimizing certain lifestyle choices closely associated with the development of macular degeneration can help prevent AMD. Lifestyle changes to consider include:
- quit smoking
- dietary changes, such as limiting foods high in saturated fat
- maintain a healthy weight
- maintain healthy blood pressure
- Manage other chronic diseases, such as diabetes
The Age-Related Eye Disease Study (AREDS) shows that specific dietary modifications, including taking specific vitamins and minerals, can slow macular degeneration. Foods that can help prevent AMD include leafy green vegetables, yellow fruits and vegetables, and fish.
The best way to prevent glaucoma is to have routine eye exams performed by an eye specialist, such as an ophthalmologist (a doctor who specializes in eye diseases) or an optometrist (a primary vision care physician). Because of the genetic component of the disease, it is also important to determine if there is a family history of glaucoma. Similar to macular degeneration, maintaining a healthy weight, not smoking, and controlling blood pressure and other chronic diseases can minimize vision loss from glaucoma.
What is the difference between an optometrist and an ophthalmologist?
So far, there is no surgery or specific procedure that can cure dry AMD. However, there are some options that can help people with this condition. Low vision tools, such as magnification tools and handheld computers, may be helpful. Low vision techniques, such as using high-lumen light sources, reducing glare, and increasing contrast, can also help compensate for central vision loss.
A vision rehabilitation specialist can give you tips on using your peripheral vision to read, shop, and even cook. They can also identify other services that may be useful, such as mobility services or conducting home assessments, to minimize hazards and risk of injury.
People with glaucoma do have some medications and procedures that can help prevent vision loss. Eye drops can be prescribed. They both reduce the production of aqueous humor and help it drain through the drainage angle. The ultimate goal is to reduce intraocular pressure and prevent optic nerve damage.
People with glaucoma may be eligible for laser surgery. These procedures are usually performed in the ophthalmologist’s office or same-day surgery center and allow the ophthalmologist to widen the drainage angle to help better drain the aqueous humor. In the case of angle-closure glaucoma, laser surgery can be used to create a small hole in the iris that allows the aqueous humor to drain through the drainage angle.
Purpose of glaucoma surgery
Age-related macular degeneration and glaucoma both affect your eyes, but they work in different ways. There are two types of macular degeneration: dry and wet AMD. Both can cause loss of central vision, but peripheral or lateral vision is usually not affected. Glaucoma, on the other hand, causes complete loss of vision. There are no treatment options for dry AMD, but there are treatments for wet AMD and glaucoma.
Routine eye exams by specialists such as an ophthalmologist or optometrist and adopting a healthy, active lifestyle can help prevent macular degeneration and glaucoma and their potential impact on vision. Make sure you find a reputable eye specialist to discuss the use of any medication or therapy to prevent macular degeneration or glaucoma.
Frequently Asked Questions
How can macular degeneration be prevented?
Macular degeneration cannot always be prevented. The biggest risk factors — family history and being white — aren’t something you can change. However, you can minimize other risk factors—being overweight and using tobacco products—to reduce your chances of developing macular degeneration.
The early symptoms of macular degeneration are not always obvious in people with macular degeneration. A routine annual eye exam by an eye specialist, such as an ophthalmologist or optometrist, is necessary because an eye specialist can perform tests to identify early signs of AMD.
Can you reverse macular degeneration naturally?
No, there is currently no natural way to reverse macular degeneration. Current evidence supports reducing risk factors. Quit smoking. maintain a healthy weight. Certain vitamins and minerals, as well as a diet rich in fish, leafy greens, and yellow fruits and vegetables, can help relieve this condition.
How long does macular degeneration blindness take?
Blindness is not a common result of macular degeneration. Macular degeneration results in loss of vision in only the central portion of the visual field. Peripheral vision is usually not affected. However, macular degeneration can affect your ability to drive, read small print, and even see your face. Since peripheral vision remains intact, it is often possible to move around and not bump into things.