A cataract is a cloudy area in the lens, the clear part of the eye that helps focus light. Age-related macular degeneration (AMD) is damage to the macula, part of the retina at the back of the eye. Both can blur vision, make colors look duller and make low light harder, so symptoms alone cannot tell you which one you have. A dilated eye exam can, and the treatments are very different: surgery removes a cataract, while AMD care depends on the stage.
If your vision has become blurry, you may wonder whether it is a cataract or macular degeneration. Both become more common with age, and some of their symptoms overlap.
This guide compares them side by side using the National Eye Institute (NEI) pages on each condition. It covers where each one happens in the eye, how the symptoms differ, how an eye doctor tells them apart, and how each is treated, including two newer drugs for a late form of dry AMD.
Two different parts of the eye
Cataracts affect the lens. NEI explains: "A cataract is a cloudy area in the lens of your eye (the clear part of the eye that helps to focus light)." That is why NEI's cataract symptom list starts with cloudy or blurry vision.
AMD affects the macula. NEI says AMD happens when aging causes damage to the macula, and that "The macula is part of the retina (the light-sensitive tissue at the back of the eye)." The macula handles sharp, straight-ahead vision. NEI notes that "AMD doesn't cause complete blindness, but losing your central vision can make it harder to see faces, read, drive, or do close-up work."
Symptoms side by side
Neither condition usually announces itself early. NEI lists the early symptoms of cataracts as "None", and says "Early dry AMD doesn't cause any symptoms." In intermediate dry AMD, NEI says some people still have no symptoms, while others notice mild blurriness in their central vision or trouble seeing in low lighting.
Later on, the lists from NEI look like this:
| What you might notice | Cataract (NEI) | AMD, mostly late stage (NEI) |
|---|---|---|
| Blur | Vision is cloudy or blurry | A blurry area near the center of your vision that may get bigger over time |
| Colors | Colors look faded | Colors may seem less bright than before |
| Dim light | You can't see well at night | More trouble seeing in low lighting |
| Bright light | Lamps, sunlight or headlights seem too bright; halos around lights | Not on NEI's AMD symptom list |
| Straight lines | Not on NEI's cataract symptom list | Straight lines start to look wavy or crooked |
| Other | Double vision (this sometimes goes away as the cataract gets bigger); needing new glasses or contact lens prescriptions often | Blank spots in your vision |
Blur, duller colors and trouble in dim light appear on both lists. That overlap is why guessing is not a good plan. NEI's cataract page puts it simply: "Talk with your eye doctor if you have any of these symptoms." NEI adds that they could also be signs of other eye problems.
Keep in mind: NEI says "Straight lines looking wavy is a warning sign for late AMD. If you notice this symptom, see your eye doctor right away." Our guide on how to use an Amsler grid explains how people with AMD check for this at home, and our article on the symptoms of macular degeneration covers the full range of AMD changes.
Who gets them
Both conditions become more common with age. NEI reports that "more than half of all Americans age 80 or older either have cataracts or have had surgery to get rid of cataracts." For AMD, a 2022 study in JAMA Ophthalmology estimated that in 2019 about 18.34 million Americans age 40 and older had early AMD and about 1.49 million had late AMD.
The risk factor lists are different, with one important overlap:
- Cataract risk factors (NEI): diabetes, smoking, drinking too much alcohol, a family history of cataracts, an eye injury or past eye surgery, radiation treatment, lots of time in the sun, and steroid medicines.
- AMD risk factors (NEI): age (people 55 and older are more likely to have it), a family history of AMD, being Caucasian, and smoking.
Smoking is on both lists. The CDC says people who smoke are twice as likely to develop AMD and two to three times more likely to develop cataracts than people who do not smoke. Our article on smoking and eye health goes into the evidence.
How an eye doctor tells them apart
You cannot see your own lens or macula, but your eye doctor can. NEI says an eye doctor can check for cataracts as part of a dilated eye exam, and that AMD is checked as part of a comprehensive dilated eye exam. For AMD, your doctor may also recommend a scan called optical coherence tomography (OCT).
NEI's dilated eye exam page lists what the exam can include: a visual acuity test, a visual field test, an eye muscle function test, a pupil response test, tonometry to measure eye pressure, and dilation. On timing, NEI's cataract page says: "If you're age 60 or older, get a dilated eye exam every 1 to 2 years."
Having one condition does not rule out the other. NEI's page on cataract surgery notes that a doctor may recommend removing a cataract so they can see and treat problems at the back of the eye, including AMD.
How cataracts are treated
NEI says: "Surgery is the only way to get rid of a cataract, but you may not need to get surgery right away." Early on, NEI suggests simple steps such as brighter lights, anti-glare sunglasses, magnifying lenses, or new glasses or contacts.
When surgery is needed, the surgeon replaces the clouded lens with an artificial one called an intraocular lens. Here is what NEI says about it:
- "9 out of 10 people who get it can see better afterwards."
- "Waiting to have surgery usually won't harm your eyes or make surgery more difficult later."
- The surgery "lasts about 1 hour."
- "Most people are completely healed 8 weeks after their surgery."
How AMD is treated, by stage
AMD care depends on the stage and type. Our article on dry vs. wet macular degeneration explains the two forms.
| Stage | What the sources say |
|---|---|
| Early AMD | NEI: "There's currently no treatment for early AMD." NEI's trials FAQ says supplements showed no benefit at this stage. |
| Intermediate AMD | NEI: AREDS2 supplements "may delay progression of intermediate to advanced AMD." |
| Wet AMD | NEI lists two options: anti-VEGF injections and photodynamic therapy. Anti-VEGF injections are the most common treatment to slow vision loss. They usually work only for a short time, so most people need them many times, and at first most people need an injection once a month. |
| Geographic atrophy (a late form of dry AMD) | Two injected drugs were approved by the FDA in 2023. They slow the growth of damaged areas, but their main trials did not show better visual function on key secondary measures. |
The 2023 geographic atrophy drugs
NEI's AMD overview, last updated in June 2021, says there is currently no treatment for late dry AMD. That page was written before two FDA approvals in 2023:
- Pegcetacoplan (Syfovre) was approved on February 17, 2023, according to Drugs@FDA.
- Avacincaptad pegol (Izervay) was approved on August 4, 2023, according to Drugs@FDA and the FDA's list of novel drug approvals for 2023.
Both are given as injections into the eye. In the OAKS and DERBY trials of pegcetacoplan (Lancet, 2023), 1,258 patients aged 60 and older received monthly or every-other-month injections or a sham (pretend) treatment. At 24 months, monthly and every-other-month injections slowed the growth of geographic atrophy lesions by 22% and 18% in OAKS and by 19% and 16% in DERBY, compared with sham. The authors reported no differences in key secondary visual function measures at 24 months. New wet AMD by 24 months was more common with treatment: 11% (monthly) and 8% (every other month) vs 2% with sham in OAKS, and 13% and 6% vs 4% in DERBY. The trials were funded by the drug's maker, Apellis.
In the GATHER2 trial of avacincaptad pegol (Lancet, 2023), 448 patients aged 50 and older received monthly injections or sham for 12 months. Lesion growth was 14% slower with the drug. Macular neovascularization (new blood vessel growth in the macula) occurred in 7% of treated patients vs 4% with sham. The trial was funded by Iveric Bio, an Astellas company.
In plain terms, these drugs slow the spread of damage. They have not been shown to improve vision, and the OAKS and DERBY trials found no differences in key secondary visual function measures at 24 months. If you have geographic atrophy, your eye doctor can talk through whether they fit your situation.
Can eye vitamins help either one?
For cataracts, the large NEI trials found no effect. NEI's summary of the AREDS and AREDS2 trials says the supplements do not have an effect on cataract. A 2013 AREDS2 report found lutein and zeaxanthin had no overall effect on the need for cataract surgery (hazard ratio 0.96).
For AMD, NEI's AREDS/AREDS2 FAQ says nutritional supplements cannot prevent AMD. The benefit in the trials was for people who already had intermediate or late AMD. NEI also says current and former smokers should choose the AREDS2 formula rather than the original one. Our article What Is AREDS2 and Who Needs It? explains who the formula is for, and our science page lists the doses used in the trials.
Frequently asked questions
Can a cataract spread from one eye to the other?
No. NEI says cataracts "can't spread from one eye to the other."
If I have a cataract, should I have surgery right away?
Not necessarily. NEI says you may not need surgery right away, and that waiting usually won't harm your eyes or make surgery harder later. Your eye doctor can help you decide when it makes sense.
Does AMD make people completely blind?
NEI says AMD doesn't cause complete blindness. Losing central vision can still make it harder to see faces, read, drive or do close-up work.
How often should I get my eyes checked?
NEI's cataract page advises a dilated eye exam every 1 to 2 years if you are 60 or older. Your eye doctor may suggest a different schedule based on what they find. Our guide to eye health after 50 brings the recommendations together.
Related reading
- Eye Health After 50
- Glaucoma After 60
- How to Use an Amsler Grid
- The Symptoms of Macular Degeneration
- Can AREDS2 Prevent Macular Degeneration?
- Browse the Eye Health Library
References
- National Eye Institute. Cataracts (updated August 19, 2026). nei.nih.gov
- National Eye Institute. Cataract surgery (updated December 5, 2024). nei.nih.gov
- National Eye Institute. Age-related macular degeneration (AMD) (updated June 22, 2021). nei.nih.gov
- National Eye Institute. Treatments for wet AMD (advanced neovascular AMD) (updated December 5, 2024). nei.nih.gov
- National Eye Institute. Get a dilated eye exam (updated November 26, 2025). nei.nih.gov
- National Eye Institute. About AREDS and AREDS2 (updated October 22, 2025). nei.nih.gov
- National Eye Institute. AREDS/AREDS2 frequently asked questions (updated November 19, 2020). nei.nih.gov
- Centers for Disease Control and Prevention. Vision loss, blindness, and smoking (last reviewed February 24, 2025). cdc.gov
- U.S. Food and Drug Administration. Drugs@FDA, NDA 217171 (pegcetacoplan). accessdata.fda.gov
- U.S. Food and Drug Administration. Drugs@FDA, NDA 217225 (avacincaptad pegol). accessdata.fda.gov
- U.S. Food and Drug Administration. Novel drug approvals for 2023. fda.gov
- Heier JS, Lad EM, Holz FG, et al. Pegcetacoplan for the treatment of geographic atrophy secondary to age-related macular degeneration (OAKS and DERBY): two multicentre, randomised, double-masked, sham-controlled, phase 3 trials. Lancet. 2023;402(10411):1434-1448. doi:10.1016/S0140-6736(23)01520-9
- Khanani AM, Patel SS, Staurenghi G, et al. Efficacy and safety of avacincaptad pegol in patients with geographic atrophy (GATHER2): 12-month results from a randomised, double-masked, phase 3 trial. Lancet. 2023;402(10411):1449-1458. doi:10.1016/S0140-6736(23)01583-0
- Rein DB, Wittenborn JS, Burke-Conte Z, et al. Prevalence of age-related macular degeneration in the US in 2019. JAMA Ophthalmol. 2022;140(12):1202-1208. doi:10.1001/jamaophthalmol.2022.4401
- Age-Related Eye Disease Study 2 (AREDS2) Research Group. Lutein/zeaxanthin for the treatment of age-related cataract: AREDS2 randomized trial report no. 4. JAMA Ophthalmol. 2013;131(7):843-850. doi:10.1001/jamaophthalmol.2013.4412
This article is for general education and is not medical advice. Talk with your eye doctor before starting any supplement, especially if you smoke, take other medicines, or have a health condition. These statements have not been evaluated by the Food and Drug Administration. TruVista products are not intended to diagnose, treat, cure, or prevent any disease.
