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Glaucoma vs. Cataracts

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As you get older, you may worry about developing glaucoma or cataracts, especially if you have a family history of these conditions. You may fear that if you get one, you are at greater risk of the other.

Fortunately, glaucoma and cataracts are not the same. They have different symptoms and treatments. One will not cause the other to develop, although they are often found simultaneously in older adults.

Both conditions are very treatable. If untreated, their progression will lead to blindness.

It is important to work with optometrists and ophthalmologists to understand your symptoms, get a correct diagnosis, and start treatment.

Glaucoma Vs. Cataracts at a Glance

GlaucomaCataracts
DefinitionA group of eye conditions that damage the optic nerve, often due to increased pressure in the eye.A clouding of the eye’s lens leading to decreased vision.
SymptomsEye pain or pressure, nausea, vomiting, blurry vision, headaches, and eye redness.Clouded or blurry vision, halos around lights, poor night vision, faded or yellowing colors, frequently needing updated glasses prescriptions, difficulties with night vision, double vision in one eye, needing brighter light for normal activities.
TypesOpen-angle glaucoma, Angle-closure glaucoma, Normal-Tension glaucoma, Secondary glaucoma, Congenital glaucoma, Pigmentary glaucoma.Nuclear cataracts (center of lens), Cortical cataracts (edges of lens), Congenital cataracts (formed in utero or just after birth), Posterior capsular cataracts (bottom of the lens capsule).
CauseCaused by fluid buildup in the eyeCaused by protein buildup on the lens.
TreatmentInitially treated with various medications (alpha agonists, beta-blockers, carbonic anhydrase inhibitors, miotics, and prostaglandin analogs) aimed at reducing eye pressure. If ineffective, different surgical methods may be used to reduce eye pressure.Initially treated with lifestyle changes like healthier eating, taking vitamin supplements, quitting smoking, and drinking less. If these measures are insufficient and vision impairment is significant, cataract surgery may be recommended to replace the clouded lens with an artificial one.
Outcome if untreatedCan lead to blindness.Can lead to blindness.

What Are the Symptoms of Cataract & Glaucoma?

Both cataracts and glaucoma can result in vision loss, particularly if they aren’t identified and treated early. But the symptoms are different.

Cataract symptoms include clouded or blurry vision, halos around lights, poor night vision, vision changes, and colors appearing duller.

Glaucoma symptoms include eye pain or pressure, nausea, vomiting, blurry vision, headaches, and eye redness.

Symptoms of Cataracts

If you develop cataracts, the initial symptoms may seem like other conditions, especially refractive errors like farsightedness or nearsightedness. However, these symptoms will get worse faster than an existing refractive error, or you will experience different symptoms that are not associated with a refractive error you already have.

These are signs you may have cataracts:

  • Faded or yellowing colors
  • Blurry vision
  • Needing updated prescription glasses or contact lenses more often
  • Glare or halos around lights, especially at night
  • Other difficulties with night vision
  • Double vision in one eye
  • Needing brighter light for normal activities like reading
  • Dizziness

You are most likely to experience cataracts as changes in your vision that seem like refractive errors like nearsightedness, farsightedness, or astigmatism. If you already suffer from a refractive error, you may experience sudden improvements in your vision and worsening sight. You may also see whitening of the pupil of your eye, which is the cataract forming.

Symptoms of Glaucoma

Most types of glaucoma cause few (if any) symptoms until the optic nerve becomes damaged. Then, you may notice subtle changes in your vision. 

An acute form of glaucoma causes sudden symptoms such as these:

  • Sudden blurry vision
  • Severe eye pain
  • Headaches
  • Nausea or feeling sick to your stomach
  • Vomiting
  • Rainbow rings, glares, or halos around lights

With regular eye exams, your optometrist will be able to follow the progress of any vision loss that shows up, along with your eye pressure, to determine the next steps in glaucoma treatment.

man in grass

Cataract Surgery

Cataract eye surgery is a very common and medically necessary procedure to remove and replace the eye’s natural lens when the vision has been clouded by a cataract. We offer laser-assisted cataract surgery and lifestyle lenses as options for our patients.

Learn More About Cataract Surgery

Types of Cataracts

Cataracts affect the eye’s lens, leading to cloudiness or darkening and preventing light from filtering back to the retina.

These are different types of cataracts:

  • Nuclear cataracts, which form in the center and move outward
  • Cortical cataracts, which form in streaks along the edges of the lens and move inward
  • Congenital cataracts, which form in utero or just after birth
  • Posterior capsular cataracts, which form at the bottom of the lens capsule, progress faster than other cataracts, and may also develop as secondary cataracts after initial cataract surgery

When you are diagnosed with cataracts in one eye, you will usually develop them in the other. If cataracts are left untreated, they can lead to blindness.

Eye Treatments for Glaucoma and Cataracts Are Different

Cataracts affect the eye’s lens, whereas glaucoma affects the optic nerve.

Each condition has different causes. Cataracts are caused by protein buildup on the lens, while glaucoma is caused by fluid buildup in the eye.

Since these conditions are so different, so are the therapies.

Cataract Treatment & Surgery

Once you have received a cataract diagnosis, your doctor will monitor the condition’s progress. You’ll have work to do too. 

You may need to make lifestyle changes, such as these:

  • Eating healthier
  • Taking vitamin supplements
  • Quitting smoking
  • Drinking less 

These steps can all slow — but not stop — the progress of cataracts.

Eventually, when your sight limits your daily activities and makes it unsafe for you to perform normal functions like driving, even with corrective wear like glasses, your doctor will recommend surgery.

Cataract surgery is an outpatient procedure that usually involves these steps:

  • You receive local anesthesia with eye drops.
  • A minuscule incision is made in your cornea and then another in the capsule containing the lens of your eye. 
  • The lens is broken up, either with the help of lasers or a probe using a sound wave and removed.
  • The lens is replaced with an artificial version.

Typically, recovery from cataract surgery requires several days of rest at home, and your vision may not be restored for weeks or months after the procedure.

Your ophthalmologist will work with you on the list of activities to avoid and a timeline for when you can start returning to specific activities or hobbies, like reading and exercising.

Glaucoma Treatment: Medication First, Then Surgery

Unlike cataracts, several medications can slow glaucoma’s progress. These reduce pressure in the eye, greatly slowing damage to the optic nerve.

You may get one or several prescriptions to treat glaucoma, depending on how high your eye pressure is and how rapidly the condition developed. The medications you use may change over time as the disease progresses.

These medications include the following:

  • Alpha agonists reduce the amount of fluid in the eyes and increase the amount of fluid that drains from the eye.
  • Beta-blockers reduce the amount of fluid produced by the eye.
  • Carbonic anhydrase inhibitors reduce how much fluid the eye produces.
  • Miotics make your pupil smaller (constrict), increasing how much fluid drains from the eye.
  • Prostaglandin analogs increase how much fluid drains from the eye.

Surgery for glaucoma is multifaceted but aimed at reducing eye pressure. Your doctor might use these approaches:

  • Laser surgery: The laser-assisted procedure (laser trabeculoplasty) drains fluid with a high-energy laser beam aimed at the trabecular meshwork. Some forms of glaucoma are treated with peripheral iridotomy, which creates a small hole in the iris and allows fluid to drain freely into the eye’s front chamber, where it can be removed more easily.
  • Conventional surgery: A filtering microsurgery (trabeculectomy) creates a drainage flap, allowing fluid to percolate into the rest of the vascular system.
  • Drainage implants: A silicone tube inserted into the eye directs the draining fluids out, relieving pressure.

Glaucoma & Cataracts Frequently Asked Questions

Can you have cataract and glaucoma surgery at the same time?

You may find yourself with both diagnoses. That means you may use eye drops to treat your glaucoma, while your cataracts are monitored for years until they need surgery to restore your vision.

Generally, you can have both surgeries at the same time. Your ophthalmologist will assess whether this is appropriate for your situation.

Which is worse: glaucoma or cataracts?

Glaucoma is sometimes considered more serious since it can be acute and require emergency medical attention. Vision loss from glaucoma might also be permanent, whereas vision loss from cataracts is generally reversible. Vision is often fully restored once the cataract is removed.

Neither condition is worse since it depends on the specifics of each person’s situation.

Can cataracts be mistaken for glaucoma?

It’s not likely. Cataracts are sometimes misdiagnosed as presbyopia. Glaucoma is sometimes misdiagnosed as a different type of optic nerve issue.

What are the symptoms of cataracts and glaucoma?

Cataract symptoms include clouded or blurry vision, halos around lights, poor night vision, vision changes, and colors appearing duller. Glaucoma symptoms include eye pain or pressure, nausea, vomiting, blurry vision, headaches, and eye redness.

Are glaucoma and cataracts related?

Both conditions occur in the eye, and they both can impair your vision. But they are very different issues.

References

  1. Eye Health Statistics. American Academy of Ophthalmology.
  2. County Data Demonstrates Eye Care Access Nationwide. (April 2018). American Optometric Association.
  3. Cataracts. (January 2023). National Eye Institute.
  4. What Is Glaucoma? Symptoms, Causes, Diagnosis, and Treatment. (December 2022). American Academy of Ophthalmology.
  5. What Are Cataracts? (September 2022). American Academy of Ophthalmology.

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