Ask the expert: Glaucoma or macular degeneration...which is more serious?

Answers provided by Dr. Mitchell Gossman, M.D., ophthalmologist at Eye Associates of Central Minnesota, St. Cloud

I have friends and family who have glaucoma or macular degeneration. What’s the difference? Which is worse?


Glaucoma and macular degeneration are not rare diseases, so it is natural to know people who suffer from one or the other, and of course anyone can develop these himself or herself. First, some background.


The eyes sense images, much like a camera, and deliver the images of the world around us to the brain where we experience the images. We enjoy what we see, it’s important for so many activities including work and hobbies, and brings beauty into our lives. It is our most important sense, so it can be a significant loss if something happens to it.


The entirety of the image we experience is called the “visual field,” and can be divided into two areas. First is the peripheral visual field. This provides us a general awareness of our surroundings, and is important to help guide us around obstacles and avoid threats. It is a very large area, over 180 degrees wide. However, the peripheral vision does not provide good detail, something you can verify that by trying to read the baseball score on the TV when looking off to the side.


Glaucoma and macular degeneration are serious and can impact a person’s quality of life. File photo

The other area of vision is “central vision.” The center of vision is small, but provides the necessary detail to perform many tasks such as reading a book, seeing details on a computer or TV, or recognizing road signs.


Macular degeneration affects the central area of the retina that senses the fine detail of your central vision, and this part of the retina is called the “macula,” hence the term “macular degeneration.” This disorder can come in a wide range of severities, all the way from minor distortion of vision and still being able to see the 20/20 line on a chart, all the way to being unable to see the 20/200 line (the big “E”). If an eye can see only the big E on the chart, or less, then the eye is defined as “legally blind.” This is not “complete blindness,” which is defined as the loss of all vision, a much more serious disability that can affect your ability to care for yourself.


Glaucoma generally in its earlier stages affects the peripheral vision only. It may be very mild and unnoticeable in its early stages, which is one reason why a routine eye exam is needed to catch it early. If enough peripheral vision is lost where only the central 20 degrees of vision remains, this would be another definition of legal blindness. The danger from glaucoma is not only the impairment of peripheral vision, but it can in fact lead to significant loss of both peripheral and central vision, and can be blinding. True blindness is a devastating disability that is far worse than legal blindness.


So the answer to your question is, both diseases are significant, and can causes serious disability, but because glaucoma carries a risk of complete blindness, it’s my opinion that glaucoma can be “worse.” Fortunately, though, most cases of glaucoma cause minimal symptoms if caught early and treated. Macular degeneration virtually never causes true blindness, but unfortunately seriously impacts the quality of life because of the high value we place on our detailed vision for reading.


The bottom line here is to undergo periodic screening eye exams to protect yourself against serious loss of vision.


Find Out More


Dr. Mitchell Gossman and Dr. Andrea Joplin, ophthalmologists at Eye Associates of Central Minnesota, can diagnose and treat cataracts. The office is located at 628 Roosevelt Road, Suite 101, in St. Cloud. To make an appointment or to learn more, call 320-774-3789 or email info@eaofcm.com.


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