Both cataract and age-related macular degeneration (ARMD) are common findings in our aging population. At issue is the progression of ARMD following cataract extraction. The purpose of this paper is to review the data relevant to this subject and to offer suggestions as to the management of cataract associated with macular degeneration. Published data are reviewed and an attempt is made to interpret the results. Topics discussed include the epidemiology and association between the incidence of cataract and ARMD, the role of photo-oxidative damage and inflammation in the pathogenesis of ARMD, and the possible contribution of cataract extraction to the exacerbation and acceleration of ARMD through increased photo-oxidative damage and intraocular inflammation. Recommendations for the cataract surgeon and specialist are formulated on the basis of existing literature.