What to Know About Posterior Subcapsular Cataracts

Your eye's posterior subcapsular cataract forms on the rear of the lens. Although it impairs vision, surgery is a treatment option.

On the clear lens of one or both of your eyes, cataracts are patches of cloudiness. Where your lens meets the capsule that holds it in place at the back is where a posterior subcapsular cataract form.

It is common for posterior subcapsular cataracts to develop alongside other cataracts. You can experience symptoms like decreased visual acuity and the appearance of a halo around bright lights.

Typically, doctors can repair cataracts by performing surgery to replace your natural lens with a synthetic one. Most patients experience improved eyesight soon after surgery, but some experience difficulties that may necessitate a follow-up procedure.

We look more closely at posterior subcapsular cataracts in this article, covering symptoms, risk factors, and management.

What are the symptoms of posterior subcapsular cataracts?

Similar symptoms to those of other forms of cataracts can be caused by posterior subcapsular cataracts, including:

• double vision
• cloudy vision
• blurry vision
• light sensitivity
• glare in bright lights
• seeing halos around lights

The most common complaints from patients with posterior subcapsular cataracts are double vision in one eye and glare under bright situations. In bright lighting, visual impairment is frequently more apparent.

What causes posterior subcapsular cataracts?

The tissue layer that envelops and secures your lens is known as the lens capsule. Posterior subcapsular cataracts form in the area of your lens that borders your capsule on the rear.

When crystallin proteins accumulate in your lens and reduce its transparency, cataracts can form.

The American Academy of Ophthalmology states that while aging is a common cause of posterior subcapsular cataracts, other factors may also be involved.

• exposure to ionizing radiation
• excessive alcohol consumption
• inflammation
• eye trauma
• oral corticosteroids use

Risk factors can include:

• nearsightedness
• obesity
• retinal dystrophies (degenerative disorders of your retina)
• glaucoma
• diabetes
• atopy, a specific type of allergy
• alcohol consumption
• sunlight exposure
• steroid use
• vitrectomy, removal of some of the gel inside of your eye

About 10% of age-related cataracts are posterior subcapsular cataracts. More than 40% of posterior subcapsular cataracts appear to coexist with other cataract forms.

How do doctors diagnose posterior subcapsular cataracts?

Your symptoms may lead an eye doctor to believe you have a cataract. By conducting a thorough eye examination, they can determine the diagnosis. You will be given eye drops to enlarge your pupils for this exam, and you might be tested on things like:

• a slit-lamp examination to view the inside components of your eyes
• retinal examination to evaluate the tissue in your eyes' backs
• pupil dilatation to improve visibility through your lens
• examination of visual acuity, sometimes known as an eye chart
• using tonometry to gauge your eye's pressure

Posterior subcapsular cataract grading

Based on the vertical size of the cataract, the World Health Organization (WHO) has created a straightforward grading system for posterior subcapsular cataracts:

Grade	Description
0	Cataract is less than 1 millimeter (mm) high
PSC-1	Cataract is equal to or greater than 1.0 mm high but less than 2.0 mm
PSC-2	Cataract is equal to or greater than 2.0 mm high but less than 3.0 mm
PSC-3	A cataract is greater than 3.0 mm
9	Cataracts cannot be graded

Surgery is typically required for grade 3 posterior subcapsular cataracts. If your cataracts aren't interfering with your eyesight or day-to-day activities, your doctor might not advise surgery.

What is the treatment for posterior subcapsular cataracts?

The primary treatment for posterior subcapsular cataracts is surgery. The lens is removed during surgery and is replaced with a synthetic lens.

To replace the lens, an eye surgeon may choose to make a little incision or utilize a laser. These surgeries have roughly the same recovery duration. A complete recovery often takes two to six weeks.

Secondary cataracts, also known as posterior capsular opacification, are the most frequent side effects following cataract surgery. When the covering that covers your lens clouds over, it seems.

Individuals who experience a recurrent cataract may require a second procedure to eliminate it.

What’s the outlook for people with posterior subcapsular cataracts?

Similar to other types of cataracts, posterior subcapsular cataracts may cause significant disability if left untreated. Most patients can restore good vision after surgery. Individuals who choose not to have surgery will probably still experience progressive vision loss.

Approximately 1 in 50 patients experience severe side effects after cataract surgery. These may consist of:

• blurry vision
• some loss of vision
• detached retina

Takeaway

The posterior portion of your lens is where posterior subcapsular cataracts form. They may result in symptoms including hazy vision and a decrease in visual acuity.

Removing the clouded lens and replacing it with an artificial one by surgery is the primary treatment for posterior subcapsular cataracts. The majority of patients see quick visual improvement after surgery. Individuals who do not have surgery typically experience a steady decline in their vision.