What is posterior capsule opacification?
During cataract surgery the cloudy natural lens is removed and a clear artificial lens is placed inside the lens capsule, a thin membrane that holds it in position. Cells left behind after the operation can grow over the back of the capsule, making it thicker and slightly cloudy. Less light then reaches the Retina clearly.
Your cataract has not come back: once removed, a cataract cannot return. The NHS cataract surgery page names this as a reason vision can turn cloudy months or years after an operation.
Gradual PCO
The usual pattern. The cells grow slowly, so changes to your sight creep in over months or years after surgery.
Early PCO
Less common. In a few people it appears within a few weeks of cataract surgery.
Symptoms to look out for
- Blurred or cloudy vision that returns after a good result from cataract surgery
- Glare or difficulty in bright light
- Reading becoming harder
- A slow change rather than a sudden one
How common is it, and who gets it?
It is common. The RNIB reports that around 20 in 100 eyes develop it within 3 years of cataract surgery, and about 34 in 100 within 5 years. Some things make it more likely:
- Other eye conditions, such as diabetes-related eye disease, Glaucoma, retinitis pigmentosa or a high myopic (short sight) prescription before surgery
- Being younger at the time of cataract surgery
- Inflammation or other complications during or after surgery
Plenty of people develop it without any of these, so it does not mean anything went wrong with your operation. If you notice your sight changing after a good result, mention it at your next eye test rather than assuming you need stronger glasses.
Diagnosis and treatment
An Optometrist can often spot posterior capsule opacification at a routine eye test by shining a bright light into the eye. I confirm it at an examination and check nothing else is affecting your sight. If it is getting in the way of daily life, YAG laser capsulotomy makes a small opening in the clouded capsule. It is done in the outpatient clinic and normally takes about 5 to 10 minutes.
Is it an emergency?
No. It comes on gradually, and waiting does not make the laser less successful. Sudden symptoms are different: new floaters, flashes, a dark curtain or sudden blurring need help the same day from an Optometrist, NHS 111 or eye casualty.
Coping while you wait
It can progress over weeks or months while you wait, and how quickly varies from person to person. In the meantime, making things bigger, brighter and bolder can help: larger print, a good reading lamp and strong colour contrast around the home. Coping is often harder when both eyes are affected, so tell me if everyday tasks are becoming a struggle.
How I can help
I perform cataract surgery and YAG laser capsulotomy, so I will be available to manage your eyes long term: the original operation, the follow-up and any issues that occur following the procedure. You can contact me directly without a GP referral.
Common questions
Can posterior capsule opacification come back?
Usually not. Laser removes the central part of the capsule where the cells grow, so most people need one treatment. Very rarely, cells grow around the opening or it narrows, and further laser can be given if that happens.
Will I need new glasses afterwards?
Usually not. Once the capsule is cleared, your sight should go back to how it was after cataract surgery. If your Optometrist held off changing your glasses, have your eyes tested again after treatment.
Can it be treated on the NHS?
Yes. Laser treatment for PCO is a common NHS procedure, usually after your Optometrist refers you to the eye hospital. It is also available privately, and you can see me without a GP referral if you prefer.
Can I drive with it?
It depends on how much it affects your sight. You must be able to read a number plate from 20 metres and meet the DVLA visual standard, with glasses if you use them. If you are unsure, ask your Optometrist to check.
Does it affect both eyes?
It can, if you have had cataract surgery in both eyes, but each eye may be affected by a different amount or at a different time. If both eyes need laser treatment, they can usually be treated on the same day.
A direct line to your surgeon, before and after surgery
There is no call centre or switchboard. Call my practice on 07438 437366, email enquiries@soniamall.co.uk or request an appointment online. I aim to reply within 24 hours.
Related conditions
- Cataracts
- Glaucoma
- Diabetic retinopathy
- Floaters and flashes
