Posterior Subcapsular Cataract: Symptoms, Triggers & Surgery

Have you noticed difficulty reading, increased sensitivity to bright lights, or blurry vision that seems to be getting worse faster than expected? You might be dealing with a particular type of cataract known as a posterior subcapsular cataract. This condition can influence your quality of life more quickly than other cataract types.

In this comprehensive guide, we’ll explain what a posterior subcapsular cataract is, how it differs from other cataract-related visual impairment, what causes it, and how it may impact your eye health. We’ll also explore how cataract surgery can help restore clear vision and what to expect before, during, and after treatment.

Whether you’re seeking answers for yourself or someone you care about, this article will help you feel confident and informed to move forward with clarity and peace of mind. Let’s dive in.

What Is A Posterior Subcapsular Cataract?

A posterior subcapsular cataract (PSC) is a specific type of cataract that forms just in front of the posterior lens capsule. This area plays a vital role in focusing light rays onto the retina, so even a small clouding here can have a noticeable impact on your vision.

How A Posterior Subcapsular Cataract Develops

A posterior subcapsular cataract forms when lens fibres at the back of the eye’s natural lens begin to clump together, creating a dense, cloudy area. Because this clouding sits directly in the path of incoming light rays, it interferes with how clearly images are focused onto the retina.

Unlike nuclear or cortical cataracts, which develop in the centre or outer edges of the lens, PSCs affect the area most critical for fine detail and clarity. This can cause early symptoms like blurred vision, glare sensitivity, or trouble reading under bright lights.

Another key feature of PSCs is their faster progression. While many age-related cataracts develop gradually, posterior subcapsular cataracts can become noticeable more quickly, often making tasks like night driving or reading increasingly difficult within a shorter timeframe.

Recognising The Symptoms

If you’re experiencing changes to your vision, a posterior subcapsular cataract may be the cause, especially if those changes seem to appear more quickly than expected.

Common symptoms include:

Blurry vision, particularly when reading or focusing up close.
Increased sensitivity to bright lights or difficulty coping with glare.
Struggling to see clearly at night or in low-light settings.
Vision becoming noticeably worse in sunlight.
Colours appearing less vibrant, often looking faded or dull.

While many cataracts develop gradually, posterior subcapsular cataracts can progress more rapidly. Because they affect the part of the lens most involved in focusing light, these symptoms can interfere with daily activities sooner, making early detection especially important.

Risk Factors To Know About

Understanding what might increase your chances of developing a posterior subcapsular cataract can help you stay proactive about your eye health.

Some known triggers include:

Prolonged steroid use, especially oral or topical corticosteroids.
Radiation exposure, including ionising radiation.
A history of previous eye surgery.
Certain medical conditions, such as diabetes or retinitis pigmentosa.
Skin disorders, including atopic dermatitis.
The presence of other cataracts, like cortical cataracts.
Being of a younger age compared to typical age-related cataracts.

If one or more of these factors apply to you, it doesn’t necessarily mean a PSC will develop, but being aware of them can support earlier detection and more appropriate management. Knowing your risk profile also empowers you to make well-informed decisions about your treatment options.

Cataract Surgery: What To Expect

During traditional cataract surgery, your cataract surgeon makes a tiny incision in the eye to carefully remove the cloudy lens. This is then replaced with a clear, customised intraocular lens (IOL) designed to restore your focusing ability.

The surgical procedure is usually performed under local anaesthetic, so you’ll be awake but comfortable throughout. Most surgeries take less than 30 minutes, and for many people, it’s a straightforward, day procedure with minimal downtime.

While every eye is unique, most patients find the experience manageable and are often surprised by how quick and gentle the process feels with the right care and guidance.

Frequently Asked Questions

Is cataract surgery the only option?

Not necessarily. Some cataracts remain stable and don’t significantly impact daily life. However, posterior subcapsular cataracts based on the central visual axis often cause noticeable symptoms earlier, particularly glare sensitivity and difficulty reading, making surgery more likely at an earlier stage than other types.

Can I prevent a posterior subcapsular cataract?

While you can’t guarantee prevention, managing specific risk factors and keeping up with regular eye exams may help.

What happens after surgery?

You’ll be given eye drops and instructions for aftercare. You should be able to return to normal activities within days, with continued improvements in vision over the following weeks.

Is it normal for vision to be worse before it gets better?

Sometimes, your vision may worsen for a day or two after surgery due to healing, inflammation, or residual swelling. However, most people notice improved vision shortly after surgery and continue to recover over several weeks.

Can posterior subcapsular cataracts return after surgery?

Once the cloudy lens is removed and replaced with an intraocular lens, the cataract itself can’t return. However, posterior capsular opacification, also called a secondary cataract, can mimic symptoms and may occur months or years later.

Conclusion

A posterior subcapsular cataract may sound complex, but knowing how it forms and affects your vision and options can empower you to take action.

Understanding this condition is the first step towards a clear vision, whether you’re experiencing early symptoms or looking for guidance on surgical treatment.

If you’re ready to take that next step, consider speaking to your local eye doctor for a personalised eye exam. Early detection and appropriate management can make a world of difference to your daily comfort and confidence.

Book a consultation today with Dr Edward Roufail at (03) 9071 0180 to explore your options and get answers to your questions. Taking that first step could make a meaningful difference in how you see the world.

Note: Surgical or invasive procedures carry inherent risks. As part of our standard practice, we thoroughly discuss these risks during the consent process before any surgical procedure. Your understanding and comfort are our utmost priority.

References:

Frysh P. What to Expect With Cataract Surgery [Internet]. WebMD. 2025 [cited 2025 Jul 23]. Available from: https://www.webmd.com/eye-health/cataracts/ss/slideshow-cataract-surgery-expect

Richardson R B., Ainsbury E A., Prescott C R., Lovicu F J. Etiology of Posterior Subcapsular Cataracts Based on a Review of Risk Factors Including Aging, Diabetes, and Ionizing Radiation. International Journal of Radiation Biology [Internet]. 2020 Sep 22;96(11):1339–61. Available from: https://www.tandfonline.com/doi/full/10.1080/09553002.2020.1812759

Pietrangelo A. Cataract Symptoms and How to See Better [Internet]. Verywell Health. 2025 [cited 2025 Jul 23]. Available from: https://www.verywellhealth.com/cataracts-11691716