Types of Cataracts
There are three primary types of cataract, and they do not behave the same way. One creeps along for years; another can take significant vision in a matter of months. Which you have changes how closely you are watched.
Nuclear sclerotic cataracts
The most common type. This cataract begins with a gradual hardening and yellowing of the center of the lens, called the nucleus, and that hardening gradually expands to the other layers of the lens.
Nuclear cataracts cause light to scatter as it passes through the lens, decreasing the amount of light reaching the retina. Left untreated, the symptoms increase in severity and eventually lead to severe vision loss.
These are the slow ones. Many patients have a nuclear cataract for years before it bothers them enough to act, and a curious early effect is a temporary improvement in near vision as the lens changes shape.
- Most common type of cataract.
- Starts in the nucleus — the center of the lens — and spreads outward.
- Scatters light so less of it reaches the retina.
Posterior subcapsular cataracts
A posterior subcapsular cataract is an opaque area that forms at the back of the lens and can lead to a gradual decrease in vision. An early one may not cause any symptoms at all.
However, this type can grow more rapidly than other cataracts and can sometimes cause a significant decrease in vision in a matter of months. As it grows, it scatters light entering the eye and the symptoms escalate.
It makes it difficult to see in bright light or while reading, and causes glare or halos around lights at night. Because it sits at the back of the lens, right in the visual axis, a small one causes disproportionate trouble.
- Forms at the back of the lens, directly in the line of sight.
- Can progress in months rather than years.
- Worst in bright light and while reading, with glare and halos at night.
Cortical cataracts, and what happens next
Cortical cataracts begin as small spoke-like opacities along the edge of the lens and gradually grow around the edge toward the center.
Cortical cataracts
These start as spoke-like opacities at the edge of the lens and grow inward. Because they are wedge-shaped and peripheral, glare is often the dominant complaint.
Identifying the type
A dilated slit-lamp examination shows your doctor exactly which type or combination you have — many patients have more than one.
Matching the follow-up interval
A slow nuclear cataract may be watched annually. A posterior subcapsular cataract, which can move in months, is watched more closely.
Measuring the impact
Vision testing under glare conditions often reveals far more disability than a standard chart in a dark room does.
Deciding on surgery
When the cataract interferes with what you want to do, surgery is reasonable. There is no need to wait for it to be “ripe”.
Choosing a lens
Type does not usually dictate the implant. Your lifestyle and your other eye conditions do — that is a separate conversation with your surgeon.
Frequently asked questions about cataract types
How many types of cataracts are there?
There are three primary types: nuclear sclerotic cataracts, posterior subcapsular cataracts and cortical cataracts. Many patients have more than one at the same time.
What is a nuclear sclerotic cataract?
The most common type. It begins with a gradual hardening and yellowing of the nucleus — the center of the lens — and gradually expands to the other layers, scattering light so less of it reaches the retina.
What is a posterior subcapsular cataract?
An opaque area that forms at the back of the lens. An early one may cause no symptoms, but this type can grow more rapidly than others and sometimes causes a significant decrease in vision within months.
What is a cortical cataract?
A cataract that begins as small spoke-like opacities along the edge of the lens, then gradually grows around the edge toward the center. Glare is often the dominant symptom.
Which type is the most serious?
Posterior subcapsular cataracts warrant the closest attention because they can progress quickly and sit directly in the visual axis. That said, all three are treated the same way when they affect your life.
Does the type change the surgery?
Not usually. The surgical approach is largely the same. What differs is how closely you are monitored beforehand and how soon surgery is recommended.
Can I have more than one type?
Yes, and it is common. A dilated examination identifies which types are present and how far along each one is.
How do I know which type I have?
Your doctor can tell you at a dilated eye exam. Ask — it is a reasonable question and it explains a lot about why your vision behaves the way it does.
Five Convenient Florida Locations
Sebring
4211 US Highway 27 NSebring, FL 33870(863) 385-1544
Carrollwood
13904 N Dale Mabry Hwy, Ste 200Tampa, FL 33618(813) 908-2020
South Tampa
113 S Armenia AveTampa, FL 33609(813) 908-2020
Brooksville
14543 Cortez BlvdBrooksville, FL 34613(352) 596-4030
Gainesville
2521 NW 41 StGainesville, FL 32606(352) 377-7733
Find out which type you have
It changes how closely you should be watched and how soon surgery makes sense. A dilated exam answers it in one visit.