Posterior Capsular Haze

Types of posterior capsular haze (PCO)
Causes and contributors (risk factors) of posterior capsular haze
Common symptoms
Diagnostic tests
Non-pharmacological treatments (therapies & “other” measures)
Drug treatments
Dietary “molecular” supplements
Regenerative / stem-cell” drug
Surgeries/procedures
Prevention practices
When should you see a doctor?
Foods to favor—and to limit/avoid
Frequently asked questions

“Post capsular haze” (doctors usually say posterior capsular opacification or PCO) is a common problem that can happen months or years after cataract surgery.
During cataract surgery, the cloudy natural lens is removed, and a clear artificial lens (intraocular lens, or IOL) is placed inside a thin, see-through bag in your eye called the lens capsule. The front of that bag is opened during surgery, and the back of the bag (the posterior capsule) is left in place to hold the new lens steady and to keep the eye safe.

After cataract surgery, your cloudy natural lens is removed but the thin, clear bag that held it—the capsule—is left in place to support your new artificial lens (IOL). Over months to years, leftover lens epithelial cells can grow and change on that back part of the capsule. This growth makes the capsule turn hazy or wrinkled. Light then scatters instead of passing cleanly to the retina. Vision becomes blurrier, glare gets worse (especially at night), and contrast fades. This is not the cataract “coming back”—it’s a common, treatable change in the capsule behind the implant. Most symptomatic cases are fixed quickly with a brief laser procedure called Nd:YAG laser posterior capsulotomy. EyeWikiAmerican Academy of Ophthalmology

PCO can show up months to several years after surgery and is more frequent in children and younger adults, and in certain eye conditions. The biology involves those leftover lens cells multiplying, migrating onto the back capsule, and turning into different cell types that cause either a shiny “pearl” pattern or a fibrous wrinkle pattern in the visual axis. EyeWiki

After surgery, tiny lens cells that were left behind can grow, move, and change on that back part of the bag. As they grow, they can make the back of the capsule wrinkle, scar, or become cloudy. When the back of the capsule is no longer clear, light cannot pass cleanly to the retina. Vision then looks blurry, hazy, glary, or dim, especially in bright light or at night. People often call this the “secondary cataract,” but it is not a new cataract; it is a cloudy film on the capsule behind the new lens.

The good news is that when PCO bothers vision, it is usually quickly and safely treated in the clinic with a laser procedure called Nd:YAG laser capsulotomy. This laser makes a small opening in the cloudy back capsule so light can pass through again. Most people see clearer within minutes to days. (Treatment is mentioned here for context; this guide focuses on definition, causes, symptoms, and tests.)

Why does posterior capsular haze happen?

The lens capsule is like a clear plastic wrap. After surgery, a few lens epithelial cells are always left behind on the inside of this wrap.
These cells can divide, move onto the back capsule, and change into scar-like cells that pull and wrinkle the capsule (fibrosis), or they can pile up into pearl-like clusters (called Elschnig pearls).
The capsule can also contract if the front opening is too small, which can tighten and crease the back capsule.
The design and material of the new lens, how well the front opening overlaps the lens edge, and how thoroughly the lens cortex (the soft lens substance) was cleaned during surgery all affect how easily those cells can grow across the back capsule.

Types of posterior capsular haze (PCO)

Doctors often describe PCO by how it looks and how it behaves. These “types” help explain what is happening but any person can have a mix of patterns.

Pearl-type (regenerative) PCO
Small, shiny “pearls” of cell clusters grow on the back capsule. These pearls scatter light and often cause glare and halos. It is more common in younger people because their lens cells are more active.
Fibrotic PCO
The capsule becomes thick, wrinkled, or scarred. The wrinkles can cross the visual axis and make distortion. It is often linked with inflammation or capsule contraction.
Mixed PCO
A combination of pearls and fibrosis. Many eyes show both patterns to some degree.
Capsular contraction syndrome
The front opening in the capsule shrinks and tightens after surgery. This pulls the capsule and can cause wrinkles on the back capsule, tilt of the lens, and visual fluctuations.
Sommering ring / peripheral PCO
Lens material and cells remain along the outer ring of the capsule, sometimes forming a ring-like mass. If it stays peripheral, vision may be fine; if it encroaches centrally, haze and glare can occur.
Central vs. peripheral PCO
Central haze affects vision more because it sits right behind the pupil. Peripheral haze may cause fewer symptoms until it grows inward.
Mild, moderate, severe PCO
This grading is based on how dense and wide the haze is, and how much it reduces vision or increases glare.
Early-onset vs. late-onset PCO
Some eyes develop PCO within weeks to months; others only after several years. Both are common and depend on many risk factors.
Adult vs. pediatric PCO
Children’s eyes heal very actively, so PCO can develop quickly and aggressively in kids without preventive steps like a posterior capsulotomy at the time of surgery.

Causes and contributors (risk factors) of posterior capsular haze

Note: “Causes” here means the underlying reasons and risk factors that make haze more likely or make it grow faster after cataract surgery.

Residual lens epithelial cells
Small lens cells left behind can proliferate and migrate across the back capsule, forming pearls and fibrosis.
Incomplete cortical cleanup
If soft lens material (cortex) remains under the capsule edge, it can feed cell growth and trigger scarring.
Poor overlap of the capsule opening over the lens edge
If the front capsule opening (capsulorhexis) does not overlap the entire lens edge, cells can slide behind the lens more easily and grow on the back capsule.
Excessively small capsulorhexis
A small opening can shrink further (contraction), pulling on the bag and wrinkling the back capsule.
Excessively large capsulorhexis
A large opening may not cover the lens edge well, which removes the barrier to cell migration.
IOL edge design that is not sharply square
A sharp, square edge on the lens optic acts like a speed bump to migrating cells. Rounder edges may allow easier overgrowth.
IOL material characteristics
Some materials are stickier or interact differently with the capsule, changing how easily cells adhere and spread.
Young age at surgery
Younger eyes have more active healing cells, so PCO happens more often and earlier.
Ocular inflammation (uveitis) now or in the past
Inflammation can activate lens cells and cause fibrosis of the capsule.
Diabetes mellitus
Diabetes can increase healing responses and light scatter, and may be linked with faster PCO in some eyes.
Retinitis pigmentosa and other retinal dystrophies
These eyes often show more aggressive cell behavior on the capsule.
High myopia (very nearsighted eyes)
Structural differences and healing patterns in long eyes may raise the likelihood of PCO.
Pseudoexfoliation syndrome
The capsule and zonules can be fragile, which may increase wrinkling and deposition.
Posterior capsule tear and anterior vitrectomy during surgery
Complex surgery can change support and capsule behavior, which may influence later haze or fibrotic changes near the opening.
Poor IOL centration or tilt
A tilted or off-center lens may not be fully covered by the front capsule edge, allowing cell entry and uneven stress.
Longer time since surgery
The longer the interval, the more time cells have to grow and thicken the capsule.
Oxidative stress and capsule fibrosis
Chemical signals in healing can push cells to become scar-like, making the capsule opaque and stiff.
Residual capsule plaques
Pre-existing subcapsular plaques or calcifications can act as a base for more cell growth after surgery.
Inadequate anti-inflammatory control after surgery
If early post-op inflammation is not well controlled, cells may activate and proliferate more.
Multiple prior eye surgeries or trauma
Prior operations or injuries can change the capsule, zonules, and cell behavior, raising the risk of haze later.

Common symptoms

Blurry or hazy vision
Vision looks like you are seeing through a dirty window or frosted glass.
Glare
Bright lights spread out and wash out the scene, especially under sunlight or headlights.
Halos around lights
Rings appear around lamps and car lights, especially at night.
Starbursts
Lights look like spiky stars, making night driving hard.
Reduced contrast
Dark and light areas blend together, so it is hard to see low-contrast details like gray text.
Trouble reading small print
Letters look fuzzy or shadowed, even with your glasses.
Needing more light to read
You turn up the lamp or move closer to the window to see words clearly.
Vision worse in bright light
Brightness causes more scatter, so you squint or look away.
Monocular double vision (one eye)
You may see a ghost image or double letters with one eye because of light scattering.
Frequent squinting or blinking
You try to clear the blur by blinking or squinting, but it quickly comes back.
Colors seem dull
Colors lose richness, and whites look a bit dirty.
Eye strain and headaches
You strain to focus and may feel a dull ache after reading or screen time.
Night driving difficulty
Headlights cause glare and halos, so signs are harder to read.
Vision that fluctuates
Clarity changes with lighting and pupil size, sometimes better, sometimes worse.
In children: risk of amblyopia
If haze limits a child’s seeing, the brain may “ignore” that eye, which can lead to lazy eye if not treated.

Diagnostic tests

A) Physical examination

Distance and near visual acuity (with and without pinhole)
You read letters on a chart. The pinhole test helps show if the blur is due to scattering in the eye versus a glasses issue. With PCO, the pinhole may help only a little, because the haze still scatters light.
Refraction check (basic in-room assessment before full refraction)
Your doctor quickly checks if a change in glasses power helps. In PCO, stronger lenses do not fully fix the blur because scatter is the main problem.
Slit-lamp biomicroscopy with retroillumination
The microscope light is used in a dark room. By shining light through your pupil and looking for shimmering pearls, wrinkles, or milk-glass haze on the back capsule, the doctor can see PCO directly.
Dilated pupil exam
Drops make your pupil bigger so the doctor can check the back of the eye (retina) to rule out other causes (like macular disease) and to view the entire capsule.
Pupil and optic nerve check (RAPD, color, brightness)
The doctor looks for signs of optic nerve problems. A normal nerve exam with haze on the capsule supports PCO as the main reason for blur.

B) Manual and functional tests

Full manifest refraction
A careful glasses test finds your best-corrected vision. In PCO, even the best lenses often cannot reach your expected clarity, pointing to internal scatter.
Brightness Acuity Test (BAT) or disability glare testing
You read the chart as a bright light shines toward your eye. If your vision drops a lot with brightness, it suggests scatter from PCO.
Contrast sensitivity testing (e.g., Pelli-Robson chart)
You read letters that get lighter and lighter. PCO often reduces contrast, even if standard acuity is not terrible.
Potential acuity meter (PAM) or retinometer
A small device shines a fine target through the clearer parts of your eye to estimate your retina’s potential. If the PAM shows better potential than your current vision, it suggests removing the hazy capsule would likely help.
Amsler grid or reading performance tests
Simple grids or reading tasks can show distortion or letter doubling from capsule wrinkles or scatter.

C) Laboratory and pathological tests

Blood sugar and HbA1c
Checks for diabetes control, because poor control can worsen healing responses and light scatter. Not for diagnosing PCO itself, but helpful in the whole-eye picture.
Inflammation markers (ESR, CRP)
If symptoms suggest ongoing inflammation, these tests help your doctor decide on anti-inflammatory care to calm the eye and possibly slow fibrosis.
Autoimmune and uveitis work-up (as indicated)
Tests for immune conditions may be ordered if you have a history of uveitis or systemic inflammation that could activate capsule cells.
Rare pathology of capsule material
If any capsule tissue is removed (for example, during a complex surgery), a lab may look at it under a microscope to confirm pearls or fibrosis. This is rare and usually not required.

D) Electrodiagnostic tests (— used when vision loss seems too great for the amount of haze)

Visual evoked potential (VEP)
Measures the brain’s response to visual signals. If VEP is fairly normal, but you see poorly and the capsule is hazy, it suggests the main problem is optical scatter, not a severe nerve pathway issue.
Full-field electroretinography (ERG)
Measures the retina’s electrical activity. A normal ERG supports the idea that the retina is healthy and the blur is mainly from PCO.
Multifocal or pattern ERG
Looks at macular function in detail. If these are good, but vision is still reduced, removing haze often helps.

E) Imaging tests

Optical coherence tomography (OCT) of the macula
A painless scan that shows a high-definition cross-section of the central retina. It helps rule out problems like macular edema or macular degeneration that might be causing blur instead of, or in addition to, PCO.
Anterior segment OCT or ultrasound biomicroscopy (UBM)
These images show the front structures of the eye, including the lens capsule and IOL position, helping to confirm wrinkles, fibrosis, or tilt.
Scheimpflug imaging / densitometry (e.g., Pentacam)
Creates 3D images and can quantify haze or capsule density, giving an objective measure of how cloudy the capsule has become.

Non-pharmacological treatments (therapies & “other” measures)

Quick reality check: there’s one definitive fix for visually significant PCO—the laser opening (Nd:YAG capsulotomy), which I list later under “Surgeries.” Everything below is supportive care you can use before or around the procedure to function better and protect your eyes.

Observation when vision is still good
If the haze is mild and not bothering you, your doctor may simply watch it. Many people function well for a while and only treat it when symptoms become meaningful in daily life.
Update your glasses prescription
A fresh refraction sometimes sharpens vision enough to get by until you’re ready for the laser. It won’t remove the haze, but it can help you read and drive more comfortably.
Use anti-glare strategies for night driving
Avoid oncoming headlight glare by keeping extra distance, reducing speed, and favoring well-lit routes. Anti-glare coatings on lenses can help.
Increase task lighting and contrast
Bright, direct light and high-contrast print or screens (e.g., dark text on a white background) can make reading easier when contrast sensitivity is reduced.
Magnification aids
Handheld magnifiers or device zoom features can keep you independent for reading and hobbies until you have laser treatment.
Polarized sunglasses outdoors
Polarized lenses cut stray reflections off roads and water, reducing daytime glare sensitivity.
Blue-blocking or amber tints for glare
Some people notice less haloes with a mild tint for evening screen use. This is personal preference, not a cure.
Limit risky activities if vision is unreliable
If haze causes disabling glare, skip night driving or hazardous tasks until you’re treated.
Keep both eyes optimized
If the other eye is clearer, use it as your “dominant” eye for tasks until the hazier eye is treated; set screens or seats to favor the better eye.
Treat surface dryness for comfort
Dryness does not cause PCO, but it can add blur. Frequent breaks, blinking, humidifiers, or preservative-free artificial tears (as directed by your clinician) can sharpen the “front” of the eye so you see through the back haze as cleanly as possible.
Control inflammation and allergy triggers (environmental)
While PCO is a capsular issue, happy, quiet eyes tolerate laser and post-laser recovery better. Avoid smoke, wind, and irritants when possible.
Diabetes and systemic health optimization
Good glucose and blood-pressure control keeps the retina and macula healthier. A healthier retina sees better once the haze is cleared. (Not a cure for PCO—just smart eye care.)
Plan the laser at a practical time
Arrange help for the visit if your pupil will be dilated, and avoid scheduling right before night driving.
Understand expectations
Knowing the benefits and small risks of Nd:YAG capsulotomy helps you say “yes” with confidence when you’re ready. (Details in “Surgeries.”) American Academy of Ophthalmology+1
Consistent follow-up
Your doctor checks vision, eye pressure, and the retina—especially if you’re high-risk for pressure spikes or macular swelling after laser. American Academy of Ophthalmology
Protect your eyes from UV and intense light
Sunglasses and brimmed hats don’t reverse PCO but can reduce glare sensitivity during the wait.
Use larger fonts and accessibility features
On phones/computers/TVs, enlarge text and increase contrast to offset the haze-related contrast loss.
Keep lenses and screens clean
Smudges add scatter. Clean eyewear and screens regularly so you’re not stacking one source of glare on another.
Task pacing
Break up visually demanding tasks. Short visual rests can prevent eye strain when haze makes focusing feel harder.
Low-vision consultation (when needed)
If you have other eye diseases along with PCO, a low-vision specialist can fine-tune tools to keep you independent until and after treatment.

Drug treatments

There is no approved eyedrop or pill that “melts” posterior capsular haze. Medicines are used to prevent short-term side effects of the laser (especially pressure spikes and inflammation) and to protect at-risk eyes. EyeWiki

Apraclonidine 0.5–1% (alpha-agonist)
Purpose: Prevent temporary intraocular pressure (IOP) spikes after Nd:YAG capsulotomy.
How it’s used: 1 drop 30–60 minutes before and again right after laser (typical clinic use).
Mechanism: Reduces aqueous humor production, limiting IOP rise.
Common side effects: Mild redness, dry mouth; rarely allergic lid swelling.
Evidence: Randomized studies show apraclonidine lowers post-laser IOP rise versus placebo. JAMA NetworkPubMed
Brimonidine 0.2% (alpha-agonist)
Purpose: Alternate to apraclonidine for IOP spike prevention.
Use: 1 drop pre- and post-laser.
Mechanism: Lowers aqueous production and increases uveoscleral outflow.
Side effects: Redness, fatigue; avoid in infants. (Clinic protocols vary; your surgeon will choose.)
Timolol 0.5% (beta-blocker)
Purpose: Short-term IOP control if you’re high-risk or if pressure rises after laser.
Use: 1 drop at the end of the procedure and possibly BID for a few days.
Mechanism: Decreases aqueous production.
Side effects: Can slow heart rate or trigger bronchospasm—tell your doctor about asthma or heart block.
Acetazolamide (oral carbonic anhydrase inhibitor)
Purpose: Prevent or treat larger post-laser IOP rises in high-risk patients.
Use: Often 250–500 mg by mouth shortly before or after laser, per clinician.
Mechanism: Decreases aqueous production.
Side effects: Tingling, taste changes, fatigue; avoid with sulfa allergy and certain kidney issues.
Prednisolone acetate 1% (topical steroid)
Purpose: Calm inflammation after laser; lower risk of iritis and macular swelling.
Use: Typically 1 drop QID for 3–7 days (some use shorter).
Mechanism: Blocks inflammatory cascades.
Side effects: Temporary blur, pressure rise with longer courses.
Ketorolac 0.5% (topical NSAID)
Purpose: Extra protection against cystoid macular edema (CME) in at-risk eyes.
Use: 1 drop QID for 1–2 weeks.
Mechanism: Inhibits prostaglandins.
Side effects: Sting on instillation; rare corneal irritation.
Nepafenac 0.1% (topical NSAID)
Purpose/Use: Similar to ketorolac; often TID for 1–2 weeks.
Mechanism/Side effects: As above.
Bromfenac 0.09% (topical NSAID)
Purpose/Use: Once-daily NSAID option for convenience; duration per surgeon.
Mechanism/side effects: As above.
Hyperosmotic agents (e.g., oral glycerol or IV mannitol)
Purpose: Rescue for a severe, acute IOP spike when drops aren’t enough.
Use: In-clinic, only under clinician supervision.
Mechanism: Temporarily pulls fluid out of the eye to lower pressure.
Side effects: Nausea, fluid shifts (monitored medically).
Glaucoma-drop adjustment (individualized)
Purpose: If you already have glaucoma, your doctor may temporarily step up your usual meds around the laser.
Use: Tailored to your regimen.
Why: Laser-related pressure bumps are usually brief, but glaucoma eyes are sensitive. Typical IOP behavior peaks at ~3–4 hours and drifts down by 24 hours—hence the short-term plan. American Academy of Ophthalmology

Dietary “molecular” supplements

Straight talk: no supplement has been shown to prevent or clear PCO. Supplements below support overall eye health (retina, ocular surface) so the eye can perform its best once the haze is treated. Discuss any supplement with your clinician if you take blood thinners, have kidney issues, or are pregnant. EyeWiki

Lutein (10 mg/day)
Supports macular pigment and glare recovery in general eye health. Mechanism: antioxidant carotenoid concentrated in the macula.
Zeaxanthin (2 mg/day)
Works with lutein to absorb stray blue light and reduce oxidative stress.
Omega-3s (DHA/EPA 1,000 mg/day combined)
Helps tear film quality and retinal cell health; mechanism: anti-inflammatory lipid mediators.
Vitamin C (500 mg/day)
Antioxidant that recycles other antioxidants; broad ocular support.
Vitamin E (up to 200–400 IU/day if appropriate)
Membrane antioxidant; consult your physician due to interactions.
Zinc (10–25 mg/day as zinc gluconate)
Cofactor in retinal enzymes; don’t exceed safe upper limits without medical advice.
Riboflavin (B2, 1.3–1.6 mg/day)
Supports cellular energy in ocular tissues.
Vitamin D (dose per blood level, often 800–2000 IU/day)
General immune modulation; maintain within normal range.
Alpha-lipoic acid (100–300 mg/day)
Antioxidant that regenerates vitamins C and E; can upset stomach—take with food.
Mixed polyphenols (from berries/green tea)
Diet-first is best. Mechanism: scavenges free radicals; possible support for vascular health.

(Again, these do not “treat” PCO; they support overall eye wellness.)

Regenerative / stem-cell” drug

There are no approved immune-booster, regenerative, or stem-cell drugs to treat PCO in routine care. Researchers have explored ways to stop those capsule cells from changing and scarring, but nothing is standard-of-care. Please do not use any such agents outside a clinical trial. EyeWiki

Anti–TGF-β pathway inhibitors (investigational)
Function/mechanism: TGF-β signaling drives cell transformation and fibrosis in PCO; blocking it could reduce haze formation. Dose: None established for clinical use. National Eye Institute
Immunotoxins (e.g., MDX-A, investigational)
Function/mechanism: Target remaining lens cells to prevent regrowth; early studies suggested lower PCO, but not adopted clinically. Dose: None approved. EyeWiki
Antimetabolites (e.g., 5-fluorouracil, mitomycin C) in sealed-capsule systems
Function/mechanism: Irrigate the closed capsule with a drug to kill residual cells; Status: experimental due to safety concerns. Dose: Not for routine use. EyeWiki
Drug-eluting IOLs (anti-fibrotic coatings)
Function/mechanism: Lenses that slowly release agents to deter cell growth on the capsule; Status: research stage. Dose: Not established. PMC
Rho-kinase (ROCK) pathway inhibitors (concept stage)
Function/mechanism: Could reduce contractile fibrosis of lens cells; Status: investigational in lab models; Dose: none.
Photothermal or targeted energy treatments to ablate cells during surgery
Function/mechanism: Energy delivered to the equator of the capsule to reduce cell survival; Status: experimental adjuncts; Dose: device-dependent; not routine.

Surgeries/procedures

Nd:YAG laser posterior capsulotomy (the standard fix)
What happens: In clinic, a focused laser makes a small, round opening in the hazy back capsule so light can pass freely again. No incisions. Vision often improves within hours to days.
Why it’s done: To quickly restore clarity and contrast when PCO is affecting daily life.
Risks: Short-term pressure rise, transient inflammation, rare IOL “pitting,” rare retinal detachment or macular edema—risks are uncommon and your doctor screens for them. American Academy of Ophthalmology+1
Surgical posterior capsulectomy with vitrector (operating room)
What happens: Through tiny incisions, a surgeon mechanically removes the hazy posterior capsule, often with a bit of gel (vitreous) trimming if needed.
Why: Used if YAG laser is not feasible (e.g., very dense fibrosis, unstable IOL) or in certain pediatric cases. EyeWiki
Manual membranectomy (limbal approach)
What happens: The surgeon peels or cuts the fibrotic membrane off the visual axis with micro-instruments.
Why: For thick, fibrotic PCO or when other work is being done on the capsule/IOL at the same time.
Pars plana posterior capsulotomy (vitreoretinal approach)
What happens: A retina surgeon creates the opening from the back of the eye, often combined with vitrectomy.
Why: For complex eyes (e.g., pediatric, severe fibrosis, other posterior segment surgery).
Primary posterior capsulorhexis with anterior vitrectomy (preventive, usually in children)
What happens: At the original cataract surgery, the surgeon opens the back capsule and removes a small amount of gel so the visual axis stays clear.
Why: Children form PCO very quickly; this prevents visual axis opacification and amblyopia risk. EyeWiki

Prevention practices

Prevention is largely about the way cataract surgery is done and the lens that is implanted.

A continuous curvilinear capsulorhexis that overlaps the IOL optic 360°
The “shrink-wrap” effect helps block cells from crawling into the visual axis. EyeWiki
Thorough cortical cleanup and capsule polishing
Removes as many leftover cells as safely possible. EyeWiki
Hydrodissection to aid cleanup
Helps separate cortex from the capsule so fewer cells remain. EyeWiki
In-the-bag fixation of the IOL optic and haptics
Keeps the optic where it can best block migrating cells. EyeWiki
Square-edge IOL optic design
A sharp edge mechanically deters cell migration; reduces PCO and the need for YAG compared with round-edge designs. CochranePMCScienceDirect
Hydrophobic acrylic IOLs (context-dependent)
Many studies link this material with lower PCO/YAG rates vs some alternatives, though findings vary by design and study. MDPI
Broad adhesion of IOL to the posterior capsule
Helps create a firm barrier to cell movement. EyeWiki
Meticulous control of inflammation
Quiet eyes are less prone to scarring responses. (Medical regimens vary with history.)
Primary posterior capsulotomy/anterior vitrectomy in children
Prevents rapid visual-axis opacification in pediatric eyes. EyeWiki
Good overall ocular health and surgical planning
Stable retina and macula, controlled systemic disease (e.g., diabetes), and careful IOL choice all support long-term clarity. (Risk factors like long axial length, high myopia, or prior vitrectomy can increase PCO risk.) PMC+1

When should you see a doctor?

Your vision blurs again weeks to years after cataract surgery.
You struggle with glare, haloes, or washed-out contrast, especially at night.
You notice double images through one eye or trouble reading.
After a YAG laser, urgent visit if you have eye pain, a shower of new floaters, flashes of light, a dark curtain in vision, or a severe headache with nausea (possible pressure spike or retinal issue). American Academy of Ophthalmology

Foods to favor—and to limit/avoid

Diet doesn’t remove PCO, but good nutrition supports the retina and ocular surface so your “system” sees as well as possible once the haze is cleared.

Eat more of:

Leafy greens (spinach, kale) for lutein/zeaxanthin.
Colorful veggies (bell peppers, carrots).
Oily fish (salmon, sardines) for omega-3s.
Citrus and berries for vitamin C.
Nuts and seeds (almonds, walnuts, flax).
Eggs (lutein, zeaxanthin).
Whole grains for steady energy.
Legumes for plant protein.
Olive oil for heart-healthy fats.
Plenty of water to support tear film.

Limit or avoid:

Smoking (tobacco toxins harm ocular circulation).
Excess added sugars (unhelpful for retinal health).
Ultra-processed snacks (low nutrient density).
Deep-fried foods (pro-inflammatory oils).
Heavy alcohol (dehydrates, blurs).
Large salty meals (can worsen fluid balance temporarily).
Energy drinks late at night (pupil dilation/glare).
Very bright screens in dark rooms (glare discomfort).
Poor hydration.
Anything that worsens your systemic conditions (e.g., uncontrolled diabetes).

Frequently asked questions

1) Is PCO the cataract coming back?
No. The artificial lens doesn’t turn into a cataract. The capsule behind it becomes cloudy from cell regrowth. American Academy of Ophthalmology

2) Does PCO always need treatment?
Only if it bothers you. If vision is still good and glare minimal, your doctor may watch it for a while.

3) What fixes it?
A short clinic laser called Nd:YAG posterior capsulotomy makes a tiny opening in the hazy capsule so light passes freely again. American Academy of Ophthalmology

4) How fast does the laser work?
Many notice clearer, brighter vision within hours to days; best focus may settle over a week or two as the eye calms.

5) Is the laser painful?
You’ll be seated at a machine like the exam microscope. A contact lens may be placed on the eye with gel. Most people feel light taps or nothing at all; it’s quick.

6) What are the risks?
Most are mild and short-lived (temporary pressure rise, brief inflammation). Rare risks include pitting of the IOL, retinal detachment, and macular edema; your doctor screens for these. American Academy of Ophthalmology

7) Why do doctors check eye pressure after the laser?
Because pressure can rise for a few hours after the procedure, peaking around 3–4 hours; a quick pressure check and preventive drops keep you safe. American Academy of Ophthalmology

8) Can eye drops fix PCO?
No drop removes the haze. Drops are used to prevent short-term pressure spikes and inflammation around the laser. EyeWiki

9) Will PCO come back after the laser?
Rarely, the opening can cloud again and a second laser touch-up is needed. Most people need it only once. EyeWiki

10) Can both eyes get PCO?
Yes—if both eyes had cataract surgery, both capsules can become hazy at different times.

11) Do certain lenses reduce the chance of PCO?
Yes—square-edge IOL designs reduce PCO compared with round-edge designs, and many studies suggest hydrophobic acrylic lenses have lower rates than some other materials. Your surgeon individualizes the choice. CochraneMDPI

12) I have glaucoma. Is the laser safe?
Yes, with precautions. Your team will use pressure-lowering drops and monitor IOP more closely. JAMA Network

13) I’m very nearsighted / had vitrectomy. Am I higher risk for PCO or issues?
High myopia and prior vitrectomy are associated with PCO in some studies; careful planning and follow-up reduce risks. PMC+1

14) Do kids get PCO?
Yes—far more often and faster than adults, so surgeons typically prevent it at the initial surgery with a posterior capsulotomy and small vitrectomy. EyeWiki

15) What should I expect at the visit?
Dilation, a quick laser, post-laser pressure check, and short-term drops. Most people resume normal activities soon after, avoiding eye rubbing and heavy exertion the same day. American Academy of Ophthalmology

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Last Updated: August 22, 2025.

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