Types of Cataract
Cataracts are named for where in the lens the clouding starts — the centre, the outer rim or the back surface. Where it sits decides what you notice first, and how quickly it changes.
- Three types, three patterns of symptoms
- More than one type in one eye is common
- All three treated by the same operation
Camden (Orchard)Joo ChiatClementiBedokToa PayohJurong
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The three types of cataract
There are three main types of age-related cataract, named for where in the eye’s natural lens the clouding starts: nuclear in the dense centre, cortical in the outer layer, and posterior subcapsular at the back, just under the capsule.
Many eyes have more than one type at once, and the two eyes need not match.
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Nuclear — clouding in the centre
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Cortical — clouding from the edge inwards
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Posterior subcapsular — clouding at the back
Each type has its own page below. Only an examination can tell which you have, and whether it is causing your symptoms.
- Nuclear
- Forms in the centre of the lens and is the one most associated with ageing. It yellows as it thickens, so colours wash out and distance vision goes first. It is usually the slowest of the three to change.
- Cortical
- Forms as spokes at the outer edge of the lens and works inwards. Glare and scattered light are the common complaints; it can be well advanced at the edges before the centre of vision is touched.
- Posterior subcapsular
- Forms as a patch at the back of the lens, under the capsule. It sits directly in the visual axis, so even a small one affects reading and vision in bright light first, often more than distance vision. It tends to be the fastest of the three to change.
Concerned about cataracts or vision loss? Talk to our friendly staff for a same-day appointment (subject to availability).
What each type affects first
The position of the clouding is what decides the pattern of symptoms, not how large it is.
- Nuclear
- Distance vision and colour. Whites look creamier and blues are hardest to tell apart.
- Cortical
- Glare and haloes. Light is scattered by the wedges before enough of it is blocked to blur a chart.
- Posterior subcapsular
- Reading and bright light. The patch sits in the visual axis, so a small one is enough to matter.
These are usual patterns, not rules. Symptoms overlap, and other conditions cause the same complaints. A cataract screening at our community clinics is one way to have the lens looked at.
How quickly each type changes
A posterior subcapsular cataract tends to change fastest and a nuclear cataract slowest, with cortical between them.
The Singapore Malay Eye Study re-examined Malay adults aged 40 and over after six years. Of the eyes that already had a cataract:
- Posterior subcapsular
- 40.6% had progressed within six years.
- Cortical
- 20.4% had progressed over the same period.
- Nuclear
- 5.9% had progressed over the same period.
An average describes a group, not an eye. Two people with the same finding can change at different rates. The interval between reviews is set at each examination.
How common each type is
Nuclear and cortical cataract are found at about the same rate. Posterior subcapsular cataract is the least common of the three.
In the same studies, 17.2% of adults had a cataract of some kind, and prevalence rises steeply after 60.
How the types are treated
All three are removed by the same operation, replacing the clouded lens with a clear one as day surgery under local anaesthesia. No drop, tablet or eye exercise clears a cataract.
The type changes the timing, not the operation. A posterior subcapsular cataract can be limiting while a distance chart still reads well, a cortical one may cause little trouble for years, and with a nuclear one new glasses help for a while. Either way, the timing depends on how much it affects your daily life. The next decision is picking the lens.
Cataract Surgery Cost
Cataract surgery at The Straits Eye Centre is between $5,200 and $12,000 per eye, before MediSave. The Straits Eye Centre is a MediSave-approved clinic.
| Service | Per eye |
|---|---|
| Cataract surgery by senior eye surgeons | $5,200–12,000 |
| MediSave withdrawal limit | up to $3,280 |
Figures are per eye at The Straits Eye Centre, before MediSave. Withdrawal limit subject to approval by the CPF Board.
The final range depends on the lens, whether laser assistance is used, and your insurance status. Every operation is performed by one of our senior consultant eye surgeons. See the full cost breakdown
Who performs it
Every type of cataract is removed by the same operation, and our senior consultant eye surgeons perform it — more than 60 years in ophthalmology between them. Talk to us for a quick appointment.
99%+
cataract surgery success rate at The Straits Eye Centre.
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Dr Jayant V Iyer
Senior Consultant & Medical Director
The Straits Eye CentreMBBS · GDFM · MMed (Ophth) · FRCOphth · FAMS
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Dr Jason Lee
Senior Consultant & Medical Director
The Straits Eye CentreMBBS · BMedSc · MMed (Ophth) · FRCOphth · FAMS
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Dr Audrey Pang
Senior Consultant Eye Surgeon
The Straits Eye CentreMBBChir (Cambridge) · MMed (Singapore) · FRCOphth (London) · FAMS
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Dr Laurence Lim Shen
Senior Consultant Eye Specialist and Vitreo-Retinal Surgeon
The Straits Eye CentreMBBS (S’pore) · MRCS (Edin) · FRCS (Edin) · FAMS
Common questions
What are the three types of cataract?
Nuclear, cortical and posterior subcapsular. They are named for where in the lens the clouding starts — the dense centre, the outer rim, and the back surface just under the capsule. Each affects vision in a different way, and each is removed by the same operation.
Can you have more than one type of cataract at once?
Yes, and it is common. An examination often finds changes of two types in the same lens, and the two eyes need not match. What matters for treatment is how much the vision is affected rather than how many types are named in the notes.
Which type of cataract is most common?
Nuclear and cortical cataract are found at about the same rate, and posterior subcapsular cataract is the least common of the three. Pooling 45 studies of 161,947 people worldwide gave 8.2% for nuclear, 8.1% for cortical and 2.2% for posterior subcapsular among adults of all ages.
Which type of cataract progresses fastest?
Posterior subcapsular, on average. In a six-year study of Malay adults aged 40 and over in Singapore, 40.6% of eyes that already had one had progressed, against 20.4% of cortical and 5.9% of nuclear cataracts. Individual eyes vary widely, and an average describes a group rather than an eye.
How do I know which type of cataract I have?
An examination is the only way. The lens is looked at through a slit lamp with the pupil dilated, which is how clouding at the back of the lens is seen at all. The type is recorded in the notes alongside how dense the change is.
Does the type of cataract change the operation?
The operation is the same one: the clouded lens is removed and a clear artificial lens is put in its place, as day surgery under local anaesthesia. What the type tends to change is the timing, because each affects vision in a different way and at a different pace.
Does the type of cataract change the cost?
No. The three things that move the fee are the lens chosen, whether laser assistance is used, and insurance status — not which type of cataract is being removed.
Ask about your eyes
Send us a message and we will answer. If you have been told which type of cataract you have, say so in the message and we will take it from there.
