Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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New symptoms after capsulotomy
A sudden field defect, rapidly increasing floaters, marked visual loss or a painful red eye after laser treatment may represent a complication.
Action: Arrange urgent ophthalmic assessment, including retinal examination or pressure measurement as indicated; do not attribute these symptoms to normal capsule debris.
Synopsis
Recognise visually significant posterior capsule opacification after lens surgery, exclude alternative causes of deterioration and explain safe laser treatment.
Posterior capsule opacification is a change in the retained lens capsule after cataract surgery.
It usually causes gradual painless misting, glare or reduced contrast after an initial period of improvement.
Confirm that opacity lies in the visual axis and explains the functional complaint before treating.
Key red flags
Flashes with a curtain-like shadow suggest a retinal tear or detachment rather than uncomplicated capsule opacity.
Investigation priorities
01
Acuity and refractionFirst step
Quantify visual change and identify an alternative optical correction.
Management branches
AssessConfirm a symptomatic capsular problem
Vision has deteriorated after an initially successful cataract operation.
Obtain the chronology and screen for pain, acute loss, retinal warning symptoms and central distortion.
Measure vision, assess refraction and examine the implant, capsule, pressure and fundus.
Key medicines
Apraclonidine 1% for peri-laser pressure controlInstil one drop into the treated eye one hour before anterior segment laser surgery and a second drop immediately after completion.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.