Persistent pupillary membrane remnants attached to the anterior lens capsule

Abstract

Purpose: To present an interesting case of bilateral persistent pupillary membrane remnants without visual acuity impairment. Persistent pupillary membrane remnants are an ocular “congenital anomaly” and often affect both eyes. Methods: A 12 year old dark‐haired boy presented on a routine examination with dense and wide pupillary membrane remnants attached to the iris collarette and the anterior lens capsule bilaterally. In OD the remnants covered almost the whole pupillary area however leaving some clear islands and among them a central one. In OS the remnants did not cover the central pupillary area. Results: Uncorrected visual acuity was surprisingly good (9/10 OD and 10/10 OS). Although autorefraction was OD: +3.50 ‐2.25 X 180º and OS: +0.75 ‐0.25 X 170º, subjective refraction was OD: + 1.25 X 90º providing 10/10 and Jaeger 1 and OS: plano providing 10/10 and Jaeger 1. Conclusions: The characteristic of the pupillary membrane remnants is the attachment to the iris collarette and this is the most important differential diagnostic feature from pupillary membranes of other origin. Surgical removal of these membranes or YAG‐laser membranectomy is sometimes necessary in cases with severe visual impairment. The surprisingly good visual acuity in the present case is not suggestive of any attempt to remove these pupillary membrane remnants. Excellent near and distant visual acuity was preserved in the right eye due to a “pinhole effect” of the central clear island which prevented the occurrence of amblyopia.