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Pediatric & Strabismus

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Persistent pupillary membrane demonstrates several strands inserting into the collarette of the iris with free floating edges. Note also a dense iris sheet and clumping iris pigment on the anterior lens capsule.

  • A frequently encountered congenital anomaly in routine ophthalmologic practice
  • Remnant of the anterior portion of the tunica vasculosa lentis, the vascular structure that nourishes the crystalline lens in utero
  • Clinical features:
    • Symptoms: usually asymptomatic, and rarely affect vision
    • Signs:
      • May visible as single or several strand(s) that partially bridge the pupil
      • The peripheral portion always inserts into the iris colarette
      • The central portion may attach to the anterior lens capsule or float with free edges
      • Iris melanocytes may be observed on the anterior lens capsule forming "pigment stars" or "chicken tracks"
      • In rare cases, extensive sheet of iris membrane occluding the pupil may occur
  • Treatment:
    • No treatment is indicated
    • In cases with extensive pupil occlusion, Nd:YAG laser pupilotomy may be indicated

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