Pediatric and Strabismus

Persistent Pupillary Membrane

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