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Ophthalmic Images
August 8, 2019

Spiderlike Appearance of Persistent Pupillary Membrane

Author Affiliations
  • 1Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
JAMA Ophthalmol. 2019;137(8):e185744. doi:10.1001/jamaophthalmol.2018.5744

A 22-year-old woman presented with decreased vision in both eyes since childhood. She underwent left eye pupilloplasty 10 years before presentation. Her best-corrected visual acuity at presentation was 20/60 OU. On biomicroscopic examination, her corneas were clear. In her right eye, there was the presence of thick iris strands bridging the pupil and involving the visual axis, giving a spiderlike appearance, which was suggestive of persistent pupillary membrane (Figure). Her fundus was normal in both eyes. Persistent pupillary membranes are the result of remnants of tunica vasculosa lentis, which surround the lens during embryogenesis and normally involute by the sixth month of gestation. They are usually small and rarely cause visual disturbances, but if large enough to cause visual axis obstruction, then surgical removal may be indicated.1,2