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Editor,—Persistent pupillary membranes (PPMs) which are large enough to interrupt the visual axis are uncommon. If left untreated they may cause stimulus deprivation amblyopia.1There is evidence that early treatment to remove obstructions of the visual axis in infants may minimise the risk of amblyopia.2 We report a case of bilateral persistent pupillary membranes which were successfully treated surgically before the patient was 6 weeks old.
CASE REPORT
A healthy baby induced at 41 weeks was born by normal vaginal delivery following a normal pregnancy. He weighed 8 lb 8 oz (3.8 kg) and was noted to have an abnormal red reflex from both eyes on routine ophthalmic check by a paediatrician before discharge from hospital after birth. He appeared to fix briefly on a light but did not really look at toys. The red reflexes were significantly reduced centrally and there were peripheral spoke-like opacities. Even with dilatation only a poor fundal view was obtained. The view was particularly poor on the right eye. An ultrasound scan of the posterior pole was normal for each eye. Further examination under anaesthetic showed that the child had hyperplastic persistent pupillary membranes in both eyes (Fig 1). Blood could be seen flowing through the blood vessels within the membranes under the operating microscope. There were no other abnormal examination findings. Screening tests for toxoplasmosis, cytomegalovirus, rubella, and treponemal antibodies were all negative. There was no known history of substance abuse by the mother. The visual axis especially on the right side was significantly obstructed even when the pupils were dilated and consequently we thought that the risk of stimulus deprivation amblyopia was high if they were left in place. The membranes were removed from the right …