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Editor,—A 33 year old female patient, who was born in the far east of Nepal where there were no medical facilities, had a noticeable bilateral pupillary abnormality at birth. It was not until she was 12 years of age that she was first seen by an ophthalmologist in Kathmandu.
Her present visual status is an acuity of 6/6 partly and N5 in each eye. She had no visual complaints but slit lamp examination shows a gross persistent pupillary membrane in each eye with an almost identical appearance.
The membrane is not adherent to the lens capsule. It bulges forward into the anterior chamber when the pupil constricts to light and is flat with the pupil dilated (see Fig 1). The ocular fundi are normal.
It is interesting that in the presence of this gross pupillary abnormality visual acuity is unaffected with no significant visual deprivation amblyopia.
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