Wonky Pupils
Author: Hamza Shah, OD, MS
Understanding Pupil Conditions
Polycoria
Occurs when two or more pupils are present within the iris. These pupils may be separated by iris tissue or connected. This condition is often congenital but may go undiagnosed until adulthood due to its rarity.
Iridodialysis
Refers to a condition where the iris is torn away from its attachment to the ciliary body, often resulting from trauma.
Aniridia
Is a rare genetic disorder where the iris is partially or completely absent, leading to various vision problems, including light sensitivity and reduced visual acuity.
Corectopia
Is characterized by an abnormally positioned pupil, which may be congenital or acquired, potentially affecting visual function.
Coloboma
Is a congenital defect where part of the eye structure, such as the iris, retina, or optic nerve, is missing, leading to a keyhole-shaped pupil and potential vision impairment.
Complete Aniridia in a 34-Year-Old Patient
A 34-year-old patient presented with a best-corrected visual acuity (BCVA) of 20/100. She exhibited a complete absence of iris tissue and reported significant issues with glare and light sensitivity. The patient had worn glasses her entire life and had been previously informed by her eye doctors that her condition was permanent and untreatable. Upon examination, she was diagnosed with complete aniridia in both eyes. To manage her symptoms, she was referred for fitting with an iris occlusion prosthetic contact lens. These lenses provide a synthetic pupil, which helps reduce glare, improve light sensitivity, and in some cases, enhance visual acuity.