Bilateral Persistent Pupillary Membranes

Bilateral Persistent Pupillary Membranes

NOTES, CASES AND INSTRUMENTS BILATERAL PERSISTENT PU­ PILLARY MEMBRANES. GEORGK N. BRAZEAU, M.D., F.A.C.S. MILWAUKEE, WIS. These two illustration...

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NOTES, CASES AND INSTRUMENTS BILATERAL PERSISTENT PU­ PILLARY MEMBRANES. GEORGK N.

BRAZEAU,

M.D.,

F.A.C.S.

MILWAUKEE, WIS.

These two illustrations graphically depict the congenital condition known as persistent pupillary membranes. They are vestiges of a membrane that normally disappears about the seventh month of fetal life. On closely examining the illustrations, we see that the membranes present one or more ir­

is grayish brown and the outer half is distinctly brown. Modern embryologic researches proved that these membranes are a part of the vascular sac of the lens alimented by the hya­ loid artery. They are also supposed to be nourished thru their arcades from the irides, the posterior part of the lens receiving its nourishment from the artery of Cloquet. From these cir­ cumstances, these membranes may deviate from the supposed normal in­ dependently of the circulation in the lens or inversely. The irido-capsular

rig. 1. Bilateral persistent pupillary membrane (Bra/.eau's ease).

regular openings in their centers, from which radiate narrow prolongations of the color of the irides. They are pre­ sumed to be remnants of blood vessels that have become covered by elastic connective tissue, in which pigment has been deposited. These projections are attached about the periphery of the pupils in the iris substance, and in no way interfere with their function­ ing. The irides, as the French would say, are bombes and the anterior cham­ bers are consequently shallow. The trellis work of these membranes stands about one-half millimeter anterior to the irides, as tho it was supported by so many legs. Several fine fibers at­ tach the posterior surfaces of the irides to the anterior capsule of the lenses. There is a central opacity of the right lens. Dilation of the pupils with atropin is normal. The vision in both eyes is 20/40. The inner half of each iris

adhesions are readily distinguishable from those due to inflammation by their elasticity, allowing free move­ ment to the irides. These pupillary bridges are for the most part seen in only one eye; here both eyes are similarly affected. Their form, size, and consistency may vary, not only with the individual, but in each eye as shown in the il­ lustrations. These membranes do not cause any functional troubles. The pupil in the left eye resembles one in which an iridectomy was done, leaving the pupil­ lary margin of the iris intact. There is no polyopia. The treatment consists in tearing an opening in the membrane whenever it completely occludes the pupillary opening. In this case it is advisable to let the condition alone. The patient was seen in consultation with Dr. Fowzer. 370