Esotropia And Spider's Web: A Case Report

Persistent pupillary membrane is a congenital anomaly. In some cases, strands are attached to the anterior surface of the lens, sometimes resulting in opacification. We report the case. of apersistent pupillary membrane medically treated (mydriatric drop- optical correction - amblyopia treatment) with good result. 

We report the case of a 3-year-old child, who consulted for a strabismus observed by the parents for about 6 months.

The ophthalmological examination revealed a visual acuity that was difficult to assess, an alternate esotropia with a predominant left eye. 
The right eye had a clear cornea, a good anterior chamber with persistence of a small para axial pupillary membrane, attached to the lens with lens opacification in front. The fundus was normal.
The left eye was normal.
Optical correction under cycloplegia combined with treatment of amblyopia and pupillary dilatation were prescribed. The evolution was highlighted by an improvement in visual behaviour. Close monitoring with assessment of visual acuity and amblyopia treatment and evolution of lens opacification is maintained to this day in order to watch for any indication for surgical management.

Pupillary membrane persistence is a rare condition. The risk of amblyopia is high and requires early management to ensure a better functional outcome.