Pearls of Elschnig

A 72-year-old Hispanic male patient presented with a chief complaint of blurred near vision without spectacles. He had a medical history of hypercholesterolemia, hypertension, and type 2 diabetes mellitus, controlled with medication; an ocular history of chronic uveitis about three decades ago; and a history of cataract surgery and posteriorchamber intraocular lens (PCIOL) implantation in the left eye seven years back. The patient’s visual acuity was correctable to 20/20 in each eye with refraction (bilateral compound hyperopic astigmatism). Extraocular motilities were unrestricted, and confrontation fields were full to finger count. The pupils were reactive to light and no afferent pupil defect (APD) was present. The right pupil was 4 mm and round in dim light, but the left one had a slight vertical elongation, commonly seen in an operated eye.