Backround: Significant persistent pupillary membrane (PPM) is an ocular “congenital anomaly” which affects both eyes and its consequences on visual function are usually very serious. These membranes may appear to occlude the pupil to such extent so as to preclude useful vision and to require aggressive interventions.
Case Report: We present an interesting case which despite the dense persistent pupillary membrane remnants and the refractive error and anisometropia achieved excellent visual acuity presumably due to a pinhole effect. We describe our clinical fi ndings. The overwhelming majority of similar cases show imperfect visual development.
Conclusions: The surprisingly excellent visual acuity and binocular vision in the present case precluded any attempt to remove these pupillary membrane remnants.

Keywords: persistent pupillary membrane, Amblyopia, pinhole effect