Epicapsular stars

Abstract

A 10-year-old girl was found to have decreased visual acuity in her right eye on routine eye screening. Best-corrected visual acuity was 6/36 (N18 at 35 cm) in the right eye and 6/6 (N6 at 35 cm) in the left eye. Sensory evaluation revealed right eye suppression. On slit-lamp biomicroscopy, tiny, stellate, brown pigmented flecks on the anterior lens capsule were observed, partially obstructing the pupillary axis. The flecks, called “epicapsular stars,” are the remnants of the tunica vasculosa lentis, an embryonic vascular network surrounding the lens. The retinoscopic reflex in the right eye was nonhomogeneous red. Deprivation of visual stimulation due to the epicapsular stars caused amblyopia in the right eye. Glasses were prescribed equal to her best-corrected visual acuity, and yearly follow-up was advised.