Complete Pupillary Ruff Detachment

A 65-year-old man presented for a routine eye examination with visual acuity of 20/30 in both eyes. On slit-lamp examination, two thread-like pigmented tissues were seen hanging from the right eye pupillary margin with curled ends, [Figure 1a and b] with a corresponding circumferential loss of pupillary ruff (Arrow). A completely detached pigmented pupillary ruff was seen folded and stuck to the anterior capsule like a garland with no attachment to the pupillary margin on dilatation [Figure 1c]. The rest of the anterior and posterior segments of both eyes were normal. There was no history of trauma, uveitis, glaucoma, or ocular surgery. The patient was asymptomatic and hence needed no intervention. Pupillary ruff detachment is a rare entity. A case of partial segmental incomplete pupillary ruff detachment has been reported.[1] This is the first case of complete pupillary ruff detachment to be reported. This incidental finding could be easily missed during a routine ophthalmic examination. This finding could mimic pupillary ruff hypertrophy or ectropion uveae that is commonly observed in uveitis and glaucoma. Since the patient had no history of trauma, uveitis, glaucoma, or any ocular surgery in the past, the incidental finding of a complete pupillary ruff detachment in an asymptomatic patient was very rare.Figure 1: (a) Pupillary ruff detachment from the 12 o’clock position (b) Absent pupillary ruff circumferentially all along the pupil margin(arrow) (c) Dilated pupil shows totally detached pupillary ruff hanging like a garlandDeclaration of patient consent The author (myself) certify that I have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest No conflicts of interest.