Pseudoexfoliation material on IOL mimicking pupil inside the pupil

A 68-year-old female came to the outpatient department for a regular checkup. Ophthalmic history revealed that the patient had undergone cataract surgery in both eyes 12 years back; the surgery was uneventful. The best corrected visual acuity in both eyes was 6/6, and the intraocular ocular pressure was within normal limits. On examination, posterior chamber intraocular lens (IOL) was present in both eyes, along with pseudoexfoliation in the left eye. On dilatation, the left eye revealed pseudoexfoliative material on the anterior surface of IOL, which appeared as pupil inside the pupil on slit-lamp examination [Figs. 1 and 2].Figure 1: Slit-lamp photo showing pseudoexfoliative material deposition on IOL. IOL = intraocular lensFigure 2: Retroillumination photo on slit lampDeclaration of patient consent The authors certify that they 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 The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.