Mulberry-like appearance of Elschnig pearls on anterior segment optical coherence tomography

A 22-year-old boy presented with mild posterior capsular opacity with a large grape-like mass inferonasally behind the iris (arrow) [Fig. 1] (A) in his left eye, years after phacoemulsification and implantation of intraocular lens in the capsular bag. Slit-lamp examination with retro-illumination demonstrated anterior capsule opacities (arrow) (B). The anterior segment optical coherence tomography (AS-OCT) [CASIA SS-1000 CT (Tomey, Nagoya, Japan)] showed proliferating lens epithelium on remnants of the anterior capsule (arrow-head) (C) giving a "mulberry-like appearance." The appearance bears a resemblance to that seen in histopathology.[1,2] AS-OCT, therefore, provides a useful tool for in vivo histopathology.Figure 1: Anterior segment examination on slit lamp biomicroscopy shows posterior capsular opacity (arrows) (a,b). Corresponding Anterior Segment OCT shows proliferating lens epithelium on remnants of anterior capsule (c) (arrow-head) giving a mulberry like appearanceFinancial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.