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It is possible that there is an underlying change in the back of the eye such as tiny/small congenital cataract or lesion in the at the back of the lens
capsule (mittendorf dot), vitreous
or retina due to non-harmful changes or infection in the womb or trauma in the eye during delivery. The small pupil on the affected eye is likely related to this eye lesion, but may be a normal variation in pupil size. It is also possible that this is due to a non-harmful remnant of the eye structure remaining after eye development, as mittentdof dot or Bergmeister papilla at the optic nerve. It is important to exclude infections such as toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis, and retinoblastoma
. This can be done by the pediatric ophthalmology with complete dilated eye examination.
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