This type is much less common and occurs later in life as a result of severe ocular trauma or chronic inflammatory diseases. Prolonged conditions like severe uveitis or advanced leprosy can cause the iris to fuse or become covered with thick, fibrotic scar tissue that completely obliterates the pupil. Clinical Challenges and Diagnosis

This form occurs as a birth defect due to disruptions during embryogenesis. During fetal development, the mesodermal tissue of the iris is supposed to regress to form the pupillary opening. If this regression fails, a persistent pupillary membrane or thick fibrous tissue seals the center of the iris. While many cases are idiopathic or sporadic, others show a hereditary pattern. Recent genetic research has linked familial acorea-microphthalmia-cataract syndrome to mutations in the GJA8 gene, which encodes gap junction proteins critical for lens and eye development.

Furthermore, the lack of a pupil disrupts the flow of aqueous humor from the posterior chamber to the anterior chamber of the eye. This fluid blockage often provokes pupillary block and secondary angle-closure glaucoma, leading to dangerously high intraocular pressure that can destroy the optic nerve. Acorea - Definition, Meaning & Synonyms - Vocabulary.com

Acorea is a rare ophthalmological condition defined as the . Deriving from the Greek "a-" (without) and "kore" (pupil), this condition means light cannot pass properly through the iris to the retina.