A one-month-old boy presented for severe intraventricular hemorrhage when an ophthalmology consult was requested for an abnormal red reflex in the left eye. Dilated fundus exam and fluorescein angiography revealed a tunica vasculosa lentis of the posterior lens surface with a pat­ent hyaloid artery in both eyes. The eyes were of normal size; the lenses were clear; and the retinas fully vascularized and devel­oped. The condition was diagnosed as mild persistent fetal vascu­lature, and the patient was observed.

At the six-month follow-up, the tunica vasculosa lentis had re­gressed, and the patient was fixating and following.

Top left: Right eye, posterior pole, focused on “knot” in patent hya­loid artery.
Top right: Right eye, nasal to disc, focused on posterior surface of the lens.
Bottom left: Left eye, inferotemporal, focused on retina, out-of-focus patent hyaloids visible in image.
Bottom right: Left eye, inferotemporal, focused on posterior surface of the lens, showing the extent of the tunica vasculosa lentis.