A pigmented (yellow) strand can be seen between the lens and the iris. There is an associated opacity on the anterior lens capsule. Differentials include posterior synechia or a congenital persistent pupillary membrane (PPM). The absence of inflammation or evidence of trauma would indicate that this is a congenital developmental anomaly. Note also that the iris strand arises from the collarette, an area midway between the pupil and iris root. This is the location of the embryonic attachment of the pupillary membrane and is nearly always the point of attachment of PPM. In contrast, synechia caused by inflammation nearly always arise from the pupillary margin.