Persistent pupillary membranes usually undergo considerable atrophy during the first year of life. A minimum pupillary diameter of 1.5 mm is necessary for normal retinal image formation. Mydriatics, fixation pattern determination, and occlusion therapy as indicated can obviate the need for coreoplasty in patients with an extensive persistence of the pupillary membrane. We successfully treated a patient who had an almost total persistence of the pupillary membrane.