Many patients come to us after suffering an eye injury or undergoing eye surgery that damaged the iris. Conditions such as iridodialysis, traumatic mydriasis, or post-operative iris defects can leave the pupil permanently enlarged, decentered, or torn. In these cases, uncontrolled light floods the eye, creating significant glare, discomfort, and often monocular diplopia (double vision in one eye). Pinhole lenses recreate a central, properly sized pupil, drastically reducing symptoms. For example, patients who previously relied on sunglasses indoors or struggled with reading under lights often find that their tolerance improves dramatically after lens wear.

Conditions like aniridia (absence of the iris), large iris colobomas (missing iris segments), or other congenital iris malformations often lead to debilitating photophobia from early childhood. Without the iris functioning as a light regulator, the eye cannot adjust to bright conditions, leaving patients with near-constant discomfort. A pinhole soft lens creates an artificial iris and provides a fixed aperture that limits excess light. We have seen these lenses restore comfort and function in both children and adults with these conditions, allowing them to participate in everyday activities without visual stress.

Some patients have pupils that no longer constrict due to nerve damage, medication side effects, or surgical complications. This leaves the eye constantly open to bright light, causing persistent glare and halos. A custom lens with a smaller central aperture mimics the effect of sunglasses and allows for significantly greater light control. These lenses are particularly helpful for patients who had glaucoma or retinal surgery and were left with large, non-reactive pupils.

In cases of ocular albinism, the iris lacks pigment and appears translucent. Even if structurally normal, these irides fail to block light, resulting in constant light sensitivity. Pinhole soft lenses with dark annular tints or opaque iris colors can reduce the internal light scatter, making bright environments more tolerable. Children especially benefit from these lenses, which reduce the need for wearing sunglasses indoors and help them see comfortably in classroom settings or during outdoor play.

Pupil shapes altered by surgery or disease (such as keyhole pupils or pseudopolycoria) can cause overlapping images and a degraded visual experience. Pinhole lenses cover these irregularities and provide a clean, single visual aperture. We’ve seen cases where patients with multiple iris openings regain normal function simply by masking the extras with a soft prosthetic lens. For instance, one patient who had multiple iris holes after biopsy reported complete resolution of their photophobia using a commercially available soft lens.

Double vision in one eye, often related to stray light passing through an irregular or damaged pupil, can be successfully reduced or eliminated with a pinhole lens. These lenses control the incoming light, reducing aberrant rays that cause ghosting or secondary images. Some designs even offer fully opaque pupils to completely block input from a severely damaged eye, eliminating diplopia while preserving appearance.

Although not a primary use, pinhole soft lenses can sometimes benefit patients with minor corneal irregularities by enhancing depth-of-focus. In cases where rigid lenses are not tolerated, a pinhole lens can offer some clarity through light filtration. That said, in more advanced corneal disease, our team may recommend other solutions such as gas permeable or scleral lenses, which are more appropriate for reshaping light at the corneal level.