When we see an iris coloboma, we should also think of other ocular structures that can be affected by this defect from incomplete development. There can also be absence of zonular support in this area and the coloboma defects can also affect the posterior segment such as chorio-retinal and even optic nerve defects. For the case above, how do you address these anterior segment issues? How would you bolster the capsular bag? Do you need scleral-sutured support? What about closing the iris defect? If you suture the iris coloboma area, then it will drag the pupil down inferiorly. How do you fix that? So much to learn from our guest surgeon.