The presence of multiple iris holes is most commonly called pseudopolycoria, because only the central pupil has a sphincter muscle and can constrict. Iris holes without muscle tissue arise as congenital defects or develop from ocular trauma, inflammation, or degeneration and are thus not considered to be true accessory pupils. Multiple pupils, also known as true polycoria, are distinguished by the presence of a sphincter muscle around each iris hole, permitting synchronous constriction and dilation of the 2 pupils. One presumed mechanism for polycoria is a snaring or pinching off from the margin of another pupil. This patient had a small, oval-shaped accessory pupil, which may have separated from the temporal margin of the central pupil, leaving a thin bridge of no sphincter connecting tissue. The outlook for polycoria is generally good. You may not require any treatment if your visual impairment is minimal and doesn’t interfere with your daily life. However, if treatment is needed, pupilloplasty has so far shown positive results. If you have polycoria, it’s important to have regular check-ups with an eye doctor to monitor your vision and any changes your eyes may have. Having your eye checked regularly is also beneficial for your eyesight as a whole.