Irregular pupil shape can be seen for many reasons: first, uveitis, which is the most common cause and includes iritis, iridocyclitis or total uveitis. This is a sterile inflammatory reaction in the eye that can lead to exudation from the pupil area, which can cause adhesions in the pupil, thus causing the irregular shape of the pupil. Second, trauma to the eye may damage the pupillary sphincter, causing the pupil to become dilated or irregularly shaped. Third, congenital developmental abnormalities, such as congenital iris defects, may cause irregular pupil shape. Fourth, after an acute attack of glaucoma, the pupillary sphincter of the iris can be damaged, which can also cause the pupil to become dilated.