High myopia of -26D in a 3 year old child: A rare case presentation

AbstractHigh myopia in early childhood is rare and often associated with genetic, ocular, or systemic abnormalities. This case report describes a 3-year-old girl diagnosed with high axial myopia (-24.00 DS) and an axial length exceeding 33 mm, highlighting the importance of early detection and comprehensive management. A 3-year-old female presented with squinting and difficulty seeing distant objects. Cycloplegic refraction revealed -24.00 DS in both eyes, with no nystagmus or strabismus. Examination under anesthesia confirmed -26.00 DS on retinoscopy. Ocular examination was remarkable for severe chorioretinal atrophy and pale optic discs (0.5 CDR). Axial length measurements were 33.23 mm (right eye) and 33.15 mm (left eye). A diagnosis of high axial myopia was made, and myopia management was initiated with spectacle correction, soft contact lenses, and low-dose atropine therapy (0.01%). Systemic evaluation ruled out syndromic associations, and the patient was placed on close follow-up for progression monitoring and amblyopia management.This case represents one of the highest reported myopic refractive errors in early childhood. It highlights the importance of early detection, individualized myopia management, and long-term monitoring to reduce the risk of progressive vision loss and complications. Advances in myopia control offer promising avenues for improving visual outcomes in highly myopic children.