Purpose: To report a young patient with microphthalmos associated with bilateral papillomacular fold and severe hyperopia

Case report: In this observational case report, a sixteen-year-old young man was referred with high hyperopia to Al-Zahra Eye Hospital, Zahedan University of Medicalf Sciences, Zahedan, Iran, for check up. Spherical error in right eye (RE) was +14.75 D and in the left eye (LE) was +15.00 D without astigmatism. Keratometry was reported 51.50, 52.25@113 in RE and 51.25, 52.25@65 in LE. Best corrected visual acuity (BCVA) was ²⁰/₂₅ in both eyes. Axial length in RE was 14.8 mm and 14.9 mm in LE. Also cornea diameter measured 9.9 for both eyes. In fundus exam, a papillomacular retinal fold extending from the center of the fovea toward the optic nerve head was present. In OCT exam, papillomacular fold with thickness of 322 microns in RE and 277 microns in LE were reported. In Pentacam exam, anterior chamber depth, central corneal thickness and anterior and posterior best fit sphere (BFS) were reported 2.34 mm, 565 microns, 6.54 mm and 5.39 mm in RE and 2.41 mm, 578 microns, 6.54 mm and 5.39 mm in LE. Intraocular pressure (IOP) was 13 mmHg in both eyes and there was no sign of angle closure glaucoma.

Conclusion: Microphthalmos may be associated with high hypermetropia, thick papillomacular fold, and steep cornea with a relative good vision.