axial high myopia and esotropia(heavy eye syndrome); results of surgical management

purpose: to present two cases of axial high myopia with esotropia (heavy eye syndrome) and the results of its surgical management. case report: two female subjects (15 and 17 years old) were referred to poostchi eye clinic, shiraz, iran with axial high myopia and esotropia. eye examination revealed more than 50 prism diopter (pd) esotropia and more than 10 pd hypotropia in primary position as well as limitation of abduction (-3 to -4) and elevation (-1 to -2) in both eyes. orbital ct scan disclosed compression of the lateral rectus muscle between an enlarged globe and the orbital wall. downward displacement of the lateral rectus muscle was seen intraoperatively. the results of surgery were satisfactory and acceptable. conclusion: in patients with axial high myopia and strabismus, preoperative imaging, especially orbital ct scan or mri is recommended for detection of displacement or compression of extraocular muscles against the orbital wall and for planning the surgical management based on the underlying pathophysiological process.