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Case Reports
. 2025 Jun 25;17(6):e86708.
doi: 10.7759/cureus.86708. eCollection 2025 Jun.

Unilateral Myopia With Posterior Staphyloma

Malik Muhammad Hamza Khan  1 , Muhammad Rayyan Malik  2 , Muhammad Bilal Malik  1 , Neha Maqsood  3 , Ahmad Burq Maqsood  1
Affiliations
Case Reports

Unilateral Myopia With Posterior Staphyloma

Malik Muhammad Hamza Khan et al. Cureus. .

Abstract

Pathological myopia is a major cause of visual impairment and usually affects both eyes. Unilateral presentations are rare, and posterior staphyloma in such cases is even less common. Recognizing these atypical clinical and anatomical features is vital for accurate diagnosis and management. A woman in her 30s with no significant birth or family history presented with progressive right eye protrusion over one year and gradual, painless vision loss in the same eye over five years. Visual acuity was counting fingers at 4 feet in the right eye and 20/25 in the left. Autorefraction showed -24.75 D spherical and -4.35 D cylindrical in the right eye, consistent with high myopia; the left eye had mild astigmatism. Fundoscopy revealed features of pathological myopia with a posterior staphyloma involving the macula. MRI demonstrated asymmetric right globe enlargement with posterior scleral thinning, while A-scan measured an axial length of 34.00 mm in the right eye versus 24.04 mm in the left. Optical coherence tomography (OCT) and B-scan confirmed retinal and choroidal thinning with scleral curvature. Thyroid orbitopathy and mass lesions were excluded. A diagnosis of unilateral pathological myopia with type 2 posterior staphyloma was made. This case highlights the uncommon presentation of unilateral pathological myopia with posterior staphyloma, in contrast to the more common bilateral form. Despite extensive evaluation, no clear cause was identified, underscoring the complexity of the condition. Thorough clinical and imaging assessments are essential for accurate diagnosis. Currently, no definitive treatment exists, so management focuses on monitoring and protecting the unaffected eye.

Keywords: high myopia; ocular imaging; pathologic myopia; posterior staphyloma; unilateral myopia; unilateral pathological myopia; visual health; visual impairment.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Asymmetric red reflex of highly myopic OD in comparison to normal OS
OD: Right eye; OS: Left eye
Figure 2
Figure 2. Fundus photographs of both eyes
OD: Tilted disc, temporal crescent, tigroid appearance of fundus, central round pale macular lesion with ill-defined borders suggestive of posterior staphyloma (blue lines); OS: Normal OD: Right eye; OS: Left eye
Figure 3
Figure 3. T2-weighted MRI
T2-weighted MRI shows a difference in axial length (red arrows) and subtle curvature of posterior staphyloma in the right eye (blue line). Axial length: 34 mm OD; 24.04 mm OS OD: Right eye; OS: Left eye
Figure 4
Figure 4. OCT and infrared fundus imaging of both eyes
OD: Thinning of the retina and choroid, with a scleral curvature at the location of posterior staphyloma; OS: Normal OCT: Optical coherence tomography; OD: Right eye; OS: Left eye
See this image and copyright information in PMC

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