Abstract
Extreme high myopia is associated with structural changes to the eye. The elongation of the eye, with associated choroidal thinning and macular atrophy, makes these eyes more susceptible to complex retinal detachments (RD). In this case series, we present the course of four pediatric cases with RD. All children had extreme myopia (-8.0 D to - 16.0 D). They presented with symptoms of squinting or abnormal pupillary reflex. Two had a choroidal detachment at presentation, whereas the other two had macular holes causing RD. All four required multiple surgical procedures, with anatomical success in three cases. Final visual acuity was no perception of light in all four eyes. Pediatric RD in extreme high myopia is challenging. Anatomical success needs multiple surgical procedures, but functional outcome remains dismal.