Severe anisometropic myopia in identical twins

High anisometropic myopia is a rare condition in twins. Genetic factors have been implicated in its development and there may be an association with vision-threatening complications. A pair of 11-year-old twins presented with poor distance vision in both eyes. Detailed ocular examination was performed including slit lamp examination, dilated funduscopy, cycloplegic refraction, keratometry and axial length measurement. The objective refraction was -6.50 DS -2.00 DC × 180 (right eye), -1.00 DS (left eye) for the first twin; -13.75 DS -2.25 DC × 180 (right eye), -0.50 DS -0.75 DC × 04 (left eye) for the second twin. This case suggests an underlying genetic defect in the development of myopia.