Mature cataracts in eyes with unilateral axial myopia

Seven patients with unsuspected unilateral axial myopia developed a cataract in the longer eye. Vision deteriorated in all cases between the ages of 40 and 55 years. Bilateral axial length measurements were necessary for the diagnosis and revealed a difference of 4.5 mm to 6.7 mm between the two eyes. Five cases had a mature cataract and had extracapsular cataract extraction; surgery restored isometropia, improved the visual acuity to 20/200 or better, and enlarged the field of vision. All patients were amblyopic in the cataractous eye.