Unilateral Myelinated Retinal Nerve Fibers

A 5‑year‑old boy presented to our clinic for a routine check‑up. Best corrected visual acuity was 20/20 and 20/60 in the right and left eyes, respectively. Cycloplegic refraction revealed +0.50 −0.50 × 179° in the right eye and −6.50 −0.75 × 171° in the left eye. The left eye had an exotropia of 14 prism diopters. Anterior segment examination was normal in both eyes. On dilated funduscopy, the right eye was normal [Figure 1a]; while in the left eye, there was an extensive myelination of the retinal nerve fibers [Figure 1b]. Full correction of the refractive error in the left eye was prescribed and patching of the right eye for 2 hours daily was recommended. The usage of contact lens was suggested for maximal results and in order to reduce the aniseikonia. One year later, visual acuity of the left eye improved to 20/40.