Aim: To describe a case of possible heavy eye phenomenon and discuss the differential diagnosis.
Method: Details are reported of a boy who presented at age 16 years, having previously attended the orthoptic department as a young child. Documentation of the ease is presented including the findings in childhood, findings at later presentation and photographic illustrations.
Results: The orthoptic findings for this boy when discharged at age 9 years differed from the findings at age 16 years. At age 9 the patient showed good corrected visual acuity in each eye, good binocular functions and normal stereo-acuity. At age 16, the patient had a variable right hvpotropia, refractive error of right —8.50/—1.25 × 5, left +0.25/—0.50 × 177.5 and axial lengths of right 26.22 mm and left 22.86 mm.
Conclusions: This is most likely a case of heavy eye phenomenon. Previous records are useful in determining the onset of the condition.