Managing extreme myopia remains a challenge in refractive practice. Patients are often dependent on thick spectacles or contact lenses (CLs) that may compromise comfort, peripheral vision and quality of life (QoL). Laser refractive surgery is frequently contraindicated due to corneal and biomechanical limitations. This case highlights how modern phakic intraocular lens technology provides a safe and effective solution for carefully selected patients with extreme myopia.

A 41-year-old male presented to a private ophthalmology clinic seeking alternatives to spectacles and CLs, finding these increasingly uncomfortable. He had been myopic since childhood and repeatedly told he was unsuitable for refractive surgery due to his prescription magnitude. The most recent eye examination and spectacles were two months old.