We report a rare case of posterior microphthalmos with prominent papillomacular folds, pseudo disc edema and high hyperopia in a 12 year old child with no systemic anomalies. The patient was diagnosed as high hyperopia two years ago but the posterior findings were missed. The anterior segment of the eye was normal on slit lamp examination but the appropriate diagnosis was missed. Hence detailed evaluation of every hyperopic child should be done for the timely management. This case report highlights the importance of detailed fundus and biometric evaluation to avoid missing the diagnosis of posterior microphthalmos in a high hyperopic child with no systemic anomalies.