Beyond the Golden Gleam: The Silent Spiral of Straatsma Syndrome

The presence of myelinated nerve fibers (MNFs) is usually a benign and isolated finding but it could present with other ophthalmic conditions rarely such as nystagmus, myopia, strabismus, and optic nerve hypoplasia. When MNFs occur in conjunction with high myopia and amblyopia with or without strabismus, this triad is called Straatsma syndrome. Here, we report three cases illustrating this entity, highlighting the clinical features, diagnostic findings, and management challenges associated with this rare but important ophthalmic entity.