[What big eyes you have!].

A 4-year-old girl presented to our department with a pain and symptom-free elevated intraocular pressure (IOP) of 44 mmHg in both eyes and with enlarged corneal diameters. Megalocornea, buphthalmos and anterior megalophthalmos were discussed as differential diagnoses. Due to age-related normal morphological, functional and electrophysiological results of the optic nerve head and a very deep anterior chamber, anterior megalophthalmos was diagnosed. No topical treatment was initiated and close ophthalmological surveillance control was recommended. To the best of our knowledge megalophthalmus anterior has not up to now been described as associated with a pathological sensitivity to minor changes in lid muscle tension causing a sudden increase of IOD.