In cases of high unilateral myopia good prognosis for monocular visual acuity as well as binocular vision is expected if timely and cosistent therapy is administered. Therapy comprises full optical correction, amblyopia therapy, mostly occlusion, squint therapy and possibly fitting of contact lenses. The author presents 31 cases of unilateral high myopic children up to age 12 with anisometropia between 4 and 19 dioptres. Although the aniseikonia in cases of high unilateral myopia increases with contact lenses as compared to spectacles for geometric optical reasons, we obtained good results with contact lens correction. Examination show that the child's brain adapts very well to the aniseikonia. Complicate correction with aniseikonic lenses is thus neither necessary nor advantageous.