The authors report the occurrence of exotropia-hypotropia complex in 15 cases of high myopia. The mean age at presentation was 23.5 years (10-35 years). Only two patients had high bilateral myopia. The mean axial length of the deviating eye was significantly more than the fellow eye: 29.60±1.51mm versus 24.69 ±1.82mm. The mean preoperative angle was 37±9 exo and 13±6 hypo deviation. The position of the extra ocular muscles was interpreted reliably in 93% of cases by orbital imaging. There was no significant displacement found. Eight cases were managed with strabismus surgery and one was found to have a misplaced muscle insertion. No specific aetiological factors were found for this series.