Nanophthalmos is a rare genetic disease characterized by the abnormally small eyes secondary to compromised growth inducing high degree of hypermetropia and very often associated with primary angle closure glaucoma, uveal effusion, absence of foveal pit, shallow anterior chamber, diffuse macular thickening ,rudimentary foveal avascular zone, scleral collagen fibers abnormalities etc. It may be present with familial or sporadic disorder with autosomal-dominant or recessive inheritance. Five genes and two loci have been implicated in familial forms. The five genes are MFRP, TMEM9, PRSS56, BEST1 and CRB1.The refractive error can be corrected by the spectacles and contact lens despite having their few limitations. However due to high power, optical aberrations associated with the use of spectacle is comparatively more than aberrations associated with the contact lens. In this case the total power of the optical system of eye is almost 73D in both eyes even if the power of crystalline lens is not considered when RGP is fitted.