Aim — to perform a comparative study of peripheral refraction and retinal contour in patients with congenital versus acquired high myopia. Material and methods. A total of 30 patients (60 eyes) with high myopia aged 8 to 18 years (11.2±0.32 years on average) were examined. The patients were divided into 2 groups. Group 1 consisted of 21 patients (42 eyes) with acquired myopia of –6.0 to –10.25 diopters (–7.55±0.17 diopters on average), group 2 — of 9 patients (18 eyes) with congenital myopia of –8.75 to –28.75 diopters (–16.39±1.24 diopters on average). Using the Grand Seiko WR-5100K binocular open-field autoref/keratometer (Japan), relative peripheral refraction was assessed with account to relative peripheral eye length measured by the IOL Master partial coherent interferometer («Carl Zeiss», Germany) at 15° and 30° nasally and temporally from the foveal center along the horizontal meridian. Results. In acquired myopia, relative peripheral refraction and relative peripheral eye length readings evidenced the formation of peripheral hyperopic defocus in all examined zones. Congenital high myopia cases were notable for myopic defocus at 15° of the nasal retina (N15 zone): –0.67±0.33 diopters against the eye length change of –0.33±0.13 mm. Conclusion. The research helped identify retinal contour changes characteristic of congenital myopia and indicative of posterior pole irregularity.