This report describes a case involving a Japanese patient with distance esotropia, who was followed-up for 4 years using magnetic resonance imaging（MRI）. A 68-year-old woman with high myopia exhibited esotropia of 10 prism diopters（∆）and right hypotropia of 5∆； her axial lengths were 31.0 mm oculus dextrus（OD）and 30.7 mm oculus sinister（OS）. Bilateral enlarged lateral rectus（LR）-superior rectus（SR）bands and posterior staphylomata were observed on orbital MRI. At the 4-year follow-up, her ocular deviation had deteriorated to esotropia of 18∆ and right hypotropia of 8∆； however, her axial lengths had scarcely changed（31.0 mm OD; 30.8 mm OS）. The enlargement and rupturing of the bilateral LR-SR bands had worsened. Progressive enlargement and rupturing of the LR-SR bands, which are presumably related to aging and possibly linked to progressive connective tissue degeneration, may increase ocular deviation.