Cordain et al. (2002) and recently Galvis et al. (2016) suggested that this hyperinsulinism could increase the elongation of the globe via the promotion of increased insulin-like growth factor-1 (IGF-1) and decreased insulin-like growth factor binding protein-3 (IGFBP-3) action in scleral fibroblasts [16, 17]. Here, IGF1 is linked to hyperinsulinism.