A 51-year-old woman with no known medical illness presented to the ophthalmology clinic with complaints of bilateral eyes tearing, and without blurry vision and redness. Her visual acuity is 6/6 OU and IOL is normal (15 mmhg). Anterior segment examination noted reduced tear break-up time of about 8 seconds. Fundus examination of both eyes shows large peripapillary atrophy with a tasselated fundus. The cup disc ratio is 0.5, and the macula area is normal. A diagnosis of peripapillary atrophy is made. Peripapillary atrophy describes atrophy or thinning in the layers of the retina and retinal pigment epithelium around the optic nerve. There is no treatment and it typically does not cause any symptoms or vision loss. However, the majority of cross-sectional studies agree that there is a significant association between peripapillary atrophy, glaucomatous optic nerve damage, and visual field loss. Peri-papillary atrophy is commonly observed together with high myopia, estimated to be present in about 20% of cases. In this case the patient is myopic. The patient is given follow-up to monitor the risk of glaucoma because there is correlation for peripapillary atrophy with glaucomatous optic nerve damage since the cup disc ratio is increased about 0.5. The patient is also prescribed with artificial tear eyedrops for the dry eye.