A 4-year-old boy is referred with a diagnosis of high myopia and amblyopia in the left eye. He was born full-term with normal growth and development. His best-corrected visual acuity is 20/60 right eye and 20/400 left eye. Orthoptic examination reveals a left exotropia of 30 prism diopters. Anterior segment examination is unremarkable. Cycloplegic refraction is -5.00-3.75x180o right eye and -10.00-4.00x180o left eye. What could be happening?