  $\bf{Purpose}$: To assess whether Growth & Remodeling (G&R) theory could
explain staphyloma formation from a local scleral weakening.
  $\bf{Methods}$: A finite element model of a healthy eye was reconstructed,
including the following connective tissues: the lamina cribrosa, the
peripapillary sclera, and the peripheral sclera. The scleral shell was modelled
as a constrained mixture, consisting of an isotropic ground matrix and two
collagen fiber families (circumferential and meridional). The homogenized
constrained mixture model was employed to simulate the adaptation of the sclera
to alterations in its biomechanical environment over a duration of 13.7 years.
G&R processes were triggered by reducing the shear stiffness of the ground
matrix in the peripapillary sclera and lamina cribrosa by 85%. Three distinct
G&R scenarios were investigated: (1) low mass turnover rate in combination with
transmural volumetric growth; (2) high mass turnover rate in combination with
transmural volumetric growth; and (3) high mass turnover rate in combination
with mass density growth.
  $\bf{Results}$: In scenario 1, we observed a significant outpouching of the
posterior pole, closely resembling the shape of a Type-III staphyloma.
Additionally, we found a notable change in scleral curvature and a thinning of
the peripapillary sclera by 84%. In contrast, scenarios 2 and 3 exhibited less
drastic deformations, with stable posterior staphylomas after approximately 7
years.
  $\bf{Conclusions}$: Our framework suggests that local scleral weakening is
sufficient to trigger staphyloma formation under normal intraocular pressure.
With patient-specific scleral geometries (obtainable via wide-field optical
coherence tomography), our framework could aid in identifying individuals at
risk of developing posterior staphylomas.
