A Comprehensive Review of Myopia

Abstract

Myopia is a prevalent refractive error affecting millions worldwide, with a significant increase in incidence expected in the coming years, particularly in areas experiencing rapid urbanization. Uncorrected myopia as low as -1.50 diopters is considered to cause moderate visual impairment, and regular monitoring by healthcare professionals is crucial for effective management. High myopia poses a greater risk for sight-threatening complications such as myopic maculopathy, glaucoma, and cataracts. The onset and progression of myopia are influenced by both genetic and environmental factors, with the latter playing a more prominent role. Significant efforts have been made to slow myopia progression through optical, environmental, and pharmaceutical interventions. Genes involved in circadian rhythm regulation, pigmentation, and collagen metabolism have been associated with myopia development. Environmental factors such as near work, lack of outdoor activity, improper lighting, and socioeconomic conditions contribute to the rising prevalence of myopia. Optical approaches for myopia control include bifocals, progressive addition spectacles, and contact lenses incorporating peripheral defocus management. Pharmaceutical strategies explored include atropine, pirenzepine, tropicamide, 7-methylxanthine, and certain intraocular pressure-lowering agents. Long-term efficacy data for these interventions are limited, and concerns exist regarding the potential rebound effect upon treatment discontinuation. A multifaceted approach addressing both genetic predisposition and environmental modifications is necessary to control the growing global burden of myopia effectively.