From the Research
Myopia, or nearsightedness, occurs when the eye grows too long from front to back, causing light rays to focus in front of the retina rather than directly on it, with excessive axial elongation being the primary pathophysiological mechanism, as supported by recent studies 1, 2. The condition typically develops during childhood when the eye is growing, with genetic factors playing a significant role in determining risk. Some key factors that contribute to the development of myopia include:
- Genetic predisposition
- Environmental factors such as prolonged near work, insufficient outdoor time, and increased screen use
- Disrupted signaling between the retina and sclera, with neurotransmitters like dopamine and growth factors influencing the scleral remodeling process This remodeling leads to thinning of the sclera and subsequent axial elongation. The biomechanical changes result in clear vision for near objects but blurred distance vision as light rays converge before reaching the retina. Understanding this pathophysiology helps explain why interventions like atropine eye drops, which affect these signaling pathways, can slow myopia progression in children, and why optical corrections like glasses or contact lenses are necessary to diverge light rays appropriately to compensate for the elongated eye, as shown in studies 3, 4. Recent research has also highlighted the efficacy of combined treatments, such as orthokeratology with atropine, in slowing myopia progression 1, 5, 2. Overall, the pathophysiology of myopia is complex and multifactorial, involving both genetic and environmental factors, and requires a comprehensive approach to management and treatment. Key points to consider in the management of myopia include:
- Early detection and intervention
- Correction of refractive errors with glasses or contact lenses
- Use of atropine eye drops or other pharmacological treatments to slow myopia progression
- Orthokeratology and other optical interventions to reshape the cornea and slow axial elongation
- Education on healthy eye habits, such as spending time outdoors and following the 20-20-20 rule to reduce near work-induced myopia.