From the Research
Myopia, or nearsightedness, occurs when the eye grows too long from front to back or when the cornea is too curved, causing light rays to focus in front of the retina rather than directly on it, and this elongation of the eyeball is the primary pathophysiological mechanism, as supported by recent studies 1, 2. The process typically begins in childhood, with the axial length of the eye continuing to increase during periods of growth. Several factors contribute to this abnormal eye growth, including:
- Genetic predisposition, which influences the eye's structural development
- Environmental factors such as prolonged near work, insufficient outdoor time, and reduced exposure to natural light, which play significant roles by altering the biochemical signals that regulate eye growth At the molecular level, this process involves changes in the scleral extracellular matrix, with increased activity of matrix metalloproteinases leading to scleral thinning and subsequent axial elongation, as discussed in 3. The retina also responds to visual input by releasing neurotransmitters and growth factors that influence eye growth. As the eye elongates, distant objects appear blurry while near objects remain clear, as light rays from distant objects converge before reaching the retina. This refractive error typically stabilizes in early adulthood when physical growth ceases, but recent studies have shown that interventions such as orthokeratology and atropine can slow down myopia progression in children 4, 5. The most effective treatment for controlling myopia progression in children is orthokeratology combined with atropine, which has been shown to reduce the progression of myopia and axial elongation 2.