1. Prevalence and Hazards of Global Myopia
Currently, 1.9 billion people worldwide suffer from myopia, and the figure is projected to reach 4.9 billion by 2050, with the prevalence of high myopia rising from 2.8% to 10%. High myopia may trigger irreversible blinding complications such as maculopathy, retinal detachment and glaucoma. Uncorrected refractive errors also cause global economic losses of over 250 billion US dollars annually. This article reviews myopia pathogenesis and interventions to guide clinical work.

2. Core Pathological Mechanisms of Myopia
The study establishes a clear pathogenic chain: Environmental triggers → Optical defocus → Retinal signaling → Ocular structural remodeling. Excessive near work and insufficient outdoor light lead to abnormal retinal imaging. Combined with genetic susceptibility, these changes cause choroidal thinning, scleral remodeling and axial elongation of the eye. This mechanism lays a solid theoretical foundation for modern myopia management.

3. Classification of Main Myopia Interventions
3.1 Single corrective measures
Single-vision lenses, regular soft contact lenses and refractive surgeries only correct visual acuity but fail to slow axial growth, so they are not suitable for childhood myopia control.
3.2 Dual-function optical interventions
These methods correct vision and regulate eye growth simultaneously. Orthokeratology (OK lenses) can reduce axial elongation rate by 33%. Functional lenses including DIMS, HALT, DOT, CARE, as well as multifocal soft contact lenses, can effectively slow myopia progression by nearly 50% within two years.
3.3 Pharmacological interventions
Low-dose atropine (0.01%–0.05%) can reduce myopia progression by 30% to 60%. However, side effects such as photophobia, accommodative impairment and rebound effect after discontinuation limit its standalone use, and it is mostly applied in combined therapy.
3.4 Behavioral interventions
Increased outdoor activities stimulate retinal dopamine release and inhibit axial elongation. Research proves that outdoor time interacts with the VIPR2 gene, further demonstrating the combined effect of genetics and environment on myopia.

4. Core Clinical Principles and New Perspectives
Three key clinical principles are concluded: There is no safe diopter for myopia; effective interventions work through verified biological mechanisms; individualized plans should be made based on personal conditions.
Myopia develops under the joint influence of genetics and environment. Modern lifestyles accelerate myopia progression among genetically susceptible populations. More large-scale studies are still needed to explore gene-environment interactions.

5. Future Trends
Combined interventions integrating optical methods, medication and behavioral guidance will become the mainstream for high-risk progressive myopia. This review comprehensively elaborates the whole picture of myopia development and treatment, strongly supporting the formulation of individualized myopia control plans in clinical settings.

The work titled “Myopia Development and Control: An Integrative Review of Genetic, Optical, and Environmental Mechanisms With Implications for Personalized Intervention”, was published on Eye & ENT Research (published on April 3, 2026).
DOI：10.1002/eer3.70036