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Myopia

Nature Reviews Disease Primers volume 6, Article number: 99 (2020) Cite this article

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Abstract

Myopia, also known as short-sightedness or near-sightedness, is a very common condition that typically starts in childhood. Severe forms of myopia (pathologic myopia) are associated with a risk of other associated ophthalmic problems. This disorder affects all populations and is reaching epidemic proportions in East Asia, although there are differences in prevalence between countries. Myopia is caused by both environmental and genetic risk factors. A range of myopia management and control strategies are available that can treat this condition, but it is clear that understanding the factors involved in delaying myopia onset and slowing its progression will be key to reducing the rapid rise in its global prevalence. To achieve this goal, improved data collection using wearable technology, in combination with collection and assessment of data on demographic, genetic and environmental risk factors and with artificial intelligence are needed. Improved public health strategies focusing on early detection or prevention combined with additional effective therapeutic interventions to limit myopia progression are also needed.

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Fig. 1: Ocular shape changes in myopia.
Fig. 2: Prevalence of high myopia in young adults.
Fig. 3: Gene–environment interactions in myopia.
Fig. 4: Magnetic resonance image of a primate eye comparing vision-induced myopia to fellow control eye growth.
Fig. 5: Retinal changes in pathologic myopia.
Fig. 6: Optical intervention strategies for vision correction or myopia control.

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Acknowledgements

The authors thank Ian Morgan (Australian National University) for his tremendous help on preparing this manuscript. This study was supported by the Australian National Health and Medical Research Council (NHMRC) through project grant 1034329 and a Senior Research Fellowship (1138585 to P.N.B.); the National Medical Research Council (NRMC) Grant NMRC/CIRG/1446/2017 and A*STAR World Without Disease (Grant JRBMRR 151701) (S.-M.S. and C.L.); Clinician Scientist Award (Senior; NMRC/CSA-SI/0009/2016) (E.L.L.) and Transition Award (MOH-TA19may-0002) (R.M.); National Institutes of Health Grant EY-03611 and funds from the Brien Holden Vision Institute (E.L.S.); grants 81800860, 81422007 and 81371047 from the National Natural Science Foundation of China (X.Z.); Fight for Sight and Welsh Government Project Grant (Ref: 24WG201) (J.A.G.); and Fundamental Research Funds of the State Key Laboratory of Ophthalmology, the Research Accelerator Program at the University of Melbourne and the CERA Foundation in Australia (M.H.).

Author information

Authors and Affiliations

  1. Department of Surgery in Ophthalmology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia

    Paul N. Baird

  2. Myopia Research Group, Singapore Eye Research Institute, Singapore, Singapore

    Seang-Mei Saw & Carla Lanca

  3. Duke-NUS Medical School, Singapore, Singapore

    Seang-Mei Saw

  4. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Seang-Mei Saw

  5. School of Optometry & Vision Sciences, Cardiff University, Cardiff, UK

    Jeremy A. Guggenheim

  6. College of Optometry, University of Houston, Houston, TX, USA

    Earl L. Smith III

  7. School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China

    Xiangtian Zhou

  8. Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan

    Kyoko-Ohno Matsui

  9. Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital; Chang Gung University College of Medicine, Taoyuan, Taiwan

    Pei-Chang Wu

  10. Brien Holden Vision Institute, Sydney, New South Wales, Australia

    Padmaja Sankaridurg

  11. Paediatric Ophthalmology Service, Singapore National Eye Centre, Singapore, Singapore

    Audrey Chia

  12. Refractive Surgery Department, Singapore National Eye Centre, Singapore, Singapore

    Mohamad Rosman

  13. Duke-NUS Medical School and Singapore Eye Research Institute, Singapore, Singapore

    Mohamad Rosman, Ecosse L. Lamoureux & Ryan Man

  14. Population Health Research Unit, Singapore Eye Research Institute, Singapore, Singapore

    Ecosse L. Lamoureux & Ryan Man

  15. Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia

    Mingguang He

  16. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China

    Mingguang He

Authors
  1. Paul N. Baird
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  2. Seang-Mei Saw
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  3. Carla Lanca
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  4. Jeremy A. Guggenheim
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  5. Earl L. Smith III
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Contributions

Introduction (M.H., P.N.B. and J.A.G.); Epidemiology (S.-M.S., C.L., M.H., J.A.G. and P.N.B.); Mechanisms/Pathophysiology (M.H., P.N.B., J.A.G., E.L.S. and X.Z.); Diagnosis, screening and prevention (M.H. and K.-O.M.); Management (P.-C.W., P.S., A.C. and M.R.); Quality of life (E.L.L. and R.M.); Outlook (P.N.B., M.H. and J.A.G.); Overview of Primer (P.N.B. and M.H.).

Corresponding authors

Correspondence to Paul N. Baird or Mingguang He.

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The authors declare no competing interests.

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Peer review information

Nature Reviews Disease Primers thanks C. Leung, F. Schaeffel, K. Tsubota, T. Young and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Glossary

Form deprivation myopia

Placing a diffusing filter in front of the eye.

Myopic defocus

Image formed in front of retinal plane.

Axial length

The distance from the anterior surface of the cornea to the retina.

Hyperopic

Ability to focus on distant objects.

Emmetropization

The development of the eye towards emmetropia, wherein the focus of distant objects is on the retina when the lens is in a relaxed state.

Accommodation

The ability of the eye to change its focus from near to far.

Hyperopic defocus

Blur resulting from the image formed behind the retinal plane.

Choroid

A highly vascularized layer between the sclera and the retina.

Cycloplegia

Paralysis of the ciliary muscles of the eye.

Fundus

The interior surface of the back of the eye, comprising the retina, choroid and sclera.

Indirect ophthalmoscopy

Examination to provide a wide view of the back of the eye using a beam of light and a hand-held lens.

Staphyloma

Protrusion of a limited area of the posterior sclera.

Choroidal neovascularization

The formation of new blood vessels in the choroid of the eye.

Orthokeratology lenses

Rigid, gas-permeable lenses to flatten corneal curvature during overnight wear.

Photophobia

Sensitivity to light.

Excimer or femtosecond laser

A laser emitting concentrated light in the ultraviolet region of the spectrum.

Phakic intraocular lens

(PIOL). Silicon or plastic lenses inserted into a person’s eye to restore vision but leaves the eye’s natural lens intact.

Corneal ectasia

Abnormal change in shape of the cornea.

Haze

A granular scarring of the corneal stroma due to inflammation.

Corneal lenticule tissue

A small piece of corneal or synthetic material with a precise shape and thickness implanted into the cornea in order to change the corneal curvature.

Infective endophthalmitis

Infection of the interior of the eye.

Ocular biometry

Measurement of specific features that are common to the eye.

Rasch analysis

A psychometric model for analysing categorical data, typically in the form of a questionnaire.

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Baird, P.N., Saw, SM., Lanca, C. et al. Myopia. Nat Rev Dis Primers 6, 99 (2020). https://doi.org/10.1038/s41572-020-00231-4

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