Myopia and Myopia Management

This lecture discusses the basic mechanisms underlying the development of myopia, the prevalence of myopia, risk factors for onset and progression of myopia, and effective strategies for the management of myopia progression. The management strategies presented in this lecture are backed by up-to-date peer-reviewed research studies. They are critically discussed and compared according to their efficacy.

Retinal image quality is known to be a factor during the normal emmetropization process. In this context, a hyperopic defocus, especially in the retinal periphery, plays a role in the development of myopia. A peripheral myopic retinal defocus is considered to stabilize the progression of myopia.

By 2050, approximately 50% of the world population will be myopic. The main risk factors for the development of myopia are age, ethnicity, parental myopia, time spent outdoors, and time spent on near work.

The management of myopia is an important aspect of patient care. The risk of ocular disease, especially myopic maculopathy and retinal detachment exponentially increases with each diopter of myopia and reaches critical values when the refraction exceeds 5.00 diopter of myopia. The progression of myopia slows down with age, and active management should start as early as possible.

According to the research literature, effective myopia management strategies are either pharmaceutical or optical interventions. Pharmaceutical interventions include atropine eye drops in various doses, which directly affect the retinal and scleral biochemistry. Optical interventions include orthokeratology, multifocal contact lenses, and multifocal spectacle lenses. They affect the retinal image quality and aim to establish a peripheral myopic retinal defocus. Time spent outdoors has a protective effect for the onset of myopia.