Introduction and overview on myopia: A clinical perspective

Abstract

In this chapter, we present an overview of the major concepts and issues surrounding myopia and pathologic myopia. Myopia is a significant global public health and socioeconomic problem with significant geographic variation in its prevalence. Pathologic myopia, an extreme form of myopia characterized by sight-threatening complications in adults, has become a major cause of blindness or visual impairment in both Asian and Western populations. The pathogenesis of myopia is related to form deprivation, lens defocus, and higher-order aberrations, with accommodation playing a role as well. Outdoor activity, near work, and education are important environmental factors related to high prevalence of myopia and its progression. Myopia is a highly heritable trait and genome-wide association studies have revealed some of the loci involved. Myopia control in children is of utmost importance to reduce the burden of pathologic myopia when they reach adulthood. Public policy to increase outdoor activity in school-going children, lens-related strategies such as orthokeratology and defocus lenses, and pharmacologic intervention in the form of low-dose atropine form the main thrusts of the fight against myopia. For pathologic myopia, imaging of the retina and optic nerve are important to detect myopic macular degeneration, myopic traction maculopathy, and myopic glaucomatous optic neuropathy. Medical and surgical interventions for these complications are discussed.