(1) Background: The global prevalence of myopia has increased substantially in recent decades. Myopia development is influenced by both environmental factors and a complex genetic architecture involving more than 400 susceptibility loci. The interaction between genetic predisposition and environmental exposures plays a critical role in myopia onset and progression. Unequal access to preventive strategies and eye care services continue to limit effective global myopia control. (2) Methods: This structured narrative review synthesizes evidence identified through systematic database searches, manual reference screening, prospective cohort studies, randomized controlled trials, mechanistic investigations, and genetic analyses identified through the literature search. (3) Results: Environmental factors such as limited outdoor activity, intensive near-work, and academic pressure contribute to myopia progression. Key biometric indicators, such as AL, AL/CR ratio, and choroidal thinning, are strong predictors. Molecular and cellular mechanisms also contribute significantly to myopia progression. Genetics also plays a significant role, with both syndromic and polygenic pathways involved. (4) Conclusions: As precision medicine evolves, individualized therapeutic strategies are becoming important in myopia management. In the treatment of myopia, biomarkers, genetic profiling, and artificial intelligence may support personalized risk assessment and treatment decisions.
Dohotariu et al. (Wed,) studied this question.