The Potential for Elevated Intraocular Pressure to Influence Myopia Development and Progression

INTRODUCTION This narrative review examines the potential for episodic intraocular pressure (IOP) elevations to contribute to the development and progression of axial myopia.AREAS COVERED The review examines the extent to which distending forces of episodic IOP elevations contribute to the stretching of the posterior sclera and axial elongation. Such contributions appear more likely to occur when the sclera has been remodeled into a more compliant biomechanical state, and when IOP elevation episodes are higher, longer lasting and more prevalent.EXPERT OPINION Depending on factors such as genetic susceptibility, involvement in education as well as other near distance vision tasks, and time spent indoors, the rate of development or progression of axial myopia may be significantly influenced by participation in activities that elevate IOP. Tonometry in a clinical setting does not appear to have a significant relationship to the levels of IOP reached during activities which occur in non-clinical settings. The success of myopia prevention and control approaches may partly depend on the extent of exposure to episodic IOP elevations and the degree to which they can be avoided.