Myopia Development and Control: An Integrative Review of Genetic, Optical, and Environmental Mechanisms With Implications for Personalized Intervention

ABSTRACT Myopia is a rapidly growing global health challenge, affecting 1. 9 billion people and projected to reach 4. 9 billion by 2050, with high myopia and its sight‐threatening complications such as maculopathy, retinal detachment, and glaucoma increasing disproportionately. The condition imposes an annual socioeconomic burden exceeding 250 billion. This review synthesizes mechanistic, genetic, and environmental evidence within a framework linking near work (NW) and reduced outdoor time to optical defocus, dopamine‐mediated retinal signaling, and scleral remodeling, moderated by gene‐environment (GxE) interactions. Interventions are classified as corrective (spectacles, surgery), dual‐function optical strategies (orthokeratology, DIMS, HALT, DOT, CARE lenses), pharmacological approaches (low‐dose atropine), and behavioral measures (outdoor exposure). Three principles guide management: each diopter increases complication risk, effective interventions act through validated biological mechanisms, and individual variability necessitates personalized care. Optimal control requires tailored and combined strategies, informing clinical practice, public health policy, and future research to address the global myopia epidemic.