Environmental and lifestyle factors influencing myopia development and progression: An evidence-based narrative review

ABSTRACT

Myopia imposes a substantial strain on healthcare systems, economies, and individuals’ overall well-being, representing a growing global public health crisis that necessitates interventions aimed at postponing or halting its onset and progression. The objective of this study is to provide a comprehensive, current review of the latest insights into myopia, with emphasis on the environmental and lifestyle determinants of its development and the evolving landscape of management strategies. This narrative review synthesizes recent evidence on the epidemiology, environmental and lifestyle risk factors, and management approaches for myopia, reflecting the transformation in understanding and clinical practice as new evidence emerges. Environmental and lifestyle factors including reduced outdoor activity and increased near work were found to meaningfully influence myopia onset and progression. Behavioral interventions such as increased time outdoors and reduced near work, along with advancements in optical (e.g., specially designed spectacle lenses, orthokeratology, soft contact lenses) and pharmaceutical (e.g., low-dose atropine) management options, emerged as key strategies shaping current practice. To conclude, myopia management is an evolving field shaped by a growing evidence base on lifestyle modification and clinical intervention. A current, integrated understanding of these factors is essential for guiding effective strategies to mitigate the individual and societal burden of myopia.