Massachusetts Institute of Technology, Cambridge, Massachusetts, USA; Multivision Research, California, USA.
Surv Ophthalmol. 2022 Mar-Apr;67(2):488-509. doi: 10.1016/j.survophthal.2021.06.005. Epub 2021 Jun 25.
I review the key findings and our current knowledge of the cause of myopia, making the connections among the reliable observations on myopia development and theory to arrive at a summary of what we know about myopia, the proposed prevailing theory, and applicable action. Myopia is reaching epidemic proportions. It is estimated that half of the world's population will be myopic by 2050 unless new strategies to fight myopia are developed. Our high-level mathematical description of myopia is translated into clinical applications involving effective treatment and prevention. A regulating mechanism controlling the refraction of the eye is intimately related to myopia. The approach at hand is to review our knowledge about emmetropization, connecting myopia and emmetropization feedback theory to unveil the cause of myopia. Many observations discussed here test the validity of feedback theory positively. The cause of human myopia fits perfectly with the idea that emmetropization, in particular its feedback theory implementation, is the controlling mechanism behind myopia. They include near work, atropine, lenses, defocus, and outdoor versus indoor activities. The key findings in myopia research point the same way: myopia is the result of corrective lenses interfering with emmetropization. We have enough knowledge to answer the question of whether myopia can be reversed or prevented. There is no need to have mathematical skills to apply theory to real cases. It is enough to know the predictions of the feedback theory of emmetropization.
我回顾了近视成因的关键发现和我们目前的知识，将近视发展的可靠观察结果与理论联系起来，得出了我们对近视的了解、目前流行的理论和适用的措施的总结。近视正在达到流行的程度。据估计，除非开发出新的防治近视的策略，否则到 2050 年，世界上一半的人口将近视。我们对近视的高水平数学描述转化为涉及有效治疗和预防的临床应用。控制眼睛折射的调节机制与近视密切相关。目前的方法是回顾我们对正视化的知识，将近视和正视化反馈理论联系起来，揭示近视的原因。这里讨论的许多观察结果都积极地检验了反馈理论的有效性。人类近视的原因与正视化的想法完全吻合，特别是其反馈理论的实施，是近视背后的控制机制。这些因素包括近距工作、阿托品、镜片、离焦和户外活动与室内活动。近视研究的关键发现指向同一个方向：近视是矫正眼镜干扰正视化的结果。我们已经有足够的知识来回答近视是否可以逆转或预防的问题。不需要具备数学技能就可以将理论应用于实际案例。只需了解正视化反馈理论的预测即可。
