Myopia, also known as nearsightedness, refers to a refractive error of the eye that causes parallel rays of light to focus in front of the retina, affecting distance vision. High myopia significantly increases the risk of pathological myopia, leading to severe complications and an increased likelihood of myopia-related eye diseases. In recent decades, the incidence of myopia has continued to rise, posing significant social and human health issues. The complex interplay between genetic and environmental variables affects the development of myopia. Gene control depends to a large extent on epigenetic changes, which are reversible, inheritable, and sensitive to ecological shifts. Therefore, the pathophysiology and development of myopia are tightly linked to gene regulation mediated by epigenetic changes. To explore epigenetic modifications related to myopia, a PubMed search was conducted using keywords such as epigenetic modification, epigenetics, DNA methylation, RNA methylation, non-coding RNA, long non-coding RNA, short interfering RNA, microRNA, ribosomal RNA, circular RNA, transfer RNA, histone modification, histone methylation, and histone acetylation. This review presents the current understanding of these epigenetic modifications in myopia to provide new insights for advancing myopia research.