Biomechanical considerations in high myopia: Part III--Therapy for high myopia.

Clinical procedures for the treatment of high myopia are updated in this third part of a report on high myopia. After a discussion of testing techniques and refractive approaches for high myopia, an examination of therapeutic drug experiences shows their relative merits. The author believes that more investigation of beta blocker and epinephrine topical solutions is needed pertaining to the treatment of high myopia. Theoretically, such agents could improve deficient arterial perfusion of the highly myopic eye, and could be helpful in retarding scleral creep. Lifestyle recommendations include patient advice on accommodative reduction and proper exercise techniques. Low impact aerobics may have merit for highly myopic patients since the improved cardiovascular efficiency they can provide may improve the deficient arterial perfusion of their retinas. A summary of the three-part report on high myopia concludes the article. The physiological patterns of high myopia dovetail into the biomechanical considerations showing that a scleral pathogenesis hypothesis of myopic development is a viable working theory. The author's clinical procedures reflect the influence of that theory. If research were redirected from deprivation studies to investigating biomechanical considerations and pharmacological approaches to high myopia, the author contends that dramatically improved treatment regimens could result.