Human Myopia: Past, Present and Future.

The study of human myopia spans over two millennia, yet many of the principles shaping current research and management trace their origins to the scientific advances of the late nineteenth century. This review takes a broad historical perspective on the evolution of myopia research-from early philosophical and optical observations, through the emergence of modern ophthalmology, to the molecular and biomechanical models of the present era. Many foundational ideas, including the links between education, illumination and myopia; the concept of emmetropisation and the therapeutic use of atropine, first emerged more than a century ago and continue to inform contemporary understanding. In the modern period, the development of animal models and epidemiological research has transformed myopia from a refractive state to a treatable disease entity. Today, a diverse range of optical, pharmacological and behavioural interventions can modify the onset and progression of myopia, yet their efficacy remains limited. Two major challenges lie ahead: the incomplete effectiveness of current interventions and the absence of strategies to mitigate the long-term, vision-threatening complications of myopia in adults. Progress toward their resolution will depend on integrated research linking animal models, clinical studies, genetics and artificial intelligence to achieve a complete, lifelong understanding of human myopia, from its developmental origins to its impact on ocular health and vision in later life.