> I've always been a little surprised why we haven't figured out a treatment for myopia

Isn't the treatment for "treatable" myopia "spend more time in the sun"? IIRC, something about spending time in the sun prevents/reverses myopia in most children.

I also seem to recall that you can sleep in pure oxygen and it will change your eyesight (the cornea gets its oxygen directly from the atmosphere and high oxygen concentration encourages growth which thickens the cornea).

If myopia is structural though (misshapen eyeball, aged muscles not working to focus, etc.), what kind of non-surgical treatment would you expect to work?

One other problem that comes up is that the neural "integrators" in the human control systems get "leaky" with age. If you ask someone above about age 40 to look completely to the right or left, you can observe their eyeball "vibrate" as the saccades correct the integration error in tracking position.

(This was given as an exercise in a bioenginering class for "model the human eye tracking system". You had a series of observations you had to take and measure and then derive both the control system and the rough time constants. One of the observations that you had to account for was why the older grad students/professors had this "vibration". You could create this behavior if your "integrator" block was leaky.)

> One of the observations that you had to account for was why the older grad students/professors had this "vibration".

Microsaccade amplitude is correlated with uncorrected myopia, actually. If you have visual blur it seems fixational eye movements have higher amplitude. (Proper corrective lenses generally remove this effect).

Of course, if someone has astigmatism, often it won't be properly corrected looking far right or left, too. I'm guessing this is the effect you measured.

https://iovs.arvojournals.org/article.aspx?articleid=2281647

> I've always been a little surprised why we haven't figured out a treatment for myopia beyond LASIK, e.g. some way to manipulate the muscles around the eye.

Generally the reasons behind myopia are changes in the shape of the eye or the lens, not something the muscles are doing wrong. (And a contributing factor with age is the decreased flexibility of the lens over time).

Most naive expectation is if myopia changes the shape of your eyes, just squish them a bit!

You joke but there are orthokeratology lenses which do just that. It's a contact lense worn overnight which compresses your eye during sleep.

To people considering LASIK I want to say try ortho-k first. You'll get the sharpness, the halos and the whole experience but at least it will be reversible. I've been on ortho-k for around a decade.

Here's a wikipedia link: https://en.wikipedia.org/wiki/Orthokeratology

That'll squish the lens, but the overall shape of the eyeball is what causes the myopia in most cases.

Tecnically the crystaline lens is in an anterior chamber inside your eye, so these contacts can't really squish the lens itself.

These contact lenses are squishing against your cornea. So in actual fact an anterior portion of your eyeball is being re-shaped.

There is a procedure that stops myopia progression, although it's not offered in US. Very effective when done in young age.

https://en.wikipedia.org/wiki/Scleral_reinforcement_surgery

I had scleroplasty done on my eyes at the age of 13, at 8.5D, to stop progression, and it did help - I only progressed to 9.25D in 30 years since…

Doesn’t seem like done in any other countries other than Russia - https://www.nature.com/articles/eye2009322

Me too, stopped at 6.5. Wikipedia says they do it in Japan too.

> Scleral reinforcement is a surgical procedure used to reduce or stop further macular damage caused by high myopia

Doesn't sound like it fixes myopia, rather that it addresses one of the side effects of high myopia?

When done in children, it stops progression of myopia. I had it done at 13 after loosing 1 point every year, and it stopped at 6.5. God only knows what would it be without it.