A Mechanical Model of Myopia: Implications of Eye Movements and Orbital Fat Redistribution

Current myopia models cannot explain important clinical findings such as unilateral progression, adult onset, and optic disc tilt. We hypothesize that chronic downgaze induces mechanical traction via the superior oblique muscle, leading to orbital fat redistribution and axial elongation. This model redefines myopia as a potentially reversible mechanical disease. This hypothesis is testable through longitudinal MRI and ultrasound imaging and may lead to novel treatment strategies.