An evolutionary analysis of the aetiology and pathogenesis of juvenile-onset myopia


Loren Cordain, MD
Department of Health and Exercise Science
Colorado State University
Fort Collins
Colorado 80523
Phone: +1-970 491 7436
Fax: +1-970 491 0445


The available evidence suggests that both genes and environment play a crucial role in the development of juvenile-onset myopia. When the human visual system is examined from an evolutionary perspective, it becomes apparent that humans, living in the original environmental niche for which our species is genetically adapted (as hunter-gatherers), are either slightly hypermetropic or emmetropic and rarely develop myopia. Myopia occurs when novel environmental conditions associated with modern civilization are introduced into the hunter-gatherer lifestyle. The excessive near work of reading is most frequently cited as the main environmental stressor underlying the development of myopia. In this review we point out how a previously unrecognized diet-related malady (chronic hyperinsulinaemia) may play a key role in the pathogenesis of juvenile-onset myopia because of its interaction with hormonal regulation of vitreal chamber growth.