Why is high myopia hereditary?
Nov 19, 2025
Source: Cainiu Health
Dr. Zhou Xiaofeng
Introduction
High myopia can be hereditary, generally associated with autosomal recessive inheritance, pathogenic genes affecting axial length of the eye, genetic polymorphisms increasing susceptibility, and parental myopia elevating risk. Most cases of high myopia follow this inheritance pattern; when both parents carry the pathogenic gene but are unaffected, their children have a higher probability of inheriting two copies of the pathogenic gene, leading to high myopia, with a disease incidence higher than that of the general population.
High myopia can be hereditary, generally associated with autosomal recessive inheritance, disease-causing genes affecting axial length, genetic polymorphisms increasing susceptibility, parental myopia elevating risk, and gene-environment interactions. The detailed analysis is as follows:
1. Autosomal recessive inheritance: Most cases of high myopia follow this inheritance pattern. When both parents carry the pathogenic gene but are unaffected, their children have a higher probability of inheriting two copies of the pathogenic gene, leading to high myopia, with a disease incidence higher than that of the general population.
2. Pathogenic genes affecting axial length: Multiple disease-causing genes directly influence eye development. Abnormalities in genes regulating axial length can lead to excessive elongation of the eye axis, causing light to focus in front of the retina and resulting in high myopia. These genes can be passed on to offspring, increasing the risk of abnormal axial length in children.
3. Genetic polymorphisms increasing susceptibility: Some genes do not directly cause myopia but reduce an individual's tolerance to it. Under the same visual environment, individuals carrying these genes are more likely to develop high myopia, and this trait can be inherited.
4. Parental myopia increases risk: When one or both parents have high myopia, the genetic risk for their children significantly increases. If both parents are highly myopic, the likelihood of their children inheriting the condition is even greater, as parents can directly pass on relevant genes.
5. Gene-environment interaction: The inheritance of high myopia requires interaction with environmental factors. Individuals carrying susceptibility genes who engage in prolonged near-work and lack outdoor activities are more likely to experience accelerated myopia progression, turning genetic predisposition into actual disease onset.
Families with a history of high myopia should regularly take children for vision check-ups and monitor eye axis length; encourage children to spend more time in outdoor activities and reduce prolonged near-vision tasks; seek prompt medical intervention when a child’s vision declines rapidly, to prevent progression to high myopia.
