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Abstract

Aims/Purpose

Myopia arises primarily due to excessive axial elongation and is associated with an increased risk of ocular complications and visual impairment, particularly in high myopia. Although astigmatism may have implications on refractive development, the role of astigmatism in myopic eye growth and the effectiveness of myopia control strategies is unclear.

Methods

A scoping review was conducted in March 2025 and updated in August 2025, using MEDLINE and PubMed to explore myopia prevalence and onset, progression and astigmatism (Aim 1) and myopia control and astigmatism (Aim 2). Literature was initially screened by title, abstract and finally by the relevance of the full manuscript.

Results

A total of 1004 studies were identified; 26 duplicates were removed; 911 were excluded following title screening and 20 were excluded following abstract screening. A total of 47 studies were included (Aim 1 = 30, Aim 2 = 17), with most conducted in Asia (n = 31). A higher prevalence of astigmatism was associated with myopia. Myopia progression and astigmatism may be related, although there is limited research on the effects of uncorrected astigmatism on the course of myopia. Additionally, there is limited research regarding the influence of astigmatism on the effectiveness of myopia control strategies, with conflicting findings between studies.

Conclusions

Myopia progression and astigmatism may be interdependent. However, a causative role of astigmatism in promoting myopia is unclear. The diverse range of study designs and methodologies impairs the comparability of findings. Prospective research in children of differing ethnicities with a range of astigmatism is required to determine if astigmatism influences the effectiveness of myopia control interventions. This would provide an evidence base to inform clinical decision‐making and management plans for myopic children with astigmatism, particularly in non‐Asian populations where research is limited.

Publication Type:	Article
Additional Information:	© 2025 The Author(s). Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords:	astigmatism, myopia, myopia control
Subjects:	Q Science > QM Human anatomy R Medicine R Medicine > RE Ophthalmology
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Optometry & Visual Science
SWORD Depositor:	Symplectic Administrator

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