Background: Thyroid-associated ophthalmopathy (TAO) may lead to severe exophthalmos and dysthyroid optic neuropathy (DON), which can threaten visual function. Orbital decompression surgery is often required when medical therapy is insufficient; however, traditional deep lateral wall decompression techniques remain associated with several complications.

Objective: To evaluate the clinical efficacy and safety of modified deep lateral wall decompression surgery in patients with TAO and DON.

Method: This retrospective single-arm study included sixteen patients who underwent modified deep lateral wall decompression at the Third Affiliated Hospital of Sun Yat-sen University between January 2022 and May 2023, with a 3-month postoperative follow-up. Postoperative assessments included visual acuity, intraocular pressure, exophthalmos, ocular motility, diplopia, and complications.

Results: At 3 months postoperatively, patients showed significant improvement in visual acuity, exophthalmos, and intraocular pressure (p < 0.001). The remission rate of postoperative limited ocular motility symptoms was 60% (n = 10). Among the twelve patients with preoperative diplopia, 6 showed improvement in symptoms. No cases of cerebrospinal fluid (CSF) leakage or vibration-induced diplopia occurred, and only one patient experienced temporary periorbital skin numbness, which resolved by 3 months.

Conclusion: The modified deep lateral wall decompression surgery shows promise as a potentially safer and effective treatment option for patients with TAO and DON, demonstrating improvements in vision, exophthalmos, and intraocular pressure with a low incidence of complications. However, these preliminary results warrant further validation in prospective or comparative controlled trials.

Myopia is a rapidly growing global health challenge, affecting 1.9 billion people and projected to reach 4.9 billion by 2050, with high myopia and its sight-threatening complications such as maculopathy, retinal detachment, and glaucoma increasing disproportionately. The condition imposes an annual socioeconomic burden exceeding $250 billion. This review synthesizes mechanistic, genetic, and environmental evidence within a framework linking near work (NW) and reduced outdoor time to optical defocus, dopamine-mediated retinal signaling, and scleral remodeling, moderated by gene-environment (GxE) interactions. Interventions are classified as corrective (spectacles, surgery), dual-function optical strategies (orthokeratology, DIMS, HALT, DOT, CARE lenses), pharmacological approaches (low-dose atropine), and behavioral measures (outdoor exposure). Three principles guide management: each diopter increases complication risk, effective interventions act through validated biological mechanisms, and individual variability necessitates personalized care. Optimal control requires tailored and combined strategies, informing clinical practice, public health policy, and future research to address the global myopia epidemic.