The global rise in myopia prevalence and its increasingly earlier onset have become a serious public health concern. Drug intervention represents an important strategy for slowing myopia progression and reducing the risk of complications associated with high myopia. In studies of drug efficacy and underlying mechanisms, guinea pigs are widely regarded as an ideal animal model for experimental myopia because their ocular structure and refractive development are similar to those of humans. Current evidence indicates that chemical drugs, including muscarinic receptor antagonists, dopamine-related agents, and certain intraocular pressure-lowering drugs, may exert effects by modulating retina-choroid signaling pathways, inhibiting scleral remodeling, and suppressing excessive axial elongation. In contrast, traditional Chinese medicine and its bioactive components exhibit multitarget intervention advantages via improving retinal microcirculation, exerting antioxidant and anti-inflammatory effects, and regulating extracellular matrix metabolism.In addition, the exploration of novel therapeutic targets and advanced drug delivery systems, such as scleral collagen cross-linking, sustained-release formulations, and nanocarrier-based delivery systems, has opened new avenues for myopia control. However, this field still faces several challenges, including insufficient evidence for long-term drug safety, an incomplete understanding of the underlying molecular mechanisms, and limited progress in clinical translation. This review provides a reference for further research and clinical application of pharmacological strategies for myopia control.

四川省科技厅自然科学基金项目(No. 2026YFTX0072); 四川省优质研究生教学改革项重大项目(No.YJGXM25-A028); 四川省高等教育人才培养质量和教学改革项目(No.JG2024-0950)