Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute.

299 Another 2-year, double masked, placebo controlled parallel trial with 2% pirenzepine from the USA yielded a 41% reduction in myopia progression with 2% pirenzepine compared to the placebo treatment, however, the difference in axial elongation between the groups did not reach statistical significance. 300 As with atropine, the antimuscarinic properties of pirenzepine may lead to blurred near vision, sensitivity to light, some discomfort and itching, and medication residue on the eyelids or eyelashes.

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Based on a meta-analysis from 2015, there is a clear trend of higher myopia prevalence in the last 20 to 30 years across Western and Northern Europe. 89 , 91 In contrast, while the prevalence of myopia is reported to have been rising around the world, a similar trend in Southeast Norway appears to be absent. 58 Neither in Denmark, where nearly 140 years of

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