The exact mechanism of myopia development associated with COX deficiency specifically is currently unclear, but several studies, such as the 2013 study by Tran-Viet et al. [36,37,40,41], have detected various mutations in gene SCO2 that have been considered pathogenic or likely pathogenic for high or extreme myopia (>30 diopters). This evidence concerns the gene SCO2 and hyperinsulinemic hypoglycemia, familial, 4.