Myopia is a serious threat to children's visual health, and high myopia can not only cause vision loss, but also lead to severe complications and even blindness. In recent years, with the rising incidence of myopia and the increasing awareness of myopia, the problem of myopia has been widely concerned. At present, the specific mechanism of the incidence and progression of myopia remains ambiguous, and it is generally believed that the sclera is the effector of myopia. With the development of myopia and axial growth, the structure and function of the eyeball change accordingly. The high rates of axial length growth leads to scleral remodeling and accelerated thinning of the posterior pole sclera. Myopia changes the normal tissue structure and biomechanical properties of the sclera, and the regulation of related gene expression is the key to these changes. With the help of myopia animal models and gene sequencing technology, a large number of researchers have found that scleral extracellular matrix remodeling is closely related to the occurrence and development of myopia. This paper discusses the changes of sclera structure and related genes in the development of myopia. It provides ideas for exploring the mechanism of scleral remodeling in myopia and finding new target of treatment.