Pediatric myopia is conventionally characterized as a refractive anomaly influenced by optical defocus and environmental factors. Emerging evidence suggests that axial elongation during childhood may be usefully reframed through a neuro-ophthalmic perspective, integrating retinal signaling, visual cortex maturation, and neuroplasticity. This minireview examines myopia within an eye–brain axis framework, emphasizing the roles of retinal neurotransmitters, dopaminergic pathways, and visual process