**Core Concept**
The question is testing the understanding of the pathophysiology of myopia, a common refractive error characterized by nearsightedness. Myopia is caused by an elongation of the eyeball, leading to an increased axial length and a steepening of the cornea. This elongation affects the shape of the eyeball, causing light to focus in front of the retina rather than directly on it.

**Why the Correct Answer is Right**
In myopes, the increased axial length of the eyeball results in a greater tension on the sclera, the outermost layer of the eyeball. This increased tension leads to a greater curvature of the cornea, which further exacerbates the elongation of the eyeball. As a result, the retina is stretched, and the photoreceptors are displaced away from the point of focus, leading to blurred vision at distance. The increased axial length also causes the vitreous gel to become more elongated, which can lead to traction on the retina and potentially cause retinal detachments.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not relevant to the pathophysiology of myopia.
* **Option B:** This option is incorrect because myopia is not caused by an abnormality in the shape of the lens, but rather by an elongation of the eyeball.
* **Option C:** This option is incorrect because while presbyopia is a common age-related refractive error, it is not directly related to the pathophysiology of myopia.

**Clinical Pearl / High-Yield Fact**
Myopia is a significant risk factor for retinal detachment, and patients with high myopia are at increased risk of developing retinal tears and detachments. This is due to the increased traction on the retina caused by the elongated vitreous gel and the stretched retina.

**Correct Answer:** D