Comment | A strong "baton" is needed to prevent and control myopia in children and adolescents

Written by Luo Zhongyun (commentator of this newspaper) Graphic editor: Chen Yongjie

New Media Editor/Wang Shan Image Source/Visual China

On April 7, the Ministry of Education issued the "2023 National Comprehensive Prevention and Control of Myopia in Children and Adolescents Key Work Plan", emphasizing that the overall myopia rate and physical health of children and adolescents should be included in the government performance assessment, and that local governments at all levels are strictly prohibited from unilaterally assessing education administrative departments and schools based on student test scores and school admission rates. Local governments and schools whose children and adolescents' physical health levels have declined for three consecutive years will be held accountable in accordance with laws and regulations.

The introduction of this work plan not only reflects the country's attention to the problem of myopia among children and adolescents, but also reflects the severity of the current problem. According to research data from the World Health Organization, there are currently 600 million myopic people in my country, of which about 70% are children and adolescents, and this data is still rising. The myopia rate among children and adolescents in my country has ranked first in the world. According to a survey by the National Health Commission, the overall myopia rate among children and adolescents nationwide in 2022 was 53.6%, including 14.5% for 6-year-old children, 36% for primary school students, 71.6% for junior high school students, and 81% for high school students. It can be said that myopia among children and adolescents has become a major public health issue in my country.

Eyes are windows to the soul, and myopia can be caused by many factors. Some of them are genetic factors. Studies have found that if parents are highly myopic, the probability of their children suffering from myopia is as high as 98%. If one of the parents is highly myopic, the probability of their children suffering from myopia is also around 15%. There are also eye habits and eye hygiene. Using the eyes too close, using the eyes for too long, using the eyes in an environment with inappropriate lighting, lack of sleep, etc. can all cause myopia.

The ubiquitous electronic products are also an important cause of myopia in children. Many schools now use a lot of electronic tools such as projectors and PPT in teaching. Students also often use electronic products to receive notifications, check materials, complete and submit homework, etc., plus they spend a long time looking at mobile phones or iPads after school, so it is difficult not to be myopic.

However, these factors are similar all over the world, and the myopia rate among children and adolescents in my country ranks first in the world. Another very important reason is that the academic pressure is too high and the outdoor activity time is too little. Studies have shown that outdoor sunlight can induce the release of dopamine, which can prevent the eyeball from becoming longer, thereby reducing the probability of myopia. In addition, sufficient outdoor activities, including a certain amount of exercise, are not only helpful for protecting eyesight, but also conducive to enhancing the body's immunity and more energy, which in turn can promote the improvement of learning efficiency. In my country, because of the pursuit of academic performance and scores, both schools and parents are working hard, and students themselves are in a state of high-intensity close-range learning for a long time. Their outdoor activity time is getting shorter and shorter. Some schools even require students not to leave the classroom after class except for special reasons such as going to the toilet, let alone enter the playground for exercise. In this case, the probability of myopia among students naturally rises.

In fact, relevant national departments have been promoting the prevention and control of myopia among children and adolescents. As early as 2007, the State Council issued special opinions on strengthening sports for children and adolescents and enhancing their physical fitness. The Ministry of Education immediately formulated the "Work Plan for the Prevention and Control of Myopia among Primary and Secondary School Students", and proposed specific measures to protect students' eyesight. In 2018, the Ministry of Education, the National Health Commission and others issued the "Implementation Plan for Comprehensive Prevention and Control of Myopia among Children and Adolescents", proposing that by 2023, the overall myopia rate among children and adolescents nationwide will be reduced by more than 0.5 percentage points each year based on 2018. The "Opinions of the State Council on Implementing the Healthy China Action" issued in 2019 also proposed that "from 2022 to 2030, the overall myopia rate among children and adolescents nationwide will strive to be reduced by more than 0.5 percentage points each year, and the incidence of new myopia will drop significantly."

To achieve these goals, the relevant implementation plan also makes detailed provisions for school teaching methods and teaching aids. For example, school teaching and homework assignments should not rely on electronic products, and the use of electronic products for teaching should not exceed 30% of the total teaching time in principle, and homework should be mainly paper-based. The "Health Requirements for Myopia Prevention and Control of Children and Adolescents' Learning Supplies" implemented on March 1, 2022 stipulates that the minimum font size of the main text of primary and secondary school textbooks should not be less than size 4, and teaching multimedia should not have perceptible flickering.

However, in actual implementation, due to the lack of a strong supervision and restraint mechanism and evaluation requirements, many policies have become a formality. This work plan will formally include it in the scope of government performance evaluation, which can be said to be a major upgrade in the prevention and control of myopia among children and adolescents.

In addition, relevant departments can also organize educational and scientific research units, health institutions, medical experts, etc. to carry out scientific research, and use rigorous scientific data as support to develop standards for eye hygiene, eye habits, and use of electronic products for children and adolescents of different age groups. Pilot projects should be carried out in some areas first, and revised and improved based on practical results, and promoted when conditions are ripe.

As an important responsible party for the prevention and control of myopia among children and adolescents, schools must strictly implement relevant national policies and create a good eye environment for students in terms of hardware, such as ensuring the lighting in the classroom and providing desks and chairs that match the height of students. In terms of software, they must ensure that eye exercises, breaks between classes, extracurricular sports activities, outdoor activities, etc. meet the requirements, and strictly limit the duration of electronic teaching. Of course, as a school, it is also necessary to strictly implement the national "double reduction" policy to reduce students' academic burden and eye pressure.

As parents, we should also regard the prevention of myopia in children as a major matter. In addition to creating a good eye environment, guiding children to pay attention to eye hygiene and develop good eye habits, parents themselves should also abandon some wrong ideas and practices, such as letting children watch electronic products when they are unable to get away; using mobile phones for a long time and setting a bad example for children... These should all be avoided.

Related eye science popularization also needs to be vigorously followed up. In fact, the reason why many children and adolescents suffer from myopia is that they lack attention and awareness, and lack relevant eye protection knowledge. Education departments or schools should take the initiative to cooperate with health departments, medical institutions, and medical experts regularly or irregularly to hold various eye health science popularization activities to make the awareness of "eye protection and eye protection" deeply rooted in the hearts of the people.

Of course, the high myopia rate among children and adolescents in my country is also closely related to the existing examination-oriented education system. To fundamentally change this situation, we must resolutely promote the reform of examination-oriented education, adjust or improve the evaluation index system for the junior high school entrance examination and the college entrance examination, and thus reduce the teaching and academic pressure on schools and students through a top-down "baton" approach, reduce students' eye-use time, and reduce the intensity of eye use, so as to better protect the vision health of children and adolescents.

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