Guidelines for the Prevention of Myopia in Children and Adolescents with New Coronary Pneumonia (Updated Version)
During the New Coronary Pneumonia epidemic, the use of electronic products by children and adolescents increased and outdoor activities decreased, increasing the risk of myopia occurring and progressing. In order to guide the prevention of myopia in children and adolescents during the epidemic, the CDC organized the Anhui Medical University School of Health Management, Beijing Center for Disease Control, Shanghai Eye Disease Control Center, and Peking University People ’s Hospital Eye Vision Center to develop and publish "Guidelines on Prevention of Myopia during New Coronary Pneumonia Outbreaks among Adolescents", and updated and adjusted in a timely manner according to the situation of normalized epidemic prevention and control and resumption of school and classes.
1. Myopia prevention during online learning
(1) Time requirement for electronic products.
During online learning, the use time of online learning electronic products should be limited.
1. Online learning time, primary school students no more than 2.5 hours a day, no more than 20 minutes each time; middle school students no more than 4 hours a day, no more than 30 minutes each time.
2. Reduce the screen time outside of online learning. In addition to the online education time arranged by the education department, the screen time for other purposes does not exceed 1 hour per day.
(2) Electronic product selection and placement requirements.
During online learning, special attention should be paid to eye hygiene, reasonable selection and use of electronic products to ensure scientific use of eyes.
1. The choice of electronic products
(1) Choose large-screen electronic products as much as possible, the priority is projector, TV, desktop computer, notebook computer, tablet computer, mobile phone.
(2) Electronic products with high screen resolution and suitable definition should be selected.
(3) When using electronic products, adjust the brightness to make your eyes feel comfortable, not too bright or too dark.
2. Placement of electronic products
(1) Electronic products should be placed away from direct windows and light, with the screen side facing the window to prevent the reflection of the screen from irritating your eyes.
(2) When using a projector, the viewing distance should be more than 3 meters; when using a TV, the viewing distance should be more than 4 times the diagonal distance of the screen; when using a computer, the viewing distance should be 50 cm (about one arm long) the above.
(3) When placing electronic products (such as computers), ensure that the top of the screen is flush with the eye level.
(3) Reading and writing posture.
During online learning, children and adolescents should adjust their holiday learning arrangements in time to meet the following reading and writing requirements.
1. While watching the screen to listen to the lesson, you can keep your shoulders relaxed, your upper back extended, your upper arm at a 90-degree angle to your forearm, relax your wrist, and breathe regularly.
2. While watching the homework on the screen, the reading and writing posture should be "one foot, one punch, one inch": the eyes are about one foot (about 30 cm) from the book, the body is about one punch from the desk, and the finger holding the pen is about one inch from the pen tip.
3. Do not lie on the bed or sofa to study on the screen.
(4) Relax your eyes.
During online learning, increasing active rest time can not only relax ciliary muscles and relieve eye fatigue, but also reduce brain fatigue, improve learning efficiency, and ease tension.
1. Continuous video learning time exceeds 20-30 minutes, at least 10 minutes of active rest.
2. During the video learning process, consciously close your eyes and open your eyes slightly, turn your eyes up, down, left and right to relax your eyes.
3. Stretch your waist and arms after studying online, you can walk indoors, do gymnastics, squats, sit-ups, etc .; do eye exercises after cleaning your hands; stand in front of a window, balcony or door, and go far (6 meters Above) overlooking.
4. During the period of home isolation, you can bathe the sun through the balcony, window or your own courtyard "eyes" to expose to natural light.
(5) Lighting and lighting requirements.
During the epidemic, the family is the main place for children and adolescents to live and study. The family's lighting and lighting conditions are critical to the eye hygiene of children and adolescents.
1. Place the desk next to the window so that the long axis of the desk is perpendicular to the window. When reading and writing in the daytime, natural light should be incident from the opposite side of the writer.
2. If there is insufficient light when reading and writing during the day, you can place a desk lamp on the desk to assist the lighting, and the placement is on the front side opposite to the writer.
3. When reading and writing at night, use the desk lamp and the room ceiling lamp at the same time, and place the lamp correctly.
4. The home lighting source should use three primary color light source lighting equipment, and the color temperature of the table lamp should not exceed 4000K.
5. Bare lamps should not be used for home lighting, that is, tubes or bulbs cannot be used directly, but tubes or bulbs protected by lampshades should be used to protect eyes from glare.
6. Avoid placing glass plates or other objects prone to glare on the desk.
(6) Adjustment of family desks and chairs.
To ensure that children and adolescents can maintain correct reading and writing posture at home and reduce learning fatigue, parents should provide appropriate desks and chairs for their children.
1. For families with adjustable desks and chairs, adjust the height of the desks and chairs according to the principle of "the thighs and calves sit vertically on the chair / stool and the elbow is 3-4 cm below the tabletop when the back is upright".
2. For families without adjustable desks and chairs, adjust according to the above principles. If the table is too high, use a higher chair as much as possible, and place a foot pad under the foot so that the foot can be placed flat on the foot pad and the thigh is perpendicular to the lower leg. When the table or chair is too short, raise the table or chair.
(7) Reasonably arrange daily life.
During the epidemic, families should create a good atmosphere. Parents should help their children to maintain their study and life rhythms, and ensure that their children work regularly, sleep well, and have adequate physical activity.
1. To ensure adequate sleep time every day, primary school students should reach 10 hours, junior high school students 9 hours, high school students 8 hours.
2. When studying at home, you should avoid the formation of bad habits such as late sleep and late rise to reduce the interference to the biological clock.
3. Parents should urge their children to maintain learning laws and life rhythms, and develop more interactive and fun games to enhance parent-child communication.
4. Children and adolescents assist parents in doing the proper amount of household chores daily, such as cleaning the house, tidying the rooms, washing dishes, and cooking.
5. Parents can arrange children to perform outdoor activities in the community, such as skipping rope, racket, badminton, aerobics and other activities.
(8) Pay attention to hand hygiene and eye health.
Maintaining hand hygiene habits is an important factor to ensure eye health. Washing hands frequently can prevent viral bacterial infections and effectively prevent infectious diseases of the eyes.
1. Wash hands before and after meals and after going home, using the "7-step hand-washing method" and guaranteeing a time of more than 20 seconds.
2. Do not rub your eyes with your hands.
3. If the eyes appear dry, foreign body sensation, burning sensation, itching, photophobia, red eyes, eye pain and other symptoms, the screen behavior should be stopped. If the symptoms cannot be relieved, go to the hospital if necessary.
4. When children are found to have head tilt, frequent squint and crowded eyes and other symptoms related to myopia, they should rest and exercise in time, and go to the hospital if necessary.
2. Myopia prevention after returning to school
After returning to school, continue to cultivate and maintain good eye habits. With the gradual normalization of classroom teaching, schools should reduce the use of electronic products, restore eye exercises, provide good lighting conditions, adjust desks and chairs in time, and increase natural light Outdoor activities.
(1) Develop good eye behavior.
Good eye behavior can reduce eye fatigue and reduce over-regulation of eyes, and continue to maintain good eye behavior after returning to school.
1. Keep reading and writing posture "one foot, one punch, one inch".
2. After 30-40 minutes of reading and writing, take an active rest for 10 minutes and look out.
3. Don't read books and cell phones while walking, in direct sunlight and in turbulent cars.
(2) Reduce the use of electronic products.
Prolonged use of electronic products can cause eye discomfort and increase the risk of myopia. After resuming school, children and adolescents should reduce the use time of electronic products in time.
1. Teaching with electronic products does not exceed 30% of the total teaching time, in principle, paper-based assignments are used.
2. The use of electronic products for non-learning purposes should not exceed 15 minutes in a single session and should not exceed 1 hour in a day.
3. The younger children should spend less time using electronic products. Preschool children under 6 years of age should try to avoid exposure to mobile phones, computers and other video environments, and parents should set an example.
(3) Eye exercises.
Long-term and standardized eye exercises are of positive significance to prevent myopia. After school resumes, the school should restore the system of eye exercises in the morning and afternoon.
1. Clean your hands thoroughly before doing eye exercises.
2. Choose "eye relaxation exercises" and "love eye exercises" that do not touch the eyes.
(4) Lighting in the classroom.
Schools should provide good lighting conditions to ensure that students have sufficient light when reading and writing.
1. The average illuminance of the desktop in the ordinary classroom is not less than 300 lx, and not more than 750 lx, and the uniformity of illuminance is not less than 0.7.
2. The blackboard in ordinary classrooms should be equipped with local lighting fixtures, whose average illuminance is not less than 500 lx, and not more than 1000 lx, and the illuminance uniformity is not less than 0.8.
(5) Adjustment of school desks and chairs.
The desks and chairs should match the heights of children and adolescents, and adjust the desks and chairs in accordance with the standard of "Functional Dimensions and Technical Requirements of School Desks and Chairs" (GB / T 3976-2014).
(6) Increase outdoor activities under natural light conditions.
Outdoor activities are the simplest and most effective way to prevent myopia. Full exposure to sunlight can effectively prevent the occurrence and development of myopia.
1. During the epidemic, the school physical education class and the 30-minute large classroom should be conducted outdoors, at the wrong time and at the wrong peak, increasing the distance between the students' physical activities.
2. Ensuring more than 2 hours of outdoor activities per day, and advocating myopia children and adolescents for more than 3 hours of outdoor activities every day.
3. After returning to school, encourage children and adolescents to walk to and from school, walk out of the classroom between classes, and do outdoor activities after school in the afternoon to complete homework, etc., to increase the time of outdoor sun exposure.
3. Students' vision monitoring and refractive screening during the epidemic
After returning to school, carry out vision monitoring and refractive screening, and follow the "Visual Screening Standards for Primary and Middle School Students" (WS / T 663-2020). Various epidemic prevention measures should be taken to prevent cross infection. Schools should conduct student vision monitoring and refractive screening under the guidance of the health department, improve vision health files, and promptly detect students with poor vision and myopia.
(1) Carry out vision monitoring and refractive screening.
1. Register the vision monitoring results in time to improve the vision health file.
2. Statistics on the poor vision and screening myopia rate of students in all grades of the school, and compared with the same period of the previous year.
3. Feedback parents' vision health information to parents and guide parents to carry out myopia prevention and control work.
(2) Requirements for inspection site.
As far as possible, it should be carried out in outdoor playgrounds or large sports venues to maintain air circulation.
(3) Requirements of inspectors.
Inspectors should be familiar with the standardized use of infection prevention and control supplies and related requirements, wear disposable work caps, disposable medical surgical masks, disposable gloves, wear work clothes, and pay strict attention to hand hygiene.
(4) Check the requirements of the equipment.
1. The eye mask used in the visual inspection should be "one person, one elimination", or a disposable paper eye mask, "one person, one".
2. The surface of the refractometer should be disinfected during the refractive inspection, and the parts that come into contact with the human body should be "one person, one elimination".
3. Make sure the safety distance between the inspection equipment is more than 1.5 meters.
(5) Requirements of the students examined.
1. The inspected students should wear disposable masks without touching their eyes and their surroundings during the inspection process. After the inspection (after completing the checklist), they should wash their hands according to the “seven-step washing method”
2. Arrange students' inspection time reasonably, in batches and time periods, to ensure that the inspected personnel have a safe distance of more than 1.5 meters, and to minimize the time for students to overlap while waiting for the inspection.
4. Hygiene protection for optometry and optics during the epidemic
(1) Vision correction.
During the epidemic, children and adolescents with myopia who need low vision will need to correct their vision if they affect their studies or life.
1. Frame glasses are the safest vision correction method for children and adolescents, and glasses should be tested according to the prescription of glasses.
2. It is not recommended to wear contact lenses. Due to the need to wear special types of contact lenses such as orthokeratology to control myopia, you must strictly follow the doctor's instructions.
3. Before removing contact lenses, you must ensure that your hands are clean, and wash your hands in strict accordance with the "7-step hand-washing method".
(2) Optometry and optician.
During the epidemic, it is recommended that children and adolescents' routine vision review, optometry and optics be suspended. If optometry is really needed due to reduced vision, learning should go to a professional hospital ophthalmology department or ophthalmology center.
1. Understand the hospital information in advance and make an appointment according to the hospital's requirements, so that you can see the doctor at different times and avoid cross-infection.
2. In the process of making appointments, do personal protection and obey the management of medical staff. It is recommended that you reserve contact information when you are crowded or when it is not time for a doctor, and wait for the phone to be notified outdoors or in a place with fewer people to avoid gathering.
3. Medical institutions post new coronary pneumonia protection guidelines and personal protection standards and disinfection procedures at appropriate locations in the waiting area and refractive examination room.
4. During the visit, children and adolescents and parents accompanying them should wear masks, cooperate with the measurement of body temperature, truthfully inform the doctor to register the epidemic related information, and cooperate with the doctor to complete the examination using non-contact ophthalmic equipment.
5. Medical institutions should reasonably arrange the time for medical examinations to ensure that the "one room, one doctor, one patient" in the examination room and the waiting area are in a ventilated environment, as far as possible to reduce the time of overlap between patients in the waiting area.
6. Medical staff should be familiar with the preparatory work before refractive examination, do a good job of disinfecting the surface of the inspection equipment, and disinfect the parts that come into contact with the human body to ensure "one person, one elimination" to prevent cross infection.
7. In the process of refractive examination, reduce unnecessary verbal communication, and try to maintain a distance of more than 1.5 meters when face-to-face communication with medical staff.
8. After the consultation, leave the treatment area in time, and wipe and disinfect the parts in contact with the inspection equipment.