Our reporter Li Muming
After the "long holiday" is over, the most common "greet" for parents to "celebrate" the return of the sacred animal is "how much has your child's degree increased?"
Yes, now in the upper grades of elementary school and above, it is almost standard to wear glasses, and the degree of questioning is as normal as "have you eaten?"
During the summer vacation, the reporter learned at Panjiayuan Glasses City in Beijing that most children's myopia has increased by at least 50-100 degrees.
On August 27, the Ministry of Education's survey also showed that compared with the end of 2019, the rate of myopia among students increased by 11.7% in the past six months.
The prevention and control of myopia in teenagers and children is imminent.
In fact, the situation last year was “astonishing”. According to a set of data released by the National Health Commission in April 2019, the overall myopia rate of young people across the country was 53.6%.
Among them, the myopia rate of junior high school students was 71.6%, and that of high school students was 81%.
Therefore, after less than a year, the "National Comprehensive Measures for the Evaluation and Evaluation of Myopia Prevention and Control of Children and Adolescents" established by nine departments including the Ministry of Education has increased to 15 member units.
What is the impact of various factors on vision and how to deal with it? A few days ago, the reporter interviewed Yang Zhikuan, a doctoral supervisor of the Aier School of Ophthalmology, Central South University and deputy head of the Optometry Group of the Chinese Medical Association Ophthalmology Branch.
According to Yang Zhikuan, the impact on young people’s vision is mainly in the following aspects: The first is continuous near-sight work, that is, eye use less than 33 cm and longer than 20 minutes.
Students usually spend 40 minutes in a class at school, switching between the blackboard and the textbook, which is acceptable in theory, but there is no such switch in the online class; the second is the effective outdoor activity time, why add "effective" What?
That is, the outdoor illumination should be greater than 700lux.
Outdoor activities at night, the effect of exercise is still there, but the adjustment effect on eyesight is gone; the third is the environmental illumination, indoor non-reading, it also needs more than 150lux to avoid visual fatigue.
How bright is it bright?
Illumination is a physical term that refers to the intensity of light and the amount of illumination of the surface of an object, referred to as illuminance, in lux (lux or lx).
According to the latest "Architectural Lighting Standards" issued by the Ministry of Housing and Urban-Rural Development in 2018, taking schools as a reference, the national standard requires 300 lux for classroom desktops and 500 lux for blackboard surfaces.
This is basically the range of light that is comfortable for the eyes of reporters when reading.
Many bookstores and even some libraries that reporters have visited often fail to meet this standard.
In a cloudy morning, the illuminance of the desk close to the window without any obstruction is 700-800lux; the illuminance of the desk 1 meter away from the window is about 300lux.
Many adults do not tighten the string of environmental illumination and reading illumination.
On weekends and holidays, whether in libraries or bookstores with substandard illumination, the floor and corners next to the bookshelves are often filled with readers of all ages.
Operators of public reading places are obliged to refer to national standards and meet lighting conditions.
Those of us who love reading, especially parents, should learn more about "common sense" and resolutely refrain from reading and writing under unqualified lighting conditions. After all, "cutting the wall to steal the light" and "capsule Yingxue" are limited by the times and inspirational That's enough.
In addition to looking forward to strengthening inspections to urge the standardization of public reading spaces, the reporter has seen some parents take out rechargeable reading lamps in libraries with insufficient lighting to "fill light" for their children, which is also a stopgap measure.
The "original sin" of the screen
As for the widely criticized electronic products, where is the main "harm"?
If it cannot be completely eliminated in life, how to use it correctly?
It is also close reading. What is the difference from traditional paper books?
How harmful is blue light?
Yang Zhikuan also answered these questions one by one.
To eliminate the quality problems of the screen-type reading media itself, first of all, the reading of electronic products is not restricted.
For reading, we need at least one light, but nowadays students, even if the lights are turned off in the room, they can still watch the electronic screen while lying on the bed, which in itself increases the time for close reading.
This situation is most experienced by people who often travel around. Many environments that are not conducive to reading, such as train stations, subways, while waiting for a doctor... Taking out your mobile phone seems to be the best way to kill time.
Secondly, the information transmitted by electronic products can be made into animations, videos, including interactive forms, which increase the interest and time out if you are not paying attention.
In fact, more than students, I believe that many adults, even if they are legitimate needs, can't stop the "attraction" of various pushes, let alone games that can't get out if you enter.
The third one is the familiar blue light, which is actually not related to myopia, but it mainly causes fundus disease.
All of our electronic products now display light sources as LEDs. Generally, LEDs emit only three colors of "RGB", where R means red, which means red light; G means green, which means green light; and B means blue, which means Blu-ray.
Among the three colors of LEDs, the "blue LED" between 400nm and 500nm is the most important and basic.
The wavelength is more than 400 nm, which is just focused on the macula, so it is harmful to the fundus. When looking at the mobile phone at night or when the light is not good, the pupils will be enlarged in the dark environment, and the blue light will enter the fundus without any obstruction.
This kind of damage cannot be seen in the short term, and the consequences will be endless in the long run.
2 hours outdoors every day
If screen life is unavoidable for all mankind, including young people, in addition to controlling distance and time, a more active approach is to increase outdoor activities.
On August 29, the "China Youth Myopia Prevention and Control Big Data Report" released on the "Second National Visual Health Summit Forum" (hereinafter referred to as "the Forum") hosted by People's Daily Online pointed out that the current eye-use time of children and adolescents exceeds the standard1 More than double, the effective outdoor exposure time is seriously insufficient.
Data show that from January to July 2020, the eye distance of adolescents throughout the day is 32.3 ± 9.4 cm, of which 75.3% of adolescents spend more than 2 hours at close range daily.
The prevention and control of adolescents’ myopia requires “photosynthesis” and it is essential to insist on outdoor activities.
In outdoor activities, receiving sunlight, receiving stronger lighting, and receiving the spectrum and rhythm of sunlight are the most important means of prevention and control of myopia.
At the forum, Zeng Junwen, chief physician of Sun Yat-sen University’s Zhongshan Eye Center, explained: “Why do you always talk about outdoor activities? In fact, outdoor activities are not just to reduce the problem of getting close. The role of outdoor activities receiving light is very magical. Many people think that ultraviolet rays are not Well, in fact, some wavelengths of light in ultraviolet light have a certain positive effect on the development of the eyeball. It has not been studied in depth. My subject is the research of red light. Red light used to treat amblyopia. In fact, after the treatment of amblyopia, small The hardness of the child’s eyeballs has also increased, and the eye axis has become less long."
Liao Wenke, former inspector of the Department of Sports, Health, and Arts of the Ministry of Education mentioned that vision is an important item in the physical examination of the college entrance examination. Many children who are very gifted in certain aspects cannot choose their favorite major due to vision reasons, which seriously affects our country. Training of professionals.
Not only that, "The troops have to give us feedback every year after the conscription. Due to poor eyesight, there are fewer qualified troops. The standard for the conscription medical examination has been lowered and lowered. According to the original standards, there are not many qualified troops. Conscription tasks are difficult to complete."
The reporter also learned at the forum that, scientifically proven, one-time exercise for 14 hours on weekends will not be effective in preventing and controlling myopia.
Just like eating meals on a regular basis, outdoor activities must be dispersed to at least 2 hours a day.
The reality is that even during the suspension period when the epidemic is not too serious, few children playing downstairs in each community are in the upper grades and above.
Not to mention the students who have tighter schedules than adults on weekdays.
With glasses, OK glasses, atropine... Can these really make up for it?
For adults who seem to have all settled down, can myopia be just as blind as the toothache that I thought was not a disease many years ago?
Myopia is not just myopia
If you think that high myopia is just a thicker spectacle lens, or choose a narrower professional, that would be too optimistic.
Once the pathological changes in high myopia are irreversible damage, the risk of cataracts in people with high myopia exceeding 600 degrees will increase by 5 times, the risk of retinal detachment by 13 times, and the risk of macular degeneration by more than 800 times.
The International Association for the Prevention of Blindness has replaced cataract with high myopia as the leading cause of blindness in the world, and cataract blindness is still reversible.
The first reason for high myopia is the obvious genetic influence.
There is also myopia before the age of 12, also known as premature myopia. This kind of child develops very quickly and is also a high probability group.
Although the third category is myopia discovered after 12 years of age, it has some hidden susceptibility genes, so it may become pathological myopia.
Xu Liang, former director of the Beijing Tongren Eye Institute, emphasized that those who are nearsighted before the age of 18 are more likely to have high myopia.
From a "pessimistic" point of view, there are very few people who are not nearsighted before the age of 18.
Why is pathological myopia (high myopia) an important cause of blindness, even more "dangerous" than cataracts?
Because as the degree of myopia becomes higher and higher, the axis of the eye is stretched longer and longer, the entire biological structure of the eyeball has changed, and the back becomes like an olive, the retina is pulled forward, and the retina becomes like broken cotton. The same, fragile.
So how to effectively prevent it?
It is not difficult to say, our study habits and living habits are an important starting point, such as learning posture, reading distance, reading time, reading intensity, reading lighting and so on.
Yang Zhikuan said that prevention and control of myopia is not just a problem of wearing glasses, it may also be a problem of losing the ability to work in the future.
It's not just chanting slogans, just a few meetings can solve it.
In addition to the alarm bells for "harm", science is of great importance, especially for parents and school teachers.
What about other countries?
Lan Weizhong, a member of the World Health Organization's (WHO) Refractive Error Prevention and Control Program Expert Group, introduced that in the past few decades, the myopia rate has increased to varying degrees all over the world, Asia, especially East Asia, China, Japan, and South Korea. It ranks first in the global incidence of myopia, reaching 51.6%, followed by the United States and Europe. The lowest incidence of myopia is in Africa and Oceania, less than 10%.
An article in the American Journal of Ophthalmology predicts the global incidence of myopia. If there are no effective prevention and control measures for myopia, the global prevalence of myopia will reach 49.5% by 2050, and the total population of high myopia will be nearly 1 billion. .
A large number of studies have suggested that the main reason for the rapid increase in the global prevalence of myopia compared to decades ago is the great changes in lifestyle.
Among the many "new" lifestyles, two factors are clearly identified as causing myopia, that is, the increase in learning load and the decrease in outdoor activities.
However, in Western countries represented by Europe, as well as Australia, the overall prevalence of myopia is still far lower than in East Asia.
From a social perspective, Western society evaluates students in addition to academic performance, but also considers comprehensive qualities, such as learning ability, expertise, hobbies, development potential, etc., while the traditional culture of East Asia often focuses on academics. Especially the "near-sighted" learning in the study.
Because of the single evaluation system, the method can only be "utilitarian" single, which leads to a serious shortage of outdoor activities.
Looking at Singapore, where the Chinese society is dominated, a national-level myopia prevention and control plan was launched in 2000. After nearly 15 years of hard work, the prevalence of myopia has been successfully reduced from 37.7% to 31.6%. Their prevention The control measures are very comprehensive. First, school-age and pre-school vision screenings are taken, and very interesting health education on the prevention and control of myopia is also provided, so that the dolls know from an early age how myopia will affect their future.
In Taiwan, China has also introduced a series of measures to prevent and control myopia, including implementing eye-care exercises similar to eye exercises, improving classroom lighting, and providing tables and chairs that can be adjusted in height.
However, after the implementation of the above measures in the first ten years of the new century, the effect is not very obvious, and the prevalence of myopia has not dropped but has continued to rise.
Therefore, adjustments were made in 2010 and the "120 every day" plan was proposed, which encourages students to have at least 120 minutes of outdoor activities every day.
In order to achieve this goal, the eye protection exercise was cancelled, and the children were rushed to the playground to enjoy the sunshine twice a day.
What is the effect?
After making this adjustment in 2010, the prevalence of myopia has gradually dropped from 50% to 46.1%.
Force students or schools?
The fact that Changzhi City, Shanxi Province, which has been highly controversial on the Internet, included the eyesight assessment in the high school entrance examination results, which seems to have weighed on the students with increasingly heavy academics.
Hujialou Primary School, Chaoyang District, Beijing, took a different approach. Every semester, the results of the vision check were made into a graph and fed back to the parents. At the same time, the vision assessment indicators were included in the teacher's evaluation. To be affected.
The principal Liu Zhiguo also suggested whether a light sensor could be installed in the classroom.
Because the curtains are often drawn when using multimedia teaching methods in classrooms. Although the curtains are required to be opened when the projector and other equipment are used up, when the teacher is fully engaged in teaching, sometimes it is difficult to remember. If there is such a sensor, you will know when you call the police. The light is not enough, you need to open the curtains or turn on the lights.
Nowadays, many parks have noise warning devices, and many mobile phones can be installed with software to detect the illuminance. It should not be difficult to solve the technical level, and more importantly depends on the determination of the managers.
Informatization, digitization and other new lifestyles have impacted our health while providing related conveniences.
However, President Liu is also worried that what can be thought of at present is to start from the "monitoring side". What really matters is to arouse students' attention to these issues.
There are still too many teenagers, children and even parents who are dissatisfied with light intensity and outdoor activities. This just shows that many people's importance needs to be strengthened, and they should not be alert until the most dangerous moment.