Establish vision health files and build a vision-friendly environment
Let the soul's window open to nature (Health Express (stop 48))
Our reporter Wang Meihua
"People's Daily Overseas Edition" (Version 09 on January 15, 2021)
The prevention and control of myopia in children and adolescents has become a national strategy.
In October 2019, the National Health Commission issued the "Guidelines for Suitable Techniques for the Prevention and Control of Myopia in Children and Adolescents" (hereinafter referred to as the "Guidelines") to guide scientific and standardized prevention and control work and improve prevention and control technical capabilities.
In September 2020, the National Health Commission organized a nationwide trial of suitable technologies for the prevention and control of myopia in children and adolescents.
How to rely on the "Guide" to promote the prevention and control of myopia in children and adolescents?
A few days ago, relevant experts made an interpretation during an online interview with the National Health Commission.
Increase physical education
Explore ways to go to school together
The "Guide" has seven aspects, namely screening for poor vision and myopia, establishing visual health files, cultivating healthy eye behavior, building a visually friendly environment, increasing daytime outdoor activities, standardizing visual health monitoring and evaluation, and scientific diagnosis and treatment.
These technologies, according to Tao Fangbiao, a professor at the School of Health Management of Anhui Medical University, can be summarized in the following three aspects: vision health management-screening for poor vision and myopia, establishing vision health files, standardizing vision health monitoring and evaluation; vision-friendly environment and Healthy behavior-cultivate healthy eye behavior, build a visually friendly environment, and increase daytime outdoor activities; medical care services-scientific diagnosis and treatment.
Tao Fangbiao said that when organizing the implementation and use of appropriate technologies, localities can take measures to prevent and control myopia in children and adolescents in light of local conditions.
The first is to strengthen myopia health management: establish children and adolescents’ vision health files, form a regular vision screening and diagnosis system, and transfer them to vision health files in time; develop myopia prediction and early warning technology, such as timely evaluation of pupils’ hyperopia reserves.
The second is to promote school health education: establish a school health education system to protect eyesight and prevent myopia; do eye exercises and strictly control entertainment video activities; actively contact experts to popularize scientific knowledge of myopia prevention and control to the campus; explore and communicate with local publicity departments and The media carried out extensive health education activities.
The third is to implement one-hour outdoor activities every day in the school: let students get out of the classroom, establish a large break system between morning and afternoon, increase physical education classes, and carry out sports activities on campus after school in the afternoon.
The fourth is to explore one-hour daily activities outside of school: encourage parents of lower grades to walk to school with their parents, walk to school for upper grades, explore ways to go to school with their children, and encourage parents to participate in outdoor activities, weekend outings, and outings with their children more.
The fifth is to establish a "school-community-family-student" linkage mechanism: schools, families and communities cooperate with each other to jointly build a community environment that is conducive to the prevention and control of children and adolescents.
Sixth, the slogan for the prevention and control of myopia: In order to facilitate schools, students and parents to better understand and implement various technologies, various localities can put forward appropriate slogans, such as "'eyes' in the sun", "going to school together" and so on.
Screening is the foundation
Promote myopia prevention and control threshold
The first item of the "Guide" is "screening for poor vision and myopia."
In this regard, Xu Xun, a professor at the Shanghai Eye Disease Prevention Center and chief physician of the Eye Center of Shanghai First People's Hospital, said that screening is an important basic work for the prevention and control of myopia and ensuring the full visual health of children and adolescents.
"Screening is conducive to the early detection of myopia and promotes the advancement of the threshold for myopia prevention and control. Generally speaking, the visual development level of children and adolescents is roughly: 3 years old not less than 4.7, 4-5 years old not less than 4.8, and 6 years old and above. Less than 4.9." Xu Xun said that even with normal vision, early warning and early intervention are needed.
Under normal circumstances, people are born with a certain amount of farsighted reserves, like deposits in a bank.
If the eye develops normally, myopia will not occur in adulthood and the hyperopia reserve has not been used up.
Conversely, if the eyeball develops very quickly, myopia may occur.
Generally speaking, the reference values of hyperopia reserve for different developmental stages are: 175-200 degrees for 3 years old, 125-150 degrees for 8 years old, and 75-100 degrees for 12 years old.
The Shanghai Eye Disease Prevention and Control Center found that if the reserve of hyperopia in the first to third grade of primary school is less than 50 degrees, the proportion of myopia occurring after two years is higher than 85%.
If the reserve of hyperopia is less than 100 degrees, the incidence of myopia will be greater than 50% after two years.
Shanghai is the first province to establish a large-scale vision health file nationwide.
Xu Xun said that screening is only the starting point for myopia prevention and control.
On this basis, the establishment of refractive development files, the development of myopia early warning, referral, follow-up management, prevention, standardized correction intervention and other whole-process vision health services, and the realization of closed-loop management, can effectively play the value of screening in the prevention and control of myopia.
"A standardized and complete refractive development file, in addition to screening data such as vision and non-mydriatic refractive, should also be collected and included as much as possible early factors, height, weight, parental myopia and other related conditions. Special attention should be given to each child Set up a unique code to facilitate the horizontal and vertical integration of student health examination data and residents’ health file data." Xu Xun said that in the process of file building, it is necessary to make full use of information technology to establish a continuous and dynamic refractive development file. , Carry out the full cycle management of myopia.
Targeted measures should be taken for children and adolescents with different vision conditions.
Use your eyes moderately
Encourage students to do more outdoor activities
Cultivating healthy eye behavior is of great significance to the prevention and control of myopia.
"At present, the most important thing is to encourage everyone to do more outdoor activities. It is recommended that you accumulate more than 2 hours of outdoor activities every day, but they must be done during the day when there is sunshine." said Wang Kai, chief physician of Peking University People's Hospital, "Sunlight comparison In good times, light can stimulate the retina to secrete dopamine, which is beneficial to delay the growth of myopia. Outdoor activities belong to behavioral control and have no cost in themselves and are worth promoting."
In addition, you must maintain healthy eye habits, such as maintaining the "one punch, one foot, one inch" reading and writing posture.
Wang Kai said that there is also a "20-20-20" principle, that is, after 20 minutes of continuous reading of writing assignments, you should rest for 20 seconds and look 20 feet (6 meters) away.
According to the “Working Plan for the Pilot Program of Appropriate Technologies for the Prevention and Control of Myopia in Children and Adolescents” issued by the National Health Commission, all provinces, autonomous regions, municipalities and Xinjiang Production and Construction Corps make recommendations based on districts and counties. In principle, no more than 10 districts and counties are recommended to participate in the pilot work. .
The pilot areas will serve as an important basis for the evaluation and assessment of the local government's work on prevention and control of myopia in children and adolescents and an important content for the comprehensive evaluation of disease control work.
According to Tao Fangbiao, the pilot work focuses on three aspects.
First, on the basis of investigation and research, the technical guidance expert groups in each pilot area selectively apply the single technology or multiple combined technologies in the "Guide" to formulate a pilot program of suitable technologies for myopia in accordance with time and local conditions.
The second is to organize and implement it cautiously.
Before implementing appropriate technologies for myopia prevention and control, each pilot area should conduct a baseline survey of pilot schools to collect baseline data on students’ poor vision and myopia rates, the quality of the teaching environment, and student eye behavior.
Each pilot school shall establish student vision health files, covering basic personal information and technical parameters of vision examination.
The third is to follow up the process evaluation and supervision in a timely manner.
Under the guidance of the National Health Commission, experts from professional guidance agencies dynamically evaluate the implementation, coverage, acceptability, and spreadability of the pilot program, analyze difficulties and problems in the implementation process, and analyze myopia through comparison with non-pilot schools Prevalence rate, incidence rate, awareness rate of health knowledge, rate of health behavior development, etc., timely evaluate the effect of the pilot and evaluate whether it can be expanded.