Early care for childhood myopia called key

Beijinger Guan Jing was taken aback when she took her 14-year-old son to have his eyes examined and was told that he had developed myopia.

The condition is often called nearsightedness or shortsightedness because it can make distant objects appear blurry.

She said she couldn't help but feel regret, realizing that she could have taken measures earlier to lower the risk and slow the condition's development. She quickly urged her son to form good vision habits such as periodically resting his eyes and increasing his daily outdoor activities.

Her case is reflective of the widespread issue of myopia among students in China. According to the National Health Commission, the prevalence of myopia among Chinese children and teenagers in 2020 was 52.7 percent. That marked an increase of 2.5 percentage points from 2019 but remained 0.9 percentage points lower than 2018.

The Shanghai Association for Science and Technology, the Eye and ENT (ear, nose and throat) Hospital of Fudan University and German optics and optoelectronics company Zeiss recently joined together to launch the 2023 Chinese Children and Adolescents Myopia Prevention and Management Trend Report. It is the third yearly report since 2021.

This year's report involved over 1,500 subjects who had taken their children, aged between 3 and 16, to medical establishments for myopia. The study encompassed 15 establishments in Shanghai and Shenzhen, Guangdong province, as well as non-first-tier cities.

The report, which took about six months to complete, featured a survey of parents and interviews with 28 eye specialists.

It aims to provide new insights into the reduction and management of myopia, and offer the public guidance that is scientific, authoritative and practical.

In recent years, China has been striving to promote risk reduction and control of myopia as part of its national health policy. In March, the Ministry of Education issued a plan for ways to reduce and control myopia among children and teenagers this year.

"In China, there is a growing trend of myopia developing at an increasingly young age, accompanied by a rising prevalence of high myopia," says the report's lead reviewer, Zhou Xingtao, dean of the Eye and ENT Hospital of Fudan University.

While most eye specialists emphasize that parents should pay attention to their children's axial length, 62.2 percent of the surveyed parents considered simple eyesight as their primary concern. Axial length is a combination of eye measurements that can help gauge and predict the presence of myopia.

"It's true that eyesight is important. However, for precise control of myopia, the assessment of axial length is essential, as it's an objective and measurable factor that helps judge the progression of myopia," Zhou says.

He urges parents to prioritize their children's visual health from an early age. For children aged less than 3, it is crucial to determine their diopter and examine them for congenital eye disease. The diopter is a measure of optical power that can be used for a prescription of glasses or contacts.

Additionally, with children between the ages of 3 and 6, it is important to establish their refractive development profile. The eye's cornea and lens bend, or refract, light to focus on the retina. When the eye grows, it can change that bending, producing blurry vision.

"We should prevent high myopia and the complications it causes. Having standard and digital refractive development profiles means that an individual's eye health can be tracked continuously, and it's good for myopia management," he says.

According to Zhou, the spread of accurate and understandable scientific information about myopia is good for communication between doctors and patients and can improve myopia management.

"There are still challenges about myopia prevention in China at the grassroots level and in remote areas. A possible solution comes from digitalization and intelligent devices," says Maximilian Foerst, president and CEO of Zeiss Greater China.

In 2020, the company established the myopia management project team in China, dedicating a WeChat-based mini-program to share scientific information and accessible tools about myopia for parents.

It will soon release a digital product for practitioners, allowing them to gather data from equipment and measuring tools. Therefore, they can track if and how myopia is developing and give the best possible information to patients.

"A crucial part of the development of myopia is the behavior of children. Therefore, we need to look at it holistically, starting with education, then working together with the community and authorities to see how we can standardize management," Foerst says.