National Eye Care Day | Chu Renyuan: Caring for the eye health of children and adolescents and promoting the establishment of myopia prevention and treatment files

Editor's Note: June 6, 2024 is the 29th National Eye Care Day. This year's theme is "Pay attention to general eye health", focusing on two key groups: children, adolescents and the elderly. In order to further publicize the importance of eye health for all age groups and throughout the life cycle, this magazine will launch a manuscript solicitation and solicitation activity on the occasion of National Eye Care Day, and select excellent articles for readers.

Chu Renyuan

my country is the first country in the world to make the prevention and control of myopia among children and adolescents a national policy. The author has been engaged in this work for 62 years. On the occasion of National Eye Care Day, I call on everyone to pay attention to the following matters when participating in the establishment of files for the prevention and control of myopia among children and adolescents.

1. We must actively invest in establishing children's refractive development files, because this is the effective measure to achieve the goal of reducing the incidence of myopia among students. As we all know, normal children have hyperopia reserves. If the reserves are insufficient, they are at high risk of myopia. Taking them as key targets and implementing active preventive measures may prevent the occurrence of myopia. The team of Professor Wang Ningli and Professor Li Shiming conducted annual eye examinations and follow-up on hyperopic children with a vision of less than 1.50D in kindergarten, and found that 95.8% of them became myopic by the sixth grade of elementary school, which fully confirmed the necessity of establishing files. Some parents are afraid that mydriasis optometry is harmful. I can say responsibly that mydriasis optometry in a regular professional institution is quite safe.

2. In the huge project of establishing a file for the prevention and treatment of myopia in children and adolescents, two things should be paid special attention to: (1) It is important to attach importance to the detection and timely diagnosis and treatment of pathological myopia, because this type of myopia is often hidden in patients with high myopia and ranks at the top of the spectrum of blinding eye diseases in my country. The reason why this disease causes blindness is that: moderate to high myopia often occurs in kindergarten and continues to deepen. In adulthood, the axial length of high myopia continues to grow, causing the disease to worsen. The posterior pole of the eyeball continues to bulge backwards, causing posterior pole fundus lesions and posterior scleral staphyloma. After various refractive correction surgeries, the lesions may still develop and lead to blindness. This disease was previously called congenital progressive high myopia, hereditary high myopia, etc. It was not until 1988 that it was unified as pathological myopia internationally. Given that the cause and pathogenesis are still unclear and there is no specific treatment, posterior scleral reinforcement surgery is a relatively effective symptomatic treatment method recommended today. The principle is like patching a piece of clothing that is easy to tear. Professor Wang Xiaoying and Professor Zhou Xingtao's team found that for pathological myopia with the same condition, the efficacy of first undergoing posterior scleral reinforcement surgery and then refractive correction surgery was almost twice as high as that of those who only underwent refractive correction surgery 5 years after surgery, which fully demonstrated the importance of timely detection of pathological myopia and timely posterior scleral reinforcement surgery. (2) When performing vision screening in my country, two different distance vision charts of 2.5 meters and 5 meters are used. Because there is a deviation in the vision detected by the two vision charts, the two vision charts must not be mixed or used in series when screening vision.

(Author: Chu Renyuan, Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Fudan University)