Interpretation of ＂Technical Guide for Comprehensive Intervention of Public Health for Prevention and Control of Myopia in Children and Adolescents＂ by the National Bureau of Disease Control and Preve
Cctv newsBased on a comprehensive summary and evaluation of the five-year practical experience of the Implementation Plan for Comprehensive Prevention and Control of Myopia among Children and Adolescents and the latest scientific research results of myopia prevention and control, the Department of Health and Immunity of the National Bureau of Disease Control and Prevention organized professional teams such as China CDC and Anhui Medical University to formulate the Technical Guide for Comprehensive Public Health Intervention for Myopia Prevention and Control among Children and Adolescents (hereinafter referred to as the Guide), which scientifically promoted appropriate technologies and comprehensive intervention measures for myopia prevention and control among children and adolescents from the perspective of public health, and further improved the level of myopia prevention and control among children and adolescents.
First, adhere to the three-level prevention strategy
Strengthen primary prevention. Focusing on the progress of myopia etiology theory such as "light/ultraviolet light-increased dopamine secretion in retina-slow growth of axial" and "eye-choroidal ischemia-scleral hypoxia and remodeling change in short distance for a long time", and the environmental and behavioral risk factors related to myopia, this paper puts forward specific public health intervention technologies such as monitoring, evaluation and intervention of myopia risk behavior, improvement of school-family-community visual environment, 2 hours of outdoor activities and 1 hour of physical exercise during the day, and health education for all teachers, students and parents.
Promote secondary prevention. Pay attention to the screening of vision health, strengthen the grading management of myopia, and achieve early warning, early detection and early diagnosis. Special attention should be paid to the refractive status and hyperopia reserve of preschool children and primary school students, scientific research should be strengthened, and multi-dimensional indicators such as environmental and behavioral risk factors, hyperopia reserve, axial length, equivalent spherical lens and genetic risk should be combined to establish a myopia risk early warning model.
Implement three levels of prevention. Do a good job in grading and correcting myopia and wear glasses scientifically. Children and adolescents with early onset or rapid development of myopia should adopt optical correction, drug correction or traditional Chinese medicine to slow down the progress of myopia under the guidance of doctors or optometrists. For children and adolescents with fundus pathological changes and other complications, parents should take their children to professional medical institutions for treatment by specialists in time. When screening students’ eyesight, professional institutions should provide timely referral services for children and adolescents who find high myopia and rapid progression of myopia, so as to realize the integration of public health and clinical correction.
Second, fully reflect the new knowledge of myopia etiology
On the basis of considering that children and adolescents have multiple causes such as universal genetic susceptibility, environmental and behavioral risk factors, eye evolution law and social and cultural factors, the causes of myopia are summarized as remote factors (accelerated industrialization and urbanization, educational pressure, scientific and technological progress and other "double-edged sword" effects, Such as the popularity of smart phones and non-full spectrum lamps, etc.), intermediate factors (lack of outdoor activities, premature use of eyes at close range, changes in lighting spectrum and long artificial lighting time, lack of sleep and large social time difference, etc.) and near-end factors (genetic variation, DNA methylation, parents’ myopia, changes in the meaning of eye evolution, etc.), and put forward a theoretical system of etiological intervention, behavioral and environmental intervention and policy-oriented intervention.
Third, fully reflect the practical significance of public health prevention and control of myopia
The Guide identifies the risk behavior factors that affect children and adolescents’ myopia by establishing a monitoring and evaluation method for myopia risk behavior, and then takes targeted intervention measures. In the environment of schools, families and communities, students are the main body of intervention, and the implementation of comprehensive public health intervention for myopia prevention and control is promoted through five public health actions: prevention, promotion, protection, policy development and cooperation.
Fourth, adhere to the full cycle of all-round intervention
The Guide takes public health intervention technology as a means to implement comprehensive public health intervention measures for children and adolescents with the help of monitoring common diseases and health influencing factors of students in disease control institutions at all levels and the pilot platform of appropriate technology. Life-cycle intervention, myopia prevention and control starts from the birth of life, and the implementation of vision health management passes forward. The intervention of the whole population is combined with the intervention of key population, and the prevention and control intervention of the whole population is carried out at the first level. Combined with the strategy of key population, the corresponding intervention is carried out according to myopia stages. Take outdoor activities and sports activities during the day as the main starting point to realize the prevention of multiple diseases. Shortsightedness, abnormal spinal curvature, overweight and obesity, mental health problems and other common diseases of students, a common cause is insufficient physical exercise and too little exposure to sunlight. Taking 2 hours of outdoor activities and 1 hour of physical exercise during the day as the starting point can promote the prevention and control of the above-mentioned diseases of children and adolescents.
Five, strengthen the process evaluation, realize the demonstration.
Prevention and control of myopia in children and adolescents is a systematic project. The Guide provides specific public health intervention technologies that can be popularized for professionals in public health institutions, and all sectors of society concerned about prevention and control of myopia in children and adolescents can refer to it. All localities should make comprehensive policies, solve the difficulties and problems in the implementation process in time, and explore a comprehensive intervention plan for public health prevention and control of myopia with local characteristics. While implementing the comprehensive intervention of myopia prevention and control, we should strengthen the process evaluation, combine qualitative and quantitative research, and comprehensively analyze the accessibility and effectiveness of the comprehensive intervention of myopia prevention and control, so as to realize the unity of intervention process and effect evaluation.
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The National Bureau for Disease Control and Prevention issued the Technical Guide for Comprehensive Intervention of Public Health for Prevention and Control of Myopia in Children and Adolescents.