Yu Hong: Some Thoughts on the prevention and control of myopia in children and adolescents

2021-03-01

Editor's note: according to the bulletin of the Ministry of education in October 26, 2021, influenced by COVID-19, the overall myopia rate of children and adolescents in China was 52.7% in 2020, which basically achieved the goal of reducing the myopia rate by 0.5 percentage points per year. The realization of this goal not only benefits from the release and implementation of the top-level design of the national strategy, but also depends on the further strengthening of the awareness of myopia prevention and control of children and adolescents in the whole society, but also thanks to the targeted force and accurate service of the medical system, including social medical institutions. Recently, we had the honor to interview Mr. Yu Hong, general manager of Beijing Ming optometry, who not only introduced the work of Beijing Ming optometry in the prevention and control of myopia in children and adolescents over the past decade, but also put forward many insights through the integration of theory with practice. Q1: I have learned that you attach great importance to the prevention and control of myopia in children and adolescents. What kind of personal experience do you have here? Yu Hong: here, let me talk about my personal experience. One day at the beginning of school in the autumn of 2003, my child came back and said that he couldn't see the words on the blackboard clearly in class. So I took her to the Tongren Hospital where I worked to see a doctor. At that time, Tongren Hospital had a total of 12 sub specialties of Ophthalmology. There was a sub specialty of refractive Center for adults, but there was no special specialty for children and adolescents to see myopia. In general, patients with myopia go to the clinic of children's oblique amblyopia specialty. At that time, I made an appointment with an expert. After examination, I knew that the child had myopia and needed frame glasses. I asked if I could go without glasses? Experts say: No, and there is no other viable alternative. At that time, I thought that our Tongren Hospital was the best ophthalmic hospital in the country. Why didn't there be a department dedicated to seeing myopia for children and adolescents? And got myopia can only wear frame glasses, is there no other way? After asking around, I learned from a friend that there is a myopia massage organization nearby, which can reduce the degree of myopia. I used to massage my children three times a week. Check your eyesight on the visual acuity chart before massage and recheck after massage. Your eyesight can be improved by two lines. However, one semester later, when he returned to Tongren Hospital for re examination, the child's myopia increased by more than 100 degrees. After consulting the experts of my colleagues in detail, I learned that once the child has myopia, there is no way to reduce the degree. I can only take corrective measures to slow down the development of myopia. If I don't wear glasses, it will grow faster. At that time, I thought, why didn't the experts give me a detailed explanation at the first clinic? Later, I figured it out myself. Because too many people come to Tongren Hospital to see a doctor. Doctors generally only say diagnosis conclusions and treatment opinions, and there is no time to explain. If there were a doctor who specializes in myopia to talk more, I might have matched my children with frame glasses earlier. Therefore, as a parent, I have been looking forward to medical institutions in the society to specially carry out the prevention and control of myopia among children and adolescents, so that the myopia of children and adolescents can be timely and effectively prevented and controlled, and the anxiety and troubles of parents can be alleviated. Q2: what is the original intention of Beijing Ming optometry in the prevention and control of myopia in children and adolescents? Yu Hong: we have two wishes. The first wish is that at the beginning of the founding of Mingshi Ophthalmology, myopia surgery is the main direction. The next year, the prevention and control of myopia in children and adolescents can be started. At that time, I thought that there was a lack of professional doctors in public hospitals to engage in the field of juvenile myopia, so Mingshi Ophthalmology, as a social medical institution, should make up for the short board of medical supply. The second wish, based on the principle of "giving back to the society", we decided to "replenish blood" from the surplus of myopia surgery to the prevention and control of myopia in children and adolescents, so that more children without myopia can stay away from myopia, children with myopia develop more slowly, and children with low myopia do not develop into high myopia. In order to alleviate the anxiety of parents, Contribute to improving the physical quality of children and adolescents. Q3: in recent years, what has Beijing Ming optometry Department done in the prevention and control of juvenile myopia? Yu Hong: in order to further alleviate the general acceleration of the occurrence and development of myopia in children and adolescents, Mingshi ophthalmology relies on the team of ophthalmologists to carry out relevant work. In 2021, we opened an eye clinic in Shunyi District, which will be opened in more areas in the future. At the same time, we will continue to strengthen our efforts in myopia prevention and control. For example, we launched the first action to popularize youth eye health knowledge, compiled and printed the treasure book of myopia prevention and control for primary school students, made full use of major platforms for live broadcasting and video broadcasting, and committed to improving parents' and students' myopia prevention and control knowledge literacy. According to the requirements of national departments, we establish vision health files for children and adolescents, timely monitor their vision health status according to various data changes, and take corresponding effective measures to reduce myopia among people without myopia and curb the improvement of the degree of myopia among people. Ming optoophthalmology takes the medical standard of myopia surgery for myopia prevention and control, which makes the eye examination of children and adolescents more accurate and the data collection more complete. In the future, Mingshi ophthalmology will continue to practice its responsibility to repay the society, fully reflect the public welfare nature of medical institutions, benefit more children and adolescents with our technology and services, and truly implement the mission of "making Chinese people no longer worry about myopia". Q4: what role do ophthalmologists play in the prevention and control of myopia in children and adolescents? Under the current social situation, in order to do a good job in the prevention and control of myopia among children and adolescents, what problems will major medical institutions face to be solved urgently? Yu Hong: myopia has its own development characteristics and laws. Many ophthalmologists do not have a deep understanding of myopia and lack professional knowledge and experience in myopia prevention and control. There are only a few ophthalmologists specialized in myopia in public hospitals. At first, our myopia prevention and control doctors were mainly hired, and the visiting time was not fixed, which made it inconvenient for children and adolescents to see doctors. In this context, we have repeatedly decided to equip ourselves with professional myopia doctors and set up a team of juvenile myopia prevention and control experts led by Professor Zhou Yuehua, former director of the ophthalmic optometry center of Beijing Tongren Hospital. As people's needs become more and more personalized, in the future, ophthalmologists will differentiate into doctors specializing in the prevention and control of myopia in children and adolescents. The development and growth of this group is an important force to realize the long-term goal of myopia prevention and control of children and adolescents in China. Now let me answer the second question. According to my observation and thinking over the years, I think the following points need to be solved urgently. First, in the past, public hospitals generally had two defects in the prevention and control of myopia among children and adolescents: on the one hand, hospitals did not pay enough attention to the prevention and control of myopia among children and adolescents, and the medical resources provided for the prevention and control of myopia among children and adolescents were insufficient for a long time; On the other hand, most ophthalmologists in the hospital also believe that the technical content of myopia prevention and control is not high, and they are more willing to challenge technically difficult diseases such as glaucoma and fundus diseases, resulting in fewer doctors willing to engage in myopia prevention and control of children and adolescents. It is hoped that relevant departments can give policy preference to the field of prevention and control of children and adolescents. Public hospitals generally set up specialized clinics for prevention and control of myopia among children and adolescents, and enrich young doctors who are willing to prevent and control myopia into the medical team for prevention and control of myopia. Second, at present, the treatment time of children and adolescents with myopia is basically on weekends and holidays, and the number of public hospitals on weekends and holidays is small. On the one hand, there is huge market demand and on the other hand, there is limited outpatient time. It is hoped that more public hospitals will open children and adolescents' myopia clinics on weekends and holidays in the future. Third, from the perspective of industry characteristics, doctors engaged in myopia prevention and control not only do not have normal weekends and holidays to rest for their cherished career, but also actively give up the time they should rest and cannot reunite with their relatives and friends. Here, I call on government departments and medical institutions to give more care and encouragement to doctors engaged in the prevention and control of myopia among children and adolescents. Fourth, to carry out the prevention and control of myopia among children and adolescents, the hardware of the health room configured by the school is difficult to meet the needs. Therefore, the competent authorities have assigned more inspection and diagnosis tasks for the prevention and control of myopia among children and adolescents to public hospitals. But the reality is that in addition to the shortage of doctors for myopia prevention and control, public hospitals have small venues and few equipment. At this stage, they can not meet the needs of receiving a large number of children and adolescents for centralized examination. In short, in the face of the current situation, the task of myopia prevention and control for children and adolescents is very heavy. I hope the relevant government departments can increase the organization and coordination of public hospitals, increase the number of doctors for myopia prevention and control, increase the number of juvenile myopia prevention and control clinics, and increase the venues and equipment; At the same time, the prevention and control of juvenile myopia will be included in the basic medical security, so that more children from ordinary families can also enjoy the benefits of myopia prevention and control technology; In addition, it is suggested to coordinate social medical institutions to undertake the task of myopia prevention and control of children and adolescents, so as to give full play to the beneficial and complementary role of social medical institutions, so as to effectively implement the national strategy for myopia prevention and control of children and adolescents. Q5: from the perspective of family, what do you think is the focus of family children and adolescents' myopia prevention and control? Yu Hong: I think parents' understanding of myopia prevention and control knowledge is the key to the prevention and control of myopia in children and adolescents. Parents not only need to understand the basic principles of the occurrence and development of myopia, but also know which living habits are harmful to the eyes, but also know the examination time of their children. Parents accompany their children to professional institutions for regular inspection, which can not only detect myopia as soon as possible, but also monitor the development and prevention and control effect of myopia, and take effective corrective measures in time to slow down the development of myopia. In today's "multi screen" era, a fait accompli is that not only a large number of children and adolescents suffer from myopia, but also many middle-aged people are increasing their myopia. The reason is that electronic screens such as mobile phones and e-books have become the culprit leading to the early occurrence and deepening of myopia. Therefore, parents should set an example for their children and strictly control the length of time they use the electronic screen. Q6: what role does myopia prevention and control technology play in the field of myopia prevention and control of children and adolescents? From the point of view of normal lens and contact lens frame, it can prevent and control myopia. With the popularization and application of corneal shaping lens (OK lens) technology in recent years, it is confirmed that corneal shaping technology is a relatively more effective advanced technology in the prevention and control of myopia in children and adolescents. However, this technology includes outpatient examination, customized lenses and daily care solution. The cost of one year is 10000 ~ 15000, which is difficult for ordinary families to bear. It is hoped that the government can gradually bring the prevention and control of myopia among children and adolescents into the scope of medical insurance, conduct centralized bidding and procurement of peripheral defocus glasses and plastic lenses, reduce the product price, and encourage the R & D, promotion and application of domestic corneal plastic lenses, so that this technology can benefit more children and adolescents. Myopia prevention and control technologies emerge in endlessly, but there are few technologies that are clinically effective and have little long-term side effects. It is hoped that relevant government departments will strictly regulate the trial and use of new myopia prevention and control technologies emerging in the society, so as to prevent some institutions from taking advantage of the huge market of juvenile myopia prevention and control

Edit:Li Ling    Responsible editor:Chen Jie

Source:Outlook New Era

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