During the epidemic, online classes at home have reduced children's outdoor sports, and the use of electronic products is frequent, and the risk of myopia development also increases.

On June 6th, World Eyes Day, the China Children’s Fund "Children’s Myopia Prevention and Control Project" launched a public welfare live class on the prevention and control of myopia for young people with the theme of "Vision 2020 Focusing on General Eye Health". 19: 00, the course was broadcast live on the TikTok account of UNICEF China.

This live broadcast invited Professor Song Hongxin, Executive Deputy Director of the Optometry Center of Beijing Tongren Hospital, and Professor Wang Kai, Chief Ophthalmologist of Beijing People's Hospital to visit the scene. Wang Tengyi, Executive Director of the Children’s Myopia Prevention and Control Project and National Senior Optometrist, served as the host of this live broadcast.

The live broadcast is divided into how to use the eyes hygienically, how to effectively control myopia after occurrence of myopia, and explain in detail the currently effective 3 kinds of treatment methods. There are 15 questions in three aspects, which are excerpted as follows.

1. Question: How to manage children's eyesight when taking online lessons at home?

Professor Song Hongxin: There are a few things to pay attention to when taking online classes at home. First of all, electronic products follow the principle of big and not small. If there is a projector, use the projector at a distance of 4-5 meters. If there is no projector, use a TV. The same distance is 4-5 meters. It’s okay to be farther away, and it’s not recommended to use a mobile phone or iPad to watch it up close.

2. Q: How long can parents use iPad or mobile phone for their children?

Professor Song Hongxin: Every 20 minutes, let the child look out the window for two minutes.

3. Question: What symptoms do children have and should be alert to the occurrence of myopia?

Professor Song Hongxin: Younger children lack expression skills, and parents need to observe their children's behavior. The most common are squinting, frowning, looking sideways or tilting your head. Parents find that their children have these manifestations, and it is recommended to take their children to a regular hospital or an eye and optic center for vision inspection.

4. Q: If parents are highly myopic, will their children be myopic?

Professor Song Hongxin: High myopia is indeed hereditary. If all parents have high myopia above 600 degrees, then the child's genetic probability is more than 40%. There are two decisive factors for the occurrence of myopia. The most important factor now is the environmental factor. For example, parents are highly myopic, but if the child plays outdoors every day, myopia may not occur. So at present, genetic factors are important, and environmental factors are more important.

5. Question: What is the normal vision of children aged 3-6?

Professor Wang Kai: 1.0 at the age of six, 0.8 at the age of five, 0.6 at the age of four, and 0.5 at the age of three. These are basically the lower limits of vision for children at these ages. There is an important reminder, if a 3-year-old child has reached 1.0 or even 1.2, his vision will decrease by the age of 5, so be vigilant.

There is also a concept of hyperopia reserve. Newborn children are hyperopic. Children aged 3-4 have a hyperopia reserve of about 150 degrees. By the age of 6-7, it is generally 100-125 degrees. If it can maintain a positive 25 degrees, that is an ideal state. However, many children at about 4 years old have no degree during refraction of ciliary muscle palsy. This situation should be paid attention to, indicating that the hyperopia reserve has disappeared. In the future, as the axis of the eye is elongated, it will definitely become myopia.

6. Question: Why does the child suddenly become nearsighted, and it is already 300 degrees after being detected?

Professor Wang Kai: In many cases, the physical examination or screening is not done in time, or the physical examination is not in place, or some parents are negligent. As a result, the frequency is relatively high when it is discovered. You must pay attention to the school physical examination, the data can only be used as a reference. For example, the child can't see clearly during the examination, and there is another child behind him giving instructions. We have all seen this situation.

7. Question: At what age do you start regular vision checks, and how often do you check?

Professor Wang Kai: Children over 3 years old can cooperate with the examination, so there is no problem starting the examination around 3 years old. If the parents have high myopia, or the child has bad eye habits, it is recommended to have a screening every six months. If it is not a high-risk group, it can be checked every year. Before the age of 3, you can observe the child's grasping and following objects for obvious abnormalities through behavioral studies, and also judge whether the child's vision has problems by looking at distant objects.

8. Q: Is mydriatic refraction harmful to children's eyes?

Prof. Song Hongxin: The scientific name of mydriatic optometry is cycloplegia optometry, and mydriasis is a side effect of cycloplegia. Mydriatic optometry is very important for judging whether a child is true myopia or false myopia. The condition of ciliary muscle spasm is scientifically called accommodative myopia, which is generally called pseudomyopia. If the child has pseudomyopia, it is equivalent to having glasses for a child without myopia, which will induce the occurrence of myopia. Parents don’t need to worry too much about the side effects. The main side effects are photophobia and inability to see near. Photophobia can be solved by wearing sunglasses. If you look close and cannot see clearly, stay away.

9. Q: What is the difference between rapid mydriatic optometry and slow mydriatic optometry? Which is more accurate?

Professor Song Hongxin: Slow mydriasis optometry, the medicine used is atropine at a concentration of 1%. This drug has a long action time. For hyperopic eyes, or younger children with strong accommodation ability, it is recommended to do slow mydriatic optometry. The data obtained is more accurate, especially for hyperopia eyes, which has a very strong accommodation ability and is better than Rapid mydriasis optometry.

However, slow mydriasis optometry has a drawback. The whole process needs to last two to three weeks. During this period, the pupils are in a state of dilation, and the pupils cannot be seen clearly. If the child is older or has myopia, you can do rapid mydriatic refraction.

10. Q: Are the long-term side effects of low-concentration atropine used? The doctor said it would take 2 years.

Professor Song Hongxin: First of all, anyone who says that myopia can be cured is definitely a lie. All we can do now is to slow down the development of myopia. There are currently three methods. The first is daytime outdoor sports, which is simple and does not cost money; the second is to wear OK lenses, which is an orthokeratology lens; and the third is 0.01 atropine, which is confirmed by scientific experiments. It has the effect of controlling the increase of myopia.

Atropine may also produce certain side effects. A common side effect is pupil dilation. Secondly, although the concentration is very low, it may also cause ciliary muscle paralysis and decrease the accommodation, including the possibility of dry eyes. However, the incidence of side effects is relatively low. You need to go to the hospital for an evaluation before use, and then do another evaluation after half a year. If there are no side effects, you can continue to use it.

Professor Wang Kai: But it doesn't mean that you can do well by wearing an OK mirror or using atropine, but you still want to exercise outdoors.

11. Question: My child went to the three hospitals to get an optometry after his pupils were dilated. The degrees are different. Why?

Professor Wang Kai: After my pupils were dilated, I went to three hospitals for examinations. The degrees were definitely different, and the efficacy of the medicine had passed. Usually there is not too much difference between hospitals, and you don't need to worry about the small difference of 25 degrees.

Professor Song Hongxin: If the difference is 100-200 degrees, it must be an optometry problem. If it is 25 degrees, the same optometrist may have a difference in the morning or evening.

12. Question: There is a saying that the power will increase very fast after mydriasis and refraction. Does this claim hold true?

Professor Song Hongxin: Mydriasis refraction will not lead to an increase in myopia. On the contrary, if the child is pseudomyopia, the myopia symptoms will disappear after mydriasis refraction.

13. Question: After my pupils are dilated, I do not wear sunglasses for my child, and continue outdoor sports and watching electronic products. Is it okay to do so?

Professor Song Hongxin: After the pupils are dilated, the pupils lose their ability to contract, and the light entering the fundus will be very strong, which will cause certain damage to the fundus. You don't need to wear sunglasses on cloudy days or in the evening, but you still need to wear sunglasses in sunny weather.

14. Q: Are children myopia all curvature myopia?

Professor Wang Kai: 95% of myopia in children is axial myopia. There is a length before and after the eyes, called the axis of the eye. After 3 years old, whether the child's cornea is flat or steep, there is not much change. Generally myopia is caused by the elongated eye axis, so it is called axial myopia. What is curvature myopia? For example, if the cornea is diseased, the pathological state is a keratoconus, because the cornea continues to expand and become steep, but the axis of the eye does not continue to elongate. This curvature type refractive myopia is called curvature myopia.

15. Question: What kind of situation is defined as curvature myopia?

Professor Wang Kai: Keratoconus is a disease of the cornea, which is characterized by continuous thinning and dilation of the cornea, with a significant increase in curvature. The incidence of young adults is higher, but the overall incidence is not high, and most children will not get such diseases.

Moderator: Thank you two experts for their answers, and we will hold a live broadcast in the future. Parents can add our customer service if they have any questions. We will take the question as feedback and answer it for everyone next time.