BEIJING, March 8 (Xinhuanet) -- What progress has the mainland made in strengthening eye health management and service capabilities, and what are the "blind spots"?
During the two sessions of the National People's Congress this year, Professor Wang Ningli, member of the National Committee of the Chinese People's Political Consultative Conference and head of the National Anti-Blindness Technical Guidance Group, focused on the two major contents of "the construction of the eye health management system in rural areas" and "enhancing the important position of the family in the prevention and control of myopia in children and adolescents", he pointed out that in rural areas where eye health resources are relatively scarce, the three-level management system of eye health is very weak, resulting in many small diseases of the rural population dragging into major diseases, missing the window of eye disease treatment, resulting in irreparable losses; and the vision health of children and adolescents is related to a lifetime. The role of the family and parents in the prevention and control of children's myopia is more important, which determines whether the future prevention and control of myopia can achieve final victory.
Professor Wang Ningli, member of the National Committee of the Chinese People's Political Consultative Conference and head of the National Anti-Blindness Technical Guidance Group
Eye diseases are difficult to "detect early", and the ability of grass-roots eye health services needs to be improved
Eye health is an important part of national health, involving all ages throughout their lives. The Party Central Committee and the State Council attach great importance to eye health. In recent years, the state has successively introduced relevant plans and policies for the prevention and treatment of blindness and eye health, continued to improve the eye health management system, technical guidance system and medical service system, the rapid development of ophthalmic medical and health undertakings, and the continuous improvement of ophthalmic service capabilities. By the end of the 13th Five-Year Plan, the age-scaled prevalence of continental blindness was lower than the global average. The World Health Organization officially certified that the mainland has eliminated the public health problem of blinding trachoma.
Wang Ningli said that it should be noted that the mainland is still one of the countries with the largest number of blind and visually impaired patients in the world. The main blinding eye diseases in mainland China have changed from infectious eye diseases to eye diseases dominated by cataracts, myopic retinopathy, glaucoma, corneal disease, and diabetic retinopathy. The problem of the relatively insufficient total amount and uneven distribution of high-quality ophthalmic medical resources in the mainland still exists, and the capacity of grass-roots eye health services still needs to be strengthened. At present, at the village level, the village clinic generally lacks the basic examination equipment for eye health, and the village medical team generally lacks basic training related to eye health, making it difficult to timely discover and put forward opinions on the villagers' eye disease risk; at the township level, the group screening capacity of township health centers for eye health diseases is also generally insufficient; at the county level, the independent standard setting of ophthalmology and the level of diagnosis and treatment ability of county hospitals also need to be improved.
The "14th Five-Year Plan" National Eye Health Plan (2021-2025) proposes to "gradually establish and improve the national-regional-provincial-municipal-county five-level ophthalmic medical service system." Encourage qualified county-level general hospitals to independently set up ophthalmology departments and provide outpatient services." However, no clear opinions and requirements were put forward for the construction and capacity improvement of the rural "township-village" eye health management system.
To this end, Wang Ningli suggested that under the leadership of the National Health Commission, led by the National Anti-Blindness Technical Guidance Group, study and formulate the "Implementation Plan and Action Plan for Establishing and Improving the Eye Health Management System in Rural Areas", clearly refine the functional positioning and division of responsibilities of the three-level structure of eye health management in rural areas, service lists and performance appraisals, software and hardware construction standards, medical personnel training requirements, and the construction of telemedicine and referral collaboration mechanisms, etc., and effectively sink eye health management resources to the rural grassroots. Improve the eye health management capacity and eye health level of the rural population in rural areas, and implement and help the implementation of the "14th Five-Year Plan" national eye health plan.
Myopia prevention and control family is the home, do not let the child become "otaku, otaku" too early
In recent years, the mainland has implemented a strong "double reduction" policy, built a mainland children's and adolescents' eye health screening prevention and control network, actively increased the outdoor activity time of children and adolescents, and actively carried out eye health science education activities, and the myopia rate of children and adolescents has been effectively curbed.
Wang Ningli said that the effective measures carried out by the government and social forces are mainly implemented in schools, but the overall time of children and adolescents aged 0-18 accounts for only about 20% of the total time in school, and the remaining 80% or so is spent in the family.
He suggested upgrading the "family" to the main battlefield for myopia prevention and control. By strengthening social publicity, including family responsibility and intervention guidance in the prevention and control of myopia in children and adolescents into parent meeting questions and homework during winter and summer vacations, parents fully realize the importance of myopia prevention and control and put it into action.
Specific interventions include the following:
1. Actively detect the reserve of farsightedness in preschool children aged 0-6 years. The focus of myopia prevention and control in preschool children is to prevent the premature and rapid consumption of farsighted reserves, which is the basic work to prevent the occurrence of myopia.
Second, children under 12 years of age, it is recommended to use the holiday atropine eye drops mydriatic refraction, this drug paralyzes the intraocular muscles sufficiently, will get accurate refraction, but the disadvantage is that the muscle paralysis time and mydriasis time will be maintained for about 21 days; children over 12 years old, can use other drugs for mydriatic refraction, the time is about 6 hours, but its paralysis effect is weaker, and the refraction accuracy is also weaker.
Second, create a good myopia prevention and control environment for children. It is recommended that children under 6 years of age avoid using electronic products as much as possible, resolutely put an end to the phenomenon of using electronic products as "nannies", and reduce children's excessive eye time at close range. Parents keep in mind the "20-20-20" principle, that is, after watching the electronic screen for 20 minutes, look up at the distance of 20 feet (6 meters) for more than 20 seconds. Many children's play facilities and sports venues are set up in the mall, the indoor environment blocks the natural light, easy to lead to premature myopia, it is recommended to let children more outdoor activities.
Third, cultivate children's active and healthy lifestyle. A large number of outdoor exercise is the best medicine to protect children's eyes, to avoid children becoming "otaku, otaku" prematurely, not only can prevent and control myopia, but also conducive to the healthy development of children's whole body. A large intake of sweets will accelerate the growth of the eye axis and accelerate the progression of myopia. In the diet, we should pay attention to nutritional collocation, reduce sugar intake, and eat more green leafy vegetables rich in dietary fiber, as well as carrots and other foods rich in lutein. Recent studies have shown that children who sleep more than 9 hours a day have a 41% lower risk of myopia than children who sleep 5 hours a day. Regular and adequate daily sleep can ensure the circadian rhythm of the child's body, maintain the stability of hormone secretion in the body, and slow down the rapid growth of the eye axis.
Wang Ningli reminded that when choosing children's myopia prevention and control products, you must follow the advice of regular hospital doctors, and do not listen to Internet rumors and secret recipes. Use products certified by the national quality inspection department and avoid using products that exaggerate the therapeutic effect.