青少年近视高发，如何踩住“刹车”建立科学用眼习惯

Juvenile myopia is high, how to step on the "brake" to establish scientific eye habits

2023年春季学期刚开学不久，成都市民张女士趁着一个周末的时间，带着儿子到一家眼科医院检查视力。结果让张女士难过了好半天：才上二年级的儿子近视了，一只眼睛50度，两只眼睛都出现了散光。

Shortly after the beginning of the spring semester of 2023, Ms. Zhang, a citizen of Chengdu, took advantage of a weekend to take her son to an eye hospital to check his eyesight. As a result, Ms. Zhang was sad for a long time: her son, who was only in the second grade, was nearsighted, with one eye at 50 degrees and astigmatism in both eyes.

上一次检查是在2022年的5月。当时医生就发出了预警，孩子的远视储备值已经不多了。医生提醒她，一定要让孩子养成良好的用眼习惯，多带孩子到户外活动，并且半年检查一次视力。不过，原计划的检查一再推迟，直到今年3月。

The last inspection was in May 2022. At that time, the doctor issued a warning that the child's hyperopia reserve value was running out. The doctor reminded her that she must let the child develop good eye habits, take the child to outdoor activities, and check her eyesight every six months. However, the planned inspection was repeatedly postponed until March this year.

这次去医院之前，张女士内心就有点忐忑了。“过去近一年时间，由于担心疫情传染的风险，孩子的户外活动并不多，而读书、写作业等室内用眼场景则一点没少。”张女士说。

Before going to the hospital this time, ms Zhang felt a little uneasy. "In the past year or so, due to concerns about the risk of epidemic infection, children did not have much outdoor activities, while indoor eye scenes such as reading and homework were not less." Ms. Zhang said.

如今，青少年近视问题已经成为社会各界关心的热点与痛点。2018年印发的《综合防控儿童青少年近视实施方案》提出的目标是，到2023年，力争实现全国儿童青少年总体近视率在2018年的基础上每年降低0.5个百分点以上。而国家卫健委的公开数据显示，2018至2021年，我国儿童青少年总体近视率分别为53.6%，50.2%、52.7％、52.6%。

Nowadays, the problem of juvenile myopia has become a hot and painful point of concern from all walks of life. The "Implementation Plan for Comprehensive Prevention and Control of Myopia in Children and Adolescents" issued in 2018 aims to reduce the overall myopia rate of children and adolescents by more than 0.5 percentage points per year on the basis of 2018 by 2023. According to the public data of the National Health Commission, from 2018 to 2021, the overall myopia rate of children and adolescents in China was 53.6%,50.2%, 52.7% and 52.6% respectively.

不久前，教育部印发了《2023年全国综合防控儿童青少年近视重点工作计划》明确提出，要将儿童青少年近视防控工作、总体近视率和体质健康状况纳入政府绩效考核。并对儿童青少年体质健康水平连续3年下降的地方人民政府和学校依法依规予以问责。

Not long ago, the Ministry of Education issued the "2023 National Key Work Plan for Comprehensive Prevention and Control of Myopia in Children and Adolescents" clearly stated that the prevention and control of myopia in children and adolescents, the overall myopia rate and physical health status should be included in the government performance evaluation. And the local people's governments and schools that have declined in the physical health of children and adolescents for three consecutive years shall be held accountable in accordance with laws and regulations.

那么，作为学校和社会力量，应当如何共同努力保护好青少年的眼睛？作为家长和孩子，应当如何建立科学的用眼习惯和教育理念？降低青少年近视率，需要社会各界共同努力。

So, as schools and social forces, how should we work together to protect the eyes of young people? As parents and children, how should we establish scientific eye habits and educational concepts? Reducing the myopia rate of young people requires the joint efforts of all sectors of society.

诸多努力，挡不住近视的到来

Many efforts cannot stop the arrival of myopia.

张女士知道，照孩子的用眼强度和学习习惯，孩子近视是早晚的事。但她试图尽可能延缓近视的到来，为此作了诸多努力。

Ms. Zhang knows that according to the child's eye intensity and study habits, myopia is a matter of time. But she tried to delay the onset of myopia as much as possible, and made many efforts to do so.

孩子一年级的时候，她就买了坐姿矫正器，以阻止孩子过于靠近书本。她按照钢琴老师的推荐专门买了钢琴灯，给孩子练琴时用。今年1月，她又花了2000多元买了一盏台灯，给孩子读书和做作业的时候用。

When the child was in first grade, she bought sitting orthotics to stop the child from getting too close to the book. She bought a piano lamp according to the piano teacher's recommendation for her children to use when practicing piano. In January this year, she spent more than 2000 yuan to buy a desk lamp for her children to use when reading and doing homework.

张女士的丈夫则认为，睡眠和户外运动对视力有影响，因此晚上总是催着孩子早点洗漱睡觉，放学后常常带孩子从附近的公园绕路回家，就为了让孩子多看绿色。听说吃鱼虾对视力好，他还时不时地买鱼虾烧给孩子吃。

Ms. Zhang's husband believes that sleep and outdoor sports have an impact on vision, so he always urges his children to wash and go to bed early at night. After school, he often takes his children home from a nearby park in order to let them see more green. Heard that eating fish and shrimp has good vision, he also buys fish and shrimp to cook for children from time to time.

“但这些还是没能阻止近视的到来。”检查出近视的那天，张女士心情沮丧。丈夫尽管装出一副若无其事的样子，但他心里也清楚，情况不妙，他对儿子说“你当不成宇航员了”，以此警告孩子注意坐姿、保护视力。

"But these still failed to stop the arrival of myopia." On the day of checking out myopia, Ms. Zhang was depressed. Although the husband pretended to be as if nothing had happened, he knew in his heart that the situation was not good. He said to his son, "You will not be an astronaut" to warn the child to pay attention to sitting posture and protect his eyesight.

这并不是个例，在北京同仁医院，每逢周末，前来看诊的青少年数量总会增多一些。

This is not an example. In Beijing Tongren Hospital, the number of teenagers who come to see a doctor will always increase every weekend.

如今四年级的丫丫是在一年级下学期上网课时发现自己近视的。丫丫妈妈说：“一年级的时候只有100多度，每年来同仁医院复查，今年已经达到了400多度。一年级时，全班只有两三个同学戴眼镜，但现在，在同班58名同学中，有20多名同学戴上了眼镜”。

Now the fourth grade Ya Ya found herself nearsighted in the next semester of the first grade online class. Ya Ya mother said: "the first grade when only more than 100 degrees, every year to Tongren Hospital review, this year has reached more than 400 degrees. First grade, the class only two or three students wear glasses, but now, in the class of 58 students, more than 20 students wear glasses".

学校组织学生做眼保健操防控近视，但丫丫说，她们的班级里，“班主任就不让做眼保健操”。每到眼保健操时间，班主任便让同学们做题，“老师说做眼保健操没用。”丫丫说。

The school organizes students to do eye exercises to prevent and control myopia, but Yaya said that in their class, "the head teacher is not allowed to do eye exercises". Every time it is time for eye exercises, the head teacher asks the students to do the questions, "the teacher said it is useless to do eye exercises." Ya ya said.

周末的同仁医院也迎来了不少外地家长。来自河北某县城的张英领着她的女儿配眼镜。张英的女儿正上二年级，她说，周围的同学们仍然很少有户外运动的机会。“每天有体育课，但一到上课，老师就给我们放动画片。看动画片是老师给纪律好的同学的奖励，如果同学们表现不好，老师就让我们学习。”一次，张英女儿所在的班级因为看动画片声音太大，被巡视的校领导批评，那一周的体育课，便都变成了数学课和语文课。

Tongren Hospital also welcomed many foreign parents at the weekend. Zhang Ying from a county town in Hebei led her daughter with glasses. Zhang Ying's daughter is in the second grade. She said that the surrounding classmates still have few opportunities for outdoor sports. "There are physical education classes every day, but as soon as we get to class, the teacher will show us cartoons. Watching cartoons is a reward from the teacher to the well-disciplined students. If the students do not perform well, the teacher will let us learn." Once, Zhang Ying's daughter's class was criticized by the visiting school leaders for watching cartoons. That week's physical education class became math class and Chinese class.

不少配镜机构也观察到了青少年近视的来势汹汹。

Many institutions have also observed the menacing of juvenile myopia.

周末，北京潘家园眼镜城的顾客中多了不少孩子的身影。青少年近视数量的增加，被眼镜店老板们看在眼里。“比起疫情以前，过来的孩子数量确实变多了。”某眼镜店老板陈先生坦言，“但具体多了多少不知道，也许有三成。”

Over the weekend, many more children were among the customers of Beijing's Panjiayuan Glasses City. The increase in the number of young people's myopia has been seen by the owners of optician shops. "Compared with before the epidemic, the number of children coming has indeed increased." Mr. Chen, the owner of an optical shop, said frankly, "but I don't know how much more, maybe 30%."

面对家长们对孩子近视度数增长的焦虑，陈先生拿出镜片价格表，翻开“防蓝光镜片”一栏，熟练地开始介绍：“孩子初中毕业时，所在的班里戴眼镜的同学数量已上升到九成。如果戴这个镜片，可能每年增长25度左右。但如果不戴，那每年增长100度都不算少……”

In the face of parents' anxiety about the growth of their children's myopia, Mr. Chen took out the lens price list, opened the "anti-blue lens" column, and skillfully began to introduce: "When the child graduated from junior high school, the number of students wearing glasses in the class has risen to 90%. If you wear this lens, it may increase by about 25 degrees per year. But if you don't wear it, it's not less than 100 degrees per year......"

“疫情管控放开之后，到我们配镜中心配镜的孩子明显增多了，自疫情以来中心配镜都是预约制的，今年以来每个周末都络绎不绝。”赵大夫所在的配镜中心在北京市海淀区知春里附近，记者观察发现，配镜中心方圆500米内就有多所中小学。“可能我们这个地方比较‘卷’吧，来我们这里配眼镜的孩子一直不少。”赵大夫说。

"After the release of epidemic control, there has been a marked increase in the number of children who have come to our mirror center to match glasses. Since the epidemic, the center's glasses have been on an appointment system, and every weekend this year has been an endless stream." The glasses center where Dr. Zhao is located is near Zhichunli, Haidian District, Beijing. The reporter observed that there are many primary and secondary schools within 500 meters of the glasses center. "Maybe our place is lise' curled'. There are always many children who come here to match glasses." Dr. Zhao said.

近视来势汹汹，家长如何踩住刹车

Myopia is menacing, how do parents step on the brake

在浙江大学附属第二医院眼科中心（浙江大学眼科医院），视光中心主任倪海龙门诊每天需要接诊60多个病例。他表示，“如果是寒暑假，还要再增加一些号，可能会每天八九十个。”

In the Eye Center of the Second Affiliated Hospital of Zhejiang University (Zhejiang University Eye Hospital), Ni Hailong, director of the Optometry Center, needs to receive more than 60 cases every day. He said, "If it is winter and summer vacation, there will be more numbers, maybe 80 or 90 a day."

近年来，青少年近视率为何居高不下？

In recent years, why is the youth myopia rate high?

倪海龙认为，近视低龄化、重度化严重，主要是环境因素导致的，两大主要原因包括：一是户外活动时间严重不足；二是长时间近距离用眼负担过度过早，这其中主要是学业负担过重，也同时包含过多过早接触使用各类电子产品等。

Ni Hailong believes that the younger age and severity of myopia are mainly caused by environmental factors. The two main reasons include: one is the serious shortage of outdoor activities; the other is the excessive and premature use of eyes for a long time. The burden is too heavy, and it also includes too much premature exposure to various electronic products.

而在温州医科大学眼视光医学部主任、教育部近视综合防控专家宣讲团团长瞿佳看来，从总体上说，我国近视防控的确取得了标志性的进展。“最重要的就是我们的近视率下降了，从2018年的53.6%到2021年的52.6%，下降了一个百分点。”“其实，这几年的疫情极大干扰了近视防控工作的正常进行。”瞿佳告诉中青报·中青网记者，孩子们宅在家里上网课，活动少了，走到户外也少了，电子产品的使用却更多了，而家长对孩子近视管控的力度也不如学校。

According to Qu Jia, director of the Department of Ophthalmology and Optometry of Wenzhou Medical University and head of the expert propaganda group for comprehensive prevention and control of myopia of the Ministry of Education, on the whole, my country's myopia prevention and control has indeed made landmark progress. "The most important thing is that our myopia rate has dropped, from 53.6 percent in 2018 to 52.6 percent in 2021, a drop of one percentage point." "In fact, the epidemic in recent years has greatly interfered with the normal progress of myopia prevention and control." Qu Jia told the reporter of China Youth Daily and China Youth Network that children stay at home to take online classes, have less activities, go outdoors less, use more electronic products, and parents do not control their children's myopia as well as schools.

“从专业的角度讲，如果不是从2018年开始有效地进行近视防控，现在近视率上升三个点、五个点都有可能。所以，近视防控总体向好的基本面没有变，取得了很好的效果。”瞿佳说。

"From a professional point of view, if it were not for effective myopia prevention and control from 2018, it would now be possible for the myopia rate to rise by three or five points. Therefore, the overall positive fundamentals of myopia prevention and control have not changed, and good results have been achieved." Qu Jia said.

家庭是青少年近视的第一道防线，不少专家表示，家长们在看待青少年近视问题上仍存在一些误区和偏见。

Family is the first line of defense for adolescent myopia. Many experts say that parents still have some misunderstandings and prejudices in looking at adolescent myopia.

“有人曾经这样问家长，孩子考上名校和800度近视，你愿意选哪个？很多家长宁愿选‘名校’。这是糊涂的观念！”瞿佳说。

"Someone once asked parents like this, which one would you like to choose when your child is admitted to a prestigious school or 800 degrees of myopia? Many parents prefer to choose a 'prestigious school'. This is a confused idea!" Qu Jia said.

瞿佳表示，当前家长在认识上最大的一个误区就是“近视不过就是戴一副眼镜”。事实上，近视防控关系到一个国家和民族的未来，是健康中国的重要的部分，如果青少年近视发生得早、进展快，那么未来发展成高度近视的比例就高，而高度近视会引起许多严重的眼部并发症，造成视力低下甚至致盲。瞿佳认为，家长的另一个误区就是科普未到位，现在有一些以牟利为目的的产品，安全性和有效性存在问题，家长却盲目相信他们的宣传。

Qu Jia said that one of the biggest misunderstandings among parents at present is that "myopia is just wearing a pair of glasses". In fact, the prevention and control of myopia is related to the future of a country and nation, and is an important part of a healthy China. If juvenile myopia occurs early and progresses quickly, the proportion of high myopia will be high in the future, and high myopia will cause many serious eye complications, resulting in low vision and even blindness. Qu Jia believes that another misunderstanding of parents is that popular science is not in place. Now there are some profit-making products that have problems with safety and effectiveness, but parents blindly believe in their propaganda.

倪海龙也发出了同样的呼吁。他发现，长期以来，社会对儿童青少年近视普遍存在“重治轻防”的错误观念，防控近视伪科学及不良机构层出不穷。很多家长视近视为洪水猛兽，病急乱投医，与旁门左道为友。而一些家长对近视视而不见，觉得无非戴副眼镜而已，听之任之。

Ni Hailong made the same appeal. He found that for a long time, there has been a common misconception of "emphasizing treatment and neglecting prevention" in children and adolescents with myopia, and pseudoscience and bad institutions for the prevention and control of myopia have emerged one after another. Many parents regard myopia as a scourge, and they seek medical treatment in a hurry, making friends with others. However, some parents turn a blind eye to myopia and feel that they are nothing more than wearing a pair of glasses and letting it go.

“最常见的几大认识误区是：散瞳验光有伤害、近视戴眼镜越戴近视越深、近视手术能治愈近视。”倪海龙说。

"The most common misunderstandings are: mydriasis optometry is harmful, myopia is deeper and deeper when wearing glasses, and myopia surgery can cure myopia." Ni Hailong said.

倪海龙表示，家庭是综合防控儿童青少年近视的重要力量，家长是儿童青少年视力健康的守护者。家长要主动了解科学用眼护眼知识，不轻信“近视可治愈”“降低度数”“治眼神器”等虚假宣传；要以身作则，带头不做“低头族”，增加亲子时间；要营造良好的家庭体育运动氛围，保证孩子每天至少2小时日间户外活动；要积极配合学校减轻孩子作业负担和校外培训负担，不盲目参加课外培训、跟风报班；要密切关注孩子视力变化和眼睛异常迹象，定期检查视力，做到早发现、早干预、早矫治。

Ni Hailong said that the family is an important force in the comprehensive prevention and control of myopia in children and adolescents, and parents are the guardians of children and adolescents' vision health. Parents should take the initiative to understand the knowledge of scientific eye protection, and do not believe in false propaganda such as "myopia can be cured", "degree reduction" and "eye treatment artifact". To set an example, take the lead not to "bow the head", increase parent-child time; To create a good family sports atmosphere, to ensure that children at least 2 hours a day outdoor activities; To actively cooperate with the school to reduce the burden of children's homework and off-campus training, do not blindly participate in extracurricular training and follow the trend to report to the class; pay close attention to children's vision changes and abnormal signs of eyes, check their eyesight regularly, and achieve early detection, early intervention, and early correction.

防治青少年近视，还需多方合力

Prevention and treatment of juvenile myopia, but also need to work together

作为家长，来自北京的王先生在发现自己上高一的女儿近视后，已经尽可能地提醒女儿改善用眼习惯，防止近视进一步加深。

As a parent, Mr. Wang from Beijing has tried his best to remind his daughter to improve her eye habits and prevent her myopia from further deepening.

“我们已多次提醒她注意保护眼睛，对她的电子设备使用时间严格把控，避免屏幕过小用眼疲劳。孩子自己也清楚不应该长时间用眼或长时间使用电子设备、日常要做眼保健操、要注意用眼距离等。”王先生表示，然而，女儿并不愿意因为保护眼睛而影响社会交往、课业任务，很多用眼过度的场景都是“无法避免”。

"We have repeatedly reminded her to protect her eyes and strictly control the time she uses her electronic devices to avoid eye fatigue when the screen is too small. The child himself knows that he should not use his eyes for a long time or use electronic devices for a long time, do eye exercises on a daily basis, and pay attention to the distance between his eyes." However, his daughter is not willing to affect social interaction and schoolwork tasks because of eye protection, and many scenes of excessive eye use are "unavoidable", Mr. Wang said ".

“她的同学和我周围朋友的孩子有很多都戴眼镜，她出去和朋友玩的照片中不戴眼镜的很少。孩子说班上近视率在60%以上。”王先生说。

"Many of her classmates and the children of my friends around me wear glasses, and very few of the photos of her going out to play with her friends do not wear glasses. The child said that the myopia rate in the class is over 60%." Mr. Wang said.

的确，在防治青少年近视这条道路上，仅靠家长的努力和孩子的自觉是不够的，不少专业人士认为，青少年近视防控工作还需多方合力，形成护眼爱眼的社会风气。

Indeed, on the road of prevention and treatment of juvenile myopia, it is not enough to rely on the efforts of parents and the consciousness of children. Many professionals believe that the prevention and control of juvenile myopia still needs to work together to form a social atmosphere of eye protection and eye love.

“学校是防控近视的主战场。”倪海龙表示，学校要真正抓落实，切实保障到每一个孩子的学业负担减负和户外活动时间的增加。“比如，要让每一个课间成为真正的课间，在校期间每个课间，都要让每个孩子都能离开教室，去走廊、操场上走走，沐浴阳光、眺望远方。如果保障每天的一堂体育课、大课间，加上每天七八堂课的每个课间10分钟都能离开教室的话，是能保障孩子们每天两小时的户外活动时间的。”

"Schools are the main battleground for the prevention and control of myopia." Ni Hailong said that the school should really pay attention to the implementation, and effectively ensure that every child's academic burden is reduced and the time for outdoor activities is increased. "For example, to make every recess a real recess, every recess during school, every child should be able to leave the classroom, go to the corridors and playground for a walk, bathe in the sun and look out into the distance. If you guarantee a physical education class every day, a big recess, plus a 10-minute break for each of seven or eight classes every day, you can guarantee two hours of outdoor activity every day."

四川省成都市迎宾路小学校长陈雪表示，在学校层面，要做到强眼先强体，科学保障学生户外运动的时间；强化科学的读写姿势，让学生能够自发地纠正读写姿势；每一位老师都肩负起提醒教育的责任。

Chen Xue, principal of Yingbin Road Primary School in Chengdu City, Sichuan Province, said that at the school level, it is necessary to strengthen the eyes first and strengthen the body, scientifically guarantee the time of students' outdoor sports; strengthen scientific reading and writing postures, so that students can spontaneously correct reading and writing postures; every teacher shoulders the responsibility of reminding education.

此外，针对一些特殊群体，陈雪建议，“小学生发育生长节点不同，可根据实际需求配置超高桌椅，以满足特高学生的书写需求。对于患有严重眼疾的学生要建立台账，在座椅设置等方面进行特殊关照。”

In addition, for some special groups, Chen Xue suggested, "Primary school students have different development and growth nodes, and ultra-high tables and chairs can be configured according to actual needs to meet the writing needs of extra-high students. For students with serious eye diseases, a ledger should be established and special care should be given in terms of seating settings."

“对于近视防控，要有打持久战的思想，要持之以恒，坚持一直进行防控必有成效。”瞿佳建议，国家应加大近视发生机制和有效防控方法的研究，可以设立近视研究的全国重点实验室等，加大对防控方法、器具和药品的研究和投入，研发出更加有效的近视防控方法、设备和药品。

"For the prevention and control of myopia, we must have the idea of fighting a protracted war, we must persevere, and persisting in prevention and control will be effective." Qu Jia suggested that the state should increase research on the occurrence mechanism of myopia and effective prevention and control methods, set up national key laboratories for myopia research, increase research and investment in prevention and control methods, appliances and drugs, and develop more effective methods, equipment and drugs for myopia prevention and control.

（应采访对象要求，文中家长、儿童、配镜机构人员为化名）（记者 叶雨婷 樊未晨 王鑫昕 实习生 白子义 王浩昆）

(At the request of the interviewees, parents, children and personnel of the mirror matching organization in the article are pseudonyms) (Reporter Ye Yuting, Fan Weichen, Wang Xinxin, intern Bai Ziyi, Wang Haokun)