Wang Wenqi, an eye specialist from east China's Jiangsu Province, has noticed an alarming tendency. An increasing number of children have been developing nearsightedness, or myopia, at a younger age.

"Now, due to lifestyle changes, there is more strain on the eyes than before. It is common to see children using digital devices for long periods. In addition, if their daily diet does not provide a balanced combination of nutrients, it will have a detrimental effect on their eyesight," he told ChinAfrica. Wang is not the only one concerned about this problem. According to the National Health Commission, more than 450 million Chinese suffer from myopia. The problem is drawing mounting attention from the public, with the government devoting greater care to children's eye health.

Worrisome condition

"The prevention and control of myopia should be enhanced as a national strategy, with everyone urged to participate," said Wang Ningli, Director of the Ophthalmology Department at Tongren Hospital in Beijing. "The age for the onset of myopia in China is getting younger, with a high rate of prevalence. At the same time, the proportion of people with acute myopia is increasing."

Without effective policies, the number of those suffering from myopia will probably climb to 700 million and the number of high myopia patients will increase to 50 million by 2020, stated a report on the nation's vision health compiled by Peking University in 2015.

The increase in students' workload is one of the major reasons for deteriorating eyesight. According to a Ministry of Education (MOE) report, 14.7 percent of fourth-grade students and 19.2 percent of eighth-grade students spend over an hour every day, on average, doing math homework, while 43.8 percent of fourth graders and 23.4 percent of eighth graders take extracurricular math training.

An MOE official said that many problems were revealed during prevention, control and educational activities in recent years, including the lack of basic knowledge of vision health, defects in the medical service system and the immaturity of supervision in the optometric industry.

Appeal for attention

Chinese President Xi Jinping has highlighted the necessity to solve the problem of myopia, which he said is closely related to children's health and the development of the nation. He also pointed out that society as a whole should work hard together with relevant administrations to ensure a bright future for Chinese children.

In August 2018, with joint efforts from the MOE, the National Health Commission and six other ministries, a new plan was rolled out to curb the rise in myopia among children and teenagers. It was based on the findings from successful trials in more than 10 cities - including Wuhan of Hubei Province and Yangzhou of Jiangsu Province - and public opinion solicited online.

The plan calls on governments at various levels, schools, medical agencies, families and students to work together to tackle myopia among pre-school children. Based on the scheme, by 2023, the overall myopia rate for children and adolescents across the country should be reduced by more than 0.5 percentage points per year starting from 2018. For provinces with high incidences, myopia should be reduced by more than 1 percentage point per year.

By 2030, the percentage of children below 6 years with myopia should be capped below 3 percent; the rate for primary school students below 38 percent; that for junior middle school students to less than 60 percent; and that for senior middle school students to less than 70 percent.

The responsibilities of relevant administrations and the assessment system have all been clarified and myopia control will be used as a yardstick to evaluate local government and school performance starting this year. Results will be announced to the public and areas with worsening student eyesight for three consecutive years will be held accountable.

"The work of tackling myopia should focus on pre-school children," Wang Ningli said, echoing the emphasis of the plan.

The primary school stage is critical for visual development and parents should emphasize the protection of eyesight during this period. Moreover, the visual development of children between birth and 6 years should be tracked.

When asked about measures for prevention and control, Wang said, "We need to take a comprehensive approach because it cannot be curbed by a single solution." For instance, he suggested a reduction in the educational burden of students, which is vital to changing the current trend of myopia. He stressed that it can be achieved only with the joint efforts of different sectors.

Wang also recommended increasing time for outdoor activities. Children need to be exposed to natural light and see things moving and from far away after class. "The 10-minute break between classes should be made most of," he said.

The MOE promotes the combination of physical exercise and prevention and control of myopia, and has committed to bringing more sports to schools. In Jilin Province, 10 million yuan ($1.5 million) was invested in 2017 and 2018 to purchase ice and snow sports equipment for schools, which will continue in 2019.

Furthermore, the use of digital devices needs to be limited for students. There are nearly 200 million students in the basic stage of education in China, but a scientific regulation for the use of smartphones and tablets is still lacking.

Time to change

Currently, many schools have banned students from bringing smartphones to school. Deng Qingping, the headmaster at a middle school in Guangzhou of Guangdong Province, told China Daily, "Although our school has this regulation, many students still bring the devices under various excuses. I hope educational administrations can establish strict rules to regulate this situation."

It is also imperative to regulate online gaming. To guide children toward appropriate entertainment, a reminder system should be explored based on the age of the player. Measures should also be adopted to limit the duration of play among young people, especially adolescents.

In terms of medical services, a system of responsibility should be formed among school hospitals, primary healthcare institutions and ophthalmology institutions. Moreover, the competence of staff in these agencies needs to be enhanced, while the regulation of the industry is carried out. Wang highlighted the importance of quality equipment for prevention and control so that secondary damage is avoided.

In addition, the National Health Commission will cooperate with some ministries, including the education and finance ministries, to explore the establishment of a visual health medical file for each student in order to guide further examination and treatment.

(Comments to niyanshuo@chinafrica.cn)