Two key areas for future eye health promotion in China

The myopia epidemic is currently one of the major focuses of eye health work in China. Myopia control has been given a high priority as a national strategy and a key issue to address. The fierce intellectual competition, education workload and pressure have led to an increased amount of near work and decreased outdoor time, contributing to the high prevalence of myopia among children and adolescents.

A survey showed that 67% of the students spend less than 2 hours outdoor and 73% of the students could not get enough sleep. “An increase and a decrease”, namely an increase in time spent outdoors and a decrease in time spent on near work, are the most efficient behavioral interventions for myopia prevention and control in children and adolescents. Therefore, it is important to call for joint action with the education department and advocate for a reduction of education workload, especially near work, and an increase of outdoor activities in children and adolescents. This will serve the purpose of myopia control and also enhance physical fitness.

While evolving along the epidemiological transition stages, the disease burden contributed by infectious diseases is decreasing while the disease burden contributed by chronic non-communicable diseases (NCDs) is increasing. In China, 63% of the deaths are attributed to NCDs, and 48% of them are due to cardiovascular chronic diseases. A survey exploring the relationship between NCDs and common blinding ocular diseases in the population over 30 years old in rural areas of northern China revealed that the prevalence of blinding ocular diseases in NCD patients is significantly higher than that of the non-NCDs population. About 1.5% of NCD patients develop common blinding ocular diseases every year. In addition, compared with the non-NCDs population, NCDs patients have a 1.969 times higher risk of developing common blinding ocular diseases, and compared with age and IOP, NCDs have a much larger influence on the development of common blinding ocular diseases.

Hence, for the next step, we should integrate the control of blinding fundus diseases into the current national chronic disease management system as one of the routine screening items. This could be carried out with fundus photography, and considering the low cost of photography and increasingly wide application of artificial intelligence in screening, this ensures good feasibility and could be one of the highly cost-effective interventions.