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Guidelines for prevention of myopia in children and adolescents during the epidemic in COVID-19.
During the epidemic in COVID-19, children and adolescents used more electronic products, while outdoor activities decreased, which increased the risk of myopia. In order to guide the prevention of myopia among children and adolescents during the epidemic, the Center for Disease Control and Prevention of the National Health and Wellness Commission organized the School of Health Management of Anhui Medical University, Beijing CDC, Shanghai Ophthalmology Center and Optometry Center of Peking University People's Hospital to formulate and issue the Guidelines for the Prevention of Myopia among Children and Adolescents during the COVID-19 Epidemic, and timely updated and adjusted them according to the situation of prevention and control of the normalized epidemic and the resumption of classes.

First, myopia prevention during online learning.

Service time requirements of electronic products. During online learning, the time for electronic products to be used for online learning should be limited. 1. Online learning time, the primary school students should not exceed 2.5 hours per day, and each time should not exceed 20 minutes; Middle school students should not exceed 4 hours a day and 30 minutes at a time. 2. Reduce video time outside of online learning. Except for the online education time arranged by the education department, the video time for other purposes shall not exceed 1 hour per day.

Selection and placement requirements of electronic products. During the online study, we should pay special attention to eye hygiene, choose and use electronic products reasonably, and ensure scientific eye use. 1. Try to choose a large screen for electronic products, and the priority order is projector, TV, desktop computer, notebook computer, tablet computer and mobile phone. Electronic products with high screen resolution and appropriate definition should be selected. When using electronic products, adjust the brightness until the eyes feel comfortable, neither too bright nor too dark. 2. Placement of electronic products The placement of electronic products should avoid the direct exposure of windows and lights, and one side of the screen faces the window to prevent the screen from reflecting and irritating the eyes. When using the projector, the viewing distance should be more than 3 meters; When using TV, the viewing distance should be more than 4 times the diagonal distance of the screen; When using the computer, the viewing distance should be more than 50 cm. When placing electronic products, make sure that the top of the screen is flush with the horizontal line of sight of the eyes.

Reading and writing posture. During online study, children and teenagers should adjust their holiday study arrangements in time to meet the following reading and writing requirements. 1. When listening to a class on the screen, you can keep your shoulders relaxed, your upper back extended, your upper arm and forearm at a 90-degree angle, your wrist relaxed, and you can breathe regularly. 2. When watching video homework, keep the reading and writing posture of "one foot, one punch and one inch": the eyes are about one foot away from the book, the body is about one punch away from the desk, and the fingers holding the pen are about one inch away from the nib. Don't lie in bed or study on the sofa.

Relax your eyes. When studying online, increasing active rest time can not only relax ciliary muscles and relieve eye fatigue, but also slow down brain fatigue, improve learning efficiency and relieve tension. 1. If the continuous video learning time exceeds 20-30 minutes, take the initiative to rest at least 10 minutes. 2. In the process of video learning, consciously close your eyes, slightly open your eyes, turn your eyes up and down and relax your eyes. 3. Stretch your waist and arms after online learning, and you can walk indoors, do gymnastics, squat, sit-ups and so on. Do eye exercises after washing hands; Stand in front of the window, balcony or door and look into the distance. 4. During the period of home isolation, you can bathe in the sun and get in touch with natural light through the balcony, window or your own courtyard.

Daylighting and lighting requirements. During the epidemic period, the family is the main place for children and adolescents to live and study, and the lighting conditions in the family are very important for children and adolescents' eye hygiene. 1. Put the desk by the window so that the long axis of the desk is perpendicular to the window. When reading and writing during the day, natural light should enter from the opposite side of the writer. 2. If there is insufficient light when reading and writing during the day, you can put a desk lamp on the desk for auxiliary lighting, and the desk lamp is placed in front of the writing hand. 3. When reading and writing at night, you should use the desk lamp and the room ceiling lamp at the same time, and place the desk lamp correctly. 4. The household lighting source should be tricolor lighting equipment, and the color temperature of the desk lamp should not exceed 4000K K..5. Bare lamps are not suitable for household lighting, that is, lamps or bulbs can not be used directly, but lamps or bulbs protected by lampshades should be used to protect eyes from strong light. 6. Avoid placing glass plates or other items that are prone to glare on the desk.

Adjustment of desk and chair for family books. In order to ensure that children and adolescents can maintain correct reading and writing posture at home and reduce study fatigue, parents should provide suitable desks and chairs for their children. 1. For families with adjustable tables and chairs, adjust the height of tables and chairs according to the principle of "sitting on a chair/stool, with thighs perpendicular to calves, upper arms drooping when the back is straight, and elbows 3-4cm lower than the desktop". 2. For families without adjustable tables and chairs, adjust according to the above principles. If the table is too high, try to use a higher chair with a cushion under your feet, so that your feet lie flat on the cushion and your thighs are perpendicular to your calves. When the table or chair is too short, raise it.

Arrange your daily life reasonably. During the epidemic period, families should create a good atmosphere, and parents should help their children to keep their study rules and pace of life, and ensure their children's regular work and rest, adequate sleep and proper physical activity. 1. Ensure adequate sleep time every day, which should reach 10 hour for primary school students, 9 hours for junior high school students and 8 hours for senior high school students. 2. When studying at home, you should avoid bad habits such as staying up late and getting up late to reduce the interference with the biological clock. 3. Parents should urge their children to keep learning rules and pace of life, and carry out more interactive fun games to enhance parent-child communication. Children and teenagers help their parents to do proper housework every day, such as cleaning, tidying the room, washing dishes and cooking. 5. Parents can arrange their children to have outdoor activities in the community, such as skipping rope, racket ball, badminton and aerobics.

Pay attention to hand hygiene and eye health. Maintaining hand hygiene habits is an important factor to ensure eye health. Washing hands frequently can prevent viral and bacterial infections and effectively prevent eye infectious diseases. 1. Wash your hands before and after meals and after going out and going home. Use the "7-step washing method" and ensure that it lasts for more than 20 seconds. 2. Don't rub your eyes with your hands. 3. If the eyes are dry, foreign body sensation, burning sensation, itching sensation, photophobia, jealousy, eye pain and other symptoms. You should stop looking at the screen. If the symptoms cannot be relieved, go to the hospital if necessary. 4. When the child is found to have symptoms related to myopia, such as cocked head, frequent squinting, strabismus, etc., he should rest and exercise in time and go to the hospital if necessary.

Second, after resuming school, prevent myopia and continue to cultivate and maintain good eye habits. With the gradual normalization of classroom teaching, schools should reduce the use of electronic products, restore the eye exercise system, provide good lighting and lighting conditions, adjust tables and chairs in time, and increase outdoor activities under natural light conditions.

Develop good eye behavior. Good eye use behavior can slow down eye fatigue, reduce eye over-adjustment, and continue to maintain good eye use behavior after resuming school. 1. Keep the reading and writing posture of "one foot, one punch and one inch". 2. After reading and writing for 30-40 minutes, take the initiative to rest 10 minutes and overlook. 3. Read a book and watch your mobile phone when you are not walking, under the direct sunlight, in the bumpy carriage.

Reduce the use of electronic products. Using electronic products for a long time will cause eye discomfort and increase the risk of myopia. Children and adolescents should reduce the use time of electronic products in time after returning to school. 1. Teaching with electronic products shall not exceed 30% of the total teaching time. In principle, paper homework shall be adopted. 2. The use of electronic products for non-learning purposes shall not exceed 15 minutes at a time and 1 hour every day. The younger children are, the less time they spend using electronic products. Preschool children under the age of 6 should try to avoid contact with video environments such as mobile phones and computers, and parents should set an example.

Eye exercises. Long-term and standardized eye exercises have positive significance for preventing myopia. After classes are resumed, the school should resume the system of eye exercises between classes in the morning and afternoon. 1. Wash your hands thoroughly before doing eye exercises. 2. You can choose "eye relaxation exercises" and "eye-like exercises" that don't touch your eyes.

Lighting in the classroom. Schools should provide good lighting conditions to ensure that students have enough light when reading and writing. 1. The average illuminance on the desktop of ordinary classroom is not less than 300_lx and not more than 750_lx, and the illuminance uniformity is not less than 0.7. 2. Ordinary classroom blackboards should be equipped with local lighting, with an average illuminance of not less than 500_lx and not more than 1000_lx and an illuminance uniformity of not less than _0.8.

Adjustment of school desks and chairs. Desks and chairs should match the height of children and adolescents, and classroom desks and chairs should be adjusted according to the standard of "Functional Dimensions and Technical Requirements of School Desks and Chairs".

Increase outdoor activities under natural light conditions. Outdoor activities are the simplest and most effective way to prevent myopia, and adequate sunlight exposure can effectively prevent the occurrence and development of myopia. 1. During the epidemic period, the school physical education class and the 30-minute recess should be carried out outdoors, staggering the time and peak hours to increase the distance of students' sports activities. 2 to ensure outdoor activities for more than 2 hours a day, and to promote outdoor activities for more than 3 hours a day for nearsighted children and adolescents. 3. After classes are resumed, children and adolescents are encouraged to increase their exposure time to outdoor sunlight by walking to and from school, walking out of the classroom during recess, and doing outdoor activities after school in the afternoon.

Third, during the epidemic period, students' vision monitoring and refractive screening should be carried out after returning to school. Follow the "Vision Screening Standard for Primary and Secondary School Students" and take various epidemic prevention measures to prevent cross-infection. Schools should carry out students' vision monitoring and refractive screening under the guidance of the health department, improve students' vision health files, and timely discover students' poor vision and myopia.

Perform vision monitoring and refractive screening. 1. Register the results of vision monitoring in time and improve the vision health files. 2. Statistics of poor eyesight and screening myopia rate of students of all grades in this school, and compared with the same period last year. 3. Feedback students' vision health information to parents and guide parents to carry out myopia prevention and control work.

Check the requirements of the website. As far as possible in the open-air playground or large stadiums and other places, to maintain air circulation.

The inspector's request. Inspectors should be familiar with the standardized use and related requirements of infection prevention and control articles, wear disposable working caps, disposable medical surgical masks, disposable gloves and work clothes, and pay strict attention to hand hygiene.

Requirements for checking equipment. 1. Eye masks used for vision inspection should be "one person and one consumer", or disposable paper eye masks should be used "one person and one consumer". 2. During refractive examination, the surface of the refractive instrument should be disinfected, and the part in contact with the human body should be guaranteed to be "one person and one elimination". 3. Ensure that the safety distance between inspection equipment is above1.5m. ..

Requirements of students under examination. 1. Students should wear disposable masks during the exam, and don't touch their eyes and surrounding environment with their hands. After the inspection, they should wash their hands according to the "seven-step washing method". 2. Arrange the students' inspection time reasonably, in batches and time periods, ensure the safety distance of the inspected personnel 1.5 meters, and minimize the overlapping time of students waiting for inspection.

Fourth, the health protection of optometry glasses during the epidemic period

Vision correction. In the epidemic period, children and adolescents with myopia need vision correction if their poor eyesight affects their study or life. 1. Frame glasses are the safest vision correction method for children and adolescents, and glasses should be fitted according to prescriptions. 2. Do not advocate wearing contact lenses. To control myopia, we need to wear special types of contact lenses such as orthokeratology lenses, and we must strictly follow the doctor's advice. 3. Before taking off the contact lens, be sure to clean your hands and wash your hands in strict accordance with the "7-step washing method".

Optometry glasses. During the epidemic period, it is suggested that children and adolescents stop seeking medical treatment, and have routine vision review and optometry. If you really need optometry because of poor eyesight, you should go to the ophthalmology or optometry center of a professional hospital for treatment.

1. Know the hospital information in advance, make an appointment according to the requirements of the hospital, and see the doctor in different periods to avoid cross infection.

2. During the appointment, do a good job in personal protection and obey the management of medical personnel. When there are many people or not at the time of seeing a doctor, it is suggested to reserve contact information and wait outside or in a place with few people to call for treatment to avoid crowds.

3. Medical institutions shall post COVID-19's protection guidelines, personal protection standards and disinfection procedures at appropriate positions in the waiting area and refractive examination room.

4. In the process of seeing a doctor, children and adolescents and accompanying parents should wear masks, cooperate with temperature measurement, truthfully inform doctors to register information about the epidemic situation, and cooperate with doctors to complete the examination with non-contact ophthalmic equipment.

5. Medical institutions should reasonably arrange the physical examination time, ensure that the examination room "one room, one doctor and one patient" and the waiting area are in a ventilated environment, and minimize the time for patients to overlap and meet in the waiting area.

6. Medical personnel should be familiar with the preparation work before refractive examination, do a good job in disinfection of the surface of the inspection equipment, and disinfect the parts in contact with the human body to ensure "disinfection by one person" to prevent cross-infection.

7. In the process of refractive examination, reduce unnecessary verbal communication, and try to keep it above 1.5 meters when communicating face to face with medical staff.

8. After the visit, leave the visit area in time, and fully wipe and disinfect the parts in contact with the inspection equipment.

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