The myopia problem among our schoolchildren is becoming increasingly severe. According to the results of the "Children and Adolescents Vision Monitoring Survey" conducted by the National Taiwan University Hospital team commissioned by the Health Promotion Administration in 2017, compared to the previous survey in 2010, the prevalence has increased in all grades of elementary school. Specifically, the rate for second graders rose from 28.3% to 38.7%, for sixth graders from 62% to 70.6%, and for third graders in junior high school, it reached 89.3%. In terms of high myopia (diopters > 500), the rates were 10.3% for sixth graders, 28.0% for third graders in junior high, and 35.7% for third graders in senior high. Dr. Wang Ying-wei, Director-General of the Health Promotion Administration, expressed concern about the issue of high myopia in our country, as high myopia can lead to early-onset cataracts, glaucoma, retinal detachment, and macular degeneration, with up to 10% of cases resulting in blindness. He urged parents to recognize myopia as a disease and to understand the concept of a "vision passbook." During their free time, children should be encouraged to engage in outdoor activities, have at least one vision check-up annually, and for those who are already myopic, their progression must be controlled. It is crucial to protect children's eyes from a young age.

Implement classroom clearing during recess Outdoor activities weekly11hours Effective myopia control30%

The Health Promotion Administration promotes vision prevention based on evidence. From 2013 to 2015, they commissioned a myopia prevention and intervention research project (Recess Outside Classroom Trial 711, hereinafter referred to as ROCT711) led by Dr. Wu Pei-chang's team from the Ophthalmology Department of Kaohsiung Chang Gung Memorial Hospital. This large-scale intervention study was implemented in multiple schools in northern, central, southern, and eastern Taiwan, involving 693 students across 7 intervention schools and 9 control schools. The intervention measures included outdoor activities with classroom clearing during breaks, enhanced outdoor teaching, and after-school outdoor learning activities (such as the Sunshine Passport and outdoor worksheets, encouraging elementary school students to engage in outdoor activities for 11 hours per week). Students were equipped with light meters, kept daily logs, and completed questionnaires. The evidence-based results showed that outdoor activities had a 30% benefit in controlling myopia progression for those who were already myopic. With ophthalmological medical intervention, the benefit could reach over 50%. The study indicated that increasing outdoor activity is an effective auxiliary treatment and lifestyle habit. It also demonstrated that outdoor activities in corridors or under tree shade can prevent myopia, and it is not necessary to be in direct sunlight. Currently, the research findings from Taiwan have been published in the internationally renowned ophthalmology journal, Ophthalmology.

Promote the concept of a vision passbook Eye protection and prevention start from early childhood

According to the 2017 survey, the myopia rate in the last year of kindergarten was 9.0%. This increased to 19.8% in the first grade of elementary school (2 out of 10 children were myopic) and reached 38.7% in the second grade (4 out of 10 children were myopic). The proportion of myopia increases rapidly with age. Dr. Wang Ying-wei stated that myopia prevention efforts need to start earlier, at the preschool stage. Once myopia develops, it is lifelong, with an average increase of 75-100 diopters per year. Parents need to have the concept of a "vision passbook." If children's vision is not protected from a young age, their "vision deposit" will decrease. Therefore, to delay the onset of early-onset myopia, parents must help their children establish good lifestyle habits, including reducing close-up eye use and not using 3C products to pacify young children, which is an urgent priority.

To ensure myopia prevention starts from childhood, the Health Promotion Administration has introduced "Eye Protection 123," hoping that parents can help their children stay away from the threat of poor vision from birth:

1. Have vision checked 1-2 times annually to maintain your vision deposit.

2. Avoid screen time for children under 2 years old, and limit it to no more than 1 hour per day for those over 2 years old.

3. Spend 2-3 hours outdoors daily, and take a 10-minute break after every 30 minutes of eye use.

Myopia is a disease, do not take it lightly The Health Promotion Administration joins hands with various organizations to combat myopia

Since the preschool period is a critical time for myopia prevention, the Health Promotion Administration provides four one-on-one vision care health education sessions during preschool preventive health check-ups. They also conduct vision screenings for 4- and 5-year-old children in kindergartens through local health bureaus. For those who are already myopic, efforts are intensified to spread awareness about controlling myopia progression. In collaboration with the Ophthalmological Society of the Republic of China, they have developed "Guidelines for Children's Vision Screening and Management," which are provided not only to medical professionals but also to the Ministry of Education for school nurses and other personnel to reference and utilize.

The Ministry of Education's Department of Preschool and Elementary Education, based on the evidence provided by the Health Promotion Administration, promotes outdoor activities (including classroom clearing during recess) in health-promoting schools. They encourage students to take a 10-minute break after every 30 minutes of eye use and have set a local indicator for health-promoting schools to limit the use of 3C products to less than 1 hour, thereby strengthening children's vision care efforts. In the future, the Health Promotion Administration plans to promote health-promoting kindergartens, hoping to enhance parents' understanding of myopia as a disease through their participation in kindergarten activities with their children. Together with the government, they aim to protect children's vision from a young age, ensuring that the future generation is free from the threat of high myopia.