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 rates have increased in all elementary school grades. 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 it reached 89.3%. In terms of high myopia (diopter > 500 degrees), the rates were 10.3% for sixth graders, 28.0% for third graders, and 35.7% for third-year high school students. Director-General of the Health Promotion Administration, Wang Ying-wei, expressed concern about the issue of high myopia in our country, as high myopia can easily 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 value the concept of a "vision passbook." During leisure 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 important to protect eyesight from a young age.

Implement classroom clearing during breaks 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, implemented in multiple schools in northern, central, southern, and eastern Taiwan. This large-scale intervention study involved 7 schools implementing intervention measures and 9 schools as control groups, with a total of 693 students participating. The intervention measures included outdoor activities with classroom clearing during breaks, enhanced outdoor teaching, and after-school outdoor learning activities (including the Sunshine Passport, outdoor worksheets, etc., encouraging elementary school students to engage in outdoor activities for 11 hours per week). Students were equipped with light meters, kept diaries, and completed questionnaires. The evidence-based results found that outdoor activities have a 30% benefit in controlling myopia progression for those who are already myopic. If combined with ophthalmological medical control, the benefit can 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 for children in the last year of kindergarten was 9.0%. This increased to 19.8% in the first grade (2 out of 10 children are myopic) and reached 38.7% in the second grade (4 out of 10 children are myopic). The proportion of myopia increases rapidly with age. Wang Ying-wei stated that myopia prevention actions need to start earlier, at the preschool stage. Once myopia develops, it is lifelong, with an average increase of 75-100 degrees 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 early-onset myopia in young children, 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 the most pressing task.

To start myopia prevention from childhood, the Health Promotion Administration has specifically proposed "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 "vision deposits."

2. Avoid screen time for children under 2 years old, and do not exceed 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 declare war on myopia

Since the preschool period is a critical time for myopia prevention, the Health Promotion Administration provides four one-on-one vision 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, they strengthen the dissemination of information on controlling myopia progression and have collaborated with the Ophthalmological Society of the Republic of China to complete the "Guidelines for Children's Vision Screening and Management." These guidelines 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 Department of Preschool and Elementary Education of the Ministry of Education, based on the evidence provided by the Health Promotion Administration, promotes outdoor activities (including classroom clearing during breaks) 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 health work. 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, and to work with the government to protect children's vision from a young age, so that the future generation can be free from the threat of high myopia.