A primary school student in Dongyang, Zhejiang province, takes an eyesight test at an "eye protection class". (HAO QUNYING / FOR CHINA DAILY)
In September, Yuan Sihui, a fifth-grade primary school student in Yunnan province, discovered she could no longer see words on the classroom blackboard clearly.
She did not know how badly her sight had been affected until a recent checkup found that she had 300 degrees of myopia－a medium level－in both eyes.
However, rather than becoming depressed about her sight, Yuan, the top performer in her class, was delighted when she was handed a pair of glasses soon after a thorough eye examination.
She said she was excited to learn that her eyes were going to be examined, as she had been unable to find a sufficiently qualified professional with whom to discuss the problems with her vision.
"I once told my mother I was finding it hard to read with the dim bedside light," said the 11-year-old, who attends Shuanglong Primary School in Shidian county, Baoshan city, and spends two hours reading before going to sleep every night.
She dreams of going abroad for university studies and returning to Shidian to help local children with better healthcare and diets, and to cope with natural disasters.
Yuan was one of some 4,000 primary and middle school students from the county who were found to have potential eyesight problems.
In the middle of last month, half of the students attended a weeklong charity event that included eye health and optometry checkups. The examinations resulted in some 1,500 students receiving free glasses.
The event was launched by the Shanghai Essilor Vision Foundation and Education in Sight, an NGO in Yunnan.
Lim Kok Leong, president of Essilor Greater China's vision care division and an Essilor Vision Foundation Employees council member, said employees, including optometrists, from Essilor and other optical enterprises as well as ophthalmologists traveled to Shidian for the event. The county lies on the Yunnan-Guizhou Plateau.
"The eye health of rural children is not as good as many would imagine," Lim said.
Experts said there could be many reasons for this, including strong sunlight, ultraviolet rays, insufficient indoor lighting, and a lack of eye health education.
"The time that children in rural and mountainous areas spend on their mobile phones is no less than their counterparts in cities. However, the difference is that many rural children's vision problems cannot be detected and diagnosed in time due to insufficient eye screening and diagnosis as well as a lack of access to eyeglasses," Lim said.
The Essilor foundation said it planned to include all 4,000 students in the checkups over a two-week period, but the event had to be suspended due to an earthquake. It said that the team would visit Shidian again this year to complete eye checkups for the remaining students.
A primary school student gets a vision test in Handan, Hebei province, during the summer holiday in 2020. (HAO QUNYING / FOR CHINA DAILY)
Starting earlier
Official data for the past three years show that more than half the minors in the country have myopia.
Last month, the Ministry of Education and other authorities released a work plan involving eight measures to prevent and control myopia among minors for the next five years.
The measures include easing students' academic burdens, increasing time spent on outdoor activities, avoiding excessive use of digital products, and achieving full coverage of eyesight monitoring.
In Shidian, a spot check last year found that the myopia rate among local middle and primary school students was 52 percent. For middle school students, it was 75 percent, according to Jiang Zijian, vice-governor of the county.
Local teachers said myopia is being experienced by a rising number of children and is occurring at an earlier age.
Xu Yanan and Zhang Zhongmei, both 10, are the best friends of Yuan, the fifth-grade primary school student. Neither of her friends was aware that they could not see clearly and were surprised to learn after an eye examination that they had around 250 degrees of myopia.
Xu, who wants to become a dress designer, said, "Without the charity event, it could have been a long time before I had the opportunity to learn that I had problems with my eyesight."
The three girls said they often use their mobiles to search for learning material and watch television series. They do not have tablets or computers.
They said it was the first time they had undergone an eye checkup with optical equipment.
Yuan said, "We once had an eye check with a visual chart at school, but the teachers didn't remind us that the next step was an examination, treatment, or getting glasses."
Yang Jin, secretary-general of Education in Sight, said she rarely sees a primary school student wearing eyeglasses when entering the classroom for a checkup, but more than a few need glasses.
Xu Xiaoli, an eyeglass lens distributor from Changchun, Jilin province, who worked as a volunteer for the visual chart section of the charity event, said she is saddened whenever a child cannot see all the signs on the chart properly.
"Some students told me that for a long time they had been unable to see words on the classroom blackboard, but didn't dare tell their parents or feel the need to," she said.
Li Xuejiao, a doctor at the Hospital Affiliated with Yunnan University in Kunming, who specializes in children's eye diseases, also worked as a volunteer at the charity event. She said more than 10 children had severe cases of myopia, including high-level hyperopia, a condition in which nearby objects appear blurred, but distant ones are more clearly visible.
She said it is hard for children with uncorrected hyperopia to read or write, and most severe cases of the condition are congenital.
"Children in cities start having eye checkups at age 3. However, for some kids here, it was the first time they had taken an eye examination," Li said.
Zhu Jiacong, secretary-general of the Essilor Vision Foundation, recalled the case of one girl who was found to have amblyopia, a condition in which one eye is unable to focus as clearly as the other.
After the condition was detected, the girl's teacher said he finally understood why she often appeared to be taking a nap at her desk during classes and the standard of her school work had declined in recent months.
A medical expert from a hospital in Lianyungang, Jiangsu province, briefs kindergartners on how to protect eyesight and prevent myopia during a health campaign in June. (GENG YUHE / FOR CHINA DAILY)
Rural difficulties
Xu Yanan was excited to put on a pair of glasses, which give her clear vision, but her father was not so happy, saying that nobody in the family had ever worn spectacles before.
In some rural regions, glasses are still being refused. Yang said, "Some parents think their children aren't gifted academically and are doomed to become farm workers. They tend to believe that people without glasses have the appearance of qualified laborers."
Other parents may tell their children to wait and decide whether they need glasses if their myopia worsens, or after they start middle school, Yang added.
She said many parents in rural areas are unaware that vision deficit poses severe problems for children if measures are not taken to correct it.
"Research has shown that improved vision has more influence on children's studies than family income and parents' education levels. However, many adults are still under the misapprehension that after minors wear glasses, their myopia will deteriorate more rapidly," Yang said.
Moreover, many children are being cared for by their grandparents, who have a lower awareness of eye health.
Yang Chen, a teacher at Suanyuan Primary School in Yaoguan town, Shidian, said about two-thirds of the students' parents work in cities far from home.
"Usually, grandparents don't control the amount of time children spend on digital products. Financial difficulty also makes it harder for them to afford eyeglasses," she said.
A long-term solution to help children is to set up optometry clinics in local hospitals, with some medical workers functioning as optometrists after training, Yang Jin said.
Six such clinics have been put into operation in counties in Yunnan to allow people to access eye examinations by professionals. Discussions have also taken place with the authorities for a clinic to be built in Shidian.
Yang Jin said eye checkup and eyeglass service packages costing no more than 100 yuan (US$16) are available for children from rural families. Children from impoverished backgrounds can obtain glasses for free.
In addition, at least one teacher in each of the 1,000 schools reached by the charity has been appointed as an eye care ambassador. The teachers will instruct students in eye care by using standard materials, monitor their vision regularly and urge them to attend clinics for re-examinations.
