China’s Massive Nearsightedness Problem: an insightful survey of how China is dealing with childhood and adolescent myopia

“China’s Massive Nearsightedness Problem” (Asianometry, 20 June 2022)

With about 57% of its population in 2019 being myopic (short-sighted), and with schoolchildren in urban areas being hit particularly hard by myopia, China has long considered and implemented policies aimed at reducing the incidence of myopia among young people. Studies done on Chinese youth over past decades indicate that the problem is as much cultural as it is medical with evidence demonstrating a positive correlation between short-sightedness in school students and the length of time they spend in school education, academic performance and even their families’ wealth and the neighbourhoods they live in. (The richer a family is or the wealthier the neighbourhood where the family lives, the more likely the school child will be myopic.) With this information, the Chinese government has been treating myopia as an issue of public health and a catalyst for educational and even lifestyle reforms.

The Asianometry report treats China’s myopia problem in a very structured and succinct manner, detailing the scale of the problem and what its causes are, and then progressing to the ways in which the Chinese government is tackling the issue and aiming to change people’s attitudes around myopia and how it can be aggravated in young people. As far back as the 1960s, the Chinese government tried to get schools to institute regular eye exercises for children but this practice was not successful. Since then, studies have shown that myopia is less prevalent in young people who spend much more time outdoors on a regular basis than their peers. Beginning in the mid-2010s, the Chinese government has adopted a program that aims to shape young people’s behaviours away from environments and influences that may increase their likelihood of developing myopia. Limiting young people’s exposure to videogames, to the extent of setting maximum time limits on youngsters’ weekly use of such games and similar technologies, restrictions on the amount of homework primary and secondary school students should be given, and even clampdowns on private tutoring companies are some of the actions the Chinese government has taken to bring down myopia rates among young people. Increasing the number of doctors specialising in eye care, especially in rural regions, and health education programs aimed at parents to raise awareness of myopia have also been important.

The issue of restricting young people’s access to videogames and social media has been greeted by Western mainstream media in a mocking way that insinuates that China is acting – as the country is always presumed to do – in a heavy-handed and authoritarian manner, coming down on youngsters like the proverbial ton of bricks. The reality may be that China’s approach in gently prodding people to help themselves is the right one for the Chinese public, though it is an approach that Westerners may find hard to understand because it is based on consensus between the State and the public. The Western media reporting on the issue generally ignores the wider context in which the Chinese government carries out particular policies, and concentrates only on particular selected aspects of the issue that imply that young people’s freedom to choose how to spend their time – as though young people have the maturity to know what leisure activity is best for them, and to know when they are being exploited by private corporations – is being endangered.

Other East Asian nations like Taiwan and South Korea have also tried reducing the prevalence of myopia among their young people with policies and programs aiming at increasing the time children and teenagers spend outdoors in bright sunlight and encouraging outdoor activity and exercise. Taiwan’s initiatives in its Tian Tian 120 policy program which aim at increasing young people’s exposure to sunlight and exercise are laudable in this regard. What South Korea is doing to combat myopia in schoolchildren unfortunately is not mentioned.

At the end of the documentary the narrator makes an excellent point about global education systems and what they have traditionally aimed to do: pick out the most academically inclined and put them through certain colleges and universities that prepare future political, economic and cultural elites. Such systems with their elitist values and hierarchies encourage intense competition among families hoping to leap-frog their way through their children into the upper wealthy layers of society. As the narrator notes, children are literally going blind as a result of this competition.

There could be much more that the narrator might have mentioned – in particular the nature of modern urban environments in China and other parts of East Asia, with high air pollution levels and past urban planning practices cramming people into dense neighbourhoods with little open space, that prevents children from having the sunlight and exercise they need for their eyes and bodies to develop properly – but as it is, the documentary is an insightful investigation of a major public health issue that affects us all.