The formation and development of myopia Regarding the formation of myopia, international studies have been conducted into two types: 1. Genetic, especially in high myopia, the genetics have been relatively well established and the corresponding genes have been identified. 2. For low to moderate myopia it is more related to the environment, which is becoming earlier and higher in school-age children in China as well as in other Asian regions. Environment, stress including surrounding habits, and many basic environmental factors including the brightness of the house, density of the classroom, time spent receiving natural light, color and reflection of books, etc. are all related. Myopia is aggravated mainly by close work, which is the most critical issue, how to make the development of children’s schooling control within a range that the eyes can bear. 1. Some recent basic studies have shown that a large number of myopia is caused by close work. 2, many parents refuse to give children glasses, can delay, so that they can not get timely correction, is also a very important cause of myopia aggravation. 3, life is not scientific, many families have low to moderate myopia, called family aggregation: first, no clear more fixed genetic loci were found. Secondly, such families generally love sweets, do not like sports, like reading and quiet state. It is especially important for families with myopic parents to change the living environment in which they tend to be hobbyists. Third, parents should not force their children to study too early during their developmental period, just like people picking water, they can’t pick 100 pounds of water when they are young, but they can definitely pick it when they are 18 years old. Eyes to be about 18 years old to fully developed, after the age of 12 to 15 years old can also basically bear the current amount of children reading. In addition, including this year’s debate on lighting, as well as children’s eye function is inadequate: the ratio of regulation and collection in the visual function of both eyes are dysfunctional, disorderly, a line of words normal people read in a second, or even a glance, but the visual function of poor children to read once did not understand, the more tired, the so-called visual fatigue. The aggravation of myopia is the result of many of these unknown factors. Staying up late reading, corporal punishment, and other factors all exacerbate the progression of myopia in children. The child is in a depressed state, and a lot of stress makes the whole autonomic nervous system disorder, and there is also a reversal of day and night, like lack of sleep at night, so all these factors aggravate the progression of myopia. In this conference, the professor proposed to gradually change the Chinese school children’s physical examination and suggested that there should be a legislation to make it mandatory for children under 15 or even 18 years old to have their eyes tested by a physician, instead of handing them over to the so-called various institutions for testing. It is important to avoid the misconception that it is only a test of visual acuity. Because of this misunderstanding, coupled with the fact that parents are now pursuing perfection in their children from an early age, three-year-old children must see adult 1.5, not to see is amblyopia, they begin to stimulate the child to give the child pressure, just like the switch to the development of myopia turned on, such as the opening of Pandora’s Box, myopia continues to develop, and finally can not be controlled, and then do the work after the child entered school is too late. Our current research has found that the main time for myopia to develop is before elementary school, during kindergarten, and even before kindergarten, so I hope that more people will pay attention to this important issue. The reason for calling for myopia prevention and control is to prevent myopic children from developing high myopia when they stop developing at the age of 18, which is a very disturbing thing because there have been many cases of blindness at different ages. The goal of myopia prevention and control is not to keep them from becoming myopic, which is a natural proportion that does not need to be controlled. What needs to be controlled is not to develop high myopia, and not to let it develop until it is finally surgically treated to remove myopia, which is like an ostrich head stuck in the desert. So there must be a concept of prevention and control to consciously stop the development of high myopia, including reducing the amount of homework, improving the lighting environment, improving diet, improving lifestyle habits, there are many ways to reduce the stress of children, allowing children to grow healthily and happily, allowing children to return to childhood and so on will slow down the progress of high myopia. The international standard for high myopia is 800 degrees, and the United States and China both set it at 600 degrees. As long as a child’s myopia does not exceed 600 degrees, there is no need to worry too much as long as retinal detachment does not occur. What happens if you go over 600 degrees? There are 3 complications that cause blindness: 1. Retinal detachment, which occurs mostly insidiously, is only discovered after a large number of students go to college after their high school entrance exams, but blindness often occurs at that time. Highly myopic eyes involve both eyes, and there is a lot of evidence that retinal detachment may also occur in the second eye. 2, open angle glaucoma, its intraocular pressure is normal, the average eye pressure of Chinese people is 13mm Hg, the average eye pressure of Europeans is 16mm Hg, so the so-called 10 to 21mm Hg normal range is not any scientific basis, because it has been used in China for decades, so many parents and physicians believe that the eye pressure does not exceed 21mm Hg is normal. However, 50% of people whose IOP does not exceed 16mm Hg will suffer from open-angle glaucoma, and irreversible blindness due to open-angle glaucoma is quietly carried out. 3. The length of the eye axis exceeds 25mm, more than 25mm under the age of 15 and more than 27 or 28mm between the ages of 18 and 20, because the eye is constantly developing, and patients in this condition are prone to develop blindness in middle and old age. This blindness or low vision may be mistaken as a result of increasing age, but it is not, it is myopic macular degeneration. The dangers of high myopia are mainly in these three areas. How to prevent myopia in the Journal of Clinical Ophthalmology Professor and Professor Fang Yan published a set of consensus, she expressed the hope that Professor Chu can lead to do the prevention and treatment of myopia. Professor Shi Yining and others in doing some textual groundwork and provide some research data, proposed three levels, ten lines of defense, ten measures ten parts, probably mentioning three slogans, so that the whole prevention and control is more systematic. For example, three years old over 100 degrees of myopia should be how to do all the corresponding measures, now should be implemented corresponding treatment measures, these ten sets of preventive and control measures we have published, and in the future also hope that the public platform carried out to improve it as a draft proposal. On top of the basic work that has been carried out for 15-20 years, these ten areas have been found to be very effective through a large number of clinical studies and can indeed control myopia. However, because of poor parental follow-up, physicians can only follow up for 3, 5, or 10 years, and one generation of physicians is not enough. A patient needs to be followed up for at least 50 years, and ophthalmologists only have a working life of 25 to 30 years, so one physician cannot accomplish this, and patient records should be established, shared across the network and joint multi-centered, in order to possibly put prevention into practice is effective. There are many methods, all of which have corresponding products, but of course this requires the guidance of a physician, unlike drugs that can be bought and used, and there are corresponding indications, and the use of the wrong may get the opposite effect, which is very critical. The treatment of high myopia has formed a complete system on how to prevent high myopia, including monitoring, follow-up, basic files, how to prevent the three major complications, and specifically how to apply drugs, such as the problem of intraocular pressure, the problem of improving microcirculation, the problem of wearing glasses, how long to wear OK lenses, how to harden collagen, etc. There are very good countermeasures. The problem is that the patient needs to be followed up, and many children who have been followed up for 10 years have very good control of their vision, as many doctors have experienced. So hopefully, parents will take the right approach and keep adjusting as their child changes, and it takes a lot of patience to adjust every three months, six months, or a year, until the age of 18. But not with high myopia, where the catastrophic period begins only when the child enters the age of 18. The professor said that from observations at 20-year intervals to every five years, we now conduct meticulous annual follow-up studies and find that targeted measures can be taken according to the characteristics of each year of myopia development, enabling timely prevention of complications of high myopia and allowing patients to slow down the rate of blindness or not lose their eyesight. With high myopia of more than 1,000 degrees and an eye axis of more than 28 mm, blindness usually occurs at the age of 45, and many patients suffer from overall retinal atrophy, which is very distressing to us all. For high myopia, we set a line of defense every 3 years during childhood and a line of defense every 5 years after the age of 18, and we set about 15 lines of defense, each phase with its own characteristics. This requires a lot of data, and every week the professor spends a lot of time browsing the literature and organizing it, and doing it personally just to figure out what it takes to make the country enjoy the benefits of world-class science, which is what many ophthalmologists have been doing.