I. Purpose Through eye health promotion and education, vision assessment and screening of related eye diseases, early detection of eye diseases affecting children’s visual development, early correction or timely referral, in order to prevent the development of controllable eye diseases in children and protect and promote the normal development of children’s visual function. II. Service targets Children aged 0 to 6 years old in the district. Third, the content and methods (a) time. 1, healthy children should have their first eye screening 28 to 30 days after birth, and stage eye screening and visual acuity examination at the same time as health check-ups at 3, 6 and 12 months of age and 2, 3, 4, 5 and 6 years of age, respectively. 2. Newborns with high-risk factors for eye disease should be examined by an ophthalmologist as early as possible after birth. High-risk factors for ophthalmology in newborns include: (1) Neonatal intensive care unit stay of more than 7 days and a history of continuous oxygenation (high concentration). (2) Clinical family history of hereditary eye disease or suspected syndromes related to eye disease, such as congenital cataract, congenital glaucoma, retinoblastoma, congenital microphthalmia, and nystagmus. (3) Intrauterine infections caused by cytomegalovirus, rubella virus, herpes virus, syphilis or toxoplasma protozoa (Toxoplasma gondii), etc. (4) Craniofacial morphologic deformities, large facial hemangiomas, or ectropion of the eyeballs during crying. (5) Difficult birth, instrument-assisted delivery. (6) Persistent ocular lacrimation, with a large amount of discharge. (3) Premature and low birth weight infants with birth weight <2000g should be screened by an ophthalmologist for the first time for fundus pathology at 4-6 weeks after birth or at 32 weeks of corrected gestational age. (B) Examination content and methods. 1. Content The eye appearance examination should be performed on children aged 0 to 6 years during the child health examination, and the visual acuity examination should be increased for children aged 4 years and above. Areas with conditions can add other eye disease screening and visual acuity assessment corresponding to the age of the child: light response examination at full-term visits to detect structural abnormalities of the eye; instantaneous reflex examination and red ball test for 3-month-old infants to assess the infant's near vision and gaze ability; visual behavior observation and eye position examination (corneal reflection plus masking test) for 6-month-old infants, 1 to 3-year-old children for Eye movement examination was performed to assess the presence of visual impairment and eye position abnormalities. 2. Methods (1) Eye appearance: Observe the eyelid for defects, inflammation, swelling, eyelash entropion, symmetry of the size of the two eyes; conjunctiva for congestion, conjunctival sac for secretion, and continuous tearing; cornea for transparency in a round shape; pupil for centering, round shape, symmetry of the two eyes, and black appearance. (2) Light response: The examiner will quickly move the flashlight to the infant's eyes to illuminate the pupil area and repeat several times, separately for both eyes. It is normal for the infant to show reflexive eye closure. (3) Transient reflex: The subject takes the direction of the light, and the examiner moves the hand or a large object quickly in front of the subject's eyes without touching the subject. It is normal for the infant to have an immediate reflexive defensive blinking movement. If the test is not completed at 3 months of age, continue the test at 6 months of age. (4) Red ball test: Use a brightly colored red ball about 5 cm in diameter to move slowly in front of the infant's eyes at a distance of 20 to 33 cm, and repeat the test 2 to 3 times. Infants appear to briefly look for or follow the performance of gazing at the red ball as normal. If the examination is not completed at 3 months of age, continue this examination at 6 months of age. (5) Eye position examination (corneal light reflection plus masking test): Place a flashlight 33 cm in front of the child's eye to attract the child to look at the light source; cover the child's left and right eyes with an eye shield and observe whether the eye moves horizontally or up and down. In normal children, when both eyes are looking at the light source, there is a reflection point in the center of the pupil, and there is no obvious eye movement when the left and right eyes are covered respectively. (6) Eye movement: From the front of the child, slowly move the flashlight up, down, left and right. When a normal child looks at the light source with both eyes, both eyes can move smoothly in the same direction at the same time, and the reflective point remains in the center of the pupil of both eyes. (7) Visual behavior observation: Ask parents whether the child has abnormal behavioral manifestations when looking at things, such as not being able to look at each other with family members or reacting poorly to the outside world, being slow to avoid obstacles in front of them, having difficulty walking in the dark, looking at things with an obvious head tilt or close distance, photophobia or squinting, nystagmus, etc. (8) Visual acuity examination: The international standard visual acuity table or logarithmic visual acuity table is used to examine children's visual acuity, the testing distance is 5m, the visual acuity table illumination is 500 Lux, and the height of 1.0 lines of the visual acuity table is the height of the examinees' eyes. During the examination, one eye is shielded, but do not compress the eye, and the examination is performed monocularly in the order of right first and then left. The top-down identification of the visual scale is done until the line that cannot be identified, and the previous line can be recorded as the visual acuity of the examined person. Children with low visual acuity ≤0.6 at the age of 4 and ≤0.8 at the age of 5 and above, or children with two or more lines of visual acuity difference between the two eyes, should be re-examined once in 2 weeks to 1 month. (C) Eye and vision care guidance. 1. Early detection and timely consultation Identify common eye diseases in children. Children should go to the hospital promptly if they have abnormalities such as red eyes, photophobia, tearing, excessive secretions, white pupil area, skewed eye position or crooked head vision, nystagmus, inability to chase after the eyes, seeing too close or squinting, and difficulty walking in the dark. Children should receive regular eye disease screening and vision assessment. 2. Pay attention to eye hygiene (1) Cultivate good eye hygiene habits, including developing correct posture for reading and writing, correct pencil grip, and reading and playing in a well-lit environment. (2) Children should not spend more than 30 minutes at a time in continuous close gaze, and should not spend more than 20 minutes at a time operating various electronic video products, with the cumulative time recommended not to exceed one hour per day. The distance between the eyes and the fluorescent screen of various electronic products is generally 5-7 times the diagonal of the screen, with the screen surface slightly lower than the eye height. (3) Children with refractive error should go to a qualified medical institution or eyeglass dispensing institution for regular dilated eye examinations to adjust the diopter of the glasses and not to use poor quality and substandard glasses. (4) Do not blindly use eye care products, but use them reasonably and moderately under the guidance of a medical professional. (5) Reasonable nutrition and balanced diet. Go to outdoor activities frequently, not less than 2 hours a day. 3. Prevent eye trauma (1) Children should stay away from fireworks, sharp instruments and harmful substances, and not to move around in places with danger, and prevent eye injury from pets. (2) Do not place sharp instruments, strong acids and alkalis and other harmful objects in children's activities, and pay attention to the safety of toys. (3) Children's eyes into foreign bodies, or eye stabbing, bruising, to promptly go to the medical institutions with ophthalmology consultation. 4. Prevent infectious eye diseases (1) Educate and urge children to wash their hands frequently and not to rub their eyes. (2) Do not lead children with infectious eye disease to places where people gather. (3) The community or child care institutions should take care to isolate children with infectious eye disease to prevent the spread of the disease. (D) Referral. Children with one of the following conditions should be promptly referred to higher-level maternal and child health institutions or relevant specialist clinics of other medical institutions for further consultation and treatment. 1. Newborns with high-risk factors for eye disease and premature and low birth weight infants with birth weight <2000g. 2.The examination of eyelids, conjunctiva, cornea and pupil reveals suspicious structural abnormalities. 3.The infants who were examined for cooperation were unable to elicit light response and transient reflex by repeated testing. 4.The gaze and follow test examinations are abnormal. 5.Present with any kind of abnormal visual behavior. 6.Eye position examination and eye movement examination reveal eye position skew or movement incoordination. 7.Vision after review, ≤0.6 for children aged 4 years, ≤0.8 for children aged 5 years and above, or two lines or more difference in vision between the two eyes. Flow chart (omitted) V. Work requirements (a) Community health service centers and township health centers will conduct screening of eye diseases and visual acuity assessment corresponding to their age at the same time of children's health checkups, and at the same time conduct publicity and education on children's eye and vision care to detect children's eye diseases and poor vision at an early stage. Children with suspected eye disease or low vision detected by screening should be referred to higher-level maternal and child health institutions or other medical institutions for further consultation and treatment. (B) medical and nursing staff engaged in eye screening and vision assessment should receive relevant professional technical training and obtain a training certificate. (C) eye disease screening and visual behavior assessment should be conducted indoors under natural light, inspection equipment for power energy sufficient spotlight flashlight, red ball of about 5 cm in diameter, eye shield. Visual acuity examination equipment is the international standard visual acuity table or logarithmic visual acuity table light box. (iv) Carefully fill out the relevant examination records and conduct follow-up visits for referral ending. VI. Assessment indicators Coverage rate of vision examination for children aged 4 to 6 years = (number of children aged 4 to 6 years who received vision examination in the jurisdiction in that year / number of children aged 4 to 6 years in the jurisdiction in that year) × 100%