新冠肺炎疫情下之學童近視問題衝擊與因應

Myopia related impacts and responses among school children during Covid-19

新冠肺炎對人類生活方式與健康帶來重大影響，各國政府為避免疫情傳播採取不同程度的校園防疫措施，除了限制戶外活動外，部分國家也停止實體上課，改為線上學習，有鑑於此，國外學者紛紛以研究證實因疫情限制措施導致學童近視問題惡化的情勢。而台灣在2020年5月首次停止各級學校的實體課程、社團活動與課後輔導、安親班等，更讓健康專家對疫情時期學童視力問題感到憂心。依據文獻整理得知，在疫情前後，學童視力盛行率顯著上升、每天戶外活動時間不到1小時、每日線上課程至少1小時以上、近距離活動與螢幕使用時間顯著增加，而手機是其線上課程學習的主要載具。此外，疫情期間，學童近視屈光度數年增長約為>0.5D~0.98D，眼軸年增長速度>0.2 mm。有鑑於國內外尚未具體提出因應後疫情時代之近視防治策略，本文依文獻統整之結果，提出以下建議：（一）強化學童與家長因應近距離用眼的生活技能；（二）為教師採行線上教學做好規劃與準備；（三）落實3C載具的使用與控管原則；（四）運用科技輔助監測與追蹤產品；期望能以此四項因應策略，預防因防疫限制措施所造成的學童視力惡化問題。

The Covid-19 pandemic has affected lifestyles and health worldwide, forcing countries to adopt different levels of epidemic prevention. In addition to restricting outdoor activities, some governments have suspended in-person classes, switching to online learning. Multiple scholars have conducted studies confirming that the prevalence of myopia among school children has worsened due to the implementation of pandemic restrictions. Since May 2020, the Taiwanese government has suspended all in-person classes, club activities, after-school tutoring, and parenting classes at schools, further escalating health experts’ concerns about myopia. A literature review suggests that since the beginning of the pandemic, the prevalence of myopia increased considerably among school children, as they spent less than 1 hour in outdoor activities and at least 1 hour in online classes per day, often relying on mobile phones to complete coursework. Children also spent substantially more time engaged in close visual work and other screenrelated activities. During the pandemic, annual growth of diopter and axial length in school children were approximately >0.5–0.98 D and >0.2 mm,respectively. However, neither foreign nor domestic studies have proposed specific strategies for myopia prevention in the postpandemic era. Therefore, based on the literature review, this study proposes the following solutions: (1) strengthen life skills of children and parents in limiting close visual work; (2) assist teachers in adapting curriculum for online learning; (3) implement guidelines for the use and management of 3C products; and (4) introduce technological monitoring and tracking products. These 4 responses may prevent eyesight deterioration in school children due to pandemic restrictions.