從公共衛生觀點重建台灣視力保健計劃的新藍圖

Reconstructing a new blueprint for Taiwanʼs visual healthcare plan from a public health perspective

世界衛生組織報告推估2050年近視人口將達到49.49億，約佔總人口數50%。為避免早發性近視的不正常眼軸生長導致高度近視風險，近視兒童需要規律就醫與追蹤；再加上人口老化與3C產品盛行，將產生更多的眼科疾病，這些問題都將衝擊眼科醫療資源與量能。兒童近視已成為公共衛生的重要問題，亞洲國家，如：新加坡與中國，已應用公共衛生觀點，從預防、篩檢到近視矯治，建置較完整的國家近視防治計畫。台灣在教育部與國民健康署持續推動預防近視的策略外，部分縣市也針對幼兒與學童提供散瞳後屈光檢查，持續呈現防治成效。本文旨在借鏡亞洲國家近視政策，重新檢視台灣視力保健計畫內容，並以公共衛生觀點提出視力保健計劃新藍圖，建議教育單位能持續藉由推動健康促進學校輔導模式、透過強化教師融入視力保健教學知能，發展生活技能為導向的近視防治教育、強化眼科照護專業的合作、確保衛生單位為強力後盾、及落實視力監測調查與回饋等策略，來達到保護學童視力健康。（台灣衛誌2024；43(5)：427-437）

The World Health Organization estimates that 50% of the global population will be affected by myopia by 2050, of which 10% will have high myopia. Regular medical check-ups and follow-ups are essential to prevent abnormal axial elongation, which leads to high myopia in children. Additionally, the prevalence of aging and widespread use of digital devices (3C products) are expected to exacerbate ocular diseases, impacting ophthalmic medical resources and capacity. Childhood myopia is a major public health concern. Asian countries, such as Singapore and China, have implemented more comprehensive national programs for myopia prevention and control, including prevention, screening, and treatment. In Taiwan, along with the national myopia prevention efforts, some municipalities have introduced cycloplegic refraction examinations for young children, which have shown sustained success in controlling myopia. This article re-evaluates Taiwan’s vision care programs in light of myopia policies from other Asian countries and proposes a new blueprint for visual healthcare plans. The proposed plan recommends that educational institutions should encourage health promotion models in schools; develop knowledge-driven myopia prevention education; enhance collaboration with eye care professionals; ensure strong support from health authorities; and implement strategies for vision monitoring, surveying, and feedback to ensure the visual health of school children. (Taiwan J Public Health. 2024;43(5):427-437)