July 20, 2026
By David Ng, OD, IACMM
Photo provided by Dr. Ng
Myopia is the defining vision health challenge of our generation. By 2050, roughly half the world’s population is projected to be myopic,1 and no country has carried a heavier burden than China. Yet the nation hit hardest by the epidemic is now the one rewriting its trajectory.
That was the core message at Vision China 2026, the International Forum on Innovation and Development of Visual Health, held May 28–30 in Tianjin. The meeting drew more than 10,000 participants and 1,047 invited experts, including 58 international speakers, across more than 120 forums.2 I attended as an invited speaker, and I wanted to share what the meeting, and conversations with colleagues in China, revealed about where myopia care is heading. This will be the first part of a two-part series about the public health campaign that is helping to turn the tide.
A crisis that became a national mobilization
China’s myopia problem is more than just kids needing glasses. It is the early onset with rapid progression, resulting in too many children with high myopia and associated lifelong risks—retinal detachment, myopic maculopathy, glaucoma and irreversible vision loss.
The scale is sobering: China’s 2018 national survey put overall myopia prevalence among children and adolescents at about 53.6%, rising from roughly 36% in primary school to 71.6% in junior secondary and 81% in senior secondary.3 The risk drivers are certain—intense academic pressure, urban indoor living, limited daylight and long hours of near work. This is precisely why China stopped treating myopia as a refractive disorder and elevated it into a large-scale government campaign.
Since 2018, inter-ministerial coordinated efforts from education, health and sports have held provinces accountable for their myopia trends. This was paired with school regulation, “school brightening” lighting upgrades and mandatory vision checks woven into national health reporting.4
The trajectory has changed
For two decades, the curve has only climbed. However, that has recently changed. National monitoring shows childhood myopia prevalence fell by 3.3% between 2018 and 2024.5 With approximately 280 million children aged 6 to 18 currently in China’s school system, even a few percentage points is enormous: that decline represents millions of children who would have been expected to become myopic but did not. The results are real.
Government Sets Targets for 2030
The decline is being measured against clear government targets. In December 2025, 13 departments led by the National Health Commission and the National Administration of Disease Control and Prevention issued the Children and Adolescents’ Five Health Promotion Action Plan (2026–2030), which folds myopia control into the Healthy China 2030 agenda alongside obesity, mental health, spinal curvature and dental care.
The vision-health targets are outlined as follows:
- Hold myopia among 6-year-olds to around 3%
- Bring myopia prevalence below 32% in primary school
- Bring myopia prevalence below 60% in junior secondary
- Bring myopia prevalence below 70% in senior secondary
The primary-school target has notably tightened from the earlier plan’s 38%.6 The interim yardstick set in 2018, at least a 0.5-percentage-point annual reduction from baseline, has been met and modestly exceeded. But the steeper 2030 endpoints remain a genuine stretch, especially in the upper grades, and China is candid that it is not there yet.
The tagline is shifting from “what percentage of children wear glasses” to “how many are progressing into high myopia and long axial lengths?” Plateauing prevalence is not the same as low prevalence.
Screening and prevention at a scale no one else attempts
What converts policy into results is screening, and here China operates at a scale seen nowhere else. The 2026–2030 plan mandates refractive screening at defined checkpoints—24 and 36 months, then ages 4, 5 and 6—with explicit attention to preserving each child’s hyperopic reserve, so intervention moves upstream, before myopia onset.
Kindergarteners will be screened every six months, while primary and secondary schoolers will be tested twice per semester. Results flow into electronic vision-health records that drive tiered, individualized intervention.6
In addition, there is a rigorously enforced toolkit: at least two hours of daily outdoor time, screen-time limits, the Bright Classroom lighting program, height-adjustable desks and chairs and regulations extending even to off-campus tutoring venues.
Challenges to overcome
It would be dishonest to present this as friction-free. Colleagues in China are frank that execution can be challenging. There are a number of barriers, including:
- Study-load culture eroding recess compliance
- “Outdoor time” gets quietly subverted when children sit in the shade doing worksheets or on phones
- Dense urban housing and traffic limit free play after school.
The policy is right; the daily implementation is hard. Even so, universal, repeated screening applied to hundreds of millions of children is the mechanism that has begun to turn the tide—and it is the part of China’s model most worth adopting worldwide.
None of this happened by accident, and none of it through policy alone. Public health created the conditions; clinical and technological innovation supplied the tools. In Part 2, I turn to that side of the story: the shift from single interventions toward full-lifecycle, individualized care; the treatments genuinely working and the ones still in dispute; the AI and innovation ecosystem anchored by China Eye Valley; and how the next phase of this fight will be won or lost.
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Dr. David Ng is the owner of Bayview Vision Care and The Myopia Clinic in Toronto, where he provides myopia management with a focus on orthokeratology since 2005. He earned his Doctor of Optometry from the University of Waterloo in 1995 and holds the International Academy Certification in Myopia Management from the American Academy of Orthokeratology and Myopia Control (AAOMC). Dr. Ng currently serves on the AAOMC Board of Directors and the AAOMC Advisory Board actively contributing to the Accreditation, Education, and Content Procurement committees. You can contact him via email at themyopiaclinic.ca or on LinkedIn. |
References
- Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036–1042.
- Vision China 2026 — International Forum on Innovation and Development of Visual Health. Tianjin, May 28–30, 2026. Official conference reports and program.
- National Health Commission of the People’s Republic of China. National survey of myopia among children and adolescents (overall prevalence 53.6%, 2018; non-cycloplegic screening). State Council Information Office press materials.
- Ministry of Education and seven other departments. Implementation Plan for the Comprehensive Prevention and Control of Myopia in Children and Adolescents. Beijing, 2018.
- National Administration of Disease Control and Prevention. National childhood myopia monitoring data, 2018–2024 (as reported at Vision China 2026).
- National Health Commission and National Administration of Disease Control and Prevention (13 departments). Children and Adolescents’ Five Health Promotion Action Plan (2026–2030). December 2025.
