Notice from the General Office of the National Health Commission on Issuing the Guidelines for Prevention and Treatment of Myopia, Strabismus and Amblyopia (2026 Edition)
Key period of visual development in children and adolescents: standardized diagnosis, treatment, and
📋 Core Clinical Points
🔹 Amblyopia (2026)
During visual development, due to monocular strabismus, uncorrected anisometropia, high refractive error or form deprivation, the best‑corrected visual acuity of one or both eyes is below the age‑normal lower limit, with a difference of ≥2 lines between eyes, after excluding organic pathology.
Normal lower limit: 0.5 for ages 3–5, 0.7 for age 6 and above. Mild/moderate amblyopia: VA ≥0.2; severe: VA<0.2.<>
Classification: strabismic, anisometropic (sphere difference ≥1.50DS or cylinder ≥1.00DC), refractive (hyperopia ≥+5.00DS, astigmatism ≥2.00DC), and form‑deprivation (cataract, corneal opacity, etc.).
Treatment: optical correction (cycloplegic refraction), occlusion therapy (partial‑time occlusion, shorter duration for younger children), pharmacological/optical penalization (1% atropine), and surgical treatment of the cause. Follow‑up every 2–3 months; consolidation for 3–6 months after cure; follow‑up until visual maturity.
Relapse prevention: consolidate for at least 3 months after binocular balance; for children under 10, maintain therapy if vision difference<1 line.
🔸 Strabismus (2026)
Basic examination: history, visual acuity, cycloplegic refraction, ocular alignment (cover test, prism), ocular motility, binocular vision (Worth 4‑dot, synoptophore, stereopsis).
Esotropia: congenital (onset<6>40Δ, surgery before 24 months), accommodative (refractive/high AC/A, full hyperopic correction), partially accommodative (surgery for residual deviation), non‑accommodative, paralytic (abducens palsy), etc.
Exotropia: intermittent (common in Asia, control score guides surgery), constant (surgery mainly), congenital (surgery at 12–18 months), incomitant (oculomotor palsy), etc.
Special types: A‑V pattern, convergence insufficiency, sagging eye syndrome, myopic strabismus fixus (Yokoyama procedure), DVD, Duane syndrome, Brown syndrome, thyroid‑associated ophthalmopathy, myasthenia gravis, etc.
Surgical standards: preoperative work‑up, anesthesia, adjustable sutures, postoperative follow‑up (day 1, week 1, month 1, month 3, month 6, and long‑term).
🔹 Myopia Prevention (2026)
Definition: parallel light focuses in front of the retina under relaxed accommodation. Classification: refractive/axial, simple/pathologic, low/moderate/high (SE <‑0.50D to <‑6.00d).<>
Stages: pre‑myopia (insufficient hyperopia reserve), progressive (annual progression >50D or axial elongation >0.20 mm/year), high myopia (>‑6.00D or axial length >26 mm), and pathologic myopia (fundus lesions).
Risk factors: near work (>30–40 min), insufficient outdoor activity (<2 h/day), reading posture, lighting, heredity (parental myopia), gene‑environment interaction.
Examination: visual acuity, slit‑lamp, ocular alignment, axial length (annual growth ≤0.2 mm for ages 6–10), fundus, cycloplegic refraction (gold standard). Hyperopia reserve: about +1.38D at age 6, consuming ~0.12D per year.
Correction/control: spectacles (single‑vision/peripheral defocus), contact lenses (soft/RGP/ortho‑K), low‑dose atropine (ages 6–12, 100–400 degrees), traditional eye exercises. Follow‑up every 6 months; good control: axial elongation ≤0.20 mm/year or refraction progression ≤50D/year.
Pathologic myopia treatment: laser photocoagulation, anti‑VEGF, posterior scleral reinforcement (PSR), scleral buckling, vitreous surgery. Adult surgery: laser refractive surgery (LASIK/SMILE/PRK), phakic IOL (ICL).
📌 Integrated Analysis (within 500 words)
The three guidelines build a complete system from myopia prevention to standardized strabismus and amblyopia care. Myopia emphasises a three‑tier “prevention‑correction‑control” strategy, using hyperopia reserve, axial monitoring, low‑dose atropine and optical interventions as core tools, and clarifies management of pathologic myopia complications. The strabismus guideline details surgical timing and conservative management for congenital, accommodative and intermittent types, with emphasis on binocular vision reconstruction. The amblyopia guideline highlights age‑based visual acuity criteria, occlusion/penalization, relapse prevention, and early surgery for form‑deprivation amblyopia.
Common features: 1) evidence‑based updates on atropine and optical devices (peripheral defocus, ortho‑K); 2) reinforced follow‑up — amblyopia follow‑up until visual maturity, long‑term monitoring after strabismus surgery; 3) attention to adherence and psychological support; 4) clear surgical indications and risks. Overall, it responds to key clinical challenges: early‑onset myopia, delayed treatment of strabismus/amblyopia, and blindness from pathologic myopia.
⚙️ Core solutions & implementation
- ✅ Myopia prevention: Ensure 2 h outdoor daily, rest after 30–40 min near work, establish refractive records, regular axial measurement, low‑dose atropine or optical interventions (ortho‑K/defocus lenses).
- ✅ Strabismus: Cycloplegic refraction; choose conservative (glasses/training) or surgery (congenital esotropia before 24 months, intermittent exotropia guided by control score); long‑term follow‑up.
- ✅ Amblyopia: Optical correction + occlusion/penalization; younger age → more cautious intensity; consolidate 3–6 months after balance; follow‑up to age 9–12.
- ✅ Adherence management: Health education, behavioral incentives, electronic monitoring, psychological support to reduce relapse.
💬 Comments (10 selected)
⚕️ National Health Commission · July 13, 2026 · Open Access
