Research in Guangzhou

Taking the bullet train.
Imagine stations like these all over the country packed when the largest annual human migration in the world occurs as Chinese people flock from the cities to return home for the Lunar New Year

Chenghai

Last Thursday and Friday I went to Chenghai, a smaller city in the far east of Guangdong province, with one of my friends who is a PhD student doing research.  We went to visit the hospital that, under the direction of the Guangzhou researchers, is implementing a program of screening and incentivizing diabetes patients to get eye exams.

Hospital in Chenghai

Eye chart that doesn't require literacy or familiarity with the Roman alphabet;
patients point the direction the E is facing

The lab here in Guangzhou has a lot of ongoing research all geared towards improving eye care in China, particularly the rural areas.  Besides work addressing the extent of curable blindness in China due to cataracts and glaucoma, they are in the midst of projects concerning myopia, and this is what I've mostly been able to get involved with.

There’s an incredibly high (and rising) prevalence of myopia, or nearsightedness, in East Asian youth—also to some extent in other Western countries.  84% of school children in Guangzhou are myopic.  Besides the huge impact imperfect vision has on people without access to glasses, myopia can cause patients to be at risk for more serious eye diseases as they age.  A lot of the hypotheses concerning the source of this epidemic are rooted in culture.

An interesting example of the Chinese holistic look on health (and the government’s ability to implement nationwide measures): school children are made to do eye exercises twice daily in class, where they massage pressure points, supposedly to improve vision, but there’s no evidence it actually helps prevent myopia.
[photo from china.org]

Lack of exposure to natural light causing the development of myopia is a leading hypothesis that the lab where I’m working is testing.  A recent project has been to build classrooms with windows for walls to see if this type of environment reduces myopia.  Culturally, it’d be hard to convince parents to have their children spend more time outside in natural light instead of inside studying, so this is one alternative solution.  There’s a chance I may get to visit these experimental see-through schools in Guangdong, but the data-collecting trip will probably occur after I’ve left for Beijing.

[photo creds @WSJ]

Another branch of that project is trying to solve the lack of affordable glasses for rural school children who need them.  The researchers and doctors here are testing a sustainable system of tiered pricing, similar to the Aravind eye care system, where optional paid upgrades provide the funding for free glasses.  This also involves setting up training for local refactors so that they are able to prescribe the glasses themselves and diagnose children who have more serious eye diseases.  The ultimate goal of the project, called PRICE (Potentiating Rural Investment in Children's Eyesight), is to create a model to advocate for government adoption.  Next week some of the team (and me) are returning to the county schools to survey the children who have either received free glasses or chosen to buy the upgrade glasses.  One of the main questions is if the parents are supportive of them wearing glasses.  There's a notion among some Chinese that glasses can cause vision to deteriorate.