Following is a question by Dr the Hon Dennis Lam and a reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (October 22):

Question:

     According to the information from the Department of Health (DH), in the 2023-2024 school year, 53.8 per cent of Primary Six students wore glasses, while the proportion of secondary school students wearing glasses was even higher, at 63 per cent. The percentage of children and adolescents suffering from high myopia is also on the rise, which is a cause for concern. In this connection, will the Government inform this Council:

(1) whether it will expand the scope of the visual acuity tests provided by DH's Student Health Service (SHS) to include detailed refraction tests for students, instead of conducting only screening tests, so as to enable students to understand their visual and myopia conditions at an early stage and prevent the progression of myopia;

(2) as it has been reported that some parents are unable to spare the time to bring their children to undergo the visual acuity tests provided by SHS, resulting in a coverage rate of only about 65 per cent for such tests, whether the Government has studied how to raise the coverage rate; if so, of the details; if not, the reasons for that; and

(3) whether it will study the promotion of emerging myopia control therapies in the primary healthcare system, such as defocus lenses, orthokeratology lenses (commonly known as "OK lenses") and low-concentration atropine eye drops, and establish relevant public-private referral and subsidy mechanisms for children from grass-roots families?

Reply:

President,

     The Government has been safeguarding the visual health of children and adolescents. Among others, the Department of Health (DH) has been providing free visual assessment services for children and adolescents annually in Hong Kong from birth until secondary school graduation through Maternal and Child Health Centres (MCHCs) and Student Health Service (SHS) Centres. These services enable the early identification of students with visual acuity problems, as well as timely provision of advice and intervention.

     In consultation with the DH and Hospital Authority (HA), the reply to the question raised by Dr the Hon Dennis Lam is set out below:

(1) The MCHCs of the DH offer free and detailed physical examinations, including eye examinations, for newborn babies to rule out those with congenital visual defects. After that, the MCHCs offer free Pre-school Vision Screening for pre-school children aged 4 to 5, so as to identify those with problems, such as amblyopia, squint or significant refractive errors, as early as possible. For instance, in 2024, more than 23 600 pre-school children took part in the free vision screening, and we referred 15 per cent of them with visual acuity problems to ophthalmologists for follow-ups.

     When children enter the school years, the DH offers free and comprehensive annual health assessment services, including vision screening, for approximately 400 000 primary and secondary school students annually. Regardless of whether the students wear glasses, they will be arranged to undergo vision screening. The vision screening tests and standards provided by the DH are consistent with the latest guidelines published by the World Health Organization (WHO) in 2023.

     In response to Dr the Hon Dennis Lam's first question, our annual health assessments is far more than just screening. After the initial screening, the DH follows up with detailed ophthalmic examinations. For example, in the 2023/24 school year, among the some 257 000 primary school students who received free annual health assessments, approximately 35 per cent of them wore glasses. Following assessment, it was found that nearly 20 per cent, approximately 51 000 students failed the preliminary visual acuity test screening. They were referred to optometrists in the DH's health assessment services for further visual assessment. Among the aforementioned some 51 000 students, more than 60 per cent, i.e. about 32 000, of them underwent further assessments provided by optometrists of the DH, including diopter tests, pupil examination, retinoscopy and testing for squint. Meanwhile, some parents chose to consult private optometrists for assessments and follow-ups for their children. Students with common refractive problem should wear glasses with the correct prescription to improve their vision, while others identified with vision problems will be referred to the HA Ophthalmology for follow-ups.

(2) Regarding the second question, Dr the Hon Dennis Lam mentioned that the overall coverage rate (for the vision screening provided by the SHS) was 65 per cent as parents were unable to spare time to accompany their children to join the screening. I have to clarify that this piece of information is incorrect, because participation in the annual health assessments requires parental consent, but parents are not required to accompany their children. As revealed in the statistics, in the 2023/24 school year, 98.8 per cent of primary and secondary schools in Hong Kong participated in the DH's free annual health assessment services, which include vision tests. We see a very high, near full school participation rate, and we are grateful for schools' active involvement and emphasis on students' health.

     However, in terms of student coverage, there were 257 000 primary school students with parental consent, the coverage rate for primary school students was just 78.6 per cent. The service coverage rate for secondary school students was even lower, involved about 173 000 students, rated at only 53.6 per cent. Among them, the coverage rate for Secondary One students was 71 per cent, which dropped to 56.3 per cent by Secondary Three, and further dropped to 30.9 per cent by Secondary Six. In short, the higher grade and the older the students, the less interest for them to join the health assessments. As for why participation is lower among higher grade students, I believe there are many factors, including increasing academic pressure, more extracurricular activities, or self-perception of good health after grown-up while parents are unable to persuade their children to take part. Therefore, the participation rate has definitely nothing to do with parents being unable to spare time to accompany their children to join the screening.

     As President Xi Jinping said that health is the "1", and everything else is the "0" that follows. Without the "1", no matter how many "0s" follows, it has no meaning. If students cannot see the blackboard clearly, how can they learn and attend school? An annual health assessment takes only about 90 minutes and brings significant benefits to students' health. I hope schools, and especially parents should be more committed to working together to safeguard the healthy growth of children. 

     I would like to reiterate that, participation in the annual health assessments requires parental consent, but the DH does not require parents to accompany their children. For many years, the DH arranges time for annual health assessments for schools, and even provide free shuttle bus services to participating schools of the annual health assessment services, facilitating schools to arrange more students to attend the annual health assessment services. The DH has even implemented online enrolment starting from the 2024/25 school year to facilitate student participation in the annual health assessment services.

(3) Prevention is better than cure. Maintaining good eye care habits and having regular vision examinations are essential to preventing myopia and slowing its progression. Many regions in the world, including the Chinese Mainland and Singapore, advocate myopia prevention and control through ways including health education, promoting outdoor activities and reducing the use of electronic screen products. The DH will continue to encourage students to develop healthy lifestyles through annual health assessments and health promotion education. This includes accumulating at least 60 minutes of moderate to vigorous-intensity physical activity daily, as recommended by the WHO, reducing the use of electronic screen products and observing to guidelines on eye health.

     In recent years, some optometry centres have promoted products and treatments claiming to help control or slow the progression of myopia. However, the effectiveness of these products and treatments varies among individuals, and whether to adopt them depends on many factors, such as the preferences of parents and students, time arrangements, financial ability and the overall cost-effectiveness to society. Parents should consider multiple factors and seek professional advice from registered optometrists and ophthalmologists when deciding whether to choose the prescription glasses or new products and treatments for their children.

     Thank you, President.

Ends/Wednesday, October 22, 2025
Issued at HKT 18:55

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