Research School of Biology, ARC Centre of Excellence in Vision Science, Australian National University, Canberra, Australia.
Ophthalmic Physiol Opt. 2013 May;33(3):329-38. doi: 10.1111/opo.12040.
To analyse the relationship between myopia, educational performance and engagement in after-school tutorial classes.
Educational performance data and data on engagement in after-school tutorial classes were taken from the results of the Organisation for Economic Cooperation and Development (OECD) Program in Secondary Assessment (PISA) reports for 2009, which tested educational outcomes in representative samples of 15 year-old school children from 65 jurisdictions. High prevalence of myopia (>70%) and low prevalence of myopia (<40%) locations were identified by systematic literature search.
Six locations with a high prevalence of myopia were identified from among the participants in PISA 2009 - Shanghai-China, Hong Kong-China, Taiwan, Singapore, Japan and South Korea. All were ranked in the top quartile on educational performance. Other participants in the top educational performance quartile were identified as locations with a low prevalence of myopia, including Australia and Finland. The locations with a high prevalence of myopia combined high educational performance and high engagement in after-school tutorials, whereas the locations with a low prevalence of myopia combined high educational performance with little engagement in tutorials.
These results show that it is possible to achieve high educational outcomes without extensive engagement in after-school tutorials, and that the combination of high educational outcomes with extensive use of tutorials is associated with high prevalence rates of myopia. We suggest that extensive use of after-school tutorials may be a marker of educational environments which impose high educational loads. Further quantification of educational loads to include after- school educational activities, such as homework, tutorials and other after-school classes, as well as formal school classes, is desirable. Policy initiatives to decrease these loads may contribute to the prevention of myopia, perhaps, at least in part, by enabling children to spend more time outdoors.
分析近视、教育表现和参与课外辅导班之间的关系。
教育表现数据和参与课外辅导班的数据来自经济合作与发展组织（OECD）2009 年中学教育评估计划（PISA）报告的结果，该报告测试了来自 65 个司法管辖区的 15 岁学生代表性样本的教育成果。通过系统的文献搜索，确定了近视高发（>70%）和近视低发（<40%）的地区。
在 2009 年 PISA 的参与者中，确定了六个近视高发地区，分别是中国上海、中国香港、中国台湾、新加坡、日本和韩国。这些地区的教育表现均排名在前四分之一。其他被确定为教育表现处于前四分之一的地区，近视的发病率较低，包括澳大利亚和芬兰。近视高发地区的特点是教育表现高，同时课外辅导班的参与度也高，而近视低发地区的特点是教育表现高，课外辅导班的参与度低。
这些结果表明，在不广泛参与课外辅导班的情况下，实现高教育成果是可能的，而高教育成果与广泛使用辅导班相结合与高近视率有关。我们认为，广泛使用课外辅导班可能是教育环境施加高教育负担的标志。进一步量化教育负担，包括课外教育活动，如作业、辅导班和其他课外课程，以及正式的学校课程，是可取的。减少这些负担的政策举措可能有助于预防近视，至少在一定程度上可以通过让孩子有更多时间在户外度过。
