ABSTRACT Objective: To investigate the effect of smaller back optic zone diameter (BOZD) orthokeratology lenses on the long-term prevention and control of myopia in children. Methods: Retrospective study. A total of 191 adolescent patients with myopia (382 eyes) who underwent orthokeratology in Kangshi Eye Hospital of Anhui Medical University from August 2022 to October 2023 were included as the study objects. They were grouped according to different optical areas. Among them, 105 cases (210 eyes) underwent orthokeratology lens with an optical area of 5.5mm were in the BOZD 5.5mm group, and 86 cases (172 eyes) underwent orthokeratology lens with an optical area of 5.9mm were in the BOZD 5.9mm group. The changes of axial lengths (AL) before and after 6 and 12 months were analyzed. Based on the initial data of the subjects with BOZD 5.5mm, they were divided into different groups to further explore the myopia control effect of small optic zone orthokeratology mirror on subjects with different age, diopter and pupil diameter. Results: After 6 months of orthokeratology treatment, AL increased by 0.1mm in the BOZD 5.5mm group and 0.12mm in the BOZD 5.9mm group, and axial elongation decreased by about 0.02mm in the former group,the difference was no statistically significant(P＞0.05). After 1 year of treatment, AL increased by 0.13mm in the BOZD 5.5mm group and 0.26 mm in the BOZD 5.9mm group, and the axial elongation of the eye in the former group was about 0.13mm less than that in the latter group, the difference was statistically significant(P<0.05). After wearing orthokeratology lenses for 1 year, 63.3% of subjects in the BOZD 5.5mm group had an annual axial increase of less than 0.2mm. In the analysis of different groups, it was found that myopic children with larger pupil diameter (＞4.02mm) before wearing glasses could often get better control effect, and the difference was statistically significant (P<0.05). For children of different ages and different diopters, BOZD5.9mm orthokeratology lens had the same myopia control effect, with no statistical significance (P＞0.05). Conclusion: Reduce the back optic zone diameter orthokeratology lens can effectively slow down the axial growth of the eye. Compared with conventional orthokeratology lens, smaller back optic zone diameter orthokeratology lens can delay the myopia progression by about 47.6%~48.9%.

Objective To investigate the prevalence of high myopia among middle school students in a district of Shanghai and analyze the associated factors to provide information for preventive measures against high myopia. Method A stratified cluster sampling method was used to select middle school students in a district of Shanghai for a questionnaire survey and vision examination. Multivariate logistic regression was employed to analyze the influencing factors. Result A total of 6651 students participated in the survey, with 5048 students included in the final analysis. Among them, 2489 were boys (49.31%) and 2559 were girls (50.69%). The prevalence of high myopia was 16.8%, with 17.1% in boys and 16.5% in girls. Multivariate logistic regression analysis indicated that students with both parents having myopia (OR=2.028, 95%CI: 1.687-2.438) were more likely to develop high myopia compared to those with neither parent having myopia. Obese students were more prone to high myopia compared to students with normal BMI (OR=1.519, 95%CI: 1.235-1.869). Students engaging in moderate to high-intensity physical activity 6-7 days per week were less likely to develop high myopia compared to those with 0-1 days of such activity (OR=0.722, 95%CI: 0.547-0.954). Conclusion The prevalence of high myopia among middle school students in a district of Shanghai is relatively high. Parental myopia and obesity are risk factors for high myopia, while increased frequency of moderate to high-intensity physical activity serves as a protective factor.

Objective To evaluate the application effect of the MOOC-based blended teaching model in ophthalmology teaching of rural medicine. The rural medical students of grade 2021 and 2022 in our hospital were selected as the intervention group to implement the online and offline mixed teaching mode based on MOOC, and the rural medical students of grade 2019 were selected as the control group to implement the traditional offline teaching. The academic performance of the two groups was compared. At the same time, the attitudes of students and teachers towards mixed teaching mode were investigated through questionnaires. Results The final scores and total scores of the intervention group were significantly better than those of the control group. 71% of students believed online learning benefited their regular study. 31% of students liked this way of learning very much, and 7% did not like it. 36% of the students found it easy to understand. Conclusion The MOOC-based online and offline mixed teaching model can improve the teaching effect of rural medicine students, but it is a challenge that teachers and students cannot fully accept the model.

Objective To evaluate the application effect of the MOOC-based blended teaching model in ophthalmology teaching of rural medicine. The rural medical students of grade 2021 and 2022 in our hospital were selected as the intervention group to implement the online and offline mixed teaching mode based on MOOC, and the rural medical students of grade 2019 were selected as the control group to implement the traditional offline teaching. The academic performance of the two groups was compared. At the same time, the attitudes of students and teachers towards mixed teaching mode were investigated through questionnaires. Results The final scores and total scores of the intervention group were significantly better than those of the control group. 71% of students believed online learning benefited their regular study. 31% of students liked this way of learning very much, and 7% did not like it. 36% of the students found it easy to understand. Conclusion The MOOC-based online and offline mixed teaching model can improve the teaching effect of rural medicine students, but it is a challenge that teachers and students cannot fully accept the model.

Objective The Clinical characteristies, pathogenic causes, and risk factors affecting visual outcomes of infectious endophthalmitis were analyzed. Methods The clinical data of patients included in the study were retrospectively analyzed. Culture results of intraocular fluid, treatment and visual acuity were collected. Binary logistic regression was used to analyze the risk factors of affecting visual outcomes of infectious endophthalmitis. Results 77 patients(78 eyes, 54 male) were included. Exogenous endophthalmitis was the main cause (71 cases, 92.2%), 37 cases had a history of eye truma, 20 cases had eye surgery, and 14 cases had keratitis. 54 cases were sent for microbial culture and the positive rate was 53.7%. Fusarium solani were 6 cases(21.3%).Co-infection were 6 cases(20.7%). Among the 77 patients with infective endophthalmitis, 40(51.9%) underwent vitrectomy, and 5(6.5%) underwent enucleation (all endogenous endophthalmitis) after drug and surgical treatment. The results of the best corrected visual acuity before and after treatment showed that the best corrected visual acuity before operation was lower than 0.02 in 65 cases and after operation was lower than 0.02 in 46 cases, The difference between the two was statistically signiicant (p<0.05). Binary logistic regression analysis showed that the BCVA lower than 0.02 before treatment was an independent risk factor for bad visual outcomes. Conclusion Patients with infective endophthalmitis are mainly exogenous endophthalmitis, of which the proportion of patients with fungal infection and co-infection were higher, Patients with the BCVA lower than 0.02 before treatment was an independent risk factor for bad visual outcomes.

In the training of professional masters in ophthalmology, the cultivation of medical humanistic literacy is crucial. These qualities enhance doctor-patient communication by enabling doctors to thoroughly understand patients' needs, clearly explain conditions and treatment plans, and ultimately improve patient adherence and satisfaction. This emphasis on humanistic qualities also boosts ethical awareness and compliance with medical ethics, facilitating prudent decision-making in complex medical scenarios and conflicts of interest. Moreover, focusing on these qualities can increase job satisfaction and overall competency, forming a robust foundation for producing exemplary ophthalmologists. This article suggests cultivating humanities literacy in professional masters through comprehensive curriculum design, innovative teaching models, and humanistic case study. The effectiveness of these program is analyzed, offering theoretical support and reference for enhancing humanistic qualities in ophthalmology master's programs.

Objective: To analyze the reasons for not performing laser refractive keratomileusis surgery among refractive surgery candidates under regular preoperative examination. Methods: The patients with myopia examined in the Center of Ophthalmology in the First Affiliated Hospital of Anhui Medical University Laser between January 2015 and June 2017 were selected, the reasons for not performing laser refractive keraomileusis after regular preoperative examination were analyzed. Results: A total of 2 875 patients requested refractive surgery and 2 054 (71.4%) of them received refractive surgery. Among 821 (28.6%) patients who did not get laser refractive keratomileusis, 462 (56.3%) were male and 359 (43.7%) were female, aged 18–51 years (range, 23.69±5.85 years). The most common reason for not offering refractive surgery were social psychological factors (59.0%), low central corneal thickness (22.2%), high myopia (12.2%), high intraocular pressure (2.3%), poor corrected visual acuity (1.6%), corneal topography anomaly (1.3%), retinal disease (0.9%), corneal (0.4%) and other diseases (0.2%). Conclusion: Reasons for not performing refractive surgery are quite diverse. Social psychological factors and inadequate corneal thickness were the most common reasons in the present study. Careful preoperative examination, strictly mastering indications and contraindications and full doctor-patient communication should be done for the safety of surgery.

Congenital nasolacrimal duct obstruction is a common eye disease in children, which seriously affects the physical and mental health of children. As a traditional treatment method for congenital nasolacrimal duct obstruction, lacrimal sac massage technology has always been favored by doctors, patients and their families because of its non-invasiveness and ease of operation. However, up to now, the self-healing mechanism of congenital nasolacrimal duct obstruction is still unclear, the understanding of the intervention timing of lacrimal sac massage is not uniform, and the operation methods of lacrimal sac massage are also different. There are still great differences in the selection principles of various massage treatments and massage combined with other treatments and their corresponding efficacy evaluation in literature reports. In recent years, with the development of the concept and technology of minimally invasive diagnosis and treatment, lacrimal sac massage for the treatment of congenital nasolacrimal duct obstruction has attracted much attention and made great progress. This paper briefly summarizes the development of lacrimal sac massage for congenital nasolacrimal duct obstruction, the principles and types of lacrimal sac massage, the indications and timing of lacrimal sac massage therapy, the clinical application of lacrimal sac massage, the factors affecting its efficacy, the existing problems to be solved and its prospects.

Objective: To investigate the preoperative anxiety in patients with cataract in a township hospital. Methods: A retrospective study was conducted on preoperative anxiety of 2 182 patients with cataract according to the Anxiety Visual Analogue Scale (VAS-A) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) from Jan 1, 2017 to Sep 30, 2017 in Heyuan Guangming Eye Hospital. Student’s t-test and Spearman correlation were used to evaluate the preoperative anxiety. Results: The score of preoperative anxiety was 4.74±1.93 with the VAS-A and was 6.46±1.66 with the APAIS. The preoperative anxiety in male was lower than that in female, and the degree of the preoperative anxiety was negatively correlated with age. Conclusion:The preoperative anxiety of patients with cataract can be properly evaluated using either the VAS-A or the APAIS.The nursing care should be adjusted corresponding to patients’ different needs of the information about anesthesia and surgery in order to alleviate the preoperative anxiety and improve the nursing care.

Objective: To observe the perioperative nursing of femtosecond laser-assisted corneal endothelial transplantation in the treatment of patients with bullous keratopathy. Methods: A retrospective analysis of 20 patients with bullous keratopathy with femtosecond laser-assisted corneal endothelial transplantation in our department. The preoperative psychological counseling, preoperative preparation, ocular examination, how to cooperate with the doctors in operation, nursing of special position, high intraocular pressure after surgery, how to use eye drops correctly and health education after discharge were summarized. Results: Nursing were performed to the patients timely and effectively. Postoperative visual acuity of all the patients were improved, the endothelial and corneal stroma bed are well combined and no graft rejection and other complications occurred in the patients postoperatively. Conclusion: We concluded that the quality of nursing was improved and the time of hospitalization was shortened after perioperative nursing.