Microspherophakia (MSP) is a rare congenital zonular dysplasia characterized by increased anteroposterior lens thickness and reduced equatorial diameter, resembling a spherical shape. The related ocular manifestations of MSP include shallow anterior chamber, lens derived high myopia, ectopia lentis and secondary glaucoma. In the early stage of MSP, vision acuity may be improved by glasses. Cataract surgery is necessary once secondary lens dislocation and glaucoma occur. A 72-year-old male hospitalized patient was reported who complained increased blurred vision of his right eye for 2 years. In the past 2 years, the power of his binocular glasses was increased to -10 diopters without significant improvement in visual acuity. Lens dislocation and phakic insufficiency caused by MSP was diagnosed after he attending clinics at the Eye and ENT Hospital of Fudan University, Shanghai, China. Phacoemulsification with scleral sutured intraocular lens (IOL) implantation surgery and anterior vitrectomy were performed. One month after operation, macular edema was found at first follow-up. Compound pingdingmu granule was taken orally and Bromfenac sodium eye drops were applied three times a day. Two weeks later, visual acuity of his right eye was improved significantly and macular edema was eliminated dramatically.

Combined surgery of pars plana vitrectomy (PPV) and phacoemulsification is an effective and safe way for management of retinal diseases complicated with cataract. Posterior capsular rupture (PCR) is one of the common intraoperative complications of phacoemulsification, and it is thus very important to deal with it promptly and efficiently, and ensure the subsequent procedures of intraocular lens (IOL) implantation as well as PPV. We will summarize the key points of the surgical technique for management of PCR and capture of IOL optic during combined surgery.

More than half of the patients developed chronic graft-versus-host disease after accepting allogeneic hematopoietic stem cell transplantation suffer from ocular graft-versus-host disease. Ocular graft-versus-host disease involves persistent inflammation and fibrosis of the ocular surface and keratoconjunctivitis sicca is the most common symptom. Severe ocular graft-versus-host disease not only affects patients’ life quality, but also increases the risk of other ocular complications. The treatment of chronic ocular graft-versus-host disease mainly includes drug treatment, such as local application of artificial tears, serum eye drops and anti-inflammatory drugs; physical treatment, such as wearing contact lenses and meibomian gland massage; surgical treatment, such as punctal occlusion and reconstructing ocular surface. With the in-depth study of the pathogenesis of ocular graft-versus-host disease, many new therapeutic drugs and methods have emerged. Summarizing the latest research progress in drug, physical and surgical therapy of chronic ocular graft-versus-host disease will give us insights into treatment options and hot spot of research.

Objective: Relying on the latest 5th generation wireless systems (5G), a remote primary ophthalmology care diagnosis platform based on fundus images was constructed in order to promote the connectivity of medical resources and improve the primary health service capabilities and the overall effectiveness of the medical service system. Methods: Based on the 5G informatization development strategy of hospitals, and under the funding and guidance of the Hainan Provincial Health Commission, the Hainan Eye Hospital of Zhongshan Ophthalmic Center and China Unicom Communications Group Hainan Co., Ltd. conducted a cross-industry, multi-disciplinary technical research. To build platform construction modules and technical routes under 5G networks, present the remote ophthalmological diagnosis process, and apply it in many regions in Hainan Province. Results: The performance of the remote diagnosis platform is well. From December 2020 to November 2021, this study was carried out in 186 health centers in 17 regions of Hainan Province. A total of 1 561 patients with fundus disease image data were collected. The number of positive screening fundus disease cases was 185. The total positive rate was 11.9%. Among them, 42 cases required referral for treatment, with a referral rate of 23%, and 143 cases did not require referral for treatment, with a non-referral rate of 77%. Among 1 561 cases of fundus images, 490 fundus images were excluded due to abnormal quality. Compared the results of the diagnosis platform system with manual diagnosis, 1 002 fundus images were identical, and 69 fundus images were different in diagnosis. The accuracy of the auxiliary diagnosis system was 93.3%. Conclusions: The collaboration of 5G mobile communication and telemedicine imaging, combined with internet technology to promote new medical productivity, improve quality and efficiency of the health economy. This study is an application model for exploring 5G application scenarios in the medical field.

Chronic graft-versus-host disease (cGVHD) is one of the most devastating complications following bone marrow transplantation. GVHD develops in 10–80% of patients after hematopoietic stem cell transplantation (HSCT). The eye is one of the most vulnerable organs of the human body. Ocular GVHD occurs in 40–60% of patients with GVHD undergoing HSCT, and it mostly affects the lacrimal glands, meibomian glands, cornea, and conjunctiva. The most common form of ocular GVHD is dry eye disease (DED). The long-term treatment of cGVHD-related dry eye syndrome remains challenging and involves a multidisciplinary approach. Besides systemic immunosuppression and ocular lubricants, topical steroids, topical cyclosporine, and topical tacrolimus are commonly prescribed. Newer therapeutic interventions for moderate and severe cGVHD-related DED include using serum eye drops and scleral contact lenses. Emerging treatment options include subconjunctival injection of heavy chain-hyaluronan (HC-HA)/ pentraxin 3 (PTX3), intravenous injection of mesenchymal stromal cells, antifibrotic drugs, etc. This article reviews the mechanisms, clinical findings, and treatment of cGVHD-related dry eye syndrome.

Objective: To investigate the satisfaction and teaching effect of 8-year program medical students in live-streamed classroom on ophthalmology. Methods Based on teaching experience of live-streamed classroofrom the perspective of the 8-year program medical students, a questionnaire survey, classroom tests and course examination were conducted. The content of the questionnaire includes 3 parts: the basic information of the respondents, evaluation of live-streamed classroom teaching and its satisfaction. The SPSS 20.0 statistical software was used for data analysis. Results: A total of 92 students completed the questionnaire survey, including 37 males and 55 females, aged (22.9±0.71) years. The sores of content, resource, platform design, platform technology and learning communication of live-streamed classroom were 40.60±4.582, 17.43±2.814, 13.07±1.759, 13.14±2.052 and 20.82±2.685, respectively. Among all items, the scores of the similarity of offline classroom communication styles and enthusiasm for communication were lowest, with the points of 3.42±1.131 and 3.85±0.864, respectively, and the correlation of the two items were statistically significant (correlation coefficient =0.276, P=0.008). The total score of the live-streamed classroom satisfaction was 13.52±1.872. The classroom content has a significant effect on the satisfaction of the live-streamed classroom (P<0.001), and the standardized regression coefficient is 0.687. Compared with the pre-class test, the post-class test score was 65.9±11.4, with a statistically significant improvement (P=0.033); however, compared with grade 2013, the course test score of the students of grade 2015 was 72.6±7.0, with a statistically significant reduction (P=0.009). Conclusion: The classroom content has an important impact on the satisfaction of live-streamed classroom teaching. It is necessary to pay attention to the communication difference between live -streamed classroom and offline classroom settings, and improve the enthusiasm for participation in the study communication, in order to improve the effectiveness of teaching. 

Contact lens has been widely applied worldwide, and the advancement of fitting strategy is one of the reasons which improve the safety and comfort of contact lens fitting. During the contact lens fitting procedure, more and more ophthalmic imaging modalities have been applied to guide the contact lens fitting. These techniques simplify the contact lens fitting procedure, help optometrists accurately perform the customize contact lens fitting, and assist the personalized contact lens design technique.

Systemic diseases affect eyeballs through certain ways, resulting in eye diseases; The severity of eye diseases is closely related to the progress of systemic diseases. By identifying eye diseases, artificial intelligence (AI) can assess systemic diseases, so as to make early diagnosis of systemic diseases. For example, detection of the degree of icteric sclera can be used to assess jaundice. Detection of the hemodynamics of posterior eyeball can be used to evaluate cirrhosis. Detection of optic disc edema and macular degeneration can be used to evaluate the progress of chronic kidney disease (CKD). Detection of ocular fundus vascular injury can be used to assess diabetes, hypertension and atherosclerosis. Clinicians can estimate the risk of systemic diseases through eye images, and its accuracy depends on the experience level of clinicians, while the accuracy of AI in identifying eye diseases and evaluating systemic diseases can be comparable to clinicians. After combining various detection indexes, the specificity and sensitivity of AI model can be significantly improved, so early diagnosis and early treatment of systemic diseases can be realized by making full use of AI.

Objective: To combine the characteristics of standardized training for ophthalmic resident physicians, establishes a Total Quality Management (TQM) model based on the DingTalk platform, and explored an efficient ophthalmic teaching management model that adapts to the characteristics of the times. Methods: The research team, based at Zhongshan Ophthalmic Center, selected 82 first-year postgraduate students undergoing the national standardized training for resident doctors (STRD) as participants, randomly allocating them into two groups. The experimental group consisting of 41 trainees received TQM-modeled online learning via the DingTalk platform, adopting a management model of full participation, full process tracking, and comprehensive evaluation to ensure teaching quality. While the control group, also comprising 41 trainees, underwent traditional offline instruction. The TQM group engaged in live streaming lectures on the DingTalk platform, whereas the conventional group continued with face-to-face teaching in classroom. Data including pre- and post-teaching scores, as well as scores from satisfaction surveys are analyzed. Results: Comparing pre- and post-teaching scores, significant statistical differences were found between the TQM and traditional groups, with mean score improvements of 40(30,40) points and 30(20,50) points, respectively, indicating statistical significance (P =0.013). Furthermore, the questionnaire survey revealed that the TQM group scored higher than the traditional group in aspects such as course design, clinical relevance, content mastery, and instructor satisfaction. In addition, the questionnaire survey showed that there was no statistically significant difference in the total satisfaction score between the two groups (10(10,10) points vs. 10(9,10)points P =0.207), but in terms of mastery of satisfaction sub items, the TQM model group scored higher than the traditional model group (5(5,5) points vs. 5(4,5) points, P =0.046). Conclusions: The application of a TQM-based model on the DingTalk platform significantly enhances the teaching quality and student satisfaction in the residency training of ophthalmologists, demonstrating greater pedagogical advantages over traditional methods. This efficient ophthalmic teaching management model thus provides a promising solution for standardized residency training in ophthalmology, and holds considerable importance for nurturing highly competent ophthalmologists who can meet the demands of the current era.

Red light is visible light with a wavelength range of 620-760 nm, which has excellent photochemical and thermal effects. It can penetrate deeply into the skin and tissues with strong power, resulting in a series of biological effects. In the field of ophthalmology, red-light therapy was initially mainly used in the treatment of amblyopia and eyelid skin-related diseases, and with the further development of research, red light has been gradually used in the myopia control and the study of retina-related diseases. At present, the effect of repeated low-intensity red light (RLRL) on myopia progression has been fully recognized, and it has become one of the most concerned hotspots in the application of red-light therapy in ophthalmology. The main possible mechanisms include that red light therapy can activate the activity of cytochrome C oxidase in mitochondria, promote ATP production, and improve retinal hypoxia. It can also induce the synthesis and release of NO, cause the expansion of choroidal vessels with improvement of blood flow, and increase scleral strength by remodeling of scleral extracellular matrix. In addition, red- light therapy can reduce oxidative stress, inflammation and apoptosis in the regulatory pathways of photoreceptor cells, reduce eye inflammation and pain, and help repair peripheral nerves after injury. This article will review the mechanism, effectiveness and safety of red-light therapy in myopia, retinal diseases, amblyopia, and eyelid skin-related diseases, in order to provide important reference value and basis for the application of red-light therapy in ophthalmology.