目的：探讨督导式教学门诊在眼科住院医师规范化培训中的具体实践和教学效果。方法：通过合理排班、限制号源等措施设立每周固定的督导式教学门诊时间，安排老师和学员出诊；在教学门诊开展4个月后，通过问卷调查和临床技能考核的形式采集反馈意见并评估教学效果。 结果：共有16名老师和8名学员参加了督导式教学门诊，调查问卷结果显示100%的带教老师和学员认可该教学模式，参加过教学门诊的学员临床技能考核得分显著高于对照组(t =3.631， P<0.05)。结论：督导式教学门诊应用于眼科住院医师规范化培训具有实际可行性，并可以提高学员的临床技能水平。

Objective: To explore the application and effects of supervised teaching clinic in standardized training of ophthalmology residents. Methods: A weekly supervised teaching clinic was set through reasonable scheduling and limiting the registration numbers. After 4 months of application, feedbacks were collected through questionnaire survey from both the teachers and residents. Clinical skills assessments were also taken to evaluate the teaching effect. Results: A total of 16 teachers and 8 residents participated in the supervised teaching clinic. The results of the questionnaire showed that 100% of the teachers and residents agreed with the teaching mode. The clinical skill assessment scores of the residents who participated in the teaching clinic were significantly higher than those of the control group (t=3.631, P<0.05). Conclusion: The application of supervised teaching clinic in standardized training of ophthalmology residents is feasible and can improve the clinical skills of the residents. 

当下，我国眼科的发展存在失衡现象，大城市与农村及偏远地区在眼科相关诊疗设施水平、诊疗技术等方面存在巨大差异，仍需探寻新的智能诊疗模式以解决失衡问题。由于眼球是唯一可以直接观察人体血管和神经的器官，眼部可反映其他脏器的健康状态，部分眼科检查的医学图像可对眼部疾病做出诊断等特点，眼科开展人工智能(artificial intelligence，AI)具有独到的优势。此外，人工智能可在一定程度上提高跨时间空间传递信息的精准度及效率。人工智能在眼科及远程信息传递的优势为解决眼科发展失衡状况提供了助力。本文从眼科人工智能在眼科远程医疗相关应用的角度，主要分析并总结当下我国人工智能在眼科相关疾病远程医疗中的发展程度、所具优势以及存在问题，并讨论眼科人工智能在远程医疗的应用展望。

At present, there is an imbalance in the development of ophthalmology in China. There are huge differences in the level of ophthalmology related facilities, diagnosis and treatment technologies between big cities and rural, remote areas. New intelligent diagnosis and treatment models are still needed to solve the imbalance. Since the eye is the only organ that can directly observe the blood vessels and nerves of the human body, the eye can reflect the health status of other organs and diagnosis of eye diseases based on medical images of some ophthalmic examinations can be made as well as other characteristics. Therefore, the development of artificial intelligence in ophthalmology has unique advantages. In addition, artificial intelligence can improve the accuracy and efficiency of information transmission across time and space to a certain extent. The advantages of artificial intelligence in ophthalmology and telematics are helping to solve the imbalance in ophthalmology development. From the perspective of the application of ophthalmic artificial intelligence in telemedicine, this paper mainly analyzes and summarizes the development degree, advantages and existing problems of artificial intelligence in the telemedicine of ophthalmic diseases in China, and discusses the prospect of the application of ophthalmic artificial intelligence in telemedicine.

眼科研究型医院是推动医学创新与成果转化的核心平台。其中，专职临床研究护士（clinical research nurse，CRN）在提升临床研究的规范性及整体质量方面发挥着不可或缺的作用。然而，当前国内尚缺乏针对眼科领域CRN管理模式的系统总结和实践指导，制约了该群体专业价值的充分发挥和制度化建设的推进。本研究以中山大学中山眼科中心（三级甲等眼科研究型医院）2013—2024年间的CRN管理实践为样本，系统梳理其管理体系的构建路径与实施成效。研究发现，通过构建“准入-培训-双轨管理”体系和实践模式，能够显著提升CRN队伍的专业能力和研究项目的整体质量。机构质控数据显示，配备CRN后的研究项目质量评分由（67.5±17.2）分显著提升至（99.3±1.0）分（P<0.001），证实了该体系的有效性和可行性。研究结果还为我国眼科临床研究护理专业化发展提供了可复制的实践模板，还进一步分析提炼出CRN的三项核心职能：一是项目管理中的流程优化，保障研究环节高效协同；二是参与者管理，强化对受试者权益的保护；三是数据质量控制，确保研究数据的准确性与完整性。在此基础上，针对当前CRN发展中普遍存在的职责不清、培训缺失、政策滞后等问题，本文还提出推动“层级化培训常态化”“政策规范细则化”等优化建议，助力我国眼科临床研究由“经验驱动”向“体系驱动”转型，为临床研究护理专业化提供实践模板和决策参考。

Ophthalmic research hospitals serve as critical platforms for advancing medical innovation and translating research outcomes into practice. Dedicated Clinical Research Nurses (CRNs) play a pivotal role in enhancing the quality, compliance, and integrity of clinical research conducted within these settings. However, in China, there remains a lack of systematic models and practical guidance for CRN management specific to the field of ophthalmology, which has hindered the full realization of their professional value and the advancement of institutionalized development. This study examined CRN management practices at Zhongshan Ophthalmic Center, Sun Yat-sen University, a Grade A tertiary ophthalmic research hospital, between 2013 and 2024 as a case example to systematically examine the development pathway and outcomes of its CRN management system. The findings demonstrate that the implementation of a standardized system encompassing entry qualifications, tiered training, and structured practice models significantly enhanced both the professional competency of CRNs and the overall quality of clinical research projects. According to institutional quality control data, the quality score of clinical research projects increased significantly from 67.5±17.2 to 99.3±1.0 (P<0.001) following the integration of CRNs. Moreover, the study identifies three core functional domains of CRNs: (1) optimizing research processes to improve project coordination and efficiency; (2) managing research participants to safeguard ethical compliance and rights protection; and (3) ensuring data quality and integrity through rigorous oversight. In response to persistent challenges such as unclear role definitions, insufficient training systems, and lagging policy support, the study proposes actionable strategies, including the institutionalization of hierarchical and continuous training as well as the refinement of policy frameworks. These findings provide a scalable and evidence-based reference for promoting the professionalization and systemic development of ophthalmic clinical research nursing in China.

目的：探索和评价“线上教学-理论小课-Wetlab实操”眼解剖整合课程在眼科住院医师培范化培训（住培）教学中的应用和效果。方法：纳入中山大学中山眼科中心2023年新入培的住培学员93名，在岗前培训时进行眼解剖整合课程教学。在课程前后分别进行测试，评价课程教学效果，并在课程结束后采用匿名线下测试考核和满意度问卷调查的形式对课程的满意度进行调查。结果：培训前（T1）和培训后（T2）总分中位数分别是60分和70分，T1最低分、25%、75%和最高分分别是10、40、62.5和90，T2最低分、25%、75%和最高分分别是30、60、80和100，T2得分显著高于T1得分，差异具有统计学意义（P<0.000 1）；T1和T2的自信度平均值分别为26.53±5.08、31.83±4.02，差异有统计学意义（P<0.001）。学员普遍表示对整合课程满意。结论：学员们接受整合课程培训后，对眼解剖学知识的掌握程度有明显提高，对整合课程满意度高。眼解剖整合课程有效性显著，是具有推广意义的教学改革。

Objective: To explore and evaluate the application and effect of an integrated   ocular anatomy course comprising three main components: ‘online preview,’ ‘lecture,’ and ‘Wetlab dissection training’in the standardized training teaching of ophthalmology residents (hereinafter referred to as "resident training"). Methods: A total of 93 new resident trainees from Zhongshan Ophthalmic Center of Sun Yat-sen University in 2023 were included in the integrated course on ocular anatomy during pre-job training. Tests were carried out before and after the course to evaluate the teaching effect of the course, and questionnaires were issued after the course to investigate the satisfaction of the course. It adopts the form of anonymous offline test and satisfaction questionnaire. Results: The median total scores before (T1) and after (T2) training were 60 and 70, respectively; the lowest scores, 25%, 75% and highest scores of T1 were 10, 40, 62.5 and 90, respectively; the lowest scores, 25%, 75% and highest scores of T2 were 30, 60, 80 and 100, respectively, and the scores of T2 were significantly higher than those of T1. The difference was statistically significant (P<0.000 1). The mean confidence of T1 and T2 were 26.53±5.08 and 31.83±4.02, respectively, and the difference was statistically significant (P<0.001). Participants generally expressed satisfaction with the integrated programme. Conclusions: After receiving the training of the integrated course, the students' mastery of the knowledge of ocular anatomy has been significantly improved, and the satisfaction of the integrated course is high. The integrated course on ocular anatomy is effective, and it is a teaching reform with popularization significance.

目的：分析天津市某眼科医院急诊病例疾病谱，为规范疾病诊断流程、合理分配急诊医疗资源提供循证依据。方法 回顾性分析2019年1月~2023年12月在天津市某眼科医院急诊科就诊患者的临床资料，包括一般人口学资料、就诊时间、季节分布及初步诊断等。结果：共纳入26 077例眼科急诊患者，男女比例为1.12∶1，年龄为（36.82±15.44）岁，就诊年龄大多分布在＜14岁（26.74%）及31~40岁（21.03%）；日就诊时间分布中：10:00~12:00（11.06%）、14:00~16:00（10.41%）及20:00~22:00（10.43%）就诊人数较多，05:00~07:00（4.83%）就诊人数较少；4月就诊人数最少（3.87%），8月就诊人数最多（11.61%），夏季就诊人数（31.74%）显著多于其他3个季节；眼科急诊患者最常见的10种初步诊断中结膜炎占比最多（39.58%），其次为干眼症（14.32%）；与2019年相比，2020年和2021年眼科急诊患者前10种初步诊断显著下降（均P<0.001，2020年95%CI为-0.98~-0.68、2021年95%CI为-0.54~-0.11）；与春季相比，其他季节眼科急诊患者前10种初步诊断显著下降（P均<0.001，夏季95%CI为-0.32~-0.08、秋季95%CI为-0.39~-0.14、冬季95%CI为-0.54~-0.30）。其中在结膜炎病例中，与春、夏季相比，冬季结膜炎病例分布呈显著下降趋势（P均<0.001，95%CI分别为-0.08~-0.03]、为-0.08~-0.04）；眼科急诊患者前10种初步诊断性别分布具有统计学意义（P＜0.001）；与14岁以下年龄段相比，其他年龄眼科急诊患者前10种初步诊断均呈下降趋势，（P均<0.001，14~20岁95%CI为-0.88~-0.43、21~30岁95%CI为-1.01~-0.65、31~40岁95%CI为-1.10~-0.82、41~50岁95%CI为-0.97~-0.66、51~60岁95%CI为-1.71~-1.38、61~70岁95%CI为-1.45~-1.08、71~80岁95%CI为-1.36~-0.80、>80岁95%CI为-1.44,-0.22）。结论：眼科急诊患者以儿童和中青年男性为主，14岁以下年龄段人群相比来说有较高风险；日就诊时间分布呈现出“三个高峰一个低谷”的显著特征，就诊高峰时段分别为10:00~12:00、14:00~16:00以及20:00~22:00，就诊低谷出现在05:00~07:00期间；眼科急诊中最常见的诊断主要是那些通常被认为是非紧急的诊断，即结膜炎和干眼症；结膜炎的发病呈现明显的季节性特征，春、夏季为高发期；与2019年相比，2020年和2021年眼科急诊就诊总量显著减少，其中以结膜炎和干眼症的就诊量减少尤为明显，2022年有一定程度的恢复。

Purpose：To analyze the disease spectrum of emergency cases at an ophthalmology hospital in Tianjin, offering evidence-based support for standardizing diagnostic procedures and rationing emergency medical resources. Methods: Reviewed clinical data of patients at the hospital's emergency department from January 2019 to December 2023, covering demographics, visit timings, seasonal distribution, and preliminary diagnoses. Results: A total of 26,077 ophthalmology emergency patients were included, with a male-to-female ratio of 1.12:1 and an average age of 36.82±15.44 years. Most patients were aged <14 years (26.74%) and 31~40 years (21.03%). Daily visits peaked at 10:00~12:00 (11.06%), 14:00~16:00 (10.41%), and 20:00~22:00 (10.43%), and were lowest at 05:00~07:00 (4.83%). April had the fewest visits (3.87%), August the most (11.61%), and summer accounted for the highest quarterly proportion (31.74%). The top 10 preliminary diagnoses were led by conjunctivitis (39.58%) and xerophthalmia (14.32%). Compared to 2019, the top 10 preliminary diagnoses dropped significantly in 2020 and 2021 (both P<0.001), 2020 95%CI[-0.98~-0.68]、2021 95%CI[-0.54~-0.11]. Similarly, these diagnoses were significantly lower in summer, autumn, and winter than in spring (all P<0.001), summer 95%CI[-0.32~-0.08]、autumn 95%CI[-0.39~-0.14]、winter 95%CI[-0.54~-0.30]. In conjunctivitis cases, winter incidence was significantly lower than in spring and summer (both P<0.001). Gender distribution in the top 10 diagnoses was statistically significant (P<0.001), 95%CI[-0.08~-0.03] and [-0.08~-0.04] . Compared to those aged <14, other age groups showed a downward trend in the top 10 preliminary diagnoses (all P<0.001), 14~20 95%CI[-0.88~-0.43]、21~30 95%CI[-1.01~-0.65]、31~40 95%CI[-1.10~-0.82]、41~50 95%CI[-0.97~-0.66]、51~60 95%CI[1.71~-1.38]、61~70 95%CI[-1.45~-1.08]、71~80 95%CI[-1.36~-0.80]、>80 95%CI[-1.44,-0.22].Conclusions: Ophthalmology emergency patients are mainly children and middle-aged men, with those <14 years old at higher risk. Visit times follow a "three-peak-one-valley" pattern. Most diagnoses are non-urgent conditions like conjunctivitis and xerophthalmia. Conjunctivitis shows marked seasonality, peaking in spring and summer. Total ophthalmology emergency visits declined in 2020 and 2021 versus 2019, particularly for conjunctivitis and xerophthalmia, partially recovering in 2022.

目的：回顾2型神经纤维瘤病(neurofibromatosis type 2, NF2)患者的眼部表现，分析NF2眼部病变的临床和影像学特征，以助该病的早期诊断。方法：收集来自深圳市眼科医院的1例和来自中山眼科中心的3例NF2患者完整的临床资料并进行总结分析。结果：这4例患者均因眼部异常首诊于眼科且符合曼彻斯特诊断标准。4例患者中，3例为NF2早发型(<20岁)，1例为晚发型(>20岁)，男女比例1∶1。3例患者因视力下降、1例患者因复视首诊于眼科。3例行眼底光学相干断层成像(optical coherence tomography, OCT)检查显示，视网膜错构瘤2例，视网膜前膜2例，视盘隆起2例，视网膜神经纤维层和节细胞层变薄1例。其他表现包括麻痹性斜视2例，复视1例，白内障1例，球后段视神经增粗1例，眼眶肿瘤1例。结论：NF2的眼部表现多种多样，可出现在神经症状和听力损失之前。详细的眼科检查及影像学检查对年轻患者的早期诊断非常有价值，有助于选择更好的治疗计划。

Objective: Review the ocular manifestations of patients with neurofibromatosis type 2 (NF2), and analyze the clinical and imaging features of the ocular lesions in NF2, so as to facilitate the early diagnosis of this disease. Methods: The complete medical records of 1 case from Shenzhen Eye Hospital and 3 cases of NF2 from Zhongshan Ophthalmic Center were collected. Results: All four patients were first diagnosed in ophthalmology due to eye symptoms and met the Manchester diagnostic criteria. Of the four patients, three were NF2 early hairstyles (<20 years old), one was late hairstyle (>20 years old), and the male-to-female ratio was 1:1. Three patients were first diagnosed in the ophthalmology department due to decreased visual acuity, and one patient was first diagnosed due to diplopia. Optical coherence tomography (OCT) examinations were performed on three patients, which showed that there were two cases of retinal hamartoma, two cases of epiretinal membrane, two cases of optic disc elevation, and one case of thinning of the retinal nerve fiber layer and ganglion cell layer. Other manifestations included two cases of paralytic strabismus, one case of diplopia, one case of cataract, one case of thickening of the retrobulbar optic nerve, and one case of orbital tumor. Conclusions: The ocular manifestations of NF2 are diverse and can precede neurological symptoms and hearing loss. Detailed ophthalmic examinations and imaging studies are highly valuable for early diagnosis in young patients, aiding in the selection of a better treatment plan.

大型语言模型（large language models, LLMs）在眼科的应用为医疗领域带来了巨大的潜力，尤其是在提升诊断效率、优化医患沟通和促进个性化医疗方面。通过自然语言处理技术，LLMs可以协助医生进行临床数据的归纳和分析，可以结合患者的病史、影像资料和症状描述，提供精准的辅助诊断，并在复杂病例中提供参考。LLMs还可以帮助医生快速撰写病历报告，改善医疗记录管理效率。在医患沟通中，LLMs能够通过生成通俗易懂的解释，帮助患者理解疾病状况及治疗方案，缩短医生与患者之间的沟通障碍。在远程医疗场景下，LLMs可通过实时分析患者上传的图像文本信息，提供初步诊断建议，助力医生远程诊疗。个性化医疗也是LLMs的重要应用方向，借助患者的遗传数据和生活习惯，可以帮助医生制定更为精准的个性化治疗方案，并预测手术后的恢复情况。此外，LLMs可以通过与临床数据的不断交互进行自我优化，提升其在眼科诊疗中的智能化程度。尽管LLMs在眼科领域的应用前景广阔，但仍面临数据隐私、模型解释性、语言理解等方面的挑战。未来LLMs将继续作为医生的辅助工具，形成“人机协同”的诊疗新模式，为患者提供更好、更精准的医疗服务。

The application of Large Language Models (LLMs) in ophthalmology presents tremendous potential for the healthcare field, particularly in enhancing diagnostic efficiency, optimizing doctor-patient communication, and promoting personalized medicine. Through natural language processing technology, LLMs can assist doctors in summarizing and analyzing clinical data. They can integrate a patient's medical history, imaging data, and symptom descriptions to provide precise diagnostic support and reference for complex cases. LLMs can also help physicians quickly draft case reports, improving the management efficiency of medical records. In doctor-patient communication, LLMs can generate easy-to-understand explanations that help patients comprehend their conditions and treatment plans, thereby reducing communication barriers between doctors and patients. In telemedicine scenarios, LLMs can provide preliminary diagnostic suggestions by real-time analyzing images and textual information uploaded by patients, aiding doctors in remote diagnosis and treatment.

Personalized medicine is another significant application direction for LLMs. By utilizing patients' genetic data and lifestyle habits, LLMs can assist physicians in formulating more precise personalized treatment plans and predicting postoperative recovery outcomes. Additionally, LLMs can self-optimize through continuous interaction with clinical data, enhancing their intelligence in ophthalmic diagnosis and treatment. Despite the broad application prospects of LLMs in the field of ophthalmology, challenges remain, including data privacy, model interpretability, and language understanding. In the future,  LLMs will continue to serve as auxiliary tools for physicians, forming a new model of "human-machine collaboration" in diagnosis and treatment, ultimately providing better and more precise medical services to patients.

血泪是指因各种原因导致眼部流出血性泪液的症状，其病因和临床表现复杂多样，往往涉及多学科多专业。不同病因引起的血泪，无论是临床表现，还是诊治方法均差异很大。为了向临床医生提供可参考的血泪临床诊疗流程，中国医师协会眼科医师分会泪器病专业委员会及中国中西医结合学会眼科专业委员会泪器病学组组织有关专家以临床实践经验为基础，经过认真讨论建立本共识，对血泪的病因、临床特征及诊疗流程提出指导性意见。

Bloody tears refers to the symptoms of blooding tears flowing from the eye due to various reasons. Its etiology and clinical manifestations are complex and diverse, often involving multiple disciplines and specialties. In order to provide clinicians with a reference for the clinical diagnosis and treatment process of bloody tears, Lacrimal Diseases Professional Committee of Ophthalmologist Branch of Chinese Medical Doctor Association and Lacrimal Diseases Group of Ophthalmic Professional Committee of Chinese Association of Integrated Medicine organized relevant experts to establish this consensus based on clinical practice after serious discussion, and put forward guiding opinions on the etiology, clinical characteristics, and diagnosis and treatment process of bloody tears.

目的：探讨人文关怀护理对提高眼科专科病房护理质量及病人满意度的效果。

方法：建立人文关怀护理模式，优化环境，细化工作流程，注重护士人文关怀技能的培养，应用多元化的宣教工具，实施全程、连续、无缝隙的责任制护理。

结果：人文关怀护理措施落实，护士沟通能力提高，转变过去的被动服务为主动服务，护理的质量及患者满意度明显提高，零差错，零投诉，患者满意度为99％。

结论：将人文关怀护理体现在临床护理工作中才能给患者提供高品质的护理。

Purpose：To discuss the role of humanistic nursing care in improving the nursing quality and patients' degree of satisfaction in ophthalmic ward．

Methods：A mode of humanistic nursing care was established，hospital environment was improved and work flow was arranged in details．Nurses received professional training of humanistic care skills．By using multiple educational approaches，nursing care with responsibility system can be delivered in a continuous and seamless manner．

Results：The measures of humanistic nursing care were fully implemented．The nurses'  communication ability was improved and the nurses worked more actively. The quality of nursing and patients'  degree of satisfaction (99％) were equally significantly improved．No mistake occurred and no complaint was received from the patients．

Conclusion：Proper application of humanistic care in clinical nursing provides high-quality nursing for patients．