大麻二酚(Cannabidiol,CBD)为大麻提取物中的一种非成瘾性活性成分，是目前研究最热门的植物源性大麻素之一。内源性大麻素系统(endocannabinoid system,ECS)在眼表和视网膜中的研究也已经取得显著进展。CBD可以广泛存在于整个眼球，且其分布和功能具有组织特异性。近年来研究发现CBD具有良好的抗炎、抗损伤、降低眼压及神经保护作用。该文详细介绍了CBD在眼部疾病中的研究进展，以及其对各种眼部疾病的治疗潜力。此外，还讨论了CBD在临床眼科治疗中的应用面临的挑战和未来的发展方向。

Cannabidiol(CBD), a non-addictive active ingredient in cannabis extract, is one of the most popular plant-derived cannabinoids. The study on the endoenuous cannabionoid system (ESC) has made significant progress in the ocular surface and retina. CBD exists extensively in the eyeball, and its distrution and functions of anti-inflammatory,antiinjury, reducing intraocular pressure, and neuroprotective effects have been found. This article introduces the research progress in CBD in eye diseases and the therapeutic potential of cannabidiol for various eye diseases in detailed.Furthermore, the challenges and prospect for the application of CBD in clinical ophthalmology were discussed.

甲氨蝶呤(Methotrexate,MTX)是一种叶酸类似物，具有抗增殖、抗炎和免疫调节作用。在临床上广泛用于治疗多种疾病，包括恶性肿瘤和自身免疫性疾病。MTX通过眼局部注射或者全身给药用于眼科疾病的治疗，其安全性和有效性均已被证实。其中玻璃体腔注射可以减少糖皮质激素及免疫抑制剂的全身使用，在眼科的应用越来越广泛。MTX在备孕期男性及女性、妊娠期妇女、哺乳期妇女、儿童、青少年及老年人等特殊患者人群中的应用有其特殊性，用药情况因患者而异。低剂量MTX常见不良反应包括胃肠道症状、肝功能异常等，比较少出现严重的不良反应，但仍应做好药学监护。该篇综述总结MTX的临床使用方法及其不良反应，为其在眼科的临床应用提供参考。

Methotrexate (MTX) is a folate analog with anti-proliferative, anti-inflammatory and immunomodulatory effects.It is widely used in clinical practice to treat various diseases, including malignant tumors and autoimmune diseases.MTX is used for treating eye diseases by local injection or whole-body administration. Its safety and efficacy have been confirmed. The intravitreal injection can reduce the whole-body use of glucocorticoids and immunosuppressive agents, so it is applied in ophthalmology increasingly. The specificity of MTX has been found in its application in special patients, such as men and women in pregnancy preparation period, pregnant women, lactating women, children, adolescents and the elderly. The dosage varies from patient to patient. Common adverse reactions to low-dose MTX include gastrointestinal symptoms, liver dysfunction, etc. Serious adverse reactions are relatively rare, but pharmaceutical monitoring is still necessarily needed. This review summaries the usage and adverse reactions of MTX in clinical practice, to provide reference for its application in clinical practice in ophthalmology.

目的：评价欧堡Daytona 200度超广角激光扫描检眼镜检查近视患者眼底周边部视网膜病变的应用价值。方法：本研究为前瞻性病例研究，收集爱尔眼科医院要求行屈光手术的近视患者1 000例(2 000只眼)，分别进行小瞳下欧堡Daytona 200度超广角激光扫描检眼镜眼底检查和散瞳后三面镜检查，记录检查结果并进行比较分析。结果：通过欧堡Daytona 200度超广角激光扫描检眼镜检查发现有周边视网膜病变共230例(310只眼)，检出阳性率为15.50%；三面镜检查发现周边部视网膜病变共242例(322只眼)，检出阳性率为16.10%。两种检查方法对近视患者周边部视网膜病变检出阳性率具有很好的一致性(Kappa值0.8~1.0)。结论：欧堡Daytona 200度超广角成像系统为检查周边部视网膜病变提供了更省时高效的方法，在屈光手术前筛查视网膜周边部病变，具有广阔的临床应用前景。

Objectives: To evaluate the clinical value of peripheral retinal diseases in myopic patients examined by 200-degree ultra-wide field laser ophthalmoscope (Daytona). Methods: This was a prospective case-control study. We collected 1 000 myopic patients (2 000 eyes) who were scheduled to undergo refractive surgery in Aier Eye Hospital. They were examined by 200-degree ultra-wide field laser ophthalmoscope (Daytona) with non-mydriasis and three-mirror contact lens with mydriasis. The examination results were recorded and statistically analyzed. Results: A total of 230 cases (310 eyes) with peripheral retinopathy were found by 200-degree ultra-wide field laser ophthalmoscope (Daytona). The positive rate was 15.50%; 242 cases (322 eyes) with peripheral retinopathy were found by three- mirror contact lens, and the positive rate was 16.10%. The two methods were consistent in the detection of peripheral Retinopathy in myopic patients (the Kappa value is between 0.8 and 1.0). Conclusion: 200-degree ultra-wide field laser ophthalmoscope (Daytona) is an effective and rapid method for detecting peripheral retinopathy. It provides a broad clinical application prospects for peripheral retinopathy screening before refractive surgery.

术前有效杀灭或减少眼表微生物的数量是降低术后眼内炎的重要措施。聚维酮碘消毒液和妥布霉素均能有效的降低眼科手术术后眼内炎发生率。笔者通过文献报道，综合分析聚维酮碘消毒液及妥布霉素滴眼液及注射液对眼科手术结膜囊微生物的控制能力，为眼科手术术前准备提供理论依据。

Effectively killing or reducing the number of ocular microbes before surgery is an important measure to reduce postoperative endophthalmitis. Both povidone-iodine disinfectant and tobramycin can effectively reduce the incidence of endophthalmitis after ophthalmic surgery. Through literature reports, the author comprehensively analyzes the control ability of povidone-iodine disinfectant and tobramycin eye drops and injection on the microscopy of conjunctival sac in ophthalmic surgery, and provides theoretical basis for preoperative preparation of ophthalmic surgery

目的：探讨专科护士培训方式以提高斜视病区护士的专业技能以及专科理论水平。方法：每次由护士长安排一名护士进入科主任所在的医疗小组进行为期3~4个月的培训，培训内容主要包括与医生一起出门诊、学习术前斜视专科检查、参加患者术前手术方案的制定和术后的查房，定期参加科室的理论培训。结果：实施斜视专科护士培训方法后，经过培训的护士掌握了斜视专科常用的检查方法，能解读本专科的相关检查报告，护士的专科工作能力、应对咨询能力有提高，医生、患者对护士的满意度均有提高。结论：斜视病区专科护士培训方法对临床护理工作有积极的影响，值得临床科室借鉴。

Objective: To improve the professional skills and theoretical level of the nurses, a new training method was adopted in strabismus ward. Methods: The head nurse arranged a nurse to participate in medical team the director of the department for 3–4 months. The medical works that the nurse had to follow included coperative outpatient medical work with the doctors, clinical examination before strabismus surgery, making individual surgical plans, nursing rounds of wards after surgery, and regular theoretical training of the department. Results: After implementing the training method of strabismus specialist nurses, the trained nurses mastered the common examination methods for strabismus patients, and could analyse the relevant examination reports. The ability of the nurses’ professional work and consultative capacity were improved. Furthermore, the satisfaction of doctors and patients on nursing work was improved. Conclusion: The new training method of specialist nurses in strabismus ward exerts positive effect on clinical nursing work, which is worthy of application in clinical practice.

报告1例2019年1月因无色素性视网膜色素变性而就诊的病例。患者因发现视力差，常规眼科检查及全身的检查未发现异常，给予眼底荧光造影后确诊。给予眼底荧光造影后最终确诊为罕见的无色素性视网膜色素变性，防止了疾病的漏诊和误诊。对于缺乏视网膜色素变性典型的三联征的无色素性视网膜色素变性患者，临床要谨防漏诊，眼底荧光血管造影(fundus fluorescein angiography，FFA)可明确诊断。

We reported a case of achromatic retinitis pigmentosa admitted to the hospital in January 2019. The patient was diagnosed by fundus fluorescein angiography because of poor vision, and no abnormality was found by routine ophthalmological examination and general examination. After fundus fluorescein angiography (FFA), a rare non-pigmented retinitis pigmentosa was finally diagnosed, which prevented misdiagnosis and missed diagnosis of the disease. For the patients without typical triad of retinitis pigmentosa, we should pay attention to missing the diagnosis in clinical practice. FFA can make a definite diagnosis of retinitis pigmentosa.

真菌性眼内炎是临床上少见的眼内感染疾病。因为其诊断延迟和抗真菌药物的有效性有限，因此真菌性眼内炎常常导致视力严重损害。按照感染性途径，真菌性眼内炎包括内源性和外源性，其中外源性眼内炎常见，进展较快，眼部手术术后感染是常见原因之一。小梁切除术是抗青光眼滤过性手术，是目前手术治疗青光眼的有效方法之一。滤过泡相关性眼内炎是其并发症之一，对患者视功能的损害尤为严重。本文通过回顾1例滤过泡相关性真菌性眼内炎患者的临床病例资料，讨论及分析滤过泡相关性的真菌性眼内炎的危险因素及诊治方法。

Fungal endophthalmitis is a disease which is a rare kind of interocular infection in clinic. Fungal endophthalmitis often results in severe visual impairment because of delayed diagnosis and limited effectiveness of antifungal drugs.Fungal endophthalmitis includes endogenous and exogenous endophthalmitis which is common and progresses rapidly. Postoperative infection is one of the common causes of fungal endophthalmitis. Trabeculectomy is an anti-glaucoma filtering operation, and it is one of the effective methods for glaucoma surgery at present. Glaucoma-filtering bleb infection is one of the complications of trabeculectomy, which can lead to severe visual impairment.In this article, we analyzed and discussed the risk factors, diagnosis and treatment methods about the filtering bleb-associated fungal endophthalmitis.

目的：探讨先天性瞳孔残膜围手术期的护理方法。方法：对13例(15眼)先天性瞳孔残膜患儿围手术期给予心理护理、安全护理、优先安排术前检查、术后严密观察病情变化、延续性护理并观察其效果。结果：13例(15眼)先天性瞳孔残膜的患儿手术均顺利完成，术后均无出现并发症，其中6例患者术后视力较术前视力有所提高，住院满意度为92.3%(12/13)。结论：对先天性瞳孔残膜患儿围手术期给予针对性的心理护理、安全护理、延续性护理是瞳孔残膜围手术期的有效护理方法。

Objective: To explore the perioperative nursing methods of persistent pupillary membrane. Methods: In the perioperative period, 13 cases (15 eyes) with persistent pupillary membrane were given preoperative nursing care, psychological nursing, careful observation of the change of condition, safety nursing, continuous nursing and observation of its effect. Results: A total of 13 cases (15 eyes) with persistent pupillary membrane were successfully operated, among which 6 cases had improved postoperative visual acuity compared with preoperative visual acuity, and no postoperative complications occurred. The satisfaction rate of hospitalization was 92.3% (12/13). Conclusion: It is an effective nursing method to give psychological nursing, safety nursing and continuous nursing to children with persistent pupillary membrane in perioperative period.

目的：总结全身麻醉斜视矫正日间手术服务模式的创建与安全管理方法。方法：回顾2015年10月至2018年10月期间全身麻醉下行斜视矫正日间手术患者共9 570例。改革护理管理模式，实施医护一体化，在实施过程中对患者进行严密的术前、术后护理管理：术前评估，健康教育前移、加强核查制度、严格监测患者生命体征；术后病情严格交接，家属及患者同步术后指导、离院后回访。结果：全身麻醉斜视矫正日间手术的9 570例患者，均未发生手术并发症，术后不适34例，占0.36%，其中2例患者离院时出现头晕，2例发生尿储留，30例出现恶心、呕吐。护理人力由开展前16人减少到12人，节约25%；患者等候手术时间缩短了8 d，满意度由70%提高到90%，平均住院时间由3.2 d减少为1 d。结论：全身麻醉斜视矫正日间手术模式是一种新的医疗模式，开展全身麻醉日间手术不但可以节省医疗资源，还可提高患者满意度。

Objective: To summarize the establishment and safety management methods of ambulatory strabismus surgery that can provide the basis for carrying out ambulatory surgery nursing under general anesthesia. Methods: We carried out ambulatory surgery management that reformed nursing management model and delivered the integration of medical care in 9 570 patients undergoing strabismus surgery under general anesthesia from October 2015 to October 2018. In implementation process, we carefully managed the patients before and after operation including performing preoperative assessment and health education in advance, strengthening the verification system, strictly monitoring vital signs of the patients, strict shifting state of patients after operation, providing postoperative guidance to patients and their families, and performing follow-up clinic visits after leaving the hospital. Results: No surgical complications occurred in any of our cases. 34 patients had postoperative discomfort, accounting for 0.36%. Among these 34 patients, 2 had dizziness, 2 had urinary retention and 30 had

nausea and vomiting. After treatments, all patients were discharged on schedule. The number of nurses reduced from 16 to 12 that fell by 25%. Wait times for operation reduced by 8 days. Patient satisfaction was improved from 70% to 90%. The mean length of hospital stay was reduced from 3 days to 1 day. Conclusion: The management of ambulatory surgery under general anesthesia is a new medical care service model. Careful planning and strict preoperative and postoperative safety management can ensure the safe implementation of strabismus surgery. Ambulatory surgery under general anesthesia has benefits to save medical resources and improve patient satisfaction.