人工智能(artificial intelligence，AI)为解决中国患者“看病难”问题提供了可行方案。眼科AI已实现为患者提供筛查、远程诊断及治疗建议等方面的服务，能显著减轻医疗资源不足的压力和患者的经济负担。而AI的应用过程中，给医疗管理带来的挑战应引起重视。本文从医疗管理的角度，总结分析AI在眼科医疗过程中，尤其是交接环节中出现的主要问题，提出对策与建议，并讨论AI在眼科医疗的应用展望。

    Artificial intelligence (AI) has been proposed as a potential solution to address the shortage of ophthalmologists in China. With the increasingly extensive application of AI in the field of ophthalmology, many potential patients with eye diseases have access to a higher quality of medical services. At the same time, new challenges will emerge and proliferate with the advancement of AI application. This paper focuses on the patient handoffs process and discusses two challenges brought by the application of AI, namely “communication” and “standardization”. Natural language processing techniques and the development of standardized databases are proposed to solve each of these challenges. The application prospects of AI in ophthalmology are eventually discussed.

目的：结合眼科住院医师规范化培训(住培)的特点，建立基于钉钉平台的全面质量管理模式(total quality management, TQM)，探索一种高效的顺应时代特征的眼科教学管理模式。方法：研究团队依托中山大学中山眼科中心，选取82名眼科四证合一的住培一年级的学生作为研究对象，并将其随机分为两组，试验组41人采用基于钉钉平台的TQM模式进行全过程教学管理，采用全员参与、全程跟踪、全面评价的管理模式以保障教学质量。对照组41人接受传统的教学管理模式。观察指标为两组间教学前后测试分数、教学后满意度调查的问卷得分等。结果：通过对两组学生进行课前课后的测试，TQM模式组相较于传统模式组在学习成绩有所提升，课前课后分数的差值分别为40(30,40)分和30(20,50)分，比较差异有统计学意义(P =0.031)。问卷调查结果显示，两组满意度总分比较差异无统计学意义[10(10,10) 分 vs. 10(9,10)分，P =0.207]，但在满意度分项内容掌握性上，TQM模式组分值高于传统模式组[5(5,5)分 vs. 5(4,5)分，P =0.046]。结论：基于钉钉平台的TQM模式在眼科教学中能够有效提高住培的教学质量与学生满意度，相比传统教学管理模式具有更大的教学优势，可为眼科住培提供了一种创新且实用的教学管理模式，对于培养适应时代需求的高水平眼科医师具有重要意义。

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.

目的：评价并汇总眼科成人日间手术患者病区护理管理的最佳证据，提高临床护理质量。方法：检索国内外数据库建库至2022年6月的日间手术患者病区护理管理的相关证据，包括系统评价、临床决策、证据总结、指南及专家共识。由2名研究人员独立对文献进行质量评价后，根据主题对证据进行提取和汇总。结果：根据纳入标准，共筛选出13篇文献，包括5篇专家共识、3篇证据总结、1篇循证实践、2篇系统评价、1篇指南。通过文献阅读、证据提取和归类，从日间手术护士准入资质、制定临床护理路径、院前管理、病历标准化、手术当日术前管理、术后管理、出院评估、康复及随访指导8个方面形成17条最佳证据。结论：该项目总结了眼科成人日间手术患者病区护理管理的最佳证据，可为护理管理者制定眼科日间手术病区流程方案、实践标准提供循证依据。

Objective: To evaluate and summarize the evidences of nursing management of ophthalmic postoperative adult patients intra-day ward, and improve the quality of clinical nursing. Methods: The related databases were searched from the  establishment to June 2022. The searching contents include systematic review, clinical decision-making, evidence  summary, guidelines and expert consensus on nursing management in postoperative patients intra-day wards at home  and aboard. Based on the theme, the evidences were extracted and summarized after independent literature quality  evaluation was conducted by 2 researchers. Results: Base on the inclusion criteria, a total of 13 pieces of literature were  selected, including 5 expert consensus, 3 evidence summaries, 1 evidence-based practice, 2 systematic reviews and 1  guideline. Through literature review, evidence extraction and classification, a total of 17 pieces of evidence on 8 aspects  were summarized, including admission qualifications for daytime surgical nurses, development of clinical nursing path,  pre-hospital management, medical record standardization, preoperative management on the day of surgery, postoperative  management, discharge assessment, rehabilitation and follow-up guidance. Conclusion: This article summarized the  best evidence of nursing management for ophthalmic adult day surgery patients in intra-day ward,to provide scientific  evidences for nursing managers to develop ophthalmic intra-day ward guidelines and practical standards.

糖尿病视网膜病变是糖尿病引起的微血管病变之一，是不可逆性致盲的眼病。根据其病程可分为根据其病程可分为非增殖期和增殖期，其中还包括糖尿病性黄斑水肿。全科医师需要检测量裸眼视力、矫正视力和眼压，通过裂隙灯显微镜评估眼前节以及眼底检查来评估眼部整体情况。控制血糖、血压、血脂对改善预后很重要。需要重视餐前、餐后血糖，糖化血红蛋白和代谢记忆，一线降血压药物包括血管紧张素转化酶抑制剂和血管紧张素Ⅱ受体阻断剂，调脂药物首选他汀类，而非诺贝特有额外的视网膜保护作用。干预生活方式，宣教，早期发现也同样重要。全科医师需要进行眼底筛查和评分，及时转诊至眼科治疗。眼科治疗包括全视网膜激光光凝术、经平坦部玻璃体切除术、玻璃体抗血管内皮生长因子药物注射术。

Diabetic retinopathy is one of the microvascular diseases caused by diabetes, it is an irreversible blindness eye disease. According to its course, it can be divided into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy, including diabetic macular edema. Te general practitioner needs to measure the uncorrected visual acuity, corrected visual acuity intraocular pressure, use the slit lamp microscope to exam the anterior segment and fundus to evaluate the overall condition of the eye. Controlling blood glucose, blood pressure and blood lipid is very important to improve the prognosis. Attach importance to pre- and postprandial blood glucose, glycosylated hemoglobin and metabolic memory should be carried out. The first-line antihypertensive drugs are angiotensin converting enzyme inhibitors and angiotensin II receptor blockers. Statins are the first choice for lipid-lowering drugs, fenofibrate has additional protective efect of retinal. Intervention in lifestyle, education and early detection are is important. Te general practitioner needs to perform fundus screening and scoring, timely refer to ophthalmology department for treatment. Ophthalmic treatment includes panretinal laser photocoagulation, pars plana vitrectomy, and intravitreal injection of anti-vascular endothelial growth factor drugs.

目的：检索并总结开角型青光眼患者眼部用药规范化护理管理的最佳证据，为临床实践提供参考。方法：通过护理循证方法提出实践问题，按照循证证据检索数据库的“6S”分类模型，检索有关开角型青光眼患者眼部用药管理的所有证据资源类型，包括临床指南、最佳实践信息册、证据总结、系统评价和专家共识等。由2名循证护理研究员对纳入文献的质量进行独立评价并进行证据的归纳总结。结果：最终纳入12篇文献，包括4篇指南、3篇证据总结和5篇系统评价；汇总了19条有关开角型青光眼眼部用药管理的最佳证据，包括滴眼技术指导、依从性管理和信息提供3个方面。结论：总结开角型青光眼眼部用药管理的最佳证据，可为临床医务人员管理患者提供参考和借鉴，以达到患者规范用药、控制眼压和延缓疾病进展的目的。

Objective: To retrieve and summarize the best evidence on standardized ocular medication management among open-angle glaucoma patients. Methods: With evidence-based nursing method, practical problemswere identified. According to the “6S” pyramid model of evidence resource, studies on standardized ocular medication management among open-angle glaucoma patients were retrieved, including clinical guidelines, best practice information booklet, systematic reviews, and expert consensus. Two evidence-based nursing researchers independently evaluated the quality of the included literature and summarized the evidence. Results: A total of 12 articles were ultimately enrolled, including 4 clinical guidelines, 3 evidence summaries and 5 systematic reviews. Finally, 3 aspects including 19 pieces of best evidence were summarized, which were Eye drop technical instruction, medication adherence management and related information provision. Conclusion: The best evidence for the medication management of open-angle glaucoma patients were summarized, which provide reference for clinical medical staffs to manage patients, so as to achieve the purpose of standardizing medication,controlling intraocular pressure and preventing disease progression.

目的：探索和实践人工智能辅助诊断的闵行区视觉健康管理模式。方法：介绍闵行区人工智能辅助诊断的视觉健康管理模式；分析对比传统视觉健康管理模式和人工智能辅助诊断视觉健康管理模式下，社区视觉健康筛查情况，眼病发现、需转诊、复诊情况等；工作人员配置、眼科门诊接诊情况、居民眼病知识率和视觉健康服务满意情况等。结果：传统视觉健康管理模式和人工智能辅助诊断模式主要眼病（糖尿病视网膜病变、青光眼、年龄相关性黄斑变性、高度近视）发现率比较差异均有统计学意义（c²=954.03，P ＜0.01），需转诊率差异有统计学意义（c²=431.07，P ＜0.01）。人工智能辅助诊断管理模式与传统视觉健康管理模式的居民在青光眼的知晓率比较差异有统计学意义（c²=4.24，P＜0.05）。传统视觉健康管理模式和人工智能辅助诊断模式居民对视觉健康服务中的服务质量和服务时间的满意度比较差异有统计学意义（Z=-2.75，Z=-2.18，P ＜0.05）。结论：人工智能辅助诊断视觉健康管理模式，糖尿病视网膜病变、青光眼等主要眼病发现率高于传统模式，需转诊率降低，居民对青光眼的知晓率提升，在服务质量和服务时间上的居民满意度较高。基于人工智能辅助诊断的视觉健康筛查与管理模式值得本区其他社区的推广和应用。

Objective To explore and practice the visual health management mode of Minhang District . Methods Introduce the visual health management mode of AI-assisted diagnosis in Minhang District; analyze and compare the traditional visual health management mode and AI-assisted visual health management mode, community visual health screening projects and completion conditions, screening files, eye disease discovery , referral, actual referral and return ; analyze and compare the visual health management mode, staff allocation, ophthalmic outpatient reception, and the satisfaction of visual health service. Results The difference in the discovery rate of major eye diseases (Diabetic Retinopathy,Glaucoma,Age-related Macular Degeneration,High Myopia) between the traditional model and artificial intelligence-assisted diagnosis mode in both communities (c²=954.03, P<0.01), the referral rate (c²=431.07, P<0.01). The awareness of AI-assisted diagnosis management improved in glaucoma in the two modes was statistically significant (c²=4.24, P<0.05). Traditional model and artificial intelligence assisted diagnosis model of visual health service quality and service time is statistically significant (Z=-2.75, Z=-2.18, P<0.05). Conclusion The visual health screening and management mode based on AI-assisted diagnosis is worthy of the promotion and application in other communities in the region.

目的：规范感染性角膜炎的隔离管理。方法：回顾性分析感染性角膜炎患者在住院期间发生交叉感染的危险因素，探讨现行的隔离管理措施是否有效。结果：隔离管理到位，5年的院感发生率为0.08%。结论：规范感染性角膜炎的隔离管理，能有效地预防医院感染。

Objective: To standardized the isolation and management of infectious keratitis. Methods: Risk factors of cross-infection of patients with infectious keratitis during their hospitalization were retrospectively reviewed to investigate whether the current isolation management is effective. Results: The current isolation management is effective since the incidence of hospital infection was 0.08% in past 5 years. Conclusion: Standardized the isolation management of infectious keratitis can prevent hospital infection efficaciously. 

目的：探讨眼外伤门诊急诊与住院病房一体化管理模式。方法：中山大学中山眼科中心于2015年4月成立眼外伤急诊部，组建眼外伤急诊队伍，实现眼外伤门诊急诊与住院病房一体化管理，即眼外伤患者从门诊到病房的接诊、治疗、随访进行一体化管理，简化急诊诊疗流程，最大限度保证医疗护理质量。结果：眼外伤门诊急诊与住院病房一体化管理模式是一种以患者为中心的新型管理模式。该模式能保障急诊患者诊治的及时性、连贯性；缩短急诊患者就诊到等候手术的时间，提高患者就诊满意度；在保证医疗质量的同时，医护人力资源得到合理高效使用；并取得较好的社会效益与经济效益。结论：眼外伤门诊急诊与住院病房一体化管理模式具备长远发展及推广的价值。

Objective: To discuss the integrated management in emergency department and wards for patients of ocular trauma. Methods: The emergency department and the team were organized in April 2015 to simplify the process of treatment for patients of ocular trauma, and to improve the benefit and outcome for those patients. Results: The integrated management of emergency department and wards for patients of ocular trauma was a new management model focusing upon the benefit of patients. This model could guarantee the timeliness and continuity by reducing waiting time for diagnosis or operations. The integrated model had obvious economic and social benefits by improving quality of care and reasonably using human resource. Conclusion: TTe integrated management model in emergency department and wards for patients of ocular trauma is worthy of further application. 

目的：自行设计并应用眼科表格式护理记录单，探讨眼科日间病房精细化护理管理工作的方法。方法：于中山大学中山眼科中心眼底病中心，根据日间手术流程，设计和运用眼底病中心24 h出入院护理记录单、眼底病中心日间病房交班记录单和眼底病中心日间病房手术记录单，书写方法基本以打勾、数字或简单文字记录为主。结果：新的表格式护理记录单大大节省护理记录和交班时间，提高护理工作效率，得到临床护理人员的广泛认可，提高医护对护理工作的满意度。结论：突出专科特色的表格式护理记录单能统一规范临床护理工作，提高护理工作效率和护理质量，保障护患安全，落实精细化护理管理。

Objective: To explore ffne management method of day ward in ocular department, through applying self-designed table format of eye nursing records. Methods: According to the day surgery process, the tables of 24-h nursing records and shifting records and surgery records were designed and applied to day ward of the ophthalmic fundus center. The basic writing methods included ticking, number and filling in the blanks. Results: The new nursing records tables decreased the time consumed in recording and shifting, improving the work efficiency, accepted widely by clinical staffs. Conclusion: The new table format with highlight of special features of the nursing records can unify and standard the clinical nursing work, improve the nursing work efficiency and nursing quality, ensure patients’ safety, and implement fine management.