目的：探讨提高眼科喉罩全身麻醉患儿在麻醉恢复室(post-anesthesia care unit, PACU)复苏质量与效率的整体护理策略。方法：选取2020年1月—2023年12月在中山大学中山眼科中心行眼科全身麻醉并保留喉罩进入PACU复苏的24 180例患儿，总结患儿在PACU复苏的护理措施及复苏质量。结果：所有患儿经复苏期综合护理后均顺利拔除喉罩完成麻醉复苏，未发生苏醒期二次插管或非计划转院治疗。采取个性化的整体护理策略后，喉罩全身麻醉患儿PACU平均复苏时间明显缩短。部分术后常见并发症(术后躁动，低氧血症和呼吸道梗阻)和护理不良事件(留置针脱落和眼包脱落)发生率逐年降低，经治疗和护理后均获得改善。结论：针对眼科全身麻醉的患儿特点，在麻醉复苏期采取个性化的整体护理策略，有利于顺利完成麻醉复苏，降低麻醉并发症和护理不良事件的发生率，提高复苏质量效率，满足眼科日间手术快速康复的需求。

Objective: To explore holistic nursing strategies to improve the quality and efficiency of post-anesthesia care unit (PACU) resuscitation in childrenpatients undergoing ophthalmic laryngeal mask anesthesia. Methods: A total of 24,180 children patients who underwent general anesthesia and retained laryngeal mask airway for PACU resuscitation at Sun Yat-sen Ophthalmic Center of Sun Yat sen University from January 2020 to December 2023 was reviewed and summarized the nursing measures and resuscitation quality of children patients undergoing PACU resuscitation. Results: All patients underwent comprehensive care during the recovery period and successfully removed the laryngeal mask to complete anesthesia recovery. There were no cases of secondary intubation or unplanned transfer for treatment during the recovery period. After adopting personalized holistic nursing strategies, the average recovery time of PACU in children under laryngeal mask anesthesia was significantly shortened.The incidence of common postoperative complications(postoperative agitation, hypoxemia and respiratory obstruction)and adverse nursing events (indwelling needle falls off, eye bandage fall off)had been decreasing year by year. These complications had been improved after treatment and care. Conclusions: Based on the characteristics of children patients undergoing general anesthesia in ophthalmology, adopting personalized holistic nursing strategies during the anesthesia recovery period is beneficial for successfully completing anesthesia recovery, reducing the incidence of anesthesia complications and adverse nursing events, improving the quality and efficiency of recovery, and meeting the needs of rapid recovery in ophthalmic day surgery.

目的：评估远视儿童使用1%阿托品凝胶1周后脉络膜厚度(choroidal thickness,CT)的变化。方法：选择42例4~7岁的远视儿童，予每天使用1%阿托品凝胶两次，持续7d。使用光学相干断层成像扫描测量视网膜及CT，并分析使用1%阿托品凝胶前后中心凹以及距中心凹处间隔1.0 mm的上、下、鼻和颞侧(最多3.0mm)CT的变化。结果：在远视儿童中，基线CT随位置而变化(F=27.08, P<0.05)，与中心凹相比，鼻侧及距中心凹上方2 mm、3 mm及距中心凹颞侧3 mm处的CT较薄(P<0.05)。使用1%阿托品凝胶后，中央凹及旁中心凹CT改变比较差异无统计学意义(P＞0.05)。使用1%阿托品凝胶前后视网膜厚度无明显变化(P＞0.05)。结论：短期使用1%阿托品凝胶并没有改变远视儿童的脉络膜和视网膜厚度。

Objective: To assess changes of choroidal thickness (CT) in hyperopia children after 1 week using of 1% atropine.Methods: A total of 42 hyperopia children aged 4–7 years were included into the study.A single drop of 1% atropinegel was used twice a daily for 7 days in the subjects.The thickness of retina and choroid was measured by OCT, and the changes before and after using 1% atropine gel were analyzed at the subfovea and at 1.0 mm intervals (up to3.0 mm) from the fovea at superior, inferior, nasal, and temporal locations. Results: In the hyperopia children, baselineCT parameters were varied with the location(F=27.08,P<0.05).Compared with the fovea, the CT at the nasal side,2 mm and 3 mm above the fovea and 3 mm from the temporal side of the fovea were thinner (P<0.05).After using 1%atropine gel, there was no significant difference in the CT changes of subfoveal choroidal thickness and other sites ofparafovea (P> 0.05). There was no significant change in retinal thickness before and after using 1% atropine gel (P > 0.05).Conclusion: No changes were found in the thickness of choroid and retina in hyperopia children after short-term use of1% atropine gel.

目的：结合医院小儿眼科常见病种调研国内儿童眼用制剂药物临床试验开展现状，为儿童眼用制剂药物临床试验的发展提供参考。方法：基于国家药物临床试验登记与信息公示平台和医院信息系统，结合郑州市第二人民医院儿童眼科病种，分析儿童眼科药物临床试验开展情况。 结果：医院门诊就诊患者以屈光不正最多（占68.49% ），其次是结膜炎（占11.25%），再次是斜视（占8.60%）。平台共检索到相关临床试验165项，儿科专用药物临床试验25项，其中延缓青少年近视方面试验24个，小儿结膜炎试验1个，其他病种药物临床试验检测结果为0；药物临床试验中以I期和Ⅲ期临床试验为主；延缓青少年近视方面试验已完成试验8项，其他都在进行中。结论：儿童眼科疾病的药物治疗尚有巨大的临床需求未满足，直接关系到了儿童健康权益保障与生命安全维护。当前国内儿童眼用制剂研发呈现企业参与度低、创新动力不足的现状，其核心制约因素在于项目少、难度大、涉及更多的伦理问题。建议通过政产学研协同创新，系统性推进儿童眼用制剂的研发进展，切实解决我国儿童眼病治疗用药难的问题，为儿童视觉健康提供有力保障。

Objective：Combined with the common diseases of pediatric ophthalmology in our hospital, the current situation of clinical trials of ophthalmic preparations for children in China was investigated to provide reference for the development of clinical trials of ophthalmic preparations for children in China. Methods：Based on the national drug clinical trial registration and information publicity platform and hospital information system, combined with the pediatric ophthalmic diseases in our hospital, the development of pediatric ophthalmic drug clinical trials was analyzed. Results：Among the outpatients in our hospital, ametropia was the most common ( 68.49 % ), followed by conjunctivitis ( 11.25 % ) and strabismus ( 8.60 % ). A total of 165 clinical trials and 25 clinical trials of pediatric drugs were retrieved from the platform, including 24 trials on delaying juvenile myopia, 1 trial on pediatric conjunctivitis, and 0 clinical trial on other diseases. Drug clinical trials were mainly phase I and phase III clinical trials. Eight trials have been completed to delay juvenile myopia, and others are in progress. Conclusions：There is still a huge clinical demand for the drug treatment of children 's eye diseases, which is directly related to the protection of children 's health rights and life safety. At present, the research and development of children 's ophthalmic preparations in China presents the current situation of low enterprise participation and insufficient innovation motivation. The core constraints are fewer projects, greater difficulty, and more ethical issues. It is suggested to systematically promote the research and development of ophthalmic preparations for children through the collaborative innovation of government, industry, university and research, so as to effectively solve the problem of difficult medication for children 's eye diseases in China and provide a strong guarantee for children 's visual health.

目的：通过三棱镜融合储备力试验检查了解正常青少年的双眼水平融像性聚散范围。方法：横断面研究，随机分层整群抽样调查。在汕头地区调查9所城乡中小学校，共7 537人。从体检学生中抽取双眼正常学生4 012名，用排状三棱镜检查双眼近距水平聚散力，在融像破裂点记录三棱镜度数。按集合与散开、年龄、性别等因素对结果作分层统计分析。结果：总体检人数7 464人，其中双眼祼眼视力≥0.8为4 012人，占体检人数的53.75%；研究对象的双眼散开运动范围平均为15.87△±10.74△，双眼集合运动范围平均为26.41△±12.04△；4~8岁组及9~11岁组的双眼集合与散开运动范围均高于12~20岁组，差异有统计学意义(P<0.05)；女性的双眼集合能力高于男性。结论：在本调查人群中，双眼集合运动的储备力高于散开运动；年龄越小，双眼异向运动的储备力越强。

Objective: To investigate the fusional range by using prism bar among students in Shantou City of Guangdong Province, China. Methods: This was a cross-sectional study that included 4 012 normal eye subjects among randomly selected 7 537 students aged 6 to 19 years from 9 schools in Shantou City. Horizontal fusional range measured with prism bar. Statistical analyses were performed using SPSS statistical software to investigate the association of age, gender, vergence and divergence. Results: A total of 7 464 students were examined, including 3 928 boys and 3 536 girls, mean age 11 years. The number of students with binocular vision ≥0.8 was 4 012, accounting for 53.75% of the number of fusional examination; the mean vergence range was 15.87△±10.74△, and the mean divergence range was 26.41△±12.04△. The vergence and divergence range group of 4 to 8 years and 9 to  11 years students was higher than the group of 12 to 20 years, the difference was statistically significant (P<0.05). The vergence range of female students was higher than that of male students. Conclusion: In this study, the vergence range is higher than divergence. With an increase in ages, the range of vergence and divergence decreases.

本文总结了 15 例自膨胀水凝胶眶内植入术患儿围手术期的护理要点。术前主要评估患儿是否完善术前检查，给予患儿及其家属个性化的心理护理，进行术前准备以及禁食禁饮的管理。术后主要给予患儿安全管理，饮食、疼痛、眼部用药以及弹力绷带包扎护理，关注有无并发症的发生及给予相应的护理，并对患儿及其家属做好出院指导。15 例患儿均顺利完成手术，术后均出现术眼疼痛，2 例出现眶压增高，1 例出现呕吐，均得到妥善处理。术后随访 3~18 个月，患儿均获得了较为满意的眼部外观，生活质量得到了提高。

This paper summarized the nursing experience of 15 children with self-expanding hydrogel orbital implantation during perioperative period. Before operation, children were fully evaluated, given with psychological care, preoperative preparation and management of fasting and drinking. After the surgery, the patients were mainly given with safety management, diet, pain, medicine and elastic bandage dressing care. Nurses should pay attention to the occurrence of complications and give corresponding nursing care and offer useful discharge guidance for the children and their parents. All 15 children completed the operation successfully, postoperative eye pain occurred in 15 cases after operation, and the orbital pressure increased in 2 cases, 1 case vomited, and all cases were properly treated. After postoperative follow-up for 3–18 months, 15 children were satisfied with the appearance of the eye, and the life quality was improved. 

目的：探讨个性化护理在眼科患儿全身麻醉手术中的应用效果。方法：选取于2015年7月至2016年8月中山大学附属第一医院收治的50例眼科全身麻醉手术患儿，按手术例数单、双号顺序分组，单 数为对照组，采用传统常规护理，双数为观察组，采用个性化护理。比较两组麻醉配合度与家属对护理满意度。结果：50例患儿手术顺利。对照组在麻醉及复苏过程出现烦躁与躁动情况的患儿18例，观察组为3例,对照组明显高于观察组；观察组麻醉配合度与家属对护理满意度明显高于对照组，差异均有统计学意义(P<0.05)。结论：眼科全身麻醉手术患儿运用个性化护理，可改善患儿心理状态，提高配合度，增加患儿家属的满意度。

Objective: To detect the effect of individualized nursing on ophthalmic children under general anesthesia operation. Methods: Ophthalmic children under general anesthesia operation in First Afifliated Hospital of Sun Yat-sen University were included from July 2015 to August 2016. All of children were divided into odd and even groups by the operation sequence number. The children with odd numbers were in control group and accepted traditional nursing. The children with even numbers were in experimental group and accepted individualized nursing. Anesthesia cooperation degree and family members’ satisfaction on nursing were compared between the two groups. Results: Fifty operations were proceeded successfully. 18 children appeared irritability and restlessness during anesthesia and recovery process in the control group. Irritability and restlessness were only showed in 3 children in the experimental group. The satisfaction in experimental group was much higher than  the control group, the differences were statistically signiffcant (P<0.05). Conclusion: Individualized nursing can improve the mental state and the degree of cooperation. It can also improve family members’ satisfaction.  

Background: To date, compliance to atropine penalization in amblyopic children has only been assessed through self-report. The goal of this pilot study is to measure compliance to atropine penalization objectively.

Methods: Seven amblyopic children (3–8 years; 20/40–20/125 in the amblyopic eye) were enrolled. None had been treated with atropine previously. Children were prescribed either a twice per week or daily atropine regimen by their physicians. Compliance was defined as the percentage of days in which the atropine eye drop was taken compared to the number of doses prescribed. We used medication event monitoring system (MEMS) caps to objectively measure compliance. The MEMS caps are designed to electronically record the time and date when the bottle is opened. The parents of the children were provided a calendar log to subjectively report compliance. Participants were scheduled for return visits at 4 and 12 weeks. Weekly compliance was analyzed.

Results: At 4 weeks, objective compliance averaged 88% (range, 57–100%), while subjective compliance was 98% (range, 90–100%). The actual dose in grams and visual acuity (VA) response relationship (r=0.79, P=0.03) was signiff cantly better than the relationship between regimen and response (r=0.41, P>0.05), or the relationship between actual dose in drops and response (r=0.52, P>0.05).

Conclusions: Objective compliance to atropine penalization instructions can be monitored with MEMS, which may facilitate our understanding of the dose-response relationship. Objective compliance with atropine penalization decreases over time and varies with regimen. On average, subjective parental reporting of compliance is overestimated.  

Background: To date, compliance to atropine penalization in amblyopic children has only been assessed through self-report. The goal of this pilot study is to measure compliance to atropine penalization objectively.

Methods: Seven amblyopic children (3–8 years; 20/40–20/125 in the amblyopic eye) were enrolled. None had been treated with atropine previously. Children were prescribed either a twice per week or daily atropine regimen by their physicians. Compliance was defined as the percentage of days in which the atropine eye drop was taken compared to the number of doses prescribed. We used medication event monitoring system (MEMS) caps to objectively measure compliance. The MEMS caps are designed to electronically record the time and date when the bottle is opened. The parents of the children were provided a calendar log to subjectively report compliance. Participants were scheduled for return visits at 4 and 12 weeks. Weekly compliance was analyzed.

Results: At 4 weeks, objective compliance averaged 88% (range, 57–100%), while subjective compliance was 98% (range, 90–100%). The actual dose in grams and visual acuity (VA) response relationship (r=0.79, P=0.03) was signiff cantly better than the relationship between regimen and response (r=0.41, P>0.05), or the relationship between actual dose in drops and response (r=0.52, P>0.05).

Conclusions: Objective compliance to atropine penalization instructions can be monitored with MEMS, which may facilitate our understanding of the dose-response relationship. Objective compliance with atropine penalization decreases over time and varies with regimen. On average, subjective parental reporting of compliance is overestimated.  

Background: To investigate the 1-time success rate of probing alone and nasolacrimal duct probing combined with nasolacrimal injection of levofloxacin ophthalmic gel on congenital nasolacrimal duct obstruction (CNLDO) in young children.

Methods: A retrospective case series was performed on 494 cases (647 eyes) of 3–12 month-old children with CNLDO between July 2014 and July 2015. Material obtained from the lacrimal sac was cultured to isolate infectious agents. Susceptibility testing was done. Children from 3–12 months of age who were found to be sensitive to Levofloxacin (n=493 eyes) were separated into two groups: 3–6 months of age (276 eyes) and 7–12 months of age (217 eyes). Each of the groups were then randomized into group A (138 eyes of 3–6 months of age; 102 eyes of 7–12 months of age) and group B (138 eyes of 3–6 months of age; 115 eyes of 7–12 months of age). Children in group A underwent nasolacrimal duct probing alone; those in group B underwent nasolacrimal duct probing plus nasolacrimal duct injection of levofloxacin and the efficacy of probing was evaluated.

Results: The average detection rate of pathogenic bacteria in dacryocystitis was 75.1%, and Staphylococcus aureus was found to be the main pathogenic bacteria (42.59%, 106 cases). Among children from 7–12 months of age, the 1-time success rate of nasolacrimal duct probing alone was 88.24% and the 1-time success rate of probing combined with nasolacrimal duct injection of levofloxacin ophthalmic gel was 96.52% (statistical significance, P=0.02<0.05).

Conclusions: Most pathogenic bacteria (96.81%) were sensitive to levofloxacin. Nasolacrimal duct probing combined with nasolacrimal duct injection of levofloxacin may improve the success rate of probing in children older than 6 months of age.

Background: To investigate the 1-time success rate of probing alone and nasolacrimal duct probing combined with nasolacrimal injection of levofloxacin ophthalmic gel on congenital nasolacrimal duct obstruction (CNLDO) in young children.

Methods: A retrospective case series was performed on 494 cases (647 eyes) of 3–12 month-old children with CNLDO between July 2014 and July 2015. Material obtained from the lacrimal sac was cultured to isolate infectious agents. Susceptibility testing was done. Children from 3–12 months of age who were found to be sensitive to Levofloxacin (n=493 eyes) were separated into two groups: 3–6 months of age (276 eyes) and 7–12 months of age (217 eyes). Each of the groups were then randomized into group A (138 eyes of 3–6 months of age; 102 eyes of 7–12 months of age) and group B (138 eyes of 3–6 months of age; 115 eyes of 7–12 months of age). Children in group A underwent nasolacrimal duct probing alone; those in group B underwent nasolacrimal duct probing plus nasolacrimal duct injection of levofloxacin and the efficacy of probing was evaluated.

Results: The average detection rate of pathogenic bacteria in dacryocystitis was 75.1%, and Staphylococcus aureus was found to be the main pathogenic bacteria (42.59%, 106 cases). Among children from 7–12 months of age, the 1-time success rate of nasolacrimal duct probing alone was 88.24% and the 1-time success rate of probing combined with nasolacrimal duct injection of levofloxacin ophthalmic gel was 96.52% (statistical significance, P=0.02<0.05).

Conclusions: Most pathogenic bacteria (96.81%) were sensitive to levofloxacin. Nasolacrimal duct probing combined with nasolacrimal duct injection of levofloxacin may improve the success rate of probing in children older than 6 months of age.

目的：比较轻、中、重度近视患儿之间的视觉功能的差异，探索虚拟现实下的短期可塑训练对近视视觉功能的改善效果。方法：选择2022年6月—2022年9月就诊于苏州大学附属儿童医院的6~16岁儿童102例，按照屈光度分为正常对照组、轻度近视组和中重度近视组，进行眼科常规检查和视知觉功能检查，并进行视觉短期可塑训练。结果：近视患儿存在立体视功能缺损，近视程度与精细立体视功能损害呈正相关，各组之间比较差异具有统计学意义(P<0.05)，部分患儿存在中心凹抑制。训练后，轻度近视组的中距离精细立体视功能得到改善，比较差异具有统计学意义(P<0.05)。结论：近视患儿存在立体视功能异常和中心凹抑制，且立体视功能的损害随着近视程度的增加而加重。轻度近视患儿部分精细立体视功能经过虚拟现实短期可塑训练可得到改善，而中重度近视患儿精细立体视功能改善不明显。

Objective: To compare the difference of visual function among children with myopia in different diopter, and explore the effect of short-term plastic training of virtual reality on visual function improvement. Methods: The 102 children aged 6-16 years who admitted to Children's Hospital of SoochowUniversity from June 2022 to September 2022 were recruited and divided into control group, mild myopia group and middle and high myopia group according to diopter. Routine ophthalmologic examination and visual perception function examination were carried out, and short-term plastic training was implemented. After the training, visual perception function examination was completed again. Results: There were significant differences in stereoscopic function defect at different distances among myopic children, a negative correlation between myopia and stereoscopic function was found. while there were several cases have foveal suppression. After training, the fine stereopsis at medium distance of the mild myopia group was significantly improved with significance statistical difference. Conclusions: Myopia can lead to the abnormality of stereopsis and foveal suppression in children. The defect of binocular visual function increases with the increase of myopia. Short term plastic training of virtual reality can partially improve the fine stereoscopic function of mild myopia children whileshowsnosigni ficanceimprovementof the fine stereoscopic function in middle and high myopia group.

本文总结了15例自膨胀水凝胶眶内植入术患儿围手术期的护理要点。术前主要评估患儿是否完善术前检查，给予患儿及其家属个性化的心理护理，进行术前准备以及禁食禁饮的管理。术后主要给予患儿安全管理，饮食、疼痛、眼部用药以及弹力绷带包扎护理，关注有无并发症的发生及给予相应的护理，并对患儿及其家属做好出院指导。15例患儿均顺利完成手术，术后均出现术眼疼痛，2例出现眶压增高，1例出现呕吐，均得到妥善处理。术后随访3~18个月，患儿均获得了较为满意的眼部外观，生活质量得到了提高。

This paper summarized the nursing experience of 15 children with self-expanding hydrogel orbital implantation during perioperative period. Before operation, children were fully evaluated, given with psychological care, preoperative preparation and management of fasting and drinking. After the surgery, the patients were mainly given with safety management, diet, pain, medicine and elastic bandage dressing care. Nurses should pay attention to the occurrence of complications and give corresponding nursing care and offer useful discharge guidance for the children and their parents. All 15 children completed the operation successfully, postoperative eye pain occurred in 15 cases after operation, and the orbital pressure increased in 2 cases, 1 case vomited, and all cases were properly treated. After postoperative follow-up for 3–18 months, 15 children were satisfied with the appearance of the eye,and the life quality was improved.