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. 

蠕形螨是人类皮肤上最常见的寄生虫，在眼部主要寄居于毛囊、睑板腺及皮脂腺，可引起眼干、眼痒、异物感明显等眼部症状。目前已证实有2种寄生于人类的蠕形螨：毛囊蠕形螨和皮脂蠕形螨，二者均可诱发各类眼表疾病，如睑缘炎、睑板腺疾病、角膜病、翼状胬肉以及眼红斑痤疮等，但是由于疾病症状相似、检查遗漏以及认知不到位等主客观因素，该病易被误诊、漏诊。蠕形螨具有高度的年龄依赖性，并且可以在无症状的成年人中发现，因此蠕形螨的致病性一直存在争议，现有研究表明，蠕形螨可以通过直接损伤、诱发超敏反应和作为载体携带细菌等方式致病。蠕形螨的感染可以通过有效的手段进行检测，确诊后可通过热敷、眼睑清洁、局部或全身使用除螨药物进行治疗。了解蠕形螨在眼部疾病中的重要性对于准确诊断和适当的管理策略至关重要，近年来对于蠕形螨的研究越来越多，有必要对蠕形螨感染相关眼表疾病的诊断及治疗技术进行更新，因此本文综述了蠕形螨的病原学、流行病学、致病机制、检出方法，探讨了蠕形螨感染与各类眼表疾病之间的联系以及治疗方法，以期为蠕形螨感染相关眼表疾病的研究提供参考。

Demodex mites are the most common parasites found on human skin. They primarily reside in hair follicles, meibomian glands, and sebaceous glands of the eyes, and can trigger eye-related symptoms such as dry eyes, itchy eyes, and a pronounced foreign-body sensation. At present, it has been established that two types of Demodex mites parasitic in humans: Demodex follicle mite and Demodex sebum mite. Both types can induce various ocular surface diseases, including blepharitis, meibomian gland dysfunction, corneal disease, pterygium and ocular rosacea. However, due to subjective and objective factors, such as similar disease symptoms, omission of examination and a lack of awareness, these diseases are easy to misdiagnosis and underdiagnosis. Demodex mites exhibit a highly degree of age-dependence and can be detected in asymptomatic adults. Consequently, the pathogenicity of Demodex mites has been a subject of debate. Existing studies have shown that Demodex mites can cause diseases through direct injury, by inducing hypersensitivity reactions, and by acting as carriers for bacteria. Effective means are available for detecting Demodex mite infections. Treatment options include warm compresses, eyelid cleaning, and the use of topical or systemic anti-mite drugs. Understanding the significance of Demodex mites in ocular diseases is crucial for accurate diagnosis and the formulation of appropriate management strategies. In recent years, there has been a growing body of research on Demodex mite. It is necessary to update the diagnositic and therapeutic techniques  for ocular surface diseases associated with Demodex mite infection. Therefore, this paper reviews the etiology, epidemiology, pathogenic mechanism, and detection methods of Demodex mite. It also discusses the relationship between Demodex mite infection and various ocular surface diseases, as well as the corresponding treatment methods, with the aim of providing a reference for the research on ocular surface diseases related to Demodex mite infections. 

    泪膜是覆盖于眼球表面的一层液体薄膜，从内而外分为黏液层、水液层和脂质层，每层成分的改变都会导致泪膜不稳定，进而导致干眼的发生。在研究泪膜破裂方式及相关泪液成分改变的基础上，学者Yokoi及其团队分别在2012年和2013年提出了有关干眼治疗和诊断的新概念，称为泪膜导向治疗(tear film-oriented therapy，TFOT)和泪膜导向诊断(tear film-oriented diagnosis，TFOD)，就是根据泪膜破裂模式(tear film break-up pattern，TFBUP)的不同，推断出相应的泪膜成分改变，补充不足的泪膜成分，这种诊疗方法目前正逐渐被接受。本文对不同泪膜破裂方式与泪膜成分改变的关系做了汇总分析，旨在为干眼的诊断和治疗提供更为科学实用的指导方案。

    Tear film is a layer of fluid film covering the surface of eye global, which is divided into mucus layer, aqueous layer and lipid layer from inside to outside. The change of each layer composition will lead to tear film instability, resulting in the occurrence of dry eye. On the basis of numerous studies on the correlation between tear composition and tear film break-up patterns, Yokoi and his team proposed new concepts on the diagnosis and treatment of dry eye called tear film-oriented therapy (TFOT) and tear film-oriented diagnosis (TFOD) in 2012 and 2013. That is according to different tear film break-up patterns (TFBUP), so changes in tear film composition can be deduced and supplemented, and this diagnosis and treatment method is gradually being accepted. In this paper, we summarized and analyzed the relationship between different tear film break-up patterns and changes in tear film composition to provide a more scientific and convenient guidance program for the diagnosis and treatment of dry eye.