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.

眼健康是国民健康的重要组成部分，包括盲在内的视觉损伤严重影响人民群众的身体健康和生活质量，加重家庭和社会负担，威胁社会经济生产活动，是涉及民生的重大公共卫生问题和社会问题。弱视作为幼儿期起病的主要视觉障碍性疾病之一，是致使青少年低视力的首要因素，影响青少年自身学业和心理健康，增加致盲风险，故做好弱视的预防及康复工作刻不容缓。通过梳理研究发现，国内外对弱视的传统治疗方法有遮盖疗法、屈光矫正、压抑疗法等，知觉学习、视功能训练、电子视频游戏、针灸等则是近年逐渐新兴起并被广泛运用的弱视康复治疗方法，近年来关于年龄对弱视康复治疗影响的相关研究也较多。通过整理前人研究成果，提出建立儿童青少年视力档案、建立五位一体弱视康复治疗布局模式、进行联合临床治疗青少年弱视的对策，以期为青少年弱视提供康复治疗手段参考和选择，促进青少年弱视康复治疗眼健康事业发展。

Eye health is an important part of national health. Visual impairment, including blindness, seriously affects people’s physical health and quality of life, increases the burden on families and society, threatens social and economic production activities, and is a major public health and social problem related to people’s livelihood. Amblyopia,as one of the main visual disorders in early childhood, is the primary factor causing low vision in adolescents, which affects their academic and mental health and increases the risk of blindness. Therefore, it is urgent to do a good job in the prevention and rehabilitation of amblyopia. By summarizing existing studies, it is found that traditional treatment methods for amblyopia at home and abroad include occlusion therapy, refractive correction, and depressive therapy, while perceptual learning, visual function training, electronic video games, acupuncture and so on are gradually emerging in recent years and widely used in recent years. There are numerous studies on the impact of age on the rehabilitation of amblyopia. By sorting out the previous research results, this paper puts forward the countermeasures of establishing visual acuity files for children and adolescents, establishing the five- in-one rehabilitation treatment layout model, and combining clinical treatment for adolescent amblyopia, in order to provide reference and choice for the rehabilitation treatment of adolescent amblyopia, and promote the development of the eye health cause of adolescent amblyopia rehabilitation.

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. 

近年来，使用人工智能(artificial intelligence，AI)技术对临床大数据及图像进行分析，对疾病做出智能诊断、预测并提出诊疗决策，AI正逐步成为辅助临床及科研的先进技术。生物样本库作为收集临床信息和样本供科研使用的平台，是临床与科研的桥梁，也是临床信息与科研数据的集成平台。影响生物样本库使用效率及合理共享的因素有信息化建设水平不均衡、获取的临床及检验信息不完全、各库之间信息不对称等。本文对AI和区块链技术在生物样本库建设中的具体应用场景进行探讨，展望大数据时代智能生物样本库信息化建设的核心方向。

In recent years, artificial intelligence (AI) technology has been applied to analyze clinical big data and images and then make intelligent diagnosis, prediction and treatment decisions. It is gradually becoming an advanced technology to assist clinical and scientific research. Biobank is a platform for collecting clinical information and samples for scientific research, serving as a bridge between clinical and scientific research. It is also an integrated platform of clinical information and scientific research data. However, there are some challenges. First, clinical and laboratory information obtained is incomplete. Additionally, the information among different databases is asymmetric, which seriously impedes the information sharing among different Biobanks. In this article, the specific application scenarios of AI technology and blockchain in the construction of a Biobank were discussed, aiming to pinpoint the core direction of the information construction of an intelligent Biobank in the era of big data.

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.

帕金森病(Parkinson’s disease，PD)是老年人常见的神经系统退行性疾病，眼部及视觉功能障碍是PD常见的非运动症状之一，进一步影响其生活质量。已有研究表明PD患者视网膜内存在多巴胺浓度的减少以及α突触核蛋白的沉积。目前，PD仍缺乏有效的早期诊断及病情评估工具，光学相干断层扫描及光学相干断层扫描血管成像技术可以显示视网膜各层微细结构及微血管的异常，应用该技术研究者发现PD患者视乳头旁视网膜神经纤维层及黄斑区视网膜的厚度均存在不同程度的变薄，视网膜浅层及深层毛细血管丛的毛细血管密度和复杂性下降。进一步研究者应用该技术在PD临床应用中进行了探索，并发现其可用于检测早期PD中发生的病理变化，反映疾病的病程及严重程度，并且在鉴别诊断中起到一定的作用。总而言之，视网膜相关检测可能成为评估PD患者脑病理严重程度的指标，并且帮助疾病诊断和监测疾病的进展，不过这仍需要大样本、多中心的重复研究以提供更多理论依据。

Parkinson’s disease is a common neurodegenerative disease in the elderly, and ocular and visual dysfunction is one of the common non-motor symptoms of PD, further affecting PD patients’quality of life. Reduced dopamine concentrations and deposition of α-synuclein in the retina of PD patients have been shown in studies. At present, there is still a lack of effective tools for early diagnosis and assessment of PD. Optical coherence tomography and optical coherence tomography angiography can reveal abnormalities in the microstructure and microvasculature of the retinal layers, and researchers applying these techniques have found that the thickness of the parapapillary retinal nerve fiber layer and the retina in the macula in PD patients have had varying degrees of thinning, and the density and complexity of capillaries in the superficial and deep capillary plexus of the retina have been reduced. Further, investigators have explored the clinical application of these techniques in PD and have found that they can be used to detect pathological changes occurring in early PD, reflect the course and severity of the disease, and play a role in differential diagnosis. In conclusion, retinal-correlated testing may be an indicator to assess the severity of brain pathology in PD patients and to aid in disease diagnosis and monitoring the progression of PD, although large sample, multicenter replication studies are still needed to provide more reliable results.

角膜基质透镜是带有一定屈光度的角膜组织，为利用激光或板层刀等在角膜基质层内雕刻出一个精确对焦点的光学透镜。随着角膜屈光手术的不断发展，术中产生了大量的角膜基质透镜, 越来越多的学者也将目光聚焦于此。我国角膜供体来源匮乏与手术量需求严重不匹配, 眼库严重缺乏供体角膜，而对角膜组织的需求却越来越大。角膜穿孔作为角膜疾病的终末阶段，严重威胁患者的视力,甚至要面临摘除眼球的风险, 是对患者身体与心理的双重打击。绝大多数的角膜穿孔需要紧急手术处理, 对于一些常规治疗无效或角膜病变更严重的，角膜移植术可能是唯一有效的手段。对原本废弃的透镜重新利用, 将其用于治疗角膜溃疡、修补角膜穿孔以及辅助治疗各类角膜疾病的危重阶段, 均观察到其取得了良好的效果, 这在一定程度上缓解了临床上角膜供体缺乏的现状。本文报道了2例由角膜白斑引起的角膜穿孔患者使用异体角膜基质透镜移植治疗的病例, 术后2名患者病情均得到稳定。同时探讨了角膜基质透镜移植的局限性, 本文并未观察到角膜透镜移植对于感染性、免疫性等其他原因造成的角膜穿孔的疗效, 因此在行角膜移植之前，要正确认识及处理原发病，尽量避免一些并发症和排斥反应的发生。

Corneal stromal lenses are corneal tissues with specific refractive power, created by precisely sculpting an optical lens within the corneal stromal layer using lasers or microkeratomes. With the ongoing development of corneal refractive surgery, a large amount of corneal stromal lenses are generated during procedures, drawing increasing attention from researchers. In China, there exists a severe mismatch between the scarcity of corneal donors and the high demand for surgical procedures. This has led to a critical shortage of donor corneas in eye banks, while the need for corneal tissue keeps rising. Corneal perforation, which is the end-stage of various corneal diseases, poses a significant threat to patients' vision and may even result in enucleation, causing considerable physical and psychological distress. Most cases of corneal perforation require urgent surgical intervention. For patients with severe conditions or those for whom conventional treatments are ineffective, corneal transplantation may be the only viable option. Reusing stromal lenses that were previously discarded to treat corneal ulcers, repair corneal perforations, and assist in managing critical stages of various corneal diseases has shown promising results. This, to some extent, helps alleviate the clinical shortage of donor corneas. This article presents two cases of corneal perforation caused by corneal leukoma, both of which were successfully treated with allogeneic corneal stromal lens transplantation. Both patients achieved stable conditions after the operation. Additionally, this paper discusses the limitations of corneal stromal lens transplantation. The efficacy of corneal lens transplantation for perforations caused by infectious or immunological etiologies was not observed in this study. Therefore, it is essential to accurately diagnose and manage the underlying disease before transplantation and to minimize the occurrence of complications and rejection reactions.

近视已成为全球性流行病，预计到2050年全球将有近半数人群发生近视，已成为全球性重大功能卫生问题。近视不仅影响视力，还增加黄斑病变、青光眼等致盲性疾病的风险。近视的发病机制尚未完全明确，但与环境、遗传因素及昼夜节律紊乱密切相关。昼夜节律通过调节光照、多巴胺代谢和视网膜信号传导等机制影响近视的发生和发展。光照是调节昼夜节律的关键，户外活动时的高光照强度能有效刺激多巴胺分泌，抑制眼轴增长，减少近视发生，而异常光照模式（如夜间光暴露）则会干扰此过程。其次，睡眠不足与儿童近视患病率呈负相关，眼部关键参数（如眼轴长度、玻璃体腔深度等）均呈现显著的昼夜节律性波动。多巴胺作为视网膜中的重要神经递质，受生物钟基因调控，具有抑制眼轴生长的作用。视网膜中的生物钟基因和光敏色素也参与调节眼球生长，自主神经系统则通过调节脉络膜厚度与血流灌注参与眼球生长调控。动物实验和临床研究表明，昼夜节律紊乱会导致眼轴增长和近视进展。未来研究应进一步探讨昼夜节律与近视的因果关系、多巴胺代谢的调控机制以及生物钟基因的功能，以制定有效的近视防控策略。

Myopia has become a global epidemic,with projections indicating that nearly half of the world’s population will be affected by myopia by 2050, positioning it has a significant global functional health concern.Beyond merely impairing vision, myopia also heightens the risk of blinding diseases such as macular degeneration and glaucoma. Although the pathogenesis of myopia is not yet fully elucidated, it is stongly associated with environmental factors, genetic predispositions, and circadian rhythm disruptions. The circadian rhythm plays a pivotal role in the onset and progression of myopia by goerning mechanism such as light exposure, dopamine metabolism, and retinal signaling. Light serves as a crucial regulator of the circadian rhythm. Specifically, high light intensity during outdoor activities can effectively stimulate dopamine secretion, thereby inhibiting axial elongaation and reducing the incidence of myopia. Conversely, abnormal light patterns, such as exposure to light at night, can disrupt this regulatory process. Moreover, insufficient sleep has been found to be negatively correlated with the incidence of myopia in children. Additionally, key ocular parameters, including axial length and vitreous cavity depth, exhibit pronounced diurnal rhythmic fluctuations. Dopamine,  an important neurotransmitter in the retina, is regulated by circadian clock genes and functions to inhibit axial elongation. Both the circadian clock genes and photosensitive pigments within the retina are involved in regulating eye growth. Meanwhile, the autonomic nervous system contributes to this regulation by modulating choroidal thickness and blood flow perfusion. Animal experiments and clinical studies have consistently demonstrated that disrupted circadian rhythms can lead to axial elongation and the progression of myopia. Future research should delve deeper into the causal relationship between circadian rhythm and myopia, the regulatory mechanisms underlying dopamine metabolism, and the functions of circadian clock genes. Such investigation will pave the way for the development of effective strategies for myopia prevention and control.

散光是儿童视力发育的重要威胁之一，很多情况下其发生与眼表疾病的进展密切相关。非先天性眼表疾病如睑缘炎相关性角结膜病变、春季角结膜炎、干眼、感染性角膜炎和眼外伤等可通过慢性炎症介导的眼表微环境失衡、角膜瘢痕产生、泪膜稳定性破坏及角膜生物力学结构异常重塑等途径，导致角膜表面不规则性的产生和角膜曲率的改变。先天性眼表疾病如圆锥角膜、睑内翻和眼表肿瘤等则可通过遗传或发育异常改变眼睑结构、改变角膜曲率的对称性和机械压迫角膜产生散光，例如遗传疾病圆锥角膜的进行性角膜变薄与发生春季角结膜炎时眼表微环境的炎症性改变可协同作用加剧散光进展。针对不同病因，局部糖皮质激素滴眼液、免疫抑制剂环孢素滴眼液等药物使用和手术治疗均可改善患儿本身的病情和散光情况，只是不同疾病的治疗和散光矫正方案不尽相同。现有研究虽指出了部分儿童眼表疾病与散光的关联，但对于儿童的特异性机制部分如发育过程中免疫系统的变化、角膜可塑性差异及各种因素交互作用效应尚未完全解析。

Astigmatism is a significant threat to children's visual development and is often closely linked to the progression of ocular surface diseases. Non-congenital conditions, such as blepharitis-associated keratoconjunctivitis, vernal keratoconjunctivitis, dry eye, infectious keratitis, and ocular trauma, can induce irregularities on the corneal surface and changes in corneal curvature. This occurs through mechanisms like the ocular surface microenvironment imbalance mediated by chronic inflammation, corneal scarring, tear film instability, and abnormal corneal biomechanical remodeling. Congenital disorders, including keratoconus, entropion, and ocular surface tumors, can also lead to astigmatism. These conditions do so by causing genetic or developmental abnormalities that alter the eyelid structure, disrupt corneal symmetry, or exert mechanical pressure. Notably, there can be synergistic effects between progressive corneal thinning seen in hereditary keratoconus and the inflammatory microenvironment changes associated with vernal keratoconjunctivitis. Therapeutic interventions, such as topical corticosteroids, cyclosporine eye drops, and surgical procedures, can improve both the primary conditions and the astigmatism. However, treatment strategies vary depending on the different etiologies. Current research has established associations between pediatric ocular surface diseases and astigmatism. Nevertheless, the specific developmental mechanisms, including the  maturation of the immune system, differences in corneal plasticity, and the interactive effects of multiple factors, remain incompletely understood.

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 detectd 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. Treatement 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.