目的：探讨先天性鼻泪管阻塞的临床治疗效果。方法：选取在咸阳彩虹医院接受治疗并有随诊记录的先天性鼻泪管阻塞患儿共630例(827眼)。根据年龄大小，采用4种方式统计治疗效果。结果：年龄0~2个月患儿230例(286眼)，选取泪囊按摩和局部点抗炎眼水治疗，182眼(63.63%)治愈；2~6个月患儿240例(340眼)，选取加压冲洗或泪道探通术治疗，338眼(96.74%)治愈；6~12个月患儿150例(188眼)，选取泪道冲洗+泪道探通术治疗，188眼(89.74%)治愈；1岁以上患儿10例(13眼)，选取泪道探通术加局部抗炎治疗，10眼(76.92%)治愈。结论：2~6个月是先天性鼻泪管阻塞治疗的最佳时间，泪道冲洗加探通技术在治疗婴幼儿先天性鼻泪管阻塞创伤小，疗效肯定，远期复发率低。

Objective: To discuss the therapeutic effects of congenital nasolacrimal duct obstruction. Methods: A total of 630 children (827 eyes) with congenital nasolacrimal duct obstruction who were treated in Xianyang Rainbow Hospital and had follow-up records were selected. According to the age, the therapeutic effects were carried out in four ways. Results: A total of 230 cases (286 eyes) aged 0–2 months were treated by massaging lacrimal sac withantiinflammatory eye water, 182 eyes (63.63%) were healed; 240 cases (340 eyes) aged 2–6 months were treated by pressor clysis and lacrimal passages probing, and among them 338 eyes (96.74%) were healed. 150 cases (188 eyes) aged 6–12 months were treated with lacrimal passage irrigation and lacrimal passage probing. 188 eyes (89.74%) were cured; 10 cases (13 eyes) aged over 1 year old were tread by probing of the lacrimal passages with anti-inflammatory eye water, 10 eyes (76.92%) were healed. Conclusion: 2 to 6 months is the best time for the treatment of congenital nasolacrimal duct obstruction, the therapy of pressor clysis with lacrimal passages probing chosen according to the age can treat the congenital nasolacrimal duct obstruction efficiently and decrease the long-term recurrence

目的：观察玻璃体腔内注射不同剂量康柏西普治疗早产儿视网膜病变(retinopathy of prematurity，ROP)的疗效以及术后的眼压变化。方法：前瞻性随机对照研究。将2018年1月1日至2021年6月30日在厦门市妇幼保健院确诊为Ι型阈值前期ROP、阈值期ROP、急进性ROP(aggressive ROP，A-ROP)的患儿纳入研究。随机分为减量组和常量组，分别玻璃体腔注射10 mg/mL康柏西普注射液0.015 mL(含康柏西普0.15 mg)和0.025 mL(含康柏西普0.25 mg)。测量并记录注射前5min、注射后5min、30min、1h、12h及24 h的眼压情况。术后1周开始随访眼底情况。疗效评价分为一次治愈、复发和加重。结果：共49例98眼纳入研究，常量组27例54眼，一次治愈成功率79.6%(43/54)，复发率16.7%(9/54)，加重率3.7%(2/54)；减量组2 2例44眼，一次治愈成功率68.2%(30/44)，复发率27.3%(12/44)，加重率4.5%(2/44)；两组间差异无统计学意义(χ 2=1.672，P=0.196)。治疗前5min两组眼压差异无统计学意义(P=0.494)；注药后5 min、1 h、12h两组眼压差异有统计学意义(均P<0.05)；注药后24 h两组间的眼压差异无统计学意义(P=0.101)。常量组注药前5 min和注药后24 h眼压差异有统计学意义(P=0.03)，减量组注药前5 min和注药后24h眼压差异无统计学意义(P=0.84)。结论：减量剂量康柏西普(0.15mg)治疗ROP有效，疗效与常规剂量(0.25 mg)相近，且术后眼压升高幅度较低，更快恢复至术前水平，更安全。

Objective: To evaluate the effectiveness of intravitreal injection of various doses of conbercept in the treatment of retinopathy of prematurity (ROP) and change of intraocular pressure (IOP) after operation. Methods: It was a prospective randomized controlled study. Children who were diagnosed with pre-threshold ROP, threshold phrase ROP, and aggressive ROP (A-ROP) in Xiamen Maternity and Child Healthcare Hospital from January 1, 2018 to June 30, 2021 were included in the study. The children were randomly divided into a reduction group and a constant group, and received intravitreal injection of10 mg/mL conbercept at 0.015 mL (containing 0.15 mg of conbercept) and 0.025 mL (containing 0.25 mg of conbercept) respectively. IOP was measured and recorded 5 min before injection, 5 min, 30 min, 1 h, 12 h and 24 h after injection. The fundus condition was followed up 1 week after the operation. The efficacy evaluation is divided into one cure, recurrence and exacerbation. Results: A total of 98 eyes of 49 cases were included in thestudy. For 27 cases of 54 eyes in the constant group, the one-time cure success rate was 79.6% (43/54), the recurrence rate was 16.7% (9/54), and the exacerbation rate was 3.7% (2/54). In the reduction group, there were 22 cases (44 eyes). The one-time cure success rate was 68.2% (30/44), the recurrence rate was 27.3% (12/44), and the exacerbation rate was 4.5% (2/44). There was no significant difference between the two groups (χ2=1.672,P=0.196). There was no significant difference in IOP between the 2 groups 5 min before treatment (P=0.494). There were statistically significantdifferences in IOP between the 2 groups at 5 min after injection, 1 h after injection, and 12 h after injection (all P<0.05). There was no difference in IOP between the two groups 24 h after injection (P=0.101). There was a statistically significant difference in IOP between 5 min before and 24 h after injection in the constant group (P=0.03), and there was no significant difference in IOP between 5 min before and 24 h after injection in the reduction group (P=0.84). Conclusion: Reduced dose of conbercept (0.15 mg) is effective in the treatment of ROP, and the efficacy is similar to that of conventional dose (0.25 mg). The reduction can help lower the increase of postoperative IOP, returning to the preoperative level more rapidly and safely.

目的：分析临床应用镜下改良眼轮匝肌手术治疗儿童先天性下睑内翻的效果。方法：回顾性分析安康市中医医院2年期间，应用镜下改良眼轮匝肌手术治疗61例(112眼)儿童先天性下睑内翻，根据睑内翻程度决定缝线跨度、松紧度及去除肌皮瓣量，0/6缝线将睑缘下眼轮匝肌与下睑缩肌缝合，0/8缝线连续缝合皮肤伤口，并做好术后护理。结果：所有患儿随访6~24个月，刺激症状缓解，106眼治愈，2眼好转，4眼复发，总有效率达96.43%。结论：镜下改良眼轮匝肌手术治疗儿童先天性下睑内翻美观、易操作、复发率低。

Objective: To analyze the clinical efficacy of modified orbicularis oculi surgery under microscope in the treatment of congenital lower eyelid entropion of children. Methods: Sixty-one cases (112 eyes) of children with congenital lower eyelid entropion treated by modified orbicularis oculi surgery in Ankang Hospital of Traditional Chinese Medicine from Aug 2020 to Sep 2022 were retrospectively analyzed. The suture span, tightness and the amount of myocutaneous flap removed were determined according to the degree of entropion. The orbicularis oculi muscle of lower eyelid margin was suturedwith 0/6 suture, and the skin wound was sutured continuously with 0/8 suture, and postoperative nursing was done well. Results: All children were followed up for 6–24 months, and the irritation symptoms were relieved, 106 eyes were cured, 2 eyes turned well, and 4 eyes relapsed. The total effective ratereached 96.43%. Conclusion: The modified orbicularis oculi surgery for treatment of children with congenital lower eyelid entropion conforms to visual aesthetics. In addition, it is easy to operate and have a low recurrence rate.

目的：研究早产儿视网膜病变患儿经不同治疗措施后屈光状态的改变。方法：将72例(127眼)早产儿视网膜病变患儿按治疗方式分为3组：激光光凝组、注药(抗血管内皮生长因子药物)组和自然消退组。并于治疗前，治疗后1、4、7、12个月对其进行睫状肌麻痹检影验光，对比分析3组的球镜和等效球镜的差异。结果：在治疗后1、4、7及12个月，三组患儿的球镜度和等效球镜度的差异有统计学意义(P<0.05)：注药组的球镜和等效球镜小于自然退化组及激光组(均P0.05)。治疗后12个月时激光光凝组、注药组和自然消退组近视发生率分别是2.4%、7.8%和2.0%，差异无统计学意义(P=0.356)。结论：经不同治疗措施的ROP患儿近视发生率无明显差异，但经玻璃体腔注射抗VEGF药物的ROP患儿正视化进程更快。

Objective: To observe the changes of refractive statues in infants with retinopathy of prematurity retinopathyof prematurity (ROP) after different treatments. Methods: According to different treatment methods, 72 cases(127 eyes) of infants with ROP were divided into 3 groups: laser photocoagulation group, intravitreal injectionof anti-vascular endothelial growth factor (VEGF) drugs group and natural regression group. Their sphere andspherical equivalent were measured by retinoscopy optometrist after the ciliary muscles paralyzed. The data beforetreatments and 1, 4, 7 and 12 months after treatments were recorded and analyzed. Results: The differences ofsphere and spherical equivalent among three groups were statistically significant: intravitreal injection of VEGFdrugs group was lower than natural regression group and the laser photocoagulation group, but there was no significant difference between natural regression group and laser photocoagulation group. Incidence of myopiaof laser photocoagulation, intravitreal injection of VEGF drugs, natural regression group were 2.4%, 7.8%, 2.0%,which was not statistically significant. Conclusion: There was no significant difference about the incidence rate ofmyopia among the three groups, but the emmetropization in infants with ROP after intravitreal injection of anti-VEGF drugs might be faster in the future.

目的：对儿童癔症性视力障碍的病因进行分析，比较试镜与人工泪液给药治疗的疗效。方法：纳入2013年10月至2020年10月以“癔症性突发视力下降”于深圳市儿童医院门诊就诊的36例患儿，其中男16例，女20例。按随机原则分为试镜组与人工泪液给药组。两组在治疗过程中都辅以语言暗示。两组治疗的首次有效率采用SPSS17.0软件Fisher精确概率检验。分析儿童癔症性视力障碍的发病原因，提出诊断要点和防治对策。结果：在辅以语言暗示的前提下，试镜组人工泪液给药组治疗方案的首次有效率分别为94.4%、83.3%，差异有统计学意义(P<0.05)。在相关病因分析中，学习压力相关的有20例，占55.6%，包括成绩下降、逃避考试、因成绩受到家长或老师的训斥，甚至体罚。家庭变故13例，占36.1%，父母离异为主要原因。留守儿童不愿返乡、同学纠纷、校园霸凌以及外伤等为其他原因。结论：试镜加语言暗示比人工泪液加语言暗示更能有效提高癔症性视力障碍的首次治疗有效率。学习压力、家庭变故相关因素为癔症性视力障碍的最常见原因

Objective: To analyze the causes of hysterical visual impairment in children, and to compare the efficacy of two treatments of trial frame and artificial tears administration. Methods: A total of 36 children with sudden hysterical visual impairment admitted to Shenzhen Children’s Hospital from October 2013 to October 2020 were enrolled in our study, including 16 males and 20 females. They were randomly divided into trial frame group and artificial tears group. Both groups were supplemented with verbal suggestion during the treatment. The primary effective rates of the two groups were compared by SPSS 17.0 Fisher’s exact test. The causes of hysterical visual impairment in children were analyzed, and the main points of specific diagnostic tests and treatments were summarized. Results: The primary effective rate of the trial frame group and the artificial tears group were 94.4% and 83.3% respectively.Thedifference was statistically significant (P<0.05). In this study, therewere 20 cases (55.6%) related to study pressure, including decline in academic performance, evasion of exams, reprimand by parents or teachers, and even corporal punishment. There were 13 cases (36.1%) caused by family accidents, and parents’ divorce was the main reason. Leftover children unwilling to return hometown, classmate disputes, campus bullying and trauma were other reasons. Conclusion: Trialframe is more effective than artificial tears therapy in improving primary effective rate of hysterical visual impairment. Study pressure, family accident are the most common causes of hysterical visual impairment

剥脱性青光眼是剥脱综合征继发的一类青光眼，临床上少见。本文报告2例患者，患眼瞳孔缘可见灰白色碎屑样物质沉积，散大瞳孔后可见晶状体前囊周边部混浊带，房角镜下可见Sampaolesi线。认识其临床特征，将有助于提高其诊治率。

Exfoliation glaucoma is a category of glaucoma secondary to exfoliation syndrome, which is rarely encountered in clinical practice. We reported 2 cases with deposits of white material on the pupillary border of the iris. Opacity band could be observed surrounding the anterior lens capsule after pupil dilation, and the Sampaolesi line was seen under gonioscope. Understanding the clinical characteristics contribute to improving the diagnosis and treatment of exfoliation glaucoma.

目的：了解重度视力损伤和盲患者居家的主要护理问题及护理需求的内容，为医护人员制订居家照护支持计划提供依据。方法：采用描述性质性研究方法，于2020年4至9月对在广州市某三甲眼科专科医院的20例重度视力损伤和盲的住院患者进行面对面的半结构式访谈，采用归纳式内容分析法对访谈资料进行分析。结果：重度视力损伤和盲患者居家的主要护理问题有日常生活自理的能力缺失、外出社交活动受限和难以适应家庭角色的改变；护理需求包括希望医院提供多维度的疾病相关知识和提供多渠道的医疗咨询服务。结论：重度视力损伤和盲患者居家照护存在诸多的护理问题及需求，患者希望得到多维度相关知识和多渠道医疗咨询，医院、社区应该高度重视此类患者，同时给予相应的指导和帮助，从而提高患者的居家生活质量。

Objective: To explore the main nursing problems and demands of patients with severe visual impairment or blindness, so as to provide the basis for health staff to formulate home care support plans of high quality. Methods: By using a descriptive qualitative method, face-to-face semi-structured interviews were conducted among 20 patients with severe visual impairment or blindness who were hospitalized in the top-grade ophthalmic hospital in Guangzhou from April to September 2020. The inductive content analysis method was used to analyze the data. Results: The main nursing problems of these patients were the lack of self-care ability, limited social activities, and difficulty in adapting to changes in family roles. Nursing needs include the hope that hospitals can provide multidimensional disease-related knowledge and multi-channel medical consulting services. Conclusion: Patients with severe visual impairment or blindness have many problems and needs in home care. They would like to obtain multi-dimensional knowledge and receive multi-channel medical consultation. Health staff from hospitals and communities should attach great importance to these patients, as well as provide appropriate guidance and assistance, so as to improve their activities of daily living.

目的：调查干眼在郑州市机关工作者中的患病情况，分析相关危险因素，为有效防治干眼提供科学依据。方法：选取2019年9月到2020年9月在郑州大学第一附属医院体检的郑州市机关工作者873例。采用自行设计的一般资料问卷和OCULUS Jenvis-OSDI干眼问卷进行调查，记录评分结果，同时检查记录裂隙灯、角膜荧光素染色评分(corneal fluorescein staining score，FL)、基础泪液分泌实验(Schimier I test，SIT)、泪膜破裂时间(tear break-up time，BUT)测定结果。统计分析机关工作者干眼患病率与危险因素。结果：体检的873例郑州市机关工作者中360例诊断为干眼，干眼总患病率为41.24%，女性患病率(44.62%)明显高于男性(36.26%)，差异有统计学意义(P=0.014)。干眼问卷OSDI评分与FL评分呈正相关，BUT与SIT呈正相关，OSDI(和FL评分)与BUT(和SIT)呈负相关。Logistics多因素分析表明：干眼家族史、绝经、曾行眼部手术、滴眼液使用情况、长时间佩戴角膜接触镜、长时间操作视频终端、睡眠不足、糖尿病史是机关工作者干眼患病的危险因素(均P<0.05)，而饮酒是保护因素(P=0.001)。结论：机关工作者干眼患病率较高，危险因素囊括家族患干眼史、绝经、曾行眼部手术、滴眼液使用情况、长时间佩戴角膜接触镜、长时间操作视频终端、睡眠不足、糖尿病病史。加强干眼防治的宣传教育，针对不同危险因素提供眼健康指导并进行防控治疗，保护机关工作者的眼健康。

Objective: To investigate and analyze the prevalence of dry eyes in Zhengzhou office workers, and identify the related risk factors in order to provide evidence for effective prevention and treatment. Methods: We selected 873 cases of Zhengzhou office workers who had checkup in our hospital from September 2019 to September 2020 as the research subjects. They were investigated with self-designed general information questionnaire and OCULUS Jenvis-OSDI dry eye questionnaire and scores of the questionnaires will be assessed. At the same time,they underwent dry-eye-related inspections such as slit lamp examination, corneal fluorescein staining score (FL), Schimier I test (SIT) and tear break-up time (BUT) assessment. The prevalence and risk factors of dry eyes in these office workers were statistically analyzed. Results: Among 873 Zhengzhou office workers, 360 cases were diagnosed as dry eyes, and the total prevalence of dry eye was 41.24%. The female prevalence rate was 44.62%, which was significantly higher than that of male (36.26%, P=0.014). OSDI scores and FL scores were positively correlation as well as BUT and SIT, while OSDI (and FL) and BUT (and SIT) were negatively correlation. Logistic multivariate analysis showed that dry eyes family history, menopause, ocular surgery history, eye drops using, long time corneal contact lenses wearing, long time video terminal operating, lack of sleep and diabetes history were independent risk factors in office workers’ dry eye disease (all P<0.05), while drinking was protective factor (P=0.001). Conclusion: The dry eyes prevalence is high among office workers. The risk factors include dry eye family history, menopause, ocular surgery history, eye drops using, long time corneal contact lenses wearing, long time video terminal operating, lack of sleep and diabetes history. We should strengthen the publicity and education of the dry eye prevention and treatment, provide eye health guidance, prevention and treatment according to different risk factors, and protect the office workers’ eye health.

目的：探索白内障术眼低视力的原因。方法：对2011年10月至2013年3月在汕头国际眼科中心行白内障手术，术前无法窥清眼底，术后1周最佳矫正视力<0.3的患者进行视力、最佳矫正视力、眼压测量、裂隙灯检查、眼底镜检查、眼底照相及光学相干断层扫描(optical coherence tomography，OCT)，若未发现任何视网膜器质性病变，再进行视觉诱发电位检查及视野检查。由2位医生对检查结果进行分析，对不同的眼底病变做出诊断，统计分析白内障术眼低视力的原因。结果：共纳入行白内障手术患者5 608例，术后1周最佳矫正视力<0.3的患者共49例(共49眼)，其中男20例，女29例，右眼31只，左眼18只，年龄(69.11±12.05)岁。白内障术后低视力比例为0.87%。其中高度近视性脉络膜视网膜病变12例(24.5%)，椭圆体带连续性破坏10例(20.4%)，糖尿病性视网膜病变8例(16.3%)，黄斑孔5例(10.2%)，老年性黄斑变性4例(8.1%)，黄斑前膜3例(6.1%)，黄斑区视网膜厚度变薄1例(2.0%)，视网膜色素变性1例(2.0%)，视网膜劈裂症1例(2.0%)，视网膜分支动脉阻塞1例(2.0%)，白塞氏病1例(2.0%)，缺血性视神经病变1例(2.0%)，视网膜前膜1例(2.0%)。结论：在本组白内障术眼低视力的患者中，高度近视性脉络膜视网膜病变占主要部分，为24.5%，其次分别为椭圆体带连续性破坏、糖尿病性视网膜病变、黄斑孔、老年性黄斑变性和黄斑前膜。利用OCT可发现影响白内障术后视力的细微视网膜结构变化，对于白内障术前眼底可见的患者常规行OCT有利于判断手术预后，便于医患沟通，提高手术满意度。

Objective: To explore the causes of low vision after cataract surgery. Methods: Patients who underwent cataract surgery at Joint Shantou International Eye Center of Shantou University and the Chinese university of Hong Kong ( JSIEC) from October 2011 to March 2013, whose fundus status could not be seen before surgery, and the best corrected visual acuity <0.3 in the first week after surgery, underwent a series of detailed ocular examinations, including visual acuity, best corrected visual acuity, intraocular pressure, slit-lamp examination, fundus examination, fundus photography and optical coherence tomography. If no organic lesions of the retina were found, then visual evoked potential examination and visual field examination were performed. Two doctors analyzed the examination results of the examination, made the diagnosis of different fundus diseases, and statistically analyzed the causes of low vision after cataract surgery. Results: A total of 5 608 cataract surgeries were performed in our hospital from October 2011 to March 2013. A total of 49 patients (49 eyes) with best corrected visual acuity worse than 0.3 within postoperative 1 week 20 male and 29 female, 31 right eyes and 18 left eyes, aged (69.11±12.05) years on average. The proportion of low vision after cataract surgery was 0.87%. 12 cases (24.5%) of high myopic chorioretinopathy, 10 cases (20.4%) of ellipsoidal band defect, 8 cases (16.3%) of diabetic retinopathy, 5 cases (10.2%) of macular holes, 4 cases (8.1%) of age-related macular degeneration, 3 cases (6.1%) of macular epiretinal membrane, 1 case (2.0%) of thinning macular retinal thickness, 1 case (2.0%) of retinitis pigmentosa, 1 case of retinoschisis (2.0%), 1 case of branch retinal artery occlusion (2.0%), 1 case of Behcet’s disease (2.0%), and 1 case of ischemic optic neuropathy (2.0%), 1 case of epiretinal membrane (2.0%). Conclusion: Among patients with low vision after cataract surgery, high myopic chorioretinopathy accounts for 24.5%, followed by ellipsoidal band defect, diabetic retinopathy, macular hole, age-related macular degeneration, and macular epiretinal membrane. The use of optical coherence tomography can detect subtle microscopic retinal structural changes that affect vision after cataract surgery. For patients with visible fundus before cataract surgery, routine optical coherence tomography contributes to evaluating the prognosis of the operation, facilitating doctorpatient communication, and improving the degree of surgical satisfaction.

全科医生对个人及其家庭所提供的基本、连续性、综合性及整体性的医疗服务。全科医生要求具备更为“广博”的知识结构。那么如何在有限的培训期内更好地完成亚专科的培训并获得社区卫生服务中切实需要的临床技能及知识储备，是目前亟待解决的问题。基于社区卫生服务的基本特点，全科医生规范化培训中培训眼科学的相关内容，强调重视眼与全身疾病、眼科急症及全身药物的眼部损害等，有助于全科医生迅速、准确地发现和判断在社区医疗机构就诊的各类眼部急危重症患者，及时向专业眼科机构转诊，避免延误诊治，为后续专业的眼科治疗赢得宝贵时间，从而使全科医生更好地胜任社区居民健康“守门人”的工作。

General practitioners provide basic, continuous, comprehensive and holistic medical services to individuals and their families, which requires them to have a more “extensive” knowledge structure. However, within the limited training period, how to successfully complete subspecialty training and acquire the clinical skills and knowledge needed in community health services is an urgent problem which need to be explored. Based on the basic characteristics of community health service, the ophthalmology training of the standardized training of general practitioners, focus on the eye and systemic diseases, ophthalmic emergency and side-effect of systemic drug on eye would help general practitioners rapidly and accurately find and diagnose all kinds of serious emergent ophthalmologic diseases, and then refer to professional eye institutions in time, which avoid delay in diagnosis and treatment and save more valuable time for subsequent professional treatment. It would make the general practitioners become good healthy gatekeepers for the local community residents.