近年来随着人口老龄化的发展、人群用眼方式的改变，现有的眼科医疗资源正越来越难以满足日渐增长的医疗需求，亟需新型的诊疗模式予以补足。眼科人工智能作为眼科领域的新兴元素，在眼病的筛查诊断中发展迅速，主要表现为“眼部图像数据+人工智能”的模式。近年来，随着该模式在白内障、青光眼、糖尿病性视网膜病变(diabetic retinopathy，DR)等常见病中研究的深入，相关技术日渐成熟，表现出了较大的应用优势与应用前景，部分技术甚至成功转化并被逐渐应用于临床。眼科诊疗向智慧医学模式的过渡，有望缓解日益增长的医疗需求与紧缺的医疗资源之间的矛盾，从而提高整体的医疗服务水平。

The development of population aging and changes in the way people use their eyes over the recent years have increasingly challenged the existing ophthalmic medical resources to meet the growing medical needs, thus urgently calling for a novel diagnostic and treatment mode. Despite its status as an emerging sector in ophthalmology, ophthalmic artificial intelligence has developed rapidly in the screening and diagnosis of eye diseases, as can be seen in practices adopting the “eye imaging data + AI” mode. In recent years, with the intensified research on this mode with respect to common diseases such as cataract, glaucoma and diabetic retinopathy, relevant technologies have grown increasingly mature, presenting undeniable application superiority and prospects. Some of the relevant technical achievements have also been successfully transformed for practical usage, and are gradually being applied to clinical practices. Ophthalmic diagnosis and treatment are transitioning toward the era of intelligent medical services, which are expected to reduce the contradictions between the growing medical needs and the shortage of medical resources, as well as ultimately improve the overall experience of medical services.

近年来随着医疗领域数字化、信息化建设的加速推进，人工智能的应用越来越广泛，在眼科医学方面尤为突出。婴幼儿处于视觉系统发育的关键时期，此时发生的眼病往往会造成不可逆的视功能损伤，带来沉重的家庭和社会负担。然而，由于婴幼儿群体的特殊性以及小儿眼科医生的短缺，开展大规模小儿眼病筛查工作十分困难。最新研究表明：人工智能在先天性白内障、先天性青光眼、斜视、早产儿视网膜病变以及视功能评估等领域已经得到相关应用，在多种婴幼儿眼病的早期筛查、诊断分期、治疗建议等方面都有令人瞩目的表现，有效解决了许多临床难点与痛点。但目前婴幼儿眼科人工智能仍然不如成年人眼科发展充分，亟须进一步的探索和研发。

In recent years, with the acceleration of digitalization and informatization in medical field, artificial intelligence (AI) is more and more widely applied, especially in ophthalmology. Infants are in the critical period of visual development, during which eye diseases can lead to irreversible visual impairment and bring heavy burden to family and society. Due to the particularity of infants and the shortage of pediatric ophthalmologists, it is challenging to carry out large-scale screening for eye diseases of infants. According to the latest studies, AI has been studied and applied in the fields of congenital cataract, congenital glaucoma, strabismus, amblyopia, retinopathy of prematurity, and evaluation of visual function, and it has achieved remarkable performance in the early screening, diagnosis stage and treatment suggestions, solving many clinical difficulties and pain points effectively. However, AI for infantile ophthalmology is not as developed as for adult ophthalmology, so it needs further exploration and development.

外泌体(exosome)是直径30 nm~150 nm的纳米级囊泡，由脂质双分子层、蛋白质和遗传物质组成。人体内几乎所有类型的细胞都能分泌外泌体。它们在细胞通信、免疫调节、炎症反应和新生血管形成中起着关键作用。目前，外泌体已在肿瘤、心血管及泌尿系统中得到广泛研究。近年来，外泌体在眼科疾病中的作用受到越来越多的关注。外泌体在角膜病变、年龄相关性黄斑病变、糖尿病视网膜病变、青光眼等常见眼科疾病的发生、发展中发挥重要作用。不同间充质干细胞来源的外泌体在眼科疾病中的治疗潜力是当下的热点。间充质干细胞来源的外泌体具有与间充质干细胞相似的抗炎、抗凋亡、神经保护和组织修复的作用，因此外泌体可能是多种眼科疾病无细胞疗法治疗研究的新方向。进一步了解外泌体的生物学特性以及外泌体在眼科疾病的最新研究进展，将为相关眼病的发生机制和防治策略提供参考依据。

Exosomes are nanoscale vesicles with a diameter of 30 nm to 150 nm, which are composed of lipid bilayers, proteins, and genetic material. Almost all types of cells in the human body can secrete exosomes. Tey play key roles in cellular communication, immune regulation, infammatory responses and neovascularization. At present, exosomes have been widely studied in tumors, cardiovascular and urinary systems. In recent years, the role of exosomes in eye diseases has attracted more and more attention. The exosomes play an important role in the occurrence and development of common eye diseases such as keratopathy, age-related macular disease, diabetic retinopathy, glaucoma, etc. Currently it is a hot topic that the therapeutic potential of extracellular vesicles derived from diferent mesenchymal stem cells in eye  diseases. Te exosomes derived from mesenchymal stem cells have anti-infammatory, anti apoptotic, neuroprotective and tissue repairing effects, which are similar to those of mesenchymal stem cells. Thus, exosomes may be a novel direction of research in the treatment of many eye diseases without cell therapy. Further understanding of the biological characteristics of exosomes and the latest research progress of exosomes in common eye diseases will provide reference for the pathogenesis and prevention strategies of related eye diseases.

随着智能手机覆盖率的增加与可用性的提升，实现智能健康管理的应用程序成为新兴研究热点。新一代智能手机可通过追踪步数，监测心率、睡眠，拍摄照片等方式进行健康分析，成为新的医学辅助工具。随着深度学习技术在图像处理领域的不断进展，基于医学影像的智能诊断已在多个学科全面开花,有望彻底改变医院传统的眼科疾病诊疗模式。眼科疾病的常规诊断往往依赖于各种形式的图像，如裂隙灯生物显微镜、眼底成像、光学相干断层扫描等。因此，眼科成为医学人工智能发展最快的领域之一。将眼科人工智能诊疗系统部署在智能手机上，有望提高疾病诊断效率和筛查覆盖率，改善医疗资源紧张的现状，具有极大的发展前景。综述的重点是基于深度学习和智能手机的眼病预防与远程诊疗的进展，以糖尿病性视网膜病变、青光眼、白内障3种疾病为例，讲述深度学习和智能手机在眼病管理方面的具体研究、应用和展望。

With the increasing coverage and availability of smart phones, the application of realizing intelligent health management has become an emerging research hotspot. The new generation of smart phones can perform health analysis by tracking the step numbers, monitoring heart rate and sleep quality, taking photos and other approaches, thereby becoming a new medical aid tool. With the continuous development of deep learning technology in the field of image processing, intelligent diagnosis based on medical imaging has blossomed in many disciplines, which is expected to completely change the traditional eye diseases diagnosis and treatment mode of hospitals. The conventional diagnosis of ophthalmic diseases often relies on various forms of images, such as slit lamp biological microscope, fundus imaging, optical coherence tomography, etc. As a result, ophthalmology has become one of the fastest growing areas of medical artificial intelligence (AI). The deployment of ophthalmological AI diagnosis and treatment system on smart phones is expected to improve the diagnostic efficiency and screening coverage to relieve the strain of medical resources, which has a great development prospect. This review focuses on the prevention and telemedicine progress of eye diseases based on deep learning and smart phones, taking diabetic retinopathy, glaucoma and cataract as examples to describe the specific research, application and prospect of deep learning and smart phones in the management of eye diseases.

目的：了解中山大学中山眼科医院门诊重症疑难眼病会诊的现状，探讨门诊重症疑难眼病会诊亚专科的分布情况及会诊效果，为建立科学的门诊重症疑难眼病会诊体系提供支持和依据，同时也为合理安排会诊流程提供依据。方法：对中山大学中山眼科医院2016年3月至2017年4月收集的265例门诊重症疑难病例，通过时间、地区、性别、年龄、会诊原因、会诊亚专科、会诊后的转归及效果等方面进行统计分析，所有数据均通过Excel软件进行录入，根据分析目的和资料的类型，采用相应的统计指标进行描述，并进行统计推断，检验水准为α=0.05。结果：2016年3月至2017年4月期间中山大学中山眼科医院门诊重症疑难眼病会诊人数265例。在地区分布中，广东省地区最多，为145例，外国最少，为3例。人群分布中，男167例，女98例，男女比例为1.70:1。年龄分布中，30~44岁及45~59岁的病例数最多，均为53例(20%)，70岁以上老年病例最少，为13例(4.9%)。中山大学中山眼科医院门诊重症疑难眼病会诊中，2016年3月至2017年4月期间，各眼科亚专科共参加会诊714次，眼底外科参加会诊次数最多，为147次(20.5%)，结膜科参加会诊的次数最少，为1次(0.1%)。在分析会诊原因方面，因诊治涉及多个专科而会诊的病例数最多，为161例，因病因不明会会诊的病例最少，为20例；会诊后比会诊前明确治疗方案的病例数增加190例。结论：中山大学中山眼科医院门诊组织实施重症疑难眼病会诊使明确治疗方案率大幅提高，在提高疑难眼病治疗效果方面起到一定的促进作用。

Objective: To understand the current situation of the consultation for outpatients with severe eye disease in Zhongshan Ophthalmic Center, and to explore the distribution and effects of sub-specialty consultation for outpatients with severe eye disease. To set up a scientific system of the consultation for outpatients with severe eye disease, and also provide a basis for reasonable arrangement of consultation process. Methods: We analyzed 265 severe cases from March 2016 to April 2017 in Zhongshan Ophthalmic Center by time, region, gender, age, cause of consultation, sub-specialty, and outcomes after consultation. And all data was analyzed by Excel software, according to the purpose and the type of data, and the corresponding statistical index and statistical inference, inspection level for α=0.05. Results: There were 265 cases with severe eye disease from March 2016 to April 2017. As for the regional distribution, Guangdong province was the largest, with 145 cases, while the lowest number was from foreign countries, which was 3 cases. In the population distribution, 167 cases were males, 98 were females and the ratio was 1.70. In age distribution, patients aged from 30 to 44 years and 45 to 59 years predominated and the number of cases were both 53, accounting for 20% of the total number. Patients over 70 were the least which were 13 cases, accounting for 4.9% of the total number. From March 2016 to April 2017, all sub-specialties attended consultation for 714 times, as Ocular Fundus Department attended the most, accounting for 20.5% of the total number while Conjunctive Department attended the least, for only one, accounting for 0.1% of the total number. As for the reason of the consultation, the number of cases involving multiple specialties was the largest, with 161 cases, while the lowest number of cases due to unexplained causes, which were 20 cases. The number of cases of explicit treatment was increased by 190 after consultation. Conclusion: Consultations organized by Zhongshan Ophthalmic Center improves the treatment for outpatients with severe eye disease.

原发性干燥综合征 (primary Sjogren' s syndrome，SS) 是一种主要累及外分泌腺体的自身免疫性疾病，患者通常因为严重的干眼症状首先就诊于眼科，大多数临床医师对原发性干燥综合征相关性干眼 (Sjogren' s syndrome dry eye disease，SS-DED) 认识不足，可能导致漏诊和误诊。侵入性极小的客观检查及生物标志物的发展，将有助于发现 SS-DED 的真面目，并可能从新的角度阐释其发病机制，为其诊断、分类及治疗提供新的思路。SS-DED 的治疗没有特效的药物，大多数患者需接受多种方法的治疗，以了解哪些方法最有效。

Primary Sjogren' s syndrome is an autoimmune disease that mainly affects exocrine glands. Patients usually refer to ophthalmologists because of severe dry eye symptoms. Most clinicians have insufficient knowledge with dry eye disease associated with primary Sjogren' s syndrome probably leading to misdiagnosis or missing the diagnosis. The diagnosis of Sjogren' s syndrome dry eye disease (SS-DED) is difficult, but the extremely invasive objective examination and the development of biomarkers will help to understand this disease and explain its pathogenesis from a new perspective. There is no specific treatment for the SS-DED, and most patients should receive multiple treatments to select the optimal treatment. 

教学查房是手把手教学的重要手段和具体表现，是让同学们把书本知识应用到医疗诊疗中的重要桥梁。眼科学具有形象生动、结构复杂、直观性和操作性强等特点。外眼疾病的特征更是显而易见，针对外眼疾病诊疗中的一些不规范的操作也更易暴露出来。本文以上睑下垂为例，旨在阐明教学查房在外眼疾病教学中的重要性。

Teaching rounds are an important means and concrete manifestation of hands-on teaching, and an important bridge for students to apply book knowledge to medical diagnosis and treatment. Ophthalmology has the characteristics of vivid image, complex structure, intuition and strong operability. The characteristics of external eye diseases are more obvious, and some non-standard operations in the diagnosis and treatment of external eye diseases are easier to expose. This article takes blepharoptosis as an example to illustrate the importance of teaching rounds in the teaching of external eye diseases.

目的：探讨推广新生儿眼病筛查以及婴儿期定期眼保健的必要性。方法：回顾分析 2014 年 1 月至 2016 年 12 月 20800 例惠州市妇幼保健计划生育服务中心门诊收集的婴儿眼保健资料。结果：共检出致盲性眼病 7 种 158 例，其中满 42 d 内检出 147 例，3 个月内检出 8 例，6 个月内检出 2 例，12 个月内检出 1 例。检出时已合并眼位、眼前节异常、影响视功能者 8 例。不同出生胎龄致盲性眼病检出率：≤ 34 周为 11.64％，34～37 周为 1.24％，≥ 37 周为 1.29％。相对于纸质宣传材料，开展家长学校讲课，利用 PPT 结合实际病例讲解，更有助于普及眼保健。相对于眼底检查，眼前节的方式更容易被接受、被推广。结论：致盲性眼病婴儿期发病在临床中并不少见，并且部分是可以早期筛查、早期治疗以避免视功能损害的。临床中需要大力普及眼保健知识，并可以在具备条件的医院，适当利用新生儿广域成像系统推广新生儿眼病普筛。

Objective: To discuss the necessity of screening for neonatal eye disease and regular eye care in infancy. Methods: A retrospective analysis of 20 800 infants in our hospital from January 2014 to December 2016 was conducted. From January 2014 to December 2016. Results: Seven types of blindness eye diseases were detected in 158 cases, including 147 cases at 42 days, 8 cases at 3 months, 2 cases at 6 months and 1 case at 12 months after birth. Eight cases were supervened with abnormal eye position, anterior segment abnormality and poor visual function. The detection rate of blindness-inducing diseases was 11.64% for infants aged ≤ 34 weeks, 1.24% for 34–37 weeks and 1.29% for ≥ 37 weeks. Compared with the paper propaganda materials, the introduction of parental school lectures and PPT combined with explanation of actual cases was more conducive to popularize eye care. Compared with fundus examination, anterior segment examination was more likely to be accepted and popularized. Conclusion: Eye disease inducing blindness in infancy are commonly encountered in clinical practice, which can be screened and treated early to avoid visual impairment. It is necessary to popularize the knowledge of eye care, and promote the screening of newborn eye disease in qualified hospitals.

目的：了解干眼患者自我护理能力水平并分析其影响因素。方法：选取2022年2月—6月在中山大学中山眼科中心就诊的干眼患者为研究对象，采用一般资料调查表、自我护理能力量表、一般自我效能感量表对患者进行调查分析。结果：共调查293例干眼患者，其自我护理能力评分为(113.34±9.98)分，处于中等水平。相关性分析中干眼患者的自我护理能力总分与自我效能感得分呈正相关(r=0.421，P<0.001)，多重线性回归分析显示，累计屏幕使用时间>10 h/d、合并全身疾病、低自我效能感评分是干眼患者自我护理能力的危险因素(P<0.05)。结论：干眼患者自我护理能力水平处于中水平，仍需加强。医护工作者在工作中应重点关注屏幕使用时间长、合并全身疾病及自我效能感低的患者，并制定相应的护理对策，以改善患者的自我护理能力水平。

Objective: To understand the self-care ability of patients with dry eye and analyze its infuencing factors. Methods: A total of 293 patients with dry eye were selected from Zhongshan Ophthalmic Center, Sun Yat-sen University from February 2022 to June 2022, the general data Questionnaire the general self-efcacy scale, and the self-care ability scale survey were collected. Results: A total of 293 patients with dry eye were surveyed, and the self-care ability score was 113.34±9.98, which was at the medium level. The total score of self-care ability, the scores of self-concept, self-care responsibility, health knowledge level and self-care skills of patients with dry eye were positively correlated with the scores of self-efcacy (r=0.421, all P<0.001).Multiple linear regression analysis showed that cumulative screen usage time>10 hours/day, comorbid systemic diseases, and low self-efficacy scores were risk factors for self-care ability in patients with dry eye (P<0.05). Conclusions: Te self-care ability of patients with dry eye disease is at a medium level, and still needs to be strengthened. Medical workers should focus on patients with prolonged screen usage, comorbid systemic diseases, and low self-efficacy in their work, and tailor relevant nursing strategies to improve their self-care abilities.