目的：观察和分析儿童眼科门诊就诊的屈光不正 3～7 岁患儿，有早产史和足月产史的患儿的屈光不正的特点和差异。

方法：屈光不正 179 例（358 眼），分为 2 组：早产史者 51 人，足月产者 128 人。1％阿托品眼膏散瞳进行视网膜带状光剪影验光。

结果：足月儿的屈光不正患儿中，以远视多见，占 157／256 眼（61.3％），对比有早产儿屈光不正的远视发病 25／102（24.5％），差异有统计学意义（P < 0.05）。有早产儿屈光不正中，以散光发病为主，占 81／102 眼（79.4％），尤以高度散光、混合散光多见，相对与足月儿，其散光发病，高度散光发病和混合散光发病眼数的差异均有显著性（P < 0.05）。

结论：散光，尤其是高度散光、复杂的混合散光是有早产儿童视力低下的重要原因。临床上散光与弱视的形成关系密切相关，因此不能忽略早产儿童视力发育，最早可提前到 2 岁即可进行屈光筛查。

Purpose: To observe the abnormal refractive state and clinical characteristics in preterm and full-term children of the Department of Pediatric Ophthalmology.

Methods: The ocular refraction status of 358 eyes in 51 preterm and 128 full-term children were checked by retinoscopy in dilated pupil after being used atropine eye drops.

Results: There were 157 eyes with hyperopia accounting for 61.3% in preterm children, and 25 eyes with hyperopia accounting for 24.5% in full-term children. The main type of refractive errors in preterm children is astigmatism, especially in high astigmatism and mixed astigmatism. The morbidity of astigmatism, hyper astigmatism, and mixed astigmatism in preterm children is higher than that in full-term children.

Conclusion: Astigmatism, especially high astigmatism and complex mixed astigmatism, are important reasons for low vision in preterm children. Clinically, there is a close relationship between astigmatism and amblyopia. Therefore, the visual development of preterm children should not be ignored, and refractive screening could be brought forward to two years old.

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.  

We report a case of large graphite foreign body (FB) in the anterior chamber of eye of a 4-yearold child, incurred during unsupervised play. Despite delayed presentation, the eye had few signs of resolved inff ammation which allowed safe extraction of the FB bimanually through limbus. School play, especially in young children, should be under supervision and free of sharp objects. Graphite is inert while inside the eye, and even large pieces can be well tolerated for long time in absence of infection.  

We report a case of large graphite foreign body (FB) in the anterior chamber of eye of a 4-yearold child, incurred during unsupervised play. Despite delayed presentation, the eye had few signs of resolved inff ammation which allowed safe extraction of the FB bimanually through limbus. School play, especially in young children, should be under supervision and free of sharp objects. Graphite is inert while inside the eye, and even large pieces can be well tolerated for long time in absence of infection.  

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: 探讨 ETDRS 对数视力表对儿童视力检查的可重复性及其影响的相关因素。

方法: 在流行病学调查的过程中, 随机使用 ETDRS 对数视力表, 为 250 位裸眼视力低于 0.5 和 98 位视力正常儿童进行裸眼视力重复检查。
结果: 两次视力测量之间差异的均数为0.004log^±0.07; Kappa 分析结果具有很好的一致性(k = 0.71) ; 性别与视力检查一致性无明显相关(P = 0.845) ; 年龄与视力检查一致性有显著相关性(P = 0.019) , 年龄越小视力检查一致性越差; 屈光不正与视力检查一致性也有显著相关性(P = 0.000) , 近视度数在- 1.00D～- 5.00D 之间的儿童视力检查一致性相对差, 而正视眼的视力检查一致性较好。

结论: 结果提示 ETDRS 对数视力表适合儿童视力检查, 建议推广使用。

Purpose: To evaluate repeatability of the ETDRS log MAR visual acuity measurementin children and the relative influence factors.

Methods: The children (n = 348) with visual acuity less than 0.5 ( equal to 0.3 logunit) in either eye,or one tenth in children with normal visual acuity were chosen todo repeatable uncorrected VA measurement with Bland-Altman analysis and Kappa analysis using ETDRS acuity chart.

Results: The mean difference of visual acuity was 0.004log^±0.07. There was a significant repeatability (k = 0.71) between two visual acuity examination. There were significant consistent results both on male and female patients (P = 0.845) . A significant relationship was found between age and VA repeatability(P = 0.019) . The VA repeatability could also be influenced by refractive error (P = 0.000) . The acuity measurement in children with emmetropia (k = 0.82) had a higher repeatability than in the children with myopia (k = 0.66) .

Conclusions: The ETDRS visual acuity chart can provide a repeatable measure of visual acuity in children. It is recommended for clinic examination of children. 

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.

目的：利用儿童Glasgow受益调查问卷(Glasgow Children’s Benefit Inventory，GCBI)评估先天性上睑下垂手术后儿童健康相关生活质量(health-related quality of life，HRQOL)的受益，并探索受益的影响因素。方法：验证GCBI中文版评估先天性上睑下垂矫正术后长期患儿生活质量的信效度，并用其评估术后儿童HRQOL受益与性别、手术年龄、术后随访时间等相关性。结果：共178名先天性上睑下垂接受下垂矫正术后儿童完成问卷，结果显示不同性别、年龄均有正性受益，术后短期(<1年)受益更明显(P<0.05)。结论：GCBI中文版具有良好的信度和效度，适用于评估先天性上睑下垂儿童术后受益结果。先天性上睑下垂儿童接受下垂矫正术后不同性别均有正性受益，术后短期(<1年)受益更明显。

Objective: To explore the benefits of children’s HRQOL after congenital ptosis surgery using the Glasgow Children’s Benefit Inventory (GCBI) and the factors influencing the benefits. Methods: To verify the reliability and validity of the Chinese version of GCBI in evaluating the long-term life quality of children after correction of congenital ptosis, and to evaluate the correlation between the HRQOL benefit of children after surgery and gender, surgical age, postoperative follow-up time, etc. Results: A total of 178 children after congenital ptosis surgery completed the questionnaire. Different genders or ages of children with congenital ptosis both showed positive benefit after ptosis correction, and the short-term (<1 year) benefit was more obvious after surgery (P<0.05). Conclusion: The Chinese version of GCBI has good reliability and validity,and is suitable for evaluating the postoperative benefit results of children with congenital ptosis. All the children with congenital ptosis received positive benefit after ptosis correction, and the short-term benefit (<1 year) was more obvious.

目的：调查眼病患儿家长在患儿手术前的健康教育需求，为责任护士开展个性化、高质量的健康教育提供依据。方法：采用自制的眼病儿童手术前家长的健康教育需求调查问卷对2020年4月至2020年6月的眼病手术患儿家长进行问卷调查，并对调查结果进行统计分析。结果：家长对眼病患儿手术术前健康教育需求排名前3位的是手术治疗的效果、意义及眼病相关专科健康知识。医疗付费方式的差异、患儿年龄、疾病的差异及家长年龄、职业状态的差异对术前健康教育需求得分差异有统计学意义(P<0.05)；家长获取健康教育知识的途径以医务人员讲解和公众号等网络平台为主。结论：眼病患儿家长对患儿术前健康教育需求较高，医务工作者应丰富知识层面，加强专科学习及相关知识培训，把专科知识与健康教育有机地结合，并探索有效的线上健康教育方式，更好地为患者服务。

Objective: To investigate the health education needs of parents of children with eye diseases before operation, and to provide basis for more targeted and high-quality health education for primary nurses. Methods: A self-made questionnaire was used to investigate the health education needs of parents of children with ophthalmopathy before surgery from April 2020 to June 2020, and the results were statistically analyzed. Results: The top three of parents’ needs for preoperative health education of children with eye diseases were the effect and significance of the surgery and the related professional health knowledge of eye diseases. The differences of medical payment methods, children’s age, diseases, parents’ age, and occupational status was significant in the scores of preoperative health education needs (P<0.05). The main ways of parents obtaining health education knowledge were network platforms such as medical staff explanation and official accounts. Conclusion: The parents of children with eye diseases have a high demand for preoperative health education. Medical workers should enrich their knowledge, strengthen specialty learning and related knowledge training, organically combine professional knowledge with health education, and explore the methods of effective online health education to serve patients better.

患儿因“左眼红肿12 d”就诊。左上睑红肿(++++)，眼眶鼻侧可触及约黄豆大小硬结，界不清，质地中等，压痛(?)，伴上睑下垂，遮盖角膜下缘。双眼眼位正，左眼眼球外转轻度受限。眼眶及视神经MRI显示左眼上睑软组织肿胀，考虑炎性改变。入院诊断为左眼特发性眼眶炎性假瘤(Idiopathic orbital inflammatory pseudotumor，IOIP)。予以激素治疗后症状好转且随访期间无复发。本例患儿为拒绝外院活检而就诊于暨南大学附属第一医院的小儿IOIP病例，提示早期规范治疗是降低此病复发率的关键，尤其是儿童患者。

The pediatric patient was referred to our hospital with a 12-day history of left eye redness and swelling. On the orbital and nasal side of the eye, there was a firm, nontender mass about the size of soybeans, with unclear boundary, medium texture. Orbital examination showed left ptosis, covering limbus. Motility examination revealed both eyes were in normal position, and the left eye was slightly limited in extraocular rotation. Magnetic resonance imaging (MRI) revealed evidence of diffuse inflammation of left eyelid, and orbital inflammatory was considered. Excluding other etiologies, the child was diagnosed initially with idiopathic orbital inflammatory. The symptoms improved after hormone therapy and there was no recurrence during follow-up. This case was a case of IOIP in a child who was admitted to the First Affiliated Hospital of Jinan University for refusing biopsy from another hospital. The paper suggests that early standardized treatment is the key to reduce the recurrence rate of this disease, especially in children.