越来越多的证据表明，空气污染可严重损害人体健康，成为全球疾病负担的主要原因。并且污染空气中的主要成分空气颗粒物可渗透到肺部和心血管系统，引起缺血性心脏病、肺炎、慢性阻塞性肺疾病甚至肺癌，导致空气污染相关的发病率和死亡率升高。城市颗粒物作为城市居住人群面临的主要空气污染问题，被证实与多种炎症性眼表疾病密切相关，如过敏性结膜炎、角膜炎、干眼等。高浓度城市颗粒物暴露还会引起睑板腺病理性结构改变和功能异常，诱发炎性睑板腺功能障碍。文章综述了城市颗粒物相关的眼表疾病类型及其致病机制的最新研究，旨在阐明空气污染对于眼表组织的损害和相应的潜在治疗靶点，指导临床上环境相关眼病的诊断与治疗。

More and more evidence indicate that air pollution can seriously damage human health and become a major cause of the global disease burden. The main component of air pollution, particulate matter, can penetrate the lungs and cardiovascular system, causing ischemic heart disease, pneumonia, chronic obstructive pulmonary disease, and even lung cancer, leading to an increase in the incidence and mortality rates related to air pollution. Urban particulate matter, as the main air pollution problem faced by urban residents, has been shown to be closely related to various inflammatory eye diseases, such as allergic conjunctivitis, keratitis, and dry eye. Our research further confirms that exposure to high concentration of urban particulate matter can also cause pathological structural changes and functional abnormalities in the meibomian gland, leading to inflammatory meibomian gland dysfunction. This review comprehensively summarizes the latest research on the eye surface diseases related to urban particulate matter and their pathogenic mechanisms, aims to elucidate the damage of air pollution to eye surface tissues, identify potential therapeutic targets, and guide the diagnosis and treatment of environmentally related eye diseases in clinical practice.

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. 

目的：分析新型冠状病毒肺炎疫情期间实时面对面线上教学(以“腾讯会议”教学为例)在医学教育中的利弊及其与医学生眼表疾病的相关性，为改进线上教育方案、预防干眼提供依据。方法：以中南大学湘雅医学院本科学生为研究对象，采用横断面研究的方法，使用问卷星收集数据，研究实时面对面线上教学的效果及对眼表疾病的影响。结果：共收集到131份有效数据，绝大多数学生(84.73%)认为实时面对面线上教学是有效的，96.18%的学生认为实时面对面线上教学达到或部分达到了学习的目的，但是实时面对面线上教学的师生互动与课堂氛围有待加强，另外网络设备问题也是实时面对面线上教学需要面对的问题。同时，调查显示实时面对面线上教学参与学生的干眼患病率达66.41%，家庭所在地、家庭人均月收入、使用设备、是否全程专注听课与干眼患病率之间无相关性。结论：新型冠状病毒疫情期间实时面对面线上教学在医学教育中是有效的，但是师生互动不足、课堂氛围不够活跃、网络连接不稳定是其主要问题。此外，实时面对面线上教学会增加干眼的发病率，需要提高护眼意识，积极预防。

Objective: To analyze the advantages and disadvantages of real-time face-to-face online teaching (taking “Tencent Conference” teaching as an example) in medical education and its correlation with ocular surface diseases during the COVID-19 pandemic, and to provide basis for improving online education programs and preventing dry eye. Methods: The undergraduate students of Xiangya School of Medicine of Central South University were selected as the research objects. The method of cross-sectional study was used to collect data using questionnaires to study the effect of real-time face-to-face online teaching and its impact on ocular surface diseases. Results: A total of 131 valid data were collected. Among them, the vast majority of students (84.73%) think real time face to face online teaching is effective, and 96.18% of the students believe that real-time face-to-face online teaching at least partly achieved the purpose of learning. However, the interaction between teachers and students and the classroom atmosphere of real-time face-to-face online teaching needs to be strengthened. In addition, network equipment is also a problem that real-time face-to-face online teaching needs to face. Meanwhile, the survey showed that the prevalence rate of dry eye among the students who participated in real-time face-to-face online teaching reached 66.41%, and there was no correlation between the incidence rate of dry eye and the location of family, the per capita monthly income of family, the equipment, and whether they paid full attention to the lectures. Conclusion: Real-time face-to-face online teaching is effective in medical education during COVID-19, but the main problems are insufficient teacher-student interaction, inactive classroom atmosphere and unstable Internet connection. In addition, real-time face-to face online teaching will increase the incidence of dry eye, so it is necessary to improve the awareness of eye protection and actively prevent it.