临床上内源性真菌性眼内炎很少见，其早期临床表现类似于葡萄膜炎等常见眼病，误诊率很高。遵义医学院附属医院收治了一位 48 岁女性患者，发病 3 个月内先后被诊断为急性视网膜坏死综合征、新生血管性青光眼等，最终丧失视力手术剜除患眼眼球内容物，术后病理检查发现毛霉菌而确诊为内源性毛霉菌眼内炎。

Endogenous fungal endophthalmitis is easy to be misdiagnosed because it is quite rare and early clinical features resembling uveitis. A 48-year-old female patient was admitted to the Affiliated Hospital of Zunyi Medical College, who was diagnosed as acute retinal necrosis syndrome and neovascular glaucoma. The patient finally lost her sight and had an evisceration. Postoperative pathology showed the mucor infection.

眼视光学是一门现代光学技术和现代眼科学相结合，并运用光学理论和先进的科学技术解决视觉障碍的新兴、交叉学科。眼视光学专业在发达国家已成为眼科学领域眼保健的必要组成部分，近年来，我国与视觉健康和视功能有关的眼病患者日益增多，青少年近视患病率已高居世界第一，且随着人们生活质量的提高，人们对视觉的要求也不断提高。从治疗到预防的不断过渡，眼视光学人才的重要性日益凸显，但目前中国眼科医师和视光师人才缺口还很大，国内多所院校已相继开展视光学教育以满足视光人才需求，在我国，这个专业将成为一个新兴的热门学科。

We discussed the necessity and social demand of undergraduate education of optometry according to the current development of optometry education at home and abroad. The feasibility of setting up the four-year undergraduate education of optometry was evaluated in our university from the excellent teachers, diversified teaching modes, extensive practice base and education experience. The training mode of four-year professional development of optometry was also explored, based on humanity quality education, professional theory and practical skills.

佩戴太阳镜对眼疾患者的眼睛起保护作用。但并非所有青光眼患者适合佩戴太阳镜，闭角型青光眼患者佩戴需慎重。青光眼患者应根据病情合理地佩戴使用太阳镜。正确地选择和佩戴太阳镜才能对眼睛达到最好地保护作用。

The patients with eye diseases can wear sunglasses to protect their eyes. Not all patients with glaucoma are suitable for wearing sunglasses, especially for patients with untreated angle-closure glaucoma. Patients with glaucoma should select and wear the appropriate types of sunglasses according to individual conditions. Proper selection and wearing of sunglasses exert the optimal effect upon protecting the eyes.

目的：减轻行角膜移植术的患儿及家属的心理负担，提高患儿对手术的耐受性，减少术后并发症。方法：对45例将进行角膜移植的患儿进行围手术期护理。结果：所有患儿经过精心的治疗和护理后均恢复良好，视力均有提高。结论：术前做好充足的准备、术前心理护理，术后严密观察生命体征和眼部敷料的情况，做好相关的生活和饮食指导，遵医嘱及时有效用药，注意患儿异常的反应及眼部的情况，及时发现并处理并发症，给予细致的出院指导，有利于患儿早日康复。

Objective: To reduce the psychological burden of the children and families who are scheduled to the corneal transplantation, and to improve the patients’ tolerance and reduce postoperative complications. Methods: The perioperative care was given to 45 patients with corneal transplantation. Results: All children were treated well by careful treatment and care. Conclusion: Before operation, comprehensive preparation and psychological nursing care should be delivered. Affer operation, the physicians and nurses should guide the patients to live a healthy lifestyle, remind them to take the drugs timely, identify the abnormal symptoms and postoperative complications in children with abnormal responses, implement effective treatment timely to accelerate postoperative recovery.

目的：总结大批量白内障扶贫手术的护理安全管理经验。方法：回顾性分析2013至2016年中山大学中山眼科中心医疗队完成大批量白内障扶贫手术的经验、针对下乡扶贫的特殊环境、患者入院时间短、手术量大、接台手术多以及患者自我管理能力差等情况，分析其安全隐患，并在护理过程中采取相应的安全措施。术前充分评估和准备，对患者进行健康指导；术中对手术环境规范管理；指导加强术后患者的自我管理。结果：8批次共1 064例白内障摘除联合人工晶体植入术顺利完成，无1例发生术后感染。结论：建立大批量白内障扶贫手术护理安全质量管理的规范流程是扶贫工作的重要环节，做好术前的评估和准备工作，落实患者的健康教育及术后患者自我管理指导，才能确保手术顺利进行。

Objective: To assess the safety of mass volume of cataract surgery and to identify the possible factors with enhanced patients’ safety. Methods: TTis is a retrospective case series. Clinical data of patients undergoing charity cataract extraction by surgeons from Zhongshan Ophthalmic Center between 2013 and 2016 was reviewed. TTe following factors were analyzed: safety management peri-operatively, educational interventions, intraoperative sterilization, and self-management after operations. Results: A total of 1 064 patients (8 sessions) underwent cataract extraction and intraocular lens implantation. No evidence of endophthalmitis in any cases was observed.Conclusion: Establishment of standardized operation procedures for nursing safety management is essential for safety of mass volume of charity cataract surgery in China. Adequate assessment and peri-operative endeavor, educational interventions, nurse guided self-management should be empowered to enhance patients’ safety. 

目的：住院医师委托培养是我国医学教育标准化和国际化的重要举措。本研究采用客观考核和主观问卷两种方法评估我国眼科住院医师委托培养效果。方法：本研究对象为广东省深圳市政府于

2012年8月至2015年7月期间委托中山大学中山眼科中心进行眼科住院医师规范化培训的9名学员。本研究对所有学员的基本信息、临床培训情况、以及考核成绩等客观指标进行统计分析，同时设 计了一份包含13个问题的调查问卷，对每位学员的培训情况进行主观评估。结果：本研究纳入9名研究对象，包括2名男性和7名女性，平均年龄为(26±3)岁，学历水平情况为学士7名和硕士2名，其中有7名毕业于国家重点医学院校。3年内人均轮转眼科亚专科超过10科，平均主管病人数及参加手术例数分别为736和1 219例，门诊工作总量人均6 274人次，所有学员均按规定至少完成综 述1篇。8名(88.89%)学员认为可以独立诊断并治疗大部分常见眼科疾病，而且能独立完成大部分眼科基本临床操作，5名(55.56%)学员可以单独完成翼状胬肉切除术、霰粒肿刮除术、前房穿刺术等。6名(66.67%)学员认为培训时间安排合理。8名(88.89%)学员对这次委托培养总体比较满意。 所有9名培训学员中，最终有7名(77.8%)顺利通过中山大学第一阶段住院医师规范化培训考核。结论：培训学员对现行的眼科住院医师规范化培训方案的接受程度较高，基本达到预期的培训效果，对常见眼病能独立进行诊治。委托培养学员的学历和学习能力的差异在一定程度上影响了最终的培训考核通过率。

Objective: The entrusted standardized training for residents is an important measure to gear the medical education in China to the international conventions. In this study, the effectiveness of standardized training for entrusted ophthalmic residents in China was evaluated both objectively and subjectively. Methods: Nine ophthalmic residents, commissioned by Shenzhen government of Guangdong Province, studied at Zhongshan Ophthalmic Center, Sun Yat-sen University during August 2012 to July 2015 were included in this study. The objective indicators of all participants were analyzed, including the basic information, clinical training, the score of examination, etc. The subjective self-assessment was also implemented thought a questionnaire including 13 designed questions.Results: All 9 participants included 2 males and 7 females, 2 medical masters and 7 bachelors, and the mean age was 26±3 years. Seven of them graduated from the national key medical universities. The mean number of rotated sub-clinical departments was 10.3, the mean number of managed inpatients and the participated operations were 736 and 1,219, respectively. The total number of managed outpatients was 6,274 in average. All participants completed at least one review article. Eight (88.89%) participants could independently diagnose and treat the most common ophthalmic diseases, they also could complete the basic clinical ophthalmic operation independently. Five (55.56%) participants could independently manage the pterygium excision, curettage of chalazion, anterior chamber penetration, etc. And 6 (66.67%) of the participants believed that the training length was reasonable. Eight (88.89%) of them were satisfied with the standardized training for residents on the whole. Finally, 7 participants successfully passed the first stage of standardized training program in Sun Yat-sen University. Conclusion: There was a high level acceptance rate of the standardized training programs for entrusted ophthalmic residents. The participants achieved the expected training effects, and could managed the diagnosis and treatment of common ophthalmic diseases independently. But the training effects and passing rate of examination were partly affected by the learning ability of the training students.

目的：探讨不伴明显视力下降的糖尿病视网膜病变（Diabetic retinopathy，DR）患者黄斑部形态和功能的改变。

方法：对 DR 0 期组（未发现 DR 改变）、I～II 期组及 III～IV 期组患者进行光学相干断层扫描（Optical coherence tomography，OCT）及多焦视网膜电图（Multifocal electroretinography，mfERG）检查，并与同年龄组正常人相比较。

结果：OCT 检查确定 DR I～II 期组有 3 眼（10.0%）及 DR III～IV 期组有 6 眼（23.1%）存在黄斑水肿。DR III～IV 期组各方位神经上皮层厚度比相应方位的正常组及 DR 0 期组增加（P < 0.05）。同正常对照组相比，mfERG 检查发现 DR 0 期组、DR I～II 期、DR III～IV 期组 P1、N1 波振幅下降，反应密度下降，差异有显著性（P < 0.05）；但 P1、N1 波潜伏期未见延迟（P > 0.05）。同 DR I～II 期组相比，DR III～IV 期组 P1 波及 N1 波潜伏期轻度延长、振幅下降、平均反应密度降低（P < 0.05）。

结论：视力无明显下降的 DR 患者中，随病情的加重，无论形态和功能上均已有异常，功能异常早于形态异常。

Purpose: To investigate the macular morphology and function in patients with diabetic retinopathy (DR) without apparent visual loss.

Methods: Multifocal electroretinograms (mfERG) and optical coherence tomography (OCT) examination were performed in the DR patients on phase 0, I to II, III to IV as well as the normal control non-diabetes subjects.

Results: Macular edema was detected in DR phase I and II (3 eyes, 10%) and DR phase III and IV group (6 eyes, 23.1%). In comparison with the normal control and DR phase 0 group, the thickness of retinal neuroepithelium increased in DR phase III and IV group (P < 0.05). The amplitude and the average density of P1 wave and N1 wave decreased in all DR groups in comparison with normal controls although the latency of P1 wave and N1 wave was not statistically significant (P > 0.05). However, comparing with the DR phase I and II group, the latency of P1 wave and N1 waves were longer whereas the amplitude and the average density decreased in DR phase III and IV group (P < 0.05).

Conclusion: In the patients with DR but without apparent visual loss, abnormalities of the macular morphology and function already develop. The changes of function appear to develop earlier than that of morphology.

目的：观察睡眠呼吸暂停综合征（Sleep apnea syndrome, SAS）患者睡眠前后黄斑厚度的改变。

方法：选择 2003 年 8 月至 2007 年 1 月经确诊的在我院门诊和住院部治疗的 SAS 患者共 32 例（63 只眼），分别在上午 11:00 ～ 12:00（睡眠前）及患者晨起 20 ～ 30 分钟内（睡眠后）采用相干光断层扫描仪（Optical Coherence Tomography, OCT）进行黄斑中心凹厚度的测量。

结果：睡眠前黄斑中心小凹平均视网膜厚度为（123.00 ± 19.98）μm，睡眠后黄斑中心小凹平均视网膜厚度为（134.25 ± 19.92）μm。睡眠后黄斑中心凹厚度比睡眠前厚度增加（11.25 ± 9.04）μm，95% 可信区间为（8.98，13.53）μm，差异有统计学意义（t = 9.878，P < 0.05）。

结论：睡眠呼吸暂停综合征患者睡眠时的缺血缺氧可以导致黄斑视网膜的水肿增厚。

Purpose: To observe the changes of macular thickness in patients with sleep apnea syndrome (SAS) before and after sleep.

Methods: Thirty-two patients (63 eyes) diagnosed as SAS from August 2003 to January 2007 were enrolled. Macular thickness was measured using Optical Coherence Tomography (OCT) at 11:00 ~ 12:00 evening (before sleep) and 20 ~ 30 minutes after sleep, respectively.

Results: The mean macular thickness was (123.00 ± 19.98) μm and (134.25 ± 19.92) μm before and after sleep, respectively. The mean difference was (11.25 ± 9.04) μm before and after sleep (t = 9.878, P < 0.05), 95% CI (8.98, 13.53) μm.

Conclusions: The macular thickness of SAS is increased in SAS patients, which may be due to anoxia of SAS. 

目的：探讨多排 CT 对眼眶骨纤维异常增殖症（FD）的诊断价值及临床意义。

方法：回顾性分析 2002 年 4 月至 2009 年 8 月的我院（6 例）及中山大学中山眼科中心（12 例）收治的 18 例眼眶 FD 患者的多排 CT 表现，7 例取病变组织经病理证实，5 例经手术后病理证实，6 例具有典型的 CT 表现。

结果：本组眼眶 FD 可单发（5 例）、单骨多发（1 例）或多骨（12 例）发病，其中额骨 12 例，蝶骨 5 例，筛骨 2 例，颞骨 7 例。

结论：多排 CT 能在轴位、冠状位、矢状位上显示本病的病变特征及范围，有助于本病的早期诊断及指导临床制定合理的治疗方案。

Purpose: To evaluate the efficacy of multi-detector row CT (MDCT) findings in the diagnosis of fibrous dysplasia (FD) in orbital bone.

Methods: The MDCT manifestations of 18 cases of FD in orbital bone (6 cases from the 458th Hospital of PLA, 12 cases from the Zhongshan Ophthalmic Center of Sun Yat-sen University) collected from April 2002 to August 2009 were reviewed. Six cases were confirmed by biopsy, 5 cases were confirmed by operation and postoperative pathology, the remaining 6 cases were confirmed based on typical CT findings.

Results: FD in orbital bone could be originated from monostotic single lesion (5 cases), monostotic multiple lesions (1 case) or polyostotic multiple lesions (12 cases). Twelve lesions were originated in the frontal bone, 5 lesions in the sphenoid, 2 lesions in the ethmoid, 7 lesions in the temporal bone.

Conclusion: MDCT is very important in the diagnosis and treatment strategy of FD in orbital bone correctly. It helps identify the location and extension of the lesions based on the axial plane, coronal plane and sagittal plane view.