Volume 50 · Issue 09 · 2014

In China,corneal disease is currently the second leading cause of blindness.Severe donor shortage,insufficient technique supports and promotion,and the lack of corneal disease specialists due to poor systematic training are all urgent problems to be resolved.The last 5 years have witnessed a considerable progress in basic and clinical researches of corneal disease.Investigations on the pathogenesis and treatment of fungal keratitis have won an international reputation.Results from the study of corneal reconstruction with tissue-engineered and acellular matrix corneas have been tested in clinical trials with good preliminary performance.Moreover,the clinical researches of corneal refractive surgery have kept pace with the latest international progresses.However,Descemet's membrane endothelial keratoplasty needs further promotion,and the development and application of keratoprosthesis remains a blank.Although keratoprosthesis and corneal collagen cross-linking have been widely applied in Europe with satisfactory clinical efficacy,they are still under assessment by China Food and Drug Administration for approval of use.

Translational medicine emphasizes the application of the results of basic research to clinical practice and the solution of clinical issues through basic research.It is very important for the development direction of the medical field.Over the past decade,the translational medicine research in ocular surface disease has drawn international attention and developed rapidly.This field in China has made great progress,but overall there are still some gaps with the international advanced level.We need to establish the concept and the platform of translational research,explore scientific and effective methods,and create a whole chain to enhance our ocular research.It also requires research institutions and government departments to give full support.Finally,we need to explore a suitable way for the development of Chinese translational medical research.

Increased tear osmolarity is one of the core mechanisms of dry eye and has been considered as an important diagnostic criterion,if not" gold standard",of dry eye.However,recent studies showed the limitations of tear osmolarity measurement not only in the diagnosis,but also in the therapeutic efficacy evaluation of dry eye.The clinical significance of tear osmolarity measurement has become a hot topic of argument.Herein,we review the publications on this topic and try to find the underlying causes of such argument.

The incidence of myopia in adolescents in China is increasing year by year, and the progressive development of myopia deserves more attention. Frame glasses have been difficult to meet the needs of some patients to control the development of myopic diopter, so many strategies and methods have been derived to prevent myopia and control the development of myopia, among which the clinical application of orthokeratology lens has been paid more and more attention.

Objective To explore the distribution of relational corneal thickness parameters including central corneal thickness (CCT),thinnest pachymetry (TP),cornea thickness spatial profile (CTSP),percentage thickness increase (PTI),pachymetric progression index (PPI) and Ambrósio's relational thickness (ART) in the normal population,and their relationships with corneal astigmatism and curvature.Methods A total of 1 203 eyes from 1 203 normal outpatients were enrolled in this cross sectional study.The data information of CCT,TP,CTSP,PTI,PPI-max,PPI-nin,PPI-ave,axes of PPImax and PPI-min,ART-max and ART-ave was collected from Pentacam HR for the subsequent analysis of their distribution.Astigmatism,astigmatism axis (AA),and keratometry (K) including Km and Kmax were also collected to explore their relationships with relational thickness parameters.Results The mean values for CCT and TP were (547.20 ± 31.441) μm and (543.26 ± 31.271) μm,respectively.The mean values for CTSP-2,CTSP-4,CTSP-6 and CTSP-8 were (552.11 ± 31.654) μm,(580.72 ± 32.919) μm,(632.11 ± 34.738) μm and (711.80 ± 37.880) μm,respectively.PTI-2,PTI-4,PTI-6 and PTI-8 were (1.67 ± 0.471) ％,(6.89 ± 0.945) ％,(16.37 ± 1.996) ％ and (31.10 ± 3.652) ％.PPI-max,PPI-min and PPI-ave were 1.222 ± 0.175,0.733 ± 0.138 and 0.994 ± 0.123.The axes of PPI-max and PPI-min were 230.74 ± 104.862 and 159.81 ± 62.292.ART-max and ART-ave were (454.940 ± 78.506) μm and (556.140 ± 86.492) μm.CCT,TP,PPI and ART were found to have a weak but significant correlation with Kmax-front,Km-front and Km-back.PPI and ART were also found to weakly correlate with Astig-back.The converted astigmatism axis was found to correlate with the axes of PPI-max (rs =-0.125,P =0.000) and PPI-min (rs =0.613,P =0.000).Conclusions The front and back curvatures and the back astigmatism correlate with the distribution of corneal thickness,while the front astigmatism does not correlate with it.The front astigmatism axis tends to distribute coincidently with PPI-min axis.

Objective To compare the corneal epithelial thickness profile in keratoconic and normal eyes with advanced Fourier-domain optical coherence tomography (OCT) and to evaluate the diagnostic efficiency of pachymetry parameters.Methods Cross-sectional observational study.Twenty-five consecutive keratoconus patients (34 eyes) and 41 normal volunteers (41 eyes) in Eye & ENT Hospital of Fudan University between June 1 and July 31,2013 were enrolled.Observations of corneal epithelial thickness and corneal thickness profiles were taken from all subjects.The epithelial pachymetry parameters were superior,inferior,inferior-superior (I-S),minimum (Min),maximum (Max),Min-Max,and central.The corneal pachymetry parameters were inferotemporal-superonasal (IT-SN),I-S,Min,Min-median,Min-Max,and central.Statistical analysis methods included Chi-square test,independent two-sample t-test,and Wilcoxon rank sum test.The diagnostic efficiency of all parameters were analyzed by receiver operating characteristic (ROC) curves and Youden index.Results The inferior,I-S,Min,Min-Max,and central epithelial thickness averages were (50.5 ±4.8) μm,(-2.7 ±7.5) μm,(35.9 ± 10.7) μm,(-33.6 ± 18.9) μm,and (50.1 ± 6.8) μm in keratoconic eyes.In normal eyes,they were (54.8 ± 2.5) μm,(0.9 ± 1.3) μm,(51.4 ± 2.6) μm,(-5.7 ± 1.8) μm,and (54.7 ± 2.2) μm.Among the epithelial pachymetry parameters,Min-Max and Min showed high diagnostic efficiency for keratoconus (AUC =0.967,0.968 ; Youden index =0.882,0.829) ; inferior,I-S,and central parameters showed moderate efficiency (AUC =0.794,0.728,0.715; Youden index =0.461,0.564,0.565).The IT-SN,I-S,Min,Min-median,Min-Max,and central corneal thickness averages were (-82.8 ± 65.2) μm,(-72.5 ± 55.6) μm,(401.2 ± 83.8) μm,(-83.4 ±48.2) μm,(-169.7 ±99.4) μm,and (453.4 ±58.6) μm in keratoconic eyes.In normal eyes,these parameters were respectively (-23.7 ± 18.5) μm,(-20.5 ± 19.8) μm,(525.4 ± 28.1) μm,(-23.1 ± 4.8) μm,(-59.2 ± 23.3) μm,and (533.4 ± 28.8) μm.Min,Min-median,and Min-Max had preferable diagnostic efficiency (AUC =0.952,0.938,0.924; Youden index =0.784,0.829,0.721) ; central,IT-SN,and I-S parameters showed moderate efficiency (AUC =0.891,0.877,0.862; Youden index =0.643,0.707,0.580).Conclusions In observation with Fourier-domain OCT,keratoconus was characterized by central and inferior epithelial thinning,increased epithelial thickness variation,central cornea thinning,increase in asymmetry,and gaps between corneal IT-SN and I-S thickness.Fourier-domain OCT was confirmed to have high speed,high resolution,and noninvasion.The pachymetry parameters showed specific strengths in diagnosis of keratoconus,especially epithelial pachymetry parameters of Min and Min-Max,and corneal pachymetry parameters of Min,Min-median and Min-Max.

Objective To report the clinical results of micro incision lenticule extraction (MILE) to correct myopia or myopia with astigmatism,and enlighten its viability and mechanism.Methods Prospective case-control study.All patients enrolled were treated by the VisuMax femtosecond laser system to correct refractive errors.Sixty-one patients underwent MILE with an incision of 2 mm.Another 53 patients underwent small incision lenticule extraction (SMILE) with a 3-5 mm incision as the control group.All patients took measurements of uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),refractive power and intraocular pressure,slit-lamp microscopy,and corneal topography preoperatively and at 1 day,1 week,1 month,6 months postoperatively.The visual acuity was presented as median.To compare the visual acuity and astigmatism between the MILE group and the SMILE group,as well as before surgery and at each time point after surgery,non-parametric tests were applied in this study.The repeated measures analysis of variance was used to compare the differences between these two surgeries and between pre-and post-operation in diopters and morphological parameters.The paired-sample t test was used to compare the diopters and morphological parameters at each time point postoperatively and preoperatively.The independent-sample t test was applied to compare the basic characteristics preoperatively and the diopters,morphological parameters at each time point between these two groups.Results Forty-one eyes (24 patients) in the MILE group and fifty-one eyes (29 patients) in the SMILE group had complete follow-up data.Before surgery and at 1 day,1 week,1 month,6 months after surgery,the spherical diopters in the MILE group were (-5.09 ± 1.04),(0.12 ± 0.32),(0.11 ± 0.29),(0.02 ± 0.33) and (0.02 ± 0.23) D ; the cylinder diopters were (-0.90 ± 0.83),(-0.25 ± 0.27),(-0.23 ± 0.30),(-0.20 ± 0.25) and (-0.16 ±0.21)D.In the SMILE group,the spherical diopters were (-5.37 ± 1.26),(-0.04 ± 0.49),(0.12 ±0.38),(0.10 ±0.34) and (0.02 ±0.33) D; the cylinder diopters were (-0.76 ± 0.65),(-0.22±0.26),(-0.25±0.30),(-0.26±0.29) and (-0.21±0.28)D.No significant difference was found between the two groups (F=1.042,0.941,0.018; P =0.310,0.335,0.894).In the vector analysis of astigmatism,at 1 month and 6 months after surgery,the values on Y axis were -0.06 ±0.11 and-0.04 ±0.10 in the MILE group,smaller than-0.14 ±0.18 and-0.11 ±0.16 in the SMILE group (Z =-2.076,-2.149; P =0.038,0.032).All full-correction patients had UCVA of 20/20 or better,and no BCVA decreased after 6 month follow-up postoperatively.Refractive stability was achieved within 1 month postoperatively,and less volatility appeared in the MILE group than the SMILE group.Before surgery and at 1 day,1 week,1 month,6 months after surgery,no significant difference in the index of surface variance (ISV) and the index of vertical asymmetry (IVA) was found between the MILE group and the SMILE group (F =0.902,0.744; P =0.345,0.391),whereas the values of ISV and IVA were smaller in the MILE group than the SMILE group at each time point after surgery,and the D-value between the two groups increased with time.Six cases (9 eyes) had an opaque bubble layer while femtosecond laser passed in the procedure,2 eyes had a small tear at the incision edge,1 eye had local diffuse inflammatory exudates at 1 day postoperatively,and no eye had transient light-sensitivity syndrome,decrease of corneal transparency or infection.Conclusions MILE surgery (1.5-2.0 mm) is safe,predictable,effective and stable to treat refractive errors.It can reduce astigmatism values on oblique axis and maintain the integrality and stability of the structure of the cornea.

Objective To evaluate the clinical results of keratoconic eyes with thin corneas that were treated by using corneal collagen cross-linking with hypo-osmolar riboflavin solution.Methods Retrospective,nonrandomized study.Fifteen eyes of 15 patients with progressive keratoconus and corneal thickness of less than 400 μm (without the epithelium) were included in this study.Application of hypoosmolar riboflavin solution to the cornea for 30 minutes after its de-epithelialization was followed by ultraviolet A collagen cross-linking.Corneal thickness was measured with anterior segment OCT before surgery,after epithelial removal,and after hypotonic riboflavin solution application.Before the ultraviolet A application was started,we must be sure that the thinnest cornea was equal to or greater than 400 μm.Examinations comprised an evaluation of uncorrected distance visual acuity and best corrected visual acuity,slit-lamp microscopy,corneal topography,and endothelial cell counting after the procedure.Results Before surgery,the mean corneal thickness (with the epithelium) was (399.27 ± 17.87) μm,and after the removal of epithelium,the thickness of the cornea was reduced to (354.00 ± 18.57) μm.After the application of the hypo-osmolar riboflavin solution,this value increased to (477.73 ± 20.87) μm.The improvements in visual acuity and keratometry readings occurred during the follow-up.No statistically significant differences were found between preoperative and postoperative endothelial cell counts.No complications such as scarring lesions in the stroma and corneal endothelial damage were observed throughout the study period.Conclusions The results of our study,using hypo-osmolar riboflavin solution in a cross-linking procedure in thin corneas,show a stability of keratoconus 12 months after cross-linking.

Objective To evaluate the efficacy of two surgical treatments for conjunctivochalasis.Methods Prospective randomized control study.Thirty-three conjunctivochalasis patients (33 eyes) were randomly divided into two groups:simple resection group,and resection and fixation group.The former received simple conjunctival resection,and the latter received conjunctival resection and scleral fixation.Postoperative conjunctiva relaxation,BUT and ocular surface disease index (OSDI) points were compared to evaluate the efficacy of the two kinds of surgical methods.Results The recurrence rate of conjunctivochalasis was 6/16 in the simple resection group and 1/17 in the resection and fixation group on month 6 after operation,and there was significant difference (P =0.039).In 1 month,3 months and 6 months postoperatively,the proportion of normal BUT increased respectively in both groups (simple resection group:8/16,9/16,10/16; resection and fixation group:8/17,10/17,11/17) compared with that before operation (simple resection group:3/16; resection and fixation group:4/17).The difference was statistically significant 6 months after operation compared with that before operation (simple resection group:P =0.029 ; resection and fixation group:P =0.037),but there was no statistical significance between the two groups at each time point postoperatively (P =1.00).OSDI scores were significantly decreased in 6 months after operation in both groups (simple resection group:7.76 ± 2.42 ; resection and fixation group:7.21 ± 2.39) compared with those before operation (simple resection group:22.35 ± 14.68 ; resection and fixation group:21.83 ± 15.73).Both of the differences were statistically significant (simple resection group:t =6.598,P ＜ 0.01 ; resection and fixation group:t =6.603,P ＜ 0.01),but there was no statistically significant difference between the two groups on month 6 postoperatively (t =0.647,P =0.537).Conclusions Both conjunctival resection and conjunctival resection with sclera fixation can effectively improve symptoms,but the latter has a lower recurrence rate.

Objective To investigate the expression level of Fas-FasL in conjunctiva tissue of chronic Stevens-Johnson syndrome (SJS) patients and to analyze the role of Fas-FasL pathway in the mechanism of ocular damage related to SJS.Methods Conjunctiva tissue was obtained during symblepharon release operation and cryostat sectioned at 5 μm.The tissue morphology was observed by electron microscopy.The expression of Fas-FasL (CD95/CD178) in conjunctiva was detected by immunohistochemistry (direct immunofluorescence).The conjunctiva tissue of normal people was also observed and tested as contrast group.Results The pathogenic changes included incrassation of epithelium and cavity of mucous glands in the sub-epithelium.The expression of Fas in SJS patients focusing in the basal layer of epithelium appeared a lower level compared to that in normal human conjunctiva,which distributed equally in all layers of epithelium.The expressions of FasL in SJS patients and normal people were both weak.Conclusions The low level expression of Fas-FasL in conjunctiva of SJS patients has certain effect on the chronic ocular damage.

Ten researches that may represent the most advanced cornea and ocular surface disease (OSD) related studies in China were voted by specialists from Chinese Cornea Group of Ophthalmology Society.These researches were concentrated in the following fields:Clinical and basic research in infectious keratitis ; clinical application of modern corneal surgeries and technology; tissue engineering corneal material development ; prevention and treatment of immune rejection after corneal transplantation,et al.These studies represented the level of our national cornea and ocular surface specialists in the international cornea and OSD field and have become the landmark study of our specialists.

posterior polymorphous corneal dystrophy (PPCD) has no clinical symptoms in the early stage, and it is mostly found accidentally during eye examination. If the posterior illumination method of the slit lamp is not used for careful observation during routine slit lamp examination, the diagnosis is often missed. The author treated 4 patients with ribbon PPCD from January to September 2012, and the report is as follows. Case 1 male, 8 years old, came to Ningxia Eye Hospital for 1 week because of red itching and discomfort in his left eye. The initial diagnosis was "left eye conjunctivitis", and praprofen eye drops were given. Follow-up visit 1 week later. No abnormalities were found in the physical examination. Eye examination: the visual acuity of both eyes was 1.0. No abnormalities were found in the right eye examination. The slit lamp examination of the left eye showed no conjunctiva congestion, a small number of follicles in the palpebral conjunctiva, and the papilla. The cornea was clear, and ribbon lesions were seen on the posterior surface of corneal endothelial cells (Figure 1A). Intraocular pressure: 9.8 mmHg (1 mmHg =0.133 kPa) in the right eye and 11.6 mmHg in the left eye. The right eye was normal by corneal endothelioscopy, the density of corneal endothelial cells decreased, the mean cell area increased, the coefficient of variation increased, the proportion of hexagonal cells decreased, the corneal endothelium in the lesion area was missing, and pathological dark areas were visible (Figures 1B, 1C). The corneal topography examination was normal in both eyes.

The patient was a 79-year-old male. He was admitted to the hospital on August 7, 2013 due to 20 years after left lower eyelid mass resection and 10 years of increasing corneal neobiosis. The pathological examination result of the patient after left lower eyelid mass resection 20 years ago was "basal cell carcinoma" (patient's self-report), and the specific classification was unknown. He was treated with radiotherapy in the local hospital. The skin erosion of the left lower eyelid was more than 1 month before admission. He had previous hypertension for 20 years, diabetes for 3 years, and glaucoma and cataract surgery history for 10 years. Ocular examination: visual acuity: right eye 0.7 corrected to 0.8, left eye anterior manual correction did not improve, intraocular pressure: right eye: 11 mmHg (1 mmHg =0.133 kPa), left eye: 10 mmHg. The cornea of the right eye is transparent, the anterior chamber is medium and deep, the iris root is clearly cut, the pupil is round, the intraocular lens is in position, and the macular pigment of the fundus is disordered.

radial keratotomy (RK) still has residual degree of refractive error after operation due to the limitation of myopia correction range and poor predictability, and long-term hyperopic drift often occurs in some patients [1-2]. At present, corneal refractive surgery for patients with refractive error after RK includes superficial surgery and interlaminar surgery (LASIK). In the widely used interlaminar surgery, the scar of RK incision may affect the normal penetration of femtosecond laser. In the past, it was considered that postoperative RK was a contraindication of femtosecond laser surgery, so LASIK was commonly used to correct refractive error after RK. With the popularization of femtosecond laser, the deepening of clinical understanding of femtosecond laser ability to penetrate scar tissue and considering the special biomechanical relationship after RK, we consulted relevant foreign literatures [3-4], fully communicated with patients and informed consent, and on the premise of free femtosecond laser cost, we performed femtosecond laser flap-making LASIK surgery for two patients after RK.

The patient was a 57-year-old male with blurred vision in his left eye for half a year. He came to Tianjin Eye Hospital for treatment. He had no history of ocular trauma or surgery in the past. Eye examination showed that the visual acuity of his right eye was 0.6, the cornea was transparent, the anterior chamber depth was normal, the pupil was round, and a brown-black mass was visible at the edge of the pupil from 6 to 8 o'clock (A in the essence picture 1), and the lens was mildly turbid. The visual acuity of the left eye was 0.4, the cornea was transparent, the depth of the anterior chamber was normal, a prominent brownish-black mass was seen at the margin of the pupil from 4:30 to 8 o'clock (B in the essence picture 1), and the lens was mildly opacified. UBM examination: There were eyes with cystic echoes behind the iris at 6 to 10 o'clock and left eye at 2 to 6 o'clock. The angle of the whole chamber of both eyes was narrow or closed, and the iris was flat or swollen.

A filamentous fungal biofilm is a collection of hyphae and spores encased in a matrix,which has distinct developmental phases governed by complex molecular events.Resistance to antifungal drugs and components of the innate immune system remain the greatest threats to patients with filamentous fungal biofilms.There is increasing evidence that filamentous fungal biofilms play a role in a variety of ocular infections.Filamentous fungal biofilms may participate in ocular infections by allowing filamentous fungi to persist on abiotic surfaces that come in contact with the eye,and by direct biofilm formation on biotic surfaces of the eye.This review discusses the current understanding of the basic biology and clinical implications associated with filamentous fungal biofilms in ophthalmology.

Cytomegalovirus endotheliitis is an inflammation of the corneal endothelium caused by cytomegaloviruses.It may represent a newly identified clinical entity that has drawn increasing attention since cytomegalovirus DNA was detected from the aqueous humor of a patient with corneal endotheliitis.Its pathogenesis is still unclear,and it typically presents as corneal edema,coin-shaped/linear keratic precipitates,mild anterior chamber inflanmation and with or without raised intraocular pressure in an otherwise healthy individual.In order to make an accurate diagnosis,the patient's medical history,clinical manifestations and ocular signs should all be considered,and further detection of pathogens by PCR from the ocular tissue should be done.However,misdiagnoses may occur because cytomegalovirus endotheliitis can mimic other clinical diagnoses.Patients with cytomegalovirus endotheliitis respond to systemic and topical ganciclovir with the use of topical steroids.Therefore,making an accurate early diagnosis is crucial in preventing loss of corneal endothelial cells.Moreover,if left undiagnosed,these eyes often receive increasing amounts of immunosuppressants in attempts to control the inflammation,which may worsen the ocular infection,thus compromising their visual outcomes.

Iatrogenic keratoectasia is one of the serious complications of excimer laser refractive corneal surgery, also known as secondary keratoconus. Its clinical manifestations are mainly progressive and non-inflammatory central corneal thinning and bulging dilation causing refractive regression, increased astigmatism and decreased best corrected visual acuity, and corneal topography shows increased corneal curvature [1]. Although the incidence of secondary keratoconus is low, its consequences are serious, so it is paid more and more attention by surgeons. At present, it is considered that preoperative recessive keratoconus is an important factor in its occurrence.

Orbital fracture is the most common orbital trauma at present. The book "Diagnosis and Treatment of Orbital Fracture" written by Professor Xiao Lihua and Professor Wang Yi of the Institute of Orbital Diseases of Armed Police General Hospital was published by People's Medical Publishing House in June 2014. This book has 11 chapters, 470,000 words and more than 1,000 wonderful pictures. It describes in detail the clinical manifestations, imaging examinations, surgical treatment and treatment of postoperative complications of orbital fractures (especially orbital burst fractures).

The book "The Essence of Tongren Corneoconjunctival Cases", edited by Professor Sun Xuguang, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital affiliated to Capital Medical University, has been officially published by People's Military Medical Publishing House. The analysis of typical cases is the starting point of understanding clinical diseases, and the understanding of difficult cases is the basis of accumulating clinical experience and establishing diagnosis and treatment ideas. Ophthalmologists should always pay attention to collecting and analyzing typical or difficult cases in clinical practice. This book consists of 6 chapters, gathering a variety of difficult cases of cornea and conjunctiva,

The book "Laser Confocal Microscopy Atlas of Living Cornea" edited by Professor Sun Xuguang of Beijing Institute of Ophthalmology, Beijing Tongren Ophthalmology Center, Capital Medical University has been officially published by People's Military Medical Publishing House. The in vivo corneal laser scanning confocal microscope has a resolution of 1 μ m and a magnification of 800 times. Through non-invasive and real-time observation of corneal conjunctiva tissue, ophthalmologists can directly observe the histocytological changes of corneal conjunctiva and its many diseases from the cellular level on the living body, and dynamically understand the development and outcome of diseases,

As a complex, stubborn and fickle eye disease, how to reduce or avoid misdiagnosis of glaucoma according to its typical clinical manifestations and key points of differential diagnosis? Diagnostic Atlas of Glaucoma is a diagnostic atlas with pictures and texts, reflecting the characteristics of eye diseases in Chinese population. It has nearly 1,000 glaucoma diagnostic pictures from Beijing Tongren Hospital affiliated to Capital Medical University, including external eye images, anterior segment images, fundus images, visual field and ultrasound biomicroscopy pictures of exfoliation syndrome, pigmented glaucoma, iris-corneal endothelial syndrome, Fuchs syndrome and other diseases, which are comprehensive and distinctive. This book has been published by People's Medical Publishing House and is available in Xinhua Bookstores all over the place. The price of a single volume is 118 yuan.

Optometry is a new interdisciplinary subject, which combines modern optical technology with modern ophthalmology, and uses the principles and technologies of modern optics to solve visual impairment. It is a medical specialty with both classical and traditional color and modern high-tech characteristics. With the standardization of the industry and the demand of the market, the eyewear industry has gradually developed towards the specialization of optometry; The close combination of children's ophthalmology and optometry is a strong guarantee for the healthy development of children's vision. Therefore, the cooperation between ophthalmology and optometry has become an inevitable trend, both from the professional perspective and the perspective of customer demand.

The 20th National Symposium on Ocular Trauma, sponsored by the Ocular Trauma Group of Ophthalmology Branch of Chinese Medical Association, undertaken by Shenzhen Eye Hospital and co-organized by Shenzhen Medical Doctors Association, will be held in Shenzhen Qilin Villa Conference Center (No.4599 Qinyuan Road, Xili, Nanshan District) from October 30th to November 2nd, 2014.

The 11th National Symposium on Refractive Surgery (CSORS) and the national "Theory and Practice of Standardized Diagnosis and Treatment of Optometry" will be held in Nanchang, Jiangxi Province from November 13 to 16, 2014.

Tianjin Medical University Eye Hospital will hold the "Fifth Ophthalmology New Technology Forum of Tianjin Medical University Eye Hospital and Training Course on Cataract, Glaucoma, Ocular Surface Diseases and Corneal Refractive Surgery" from October 11 to 12, 2014. The meeting venue is Lin Shaoming International Lecture Hall on the third floor of Tianjin Medical University Eye Hospital. During the period, the 10th anniversary celebration of "Healthy and Bright Walk" cooperated between Tianjin Medical University Eye Hospital and China Federation of Overseas Chinese will be held.

From June 19th to 22nd, 2014, the 3rd National Neuroophthalmology Academic Conference (CNOS) of Ophthalmology Branch of Chinese Medical Association, the 3rd Cross-Strait Neuroophthalmology Forum (CNOF) and the 4th National Neuroophthalmology Backbone Training Course were held in Suzhou.

The 16th National Academic Conference on Cataract and Intraocular Lens, sponsored by the Ophthalmology Branch of Chinese Medical Association and jointly organized by the Cataract and Intraocular Lens Group of the Ophthalmology Branch of Chinese Medical Association, Tianjin Medical Association and Tianjin Eye Hospital, was held in Tianjin from June 19 to 22, 2014. The opening ceremony of the conference was presided over by Professor He Shouzhi, consultant of the National Cataract and Intraocular Lens Group. Professor Yao Ke, chairman of the organizing committee of the conference, chairman-designate of the Ophthalmology Branch of Chinese Medical Association, leader of the National Cataract and Intraocular Lens Group and director of the Ophthalmology Center of the Second Affiliated Hospital of Zhejiang University School of Medicine, delivered welcome speeches. Professor Wang Ningli, chairman of the Ophthalmology Branch of Chinese Medical Association, Professor Tang Xin, president of Tianjin Eye Hospital, and Tian Huiguang, vice chairman of Tianjin CPPCC, delivered congratulatory speeches.

With deep sadness, we deeply mourn Mr. Yang Jun, a famous scholar in ophthalmology in China and the former chief physician of ophthalmology department of Guang' anmen Hospital, Chinese Academy of Chinese Medical Sciences. Mr. Yang Jun passed away at 18:00 on 4 July 2014 at the age of 95 due to ineffective medical treatment.

In order to use the terminology and its abbreviations in this field more conveniently and concisely, this journal specifically publishes some foreign language abbreviations which are well-known and recognized. Authors can directly use the following abbreviations in the abstract and text without giving their full names when writing articles. For unpublished terms, please write the full Chinese name when it first appears, and write the full foreign name and its abbreviation in parentheses, such as tumor necrosis factor (TNF).

This issue focuses on the research progress in the diagnosis and treatment of ocular surface diseases. Professor Liu Guoguo is the responsible editorial committee responsible for the planning, composition and review of the key contents of this issue. The composition of 13 professional groups of the 11th Committee of Ophthalmology Branch of Chinese Medical Association has been officially approved by Chinese Medical Association. In order to give full play to the role of professional groups in the academic guidance of the development direction of this specialty in China, the Ophthalmology Branch requires all professional groups to guide the academic development of this specialty nationwide through multiple channels. As the external publicity organization of the Ophthalmology Branch,