Volume 40 ·  Issue 10 ·  2004

Strabismus is one of the most common eye diseases in children, with a prevalence rate of 1% ~2%. In recent years, with the efforts of the national strabismus and pediatric ophthalmology group and ophthalmologists from all over the world, the academic level of strabismus has developed rapidly. According to the etiology of common strabismus, a large number of clinical and basic studies have been carried out, anatomical abnormalities and special neuromuscular structures (pulleys) have been found, and a digital model of strabismus has been established for evaluating extraocular muscle function and designing surgery, etc. In the research on the changes of binocular visual function before and after surgery in strabismus patients, the law of binocular visual impairment has been found, and the view that fusion function hypoplasia is the main pathogenesis of intermittent exotropia has been put forward. These research advances have made us have a deeper understanding of the nature of strabismus. In terms of clinical work, in 1987 and 1996, the National Children's Amblyopia and Strabismus Prevention and Treatment Group of Ophthalmology Branch of Chinese Medical Association formulated and revised the definition, classification, efficacy evaluation standard of amblyopia, classification standard of strabismus and efficacy evaluation standard of strabismus respectively [1, 2] As a unified and standardized standard for the diagnosis and treatment of related diseases, it has played a very important role in guiding clinical work.

Objective to investigate the clinical characteristics and effective surgical treatment of congenital double superior rotator paralysis. Methods 11 patients with congenital double superior rotator paralysis were treated with different surgical treatments according to the condition, and the changes of eye position, strabismus degree and clinical characteristics before and after operation were observed. Results Among the 11 patients with congenital double superior rotator paralysis, 10 patients with congenital double superior rotator paralysis underwent lower oblique, and 1 case with healthy eye underwent upward oblique. The movement of the affected eye was limited to upward, upper inner and upper outer, and it was complicated with pseudoptosis. Among the 10 patients with healthy eye fixation, 2 patients underwent lower rectus muscle recession, 8 patients underwent upper oblique muscle recession and lower rectus muscle recession, 2 patients underwent upper rectus muscle recession 6 months after operation due to insufficient volume of the first operation, 7 patients with exotropia underwent lateral rectus muscle recession at the same time (5 cases in one eye, 2 cases in both eyes), 1 patient with healthy eye fixation underwent lower oblique muscle recession and upper rectus muscle recession, 9 patients underwent strabismus at the first eye position completely corrected, The symptoms of strabismus were significantly improved in 2 cases, the symptoms of exotropia disappeared in 7 cases, the functions of inferior oblique muscle and superior rectus muscle were not improved, and the symptoms of ptosis disappeared in 9 cases, significantly improved in 1 case, and no improvement in 1 case. Conclusion Congenital double superior rotator paralysis is a rare ocular motor disorder in clinic, and the simultaneous paralysis of superior rectus muscle and inferior oblique muscle is the main clinical feature of its onset; The effective surgical treatment methods are vertical rectus recession and superior oblique muscle ablation. (Chinese Journal of Ophthalmology, 2004, 40: 652-654)

Objective to investigate the changes of multifocal electroretinogram (mfERG) and retinal damage in patients with amblyopia. Methods 28 patients with anisometropic amblyopia (group A), 25 patients with strabismic amblyopia (group B) and 14 patients with refractive error amblyopia (group C) were examined by mfERG. The amplitude density and latency of first-order and second-order response N1 wave and P1 wave were recorded in total and different visual fields, and compared with those of normal controls (group D). Results The amplitude density of first-order response P1 wave, N1 wave and second-order response P1 wave of mfERG in groups A, B and C all decreased (P<0.05), and this change was obvious in the center of the visual field, and decreased with the increase of eccentricity. The amplitude density of the second-order response P1 wave in the upper visual field was lower than that in the lower visual field (P<0.05), and the other indexes were not significantly different between the upper and lower visual fields (P>0.05). The latency of each order response wave in groups A, B and C was not significantly different from that in group D (P>0.05). There was no linear correlation between the visual acuity of amblyopia patients and mfERG index (P>0.05). The differences of mfERG index in healthy eyes in groups A and B were significant compared with those in affected eyes (P<0.05); Compared with group D, there was no significant difference (P>0.05). Conclusion the mfERG of amblyopic patients was significantly changed, indicating that the retinal ganglion cells were damaged, but the transmission of neural information was not prolonged. (Chinese Journal of Ophthalmology, 2004, 40: 655-662)

Objective to observe the effect of separation and preservation of rectus anterior ciliary vessels (ACVs) on the prevention of anterior segment ischemic syndrome (ASI) during extraocular rectus surgery in rabbits. Methods 32 healthy New Zealand white rabbits were randomly divided into 4 groups, with ACVs separated and preserved in the right eye and ACVs removed in the left eye in each group. Group A: 2 horizontal rectus muscles were severed; Group B: Two vertical rectus muscles were severed; Group C: the medial and lateral rectus muscles and one vertical rectus muscle were severed; Group D: Four rectus muscles were severed.The signs of anterior segment of the eye were observed under slit lamp microscope before and after operation.The intraocular pressure, total protein and lactic acid concentration in aqueous humor were measurement.The animals were sacrificed 4 weeks after operation.The ultrastructure of iris and ciliary body was examined under light and electron microscope.Results No ischemic changes occurred in the right eye of the four groups.The left eye of group A had no obvious ischemic changes, while the left eye of group B only showed mild ischemic pathological changes. The left eye of group C and D showed obvious or even severe signs of ASI, and the intraocular pressure showed a decreasing trend. The intraocular pressure of group C was (17.21±3.76) mm Hg (1mm Hg =0.133 kPa) before operation, and the lowest decreased to (14.48±3.36) mm Hg after operation (P<0.05), while the intraocular pressure of group D was (16.68±2.33) mm Hg before operation, and the lowest decreased to (3.17±0.92) mm Hg after operation (P<0.05); The concentrations of total protein and lactic acid in aqueous humor increased significantly, (505.3±5.0) mg/L and (7.54±0.47) g/L before operation, respectively, and the highest increased to (811.9±44.4) mg/L and (11.00±3.59) g/L after operation in group C (P<0.05); In group D, the preoperative levels were (504.6±4.1) mg/L and (7.17±1.44) g/L, respectively, and the highest levels were (1025.8±78.3) mg/L and (8.23±1.68) g/L after operation, respectively (P<0.05); Conclusion Two vertical rectus muscles or three or four rectus muscles in the same eye can be cut off at one time, which can lead to local blood circulation disturbance, manifesting as ASI of different degrees.Separation and preservation of rectus ACVs during surgery can reliably prevent ASI. (Chinese Journal of Ophthalmology, 2004,40:663-669)

Objective to investigate the clinical effect of vitreous surgery in patients with vitreomacular traction syndrome. Methods the clinical data of 16 cases (16 eyes) with vitreomacular traction syndrome who were hospitalized from July 1998 to January 2002 were retrospectively analyzed. Results the vitreous traction to macula was released in all 16 patients after operation. 3 cases were lost to follow-up after operation, and the follow-up data of 13 cases were complete.The visual acuity of 10 eyes improved after operation, the visual acuity of 2 eyes did not improve, and the visual acuity of 1 eye decreased after operation. The preoperative visual acuity was ≤0.02 in 5 eyes, and the postoperative visual acuity was improved to varying degrees. Macular hole occurred in 2 eyes, cataract formed in 1 eye, macular lamellar hole was found in 1 eye 3 months after operation, and macular fold appeared in 1 eye 3 months after operation. Conclusion Vitreous surgery can effectively relieve the traction of vitreous body on macula, prevent the visual acuity of patients from decreasing further, and improve the visual acuity of some patients. (Chinese Journal of Ophthalmology, 2004, 40:670-673)

Objective to investigate the value of various imaging examinations such as ultrasound, CT, MRI and digital subtraction angiography (DSA) in the diagnosis of carotid cavernous fistula (CCF). Methods A total of 28 cases of CCF confirmed by DSA in our hospital were collected. All patients underwent standardized ophthalmic A/B ultrasound and DSA examination, and some patients underwent one or more of color Doppler ultrasound, CT and MRI examination. Results Ultrasound examination could detect thickening of superior ocular vein and pulse pulsation in the same cycle, and blood flow spectrum could be detected. CT and MRI examination could detect cavernous sinus enlargement and abnormal manifestations. DSA examination showed that CCF was divided into direct blood supply from the cavernous sinus segment of internal carotid artery and arterial blood supply from carotid artery to the dura mater. The blood supply arteries included: small meningeal branches in the cavernous sinus area of internal carotid artery; Middle meningeal artery, accessory meningeal artery, ascending pharyngeal artery, foramen rotundum artery, etc. from external carotid artery; Conclusion Ultrasound, CT, MRI and other imaging examinations have their advantages in the diagnosis of CCF, and the combined application can make a correct clinical diagnosis; DSA is the "gold standard" in the diagnosis of CCF, which can clarify the size of fistula, the origin of fistula blood and the direction of drainage. (Chinese Journal of Ophthalmology, 2004, 40:674-678)

Objective to investigate the misunderstandings and possible causes in the clinical treatment of uveitis. Methods The complete data of 154 patients (268 eyes) who attended the uveitis department of Sun Yat-sen Ophthalmology Center of Sun Yat-sen University from April to October 2000 were collected, and the treatment data were summarized and analyzed, especially the administration route, dose and treatment time of glucocorticoid and antibiotic application. Results The use rates of glucocorticoid drops, subconjunctival or retrobulbar injection and systemic application were 90.3%, 84.0% and 92.9%, respectively, in 154 patients (268 eyes), while the intravenous infusion accounted for 85.3% of patients who received systemic glucocorticoid. The previous treatment of patients with Behcet's disease (37 cases), anterior uveitis (30 cases) and Fuchs iridoheterochromatic uveitis (14 cases) showed that, In county-level, prefecture-level and provincial-level hospitals (including hospitals above provincial level and affiliated hospitals of medical schools), large doses of glucocorticoid abuse or improper use of eye drops are widespread.The use rates of antibiotic eye drops, subconjunctival injection eyes and systemic application cases in 154 patients with uveitis were 97.0%, 71.6% and 83.8% respectively; Only 6 cases (3.9%) were treated with other immunosuppressants. Conclusion The abuse and misuse of glucocorticoids and antibiotics in the treatment of endogenous non-infectious uveitis, especially Behcet's disease, anterior uveitis and Fuchs heterochromatic uveitis, is quite common; The application route, dosage and treatment time of glucocorticoids should be determined according to the type and severity of uveitis; Non-infectious uveitis does not require antibiotics. (Chinese Journal of Ophthalmology, 2004, 40:679-682)

Objective to investigate the relationship between gender, eye, age and optical disc area (DA) topography parameters. Methods Heidelberg retina tomograph (HRT) was used to detect the total and local parameters of the papilla topography of 116 normal eyes. The relationship between gender, eye, age and the papilla topography parameters was analyzed. The DA was divided into small, medium and large groups with 1.5 mm2 and 2.5 mm2 as boundaries. Results The normal values of the papilla topography of 116 normal subjects (116 eyes) were: DA (2.028 ± 0.411) mm2, cup area (CA) (0.466 ± 0.355) mm2, cup/disc area (C/DAR) ratio (0.217 ± 0.137), disc edge area (RA) (1.563 ± 0.339) mm2, height change of papilla contour (HVC) (0.404 ± 0.096) mm, and cup volume (CV) (0.404 ± 0.096) mm The cross-sectional area of retinal nerve fiber layer (RNFLA) was (1.364±0.375) mm2. There was no significant difference in the parameters between sexes (P>0.05). The values of C/DAR, RA and RV were significantly different between eyes (P<The difference of C/DAR ratio in normal subjects ranged from 0.00 to 0.18. mRNFLT and RNFLA values were negatively correlated with age. Local parameters of papilla topography showed that CA, C/DAR and CV values were the smallest in the nasal side and the largest in the temporal side; The RA and RV values were the smallest in the temporal side; MCD and MxCD were the deepest on the temporal side; mRNFLT and RNFLA values were the smallest in the temporal side and the largest in the upper side. DA values were significantly different in most parameters among small, medium and large optic discs (P<0.05), but there was no significant difference in mRNFLT, RNFLA and RV values among the three groups (P>0.05). Conclusion The normal values of the papilla topography parameters in normal subjects varied greatly; Age and the size of optic disc area have some influence on the topographic parameters of the optic papilla; There were significant differences in some parameters between eyes, but no significant differences among parameters of papilla topography between sexes; The parameters of each quadrant of the topographic map of the optic papilla are different. (Chinese Journal of Ophthalmology, 2004, 40:683-688)

Objective to evaluate the histological changes and abnormal cell biochemical indexes of retina in diabetic patients. Methods Retina was divided into four quadrants, and retinal vessels were separated by trypsin digestion, and the degree of lesions in each quadrant was compared. The temporal and nasal retinas were homogenized to detect their cellular biochemical indexes. Results The number of retinal microaneurysms, acellular vessels and apoptotic pericytes was more in the temporal side than in the nasal side. The detection results of glucose transfer factor, protein kinase C-β and cysteine protease-1 in each quadrant of retina were significantly different. Conclusion The abnormal degree of retinal microangiopathy and cell biochemical indexes were unevenly distributed in the four quadrants of retina in diabetic retinopathy patients, and it was speculated that the distribution differences played an important role in the occurrence and development of diabetic retinopathy. (Chinese Journal of Ophthalmology, 2004, 40: 689-691)

Objective to observe the ultrastructural changes and repair process of retinal pigment epithelium (RPE), Bruch membrane and choroid after laser photocoagulation. Methods Seven patients with orbital malignant tumor were collected. The retinal and choroidal structures of their eyeballs were basically normal. After the patients signed the informed consent form, the retina was photocoagulated with grade Ⅰ, Ⅱ and Ⅲ spot photocoagulation 1, 3 and 7 days before the enucleation of orbital contents. After the eyeballs were removed, the retina and choroidal tissues were made into ultrathin sections, stained with uranium acetate and lead citrate, and the ultrastructures were observed under transmission electron microscope. Results 1 day after laser photocoagulation, some RPE cells were swollen, necrotic and reduced in number, and microvilli partially disappeared after grade Ⅰ spot photocoagulation. Bruch membrane intact; The endothelium of choroidal capillary was swollen, and a few lumens were occluded. After photocoagulation, more RPE cells were dissolved and destroyed, Bruch membrane vacuoles formed, and choroidal capillary was extensively occluded. After photocoagulation, a large amount of RPE dissolved and disappeared, Bruch membrane was partially destroyed, and choroidal blood vessels were damaged. 3 days after laser photocoagulation, RPE cells and choroidal edema decreased, phagocytic cells appeared in the destroyed area, and RPE cells and choroidal fibrous tissue began to proliferate. 7 days after laser photocoagulation, the proliferated RPE cells covered the destroyed area, and choroidal blood vessels decreased and stromal fibrosis occurred. Conclusion Laser photocoagulation can cause edema and necrosis of RPE cells, Bruch membrane and choroidal blood vessels to varying degrees, and then RPE cells and fibrous tissue proliferated to repair the destroyed area. Laser treatment with different parameters can repair the diseased RPE and choroidal tissue. (Chinese Journal of Ophthalmology, 2004, 40: 692-695)

Objective to investigate the inhibitory effect of cytotoxic T-lymphocyte associated antigen-4 immunoglobulin (CTLA4-Ig) on immune rejection of high-risk corneal transplantation in mice and the mechanism of local anti-immune rejection. Methods 50 BALB/c mice were treated with penetrating keratoplasty animal models. In the treatment group (25 mice), the corneal slices of C57BL/6 mice were soaked in 10 μ g/ml CTLA4-Ig preservation solution for 24 h, and then transplanted into BALB/c mice. In the control group (25 mice), the grafts were not treated. The grafts were examined by slit lamp microscope every 3 days after operation, and the changes of various inflammatory cells and lymphocytes in the grafts were detected by histological and immunohistochemical methods every week. The expression of some cytokines was detected by reverse transcription PCR (RT-PCR). In addition, the mice treated with CTLA4-Ig and the grafts were kept transparent for more than 6 weeks were selected as recipients, and the grafts from C57BL/6 mice were transplanted. When the grafts rejected, delayed hypersensitivity reaction ( Immune rejection occurred in the control group within 14 days after operation. Histopathological examination showed that the graft of CTLA4-Ig treated group maintained normal cell structure 2 weeks after corneal transplantation, without obvious inflammatory cells and T lymphocyte infiltration; The expression of interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), B7 and CD40 were detected in the corneal grafts after immune rejection 2 weeks postoperatively. Skin from C57BL/6 mice was transplanted into BALB/c mice, and rejection occurred on average about 11 days after corneal transplantation. After skin transplantation rejection, ear edema reaction (DTH analysis) was induced, which was significantly different from that in the negative control group. Conclusion CTLA4-Ig competitively binds to B7 on CD28/B7 signaling pathway, blocking the activation of T lymphocytes, thus avoiding cell-mediated acute immune rejection after corneal transplantation. (Chinese Journal of Ophthalmology, 2004, 40: 696-700)

bullous keratopathy (BK) is caused by various mechanical, physical and chemical factors and ocular diseases, which seriously impairs the visual acuity of patients, and some of them may develop into ulcers and secondary infection after long-term treatment [1]. Although the efficacy of keratoplasty is positive, other methods for treating BK are still being sought due to the limitation of corneal material sources.

The English version of Chinese Medical Journal is the only comprehensive medical journal included in the American Scientific Citation Index (SCI). Through the joint efforts of the editorial board, editorial department and relevant parties, the quality of this journal has been continuously improved. In 2003, its impact factor in SCI was 0.393, which doubled compared with 2002. In order to further shorten the publishing time lag and expand the influence of the magazine, this magazine will be changed to a semi-monthly magazine in 2005, with 88 pages per issue, published on the 5th and 20th of each month, and the price of each issue is 45.00 yuan. The authors are welcome to contribute enthusiastically, and all relevant units are welcome to actively subscribe.

The "National Glaucoma Standardized Diagnosis and Treatment Study Class" jointly organized by Chinese Medical Doctors Association and the Department of Ophthalmology of Peking Union Medical College Hospital will be held in Beijing in mid-November, 2004. The session will last for 5 days, and the conference fee will be 860 yuan. After the study period, 10 points of national Class II continuing education credits will be awarded. Teaching content: Clinical and progress of glaucoma, epidemiology of glaucoma, heredity of glaucoma, early diagnosis and treatment of primary angle closure glaucoma, early diagnosis and treatment of primary open angle glaucoma, surgical treatment and its progress, clinical and progress of congenital glaucoma, clinical and progress of secondary glaucoma, drug treatment and progress of glaucoma, laser treatment and progress of glaucoma, complications of glaucoma surgery

The Chinese Journal of Ophthalmology was founded on October 1, 1950. It was sponsored by the Chinese Medical Association and edited by the Editorial Committee of the Chinese Journal of Ophthalmology. The editorial committee is composed of 61 well-known ophthalmologists in China. The current editor-in-chief Zhao Jialiang and the editorial director Zhao Hongmei. The main readers of this journal are ophthalmologists all over the country, and it is publicly distributed at home and abroad. China Standard Issue Number: ISSN04124D81, CN11-2142/R; Postal Code: 2-60; National map code: BM93. The Chinese Journal of Ophthalmology has always implemented the principles and policies of the Party and the state on health work, implemented the principle of combining theory with practice, popularization and improvement, reported the major progress and important achievements of clinical and scientific research in ophthalmology in China, and promoted

In order to fully reflect the innovative scientific research achievements and clinical experience of ophthalmology in China, this journal has opened up a "fast track" to publish excellent academic papers in 2002, simplifying the procedure from review to formal publication of papers and shortening the publication cycle. In view of the increasing number of authors applying for the "fast track" at present, the editorial board of this journal has supplemented and improved the specific conditions for applying for the "fast track" on the basis of its operation some time ago, and reiterated the relevant regulations of the "fast track" once again, "so that academic papers with innovative content can be published as soon as possible.

With the support of readers and authors, the "Continuing Education Garden" column of our journal was launched in 2003 in a brand-new form with multiple choice questions attached to the article. In each issue, 10 lucky participants will be drawn from those with accurate answers, and souvenirs will be sent by our journal. The answers to the thinking multiple choice questions and the list of lucky participants will be announced in our journal. Answers to multiple choice questions and the list of lucky participants in the column "Continuing Education Garden", Volume 40, Issue 7, 2004 are now announced.

Shandong Institute of Ophthalmology and Eye Hospital was founded in January 1991. It is a social welfare institution approved by the State Science and Technology Commission, which integrates scientific research, teaching and medical treatment. It is affiliated to Shandong Academy of Medical Sciences, and jointly trains ophthalmology doctoral students with Peking University and Qingdao University. The director and dean is Professor Xie Lixin, the only academician of Chinese Academy of Engineering in China's ophthalmology community. At present, our institute has 150 open hospital beds and has assets of 130 million yuan, of which more than 200 sets of scientific research and medical equipment with international advanced level of more than 10,000 yuan.

Practical Ocular Surface Diseases edited by Professor Zhu Zhizhong has been published by Beijing Science and Technology Press. This book aims at serving the clinical practice of ocular surface diseases, with detailed content, comprehensively discussing the basic theory and clinical practice of ocular surface diseases, including the latest progress in theory and technology in the field of ocular surface at home and abroad. This book focuses on the mastery and application of diagnosis and treatment technology, and has reference value for medical treatment, scientific research and teaching of medical staff at all levels of ophthalmology.

After three years of investigation and industry analysis, combined with the development status of China's medical industry, American Aolide Medical Investment Group and the "Chief Think Tank of Hospital Management"-Dean's Decision Research Center plan to invest 1 billion yuan in China within five years to build eight chain eye hospitals, so that more Chinese people can enjoy international medical services. The plan has now been implemented. At present, six hospitals in Guangdong Province are located in six cities: Guangzhou, Zhanjiang, Zhongshan, Meizhou, Shaoguan and Huizhou. Out-of-province investment targets

The "9th National Academic Conference on Ophthalmology Pathology and Basic and Clinical Diagnosis and Treatment" sponsored by the Ophthalmology Group of Ophthalmology Branch of Chinese Medical Association and the Editorial Board of Chinese Journal of Ophthalmology is scheduled to be held in Dayong City, Hunan Province in late May 2005. At that time, well-known ophthalmologists and academic leaders in China will be invited to give special academic lectures and lectures on the popularization of essential ocular pathology knowledge on clinical and basic research progress in ocular pathology, ocular tumors and related fields. Lecture contents: (1) Relationship between origin and multidirectional differentiation of ocular surface tumors and ocular surface stem cells

With the approval of China Association for Science and Technology and the Ministry of Science and Technology, the "5th International (Shanghai) Academic Conference on Ophthalmology" and "5th International (Shanghai) Academic Conference on Optometry" will be held in Shanghai Exhibition Center (No.1000 Yan' an Middle Road, Shanghai) from April 7-11, 2005, jointly sponsored by Ophthalmology Branch of six provinces and one city in East China, and jointly sponsored by Eye, Ear, Nose and Throat Hospital affiliated to Fudan University, College of Optometry of Wenzhou Medical College and China International Science and Technology Conference Center. From the United States, European countries, South Korea, Japan

An 11-year-old male, weighing 37 kg, was given cefazolin 0.5 g, intramuscular injection for 4 days, twice/d, due to pharyngeal pain in another hospital. After 3 days of stopping the drug, cefazolin 3.5 g was given intravenously again due to the aggravation of the symptoms. About 10 minutes after the drug was dripped, the child felt chest tightness and discomfort. After 0.5 hours, the whole body became red and itchy, muscle trembling, red rash, and then the body temperature rose to 38℃. After 2 days, he was admitted to our hospital due to visual loss.

Duane retroglobular syndrome is a dominant genetic disease, and the clinical manifestation is congenital abnormal eye movement, mainly sporadic. Two patients admitted to our hospital are monozygotic twins, and the clinical manifestations are inconsistent, which are rare cases [1]. The report is as follows.

Eyelid malignant tumor can invade the orbit, paranasal sinus and surrounding skin in the late stage, which brings difficulty to the treatment. Since June 2000, 3 cases of advanced eyelid malignant tumor have been treated by orbital contents resection combined with frontal metastatic flap in our hospital, and satisfactory results have been achieved.The report is as follows.

A 12-year-old girl was diagnosed with glaucoma in a hospital and was given oral acetazolamide 250 mg twice a day for 7 days in August 2001. In July 2002, the child was treated in our hospital due to the aggravation of swelling and pain in his left eye. He was given a laser hole-making treatment with neodymium-doped yttrium aluminum garnet. The laser energy was 8.8 mJ, and the hole was located at the meridian iris ring at 3 o'clock. After re-examination half a month later, the symptoms of the child did not improve due to the atresia of the iris laser hole, and he was admitted to our hospital on August 7, 2002. The whole body physical examination of the child showed no abnormalities. Ocular examination: the naked eye visual acuity of the right eye was 1.0, the anterior eye index of the left eye was 1.0, the light perception of both eyes was 5 meters, the light positioning was good, the red and green vision was normal. No abnormalities were found in the examination of the anterior segment and fundus of the right eye. The left eye had obvious irritation symptoms, mild corneal edema, extremely shallow anterior chamber, and the iris was cystic and highly swollen, partially touching the corneal endothelium. The cysts were multiple and translucent, the anterior cyst wall was thin and clear, and tiny blood vessels were visible on the surface. The pupil of the left eye was deformed, showing a narrow slit of about 1 mm ×2 mm, with posterior adhesion; The lens is opaque and the fundus is blurred (Figure 1); The intraocular pressure was 53.61 mm Hg (1 mm Hg =0.133 kPa). Ultrasound biomicroscopy showed that two cysts were seen in the anterior chamber, with thin wall and clear boundary, and no internal echo reflex. The sizes were 3.6 mm ×1.78 mm and 3.92 mm ×1.63 mm, respectively (Figure 2). Clinical diagnosis: congenital iris cyst in the left eye, secondary glaucoma and congenital cataract. With the signature and consent of the child's family, the iris cyst resection and cataract extraction of the left eye were performed under general anesthesia. The iris cyst was punctured with an empty needle from the limbus, and the cyst fluid was aspirated to make the cyst smaller. The limbus was incised from 4 o'clock to 2 o'clock, and the iris was completely removed. During the operation, a layer of gray-white turbid membrane with uneven thickness was observed after the iris, and it was removed together with the iris, but no normal lens was found. After the wound was rubbed with iodine tincture, the wound was repeatedly rinsed with normal saline. After the operation, anti-inflammatory and corticosteroid treatment was given. The child was discharged 7 days later.

A 41-year-old woman was diagnosed as "central serous chorioretinopathy" in the local hospital due to blurred vision in her left eye and gradually aggravated for 3 months. After treatment, she did not improve. She came to our hospital on November 28, 2001 for further diagnosis and treatment. Ocular examination: visual acuity of right eye 1.2, left eye 0.1. No abnormality was found in bilateral external eye examination. Right fundus was normal; fundus fluorescein angiography (FFA) showed hyperfluorescence in the early stage and fluorescein leakage in the late stage. indocyanine green angiography (ICGA) showed hypofluorescence in the early stage and fluorescein leakage in the late stage, showing strong positive reaction. Erythrocyte sedimentation rate: 12 mm/h. The viral serological examination was normal, and the chest radiograph showed no abnormalities. The diagnosis of tuberculous choroiditis was proposed by internal medicine consultation, and anti-tuberculosis treatment was given, oral isoniazid 0.1 g, 3 times/d, rifampicin 0.45 g, 1 time/d, and others were liver protection and symptomatic treatment. After 2 weeks, the visual acuity of the right eye was 1.2, the left eye was 0.2, and the irregular striated dark area was seen in the gray-yellow lesion under the temporal of the left fundus retina, which was smaller than that before treatment; FFA examination showed that there was still significant fluorescein leakage in the late stage of the lesion; ICGA examination showed that the lesion showed low fluorescence in the early stage and fluorescein leakage in the late stage, and there was linear high fluorescence, which did not change significantly compared with that before treatment (Figure 2).

A 32-year-old male came to our hospital in November 2002 due to sudden right exophthalmos, combined with ocular pain, nausea and vomiting for 2 days. The patient was in good health and had no other medical history. No abnormalities were found in physical examination. Ocular examination: visual acuity of right eye 0.5, which could not be corrected; Left eye 1.2. Exophthalmos: right eye 16 mm, left eye 12 mm, orbital distance 103 mm. Right orbital pressure increased, eye movement was limited in all directions. Slight indentation in the posterior pole was seen in the fundus of the eye.

A 42-year-old woman came to our hospital on August 4, 2001 due to bilateral progressive exophthalmos for 1 year. The patient suffered from "hyperthyroidism" 3 years ago, and her thyroid function has been normal for 2 years after taking I131. There are no symptoms of hyperthyroidism such as palpitations and weight loss. However, she often has discomfort symptoms such as dryness of the eyes, mild photophobia and redness of the eyes. Eye examination: The visual acuity of both eyes was 1.0, and there was obvious upper eyelid retraction in both eyes, but no eyelid insufficiency. The exophthalmos of the right eye was 20 mm, the left eye was 19 mm, the orbital distance was 105 mm, and the conjunctiva was mildly congested in both eyes. Eye position: both eyes were in the right position, and the eye movement showed consistent inward and outward upward turning dyskinesia of both eyes (Figure 1). Slit lamp examination showed 1.5 mm ×1.5 mm dry concave plaque in the paracorneal center of the left eye, and there was no obvious inflammatory reaction in the corneal stroma (Figure 2). After local use of artificial tears and 0.3% tobramycin eye drops through the eye, the dry concave plaque of the left eye completely disappeared on the second day.

Beijing Science and Technology Press recently published "Clinical Computer Vision" edited by Wu Dezheng and Long Shixian of Zhongshan Ophthalmology Center in Guangzhou. The book includes two parts: the basic theory and clinical application of computer vision. It focuses on the reading and analysis points of computer vision, and explains it with a large number of clinical examples. The content of the book is simple and simple, with pictures and texts, and pays attention to the combination of basic and clinical practice, which has important reference value for ophthalmologists.

Ophthalmology Department of Yantai Development Zone Hospital has advanced ophthalmic medical equipment, and was approved as Yantai Eye Hospital by Yantai Municipal Health Bureau in April 2001. Now we are looking for one deputy director and one attending physician who are skilled in cataract phacoemulsification and eye refractive surgery techniques. Interested candidates should send their resume, standard photos and specific requirements to the office of Yantai Eye Hospital (No.11 Taishan Road, Yantai Development Zone), Postal Code: 264006; Contact: Wenfang Song; Contact number: 0535-6372230, fax: 0535-6370606.

Edited by He Shouzhi, a famous ophthalmologist, "Crystallology" has been published by People's Medical Publishing House. This book is a professional book that comprehensively introduces the basic theory and clinical practice of lens and its cataract, related new technologies and new advances. The content not only includes the embryonic anatomy, histopathophysiology and genetics of lens, but also details the basic and latest examination and diagnosis technology of cataract, modern postcataract surgery skills and prospects, etc.

Lens dislocation often occurs in patients with Marfan's syndrome, and because the patients are complicated with connective tissue abnormalities, the surgical treatment is complicated and there are many complications, and there is still a lack of simple and safe treatment in clinic.We performed phacoemulsification lens aspiration and single loop fixed bolus posterior chamber folding intraocular lens implantation in 6 patients with Marfan's syndrome (11 eyes), and achieved good results. The results are reported as follows.

As the earliest university to carry out higher education in optometry in China, Wenzhou Medical College took the lead in establishing an independent optometry hospital in China in 1998. In the past six years, it has carried out beneficial exploration on the clinical characteristics of optometry and the mode of specialty hospital, and achieved staged results. This paper analyzes and discusses the service orientation, mode characteristics and specialty structure of optometry specialty hospital.

Abnormal innervation refers to the recovery of the ocular motor nerve or its various branches after about half a year of injury, and the regenerated nerve fibers from the central end descend along the original Schwan sheath, partially or completely into other Schwan sheaths, or extend along the connective tissue surrounding the sheath, and descend to unrelated muscles, resulting in abnormal nerve union, which causes or accompanied by unrelated muscle contraction when the nerve nucleus sends impulses to the related muscles.