Volume 45 ·  Issue 06 ·  2009

Dry eye is a multifactorial problem involving the nerve, lacrimal glands, the eyelids, ocular surface and lacrimal duct, which might cause a major difficulty in patients' life. It is essential to establish an accurate diagnosis of dry eye for the successful of treatment. In this article the changes of dry eye definition are analyzed and the evaluation of various clinical diagnostic tools is summarized. The advantages and disadvantages of different types of diagnostic tools are compared systemically. Only by using an efficient method to establish an accurate dry eye diagnosis, oculists can avoid treating dry eye blindly.

Surgery-associated dry eye is a common complication after eye surgery. The major causes can be attributed to surgery-induced damage of ocular surface epithelial cells, transection of the afferent sensory nerve fibers in the cornea, vigorous irrigation of tear film during surgery, and the use of medication after the surgery. Prevention of surgery-associated dry eye is mandatory to reduce the incidence of this disorder, and appropriate treatment can improve the outcome of eye surgery. More studies regarding the mechanism, prevention and treatment are required to increase our knowledge of surgery-associated dry eye.

Objective To investigate the prevalence of dry eye in populations equal or over 20 years old in Jiangning District, Shanghai, China. Methods This was a cross-sectional study. From September 2008 to January 2009, 6 small districts including 21 102 people of Jiangning District were randomly selected as survey venues by Department of Ophthalmology in First People's Hospital affiliated to Shanghai Jiaotong University. Then, 1266 people as the selected residents were enrolled, which was figured out through the random cluster sampling procedure. Every participant completed dry eye questionnaire, the ocular surface disease index (OSDI), and a series of examination including slit-lamp microscope, tear-film break-up time (BUT), Schirmer Ⅰ test, and fluorescein staining of the cornea (F1). The diagnosis of dry eye was referred to the well-accepted domestic diagnostic criteria. The SPSS11.0 software was used to analyze the database, t test,χ2 test, one-way-ANOVA and Logistic regression were used for analysis. Results One thousand and eighty five residents finally took part in this study, and the inclusion ratio was 85.70%. Three hundred and twenty six individuals, including 101 men and 225 women, were diagnosed as dry eye, and the prevalence rate was 30.05%. The prevalence of dry eye in the female (33.78%) was higher than that of the male (24.11%) (χ2=11.46, P<0.01). The prevalence of dry eye in people over 50 years old was higher than that under 50 years (χ2=94.50, P<0.01). The figure of Schirmer Ⅰ test and BUT decreased in elder people, at the same time the scores of F1 and MGD increased. Meanwhile, the score of OSDI in dry eye patients was significantly higher than that in non-dry eye individuals. The relative risk factors of dry eye were gender, age, wearing contact lens, long-time using of eye solutions, taking anti-allergy drugs. Conclusions The prevalence of dry eye in female is higher than that in the male. And the prevalence of dry eye increases following the aging process. Relative risk factors of dry eye are gender, age, wearing contact lens, long-time using of eye solutions, taking anti-allergy drugs.

Objective To investigate anethol trithione therapic efficiency on dry eye. Methods It was a prospective random double-blind controlled study. Eighty cases diagnosed dry eye in Ocular Surface Out-patient Clinic of Xiamen University Affiliated Xiamen Eye Center from 2006 to 2008 were divided into two groups: anethol trithione group and control group, 40 cases in each group. Every group was then divided into two subgroups: weak dry eye subgroup, middle and severe dry eye subgroup. All groups had been added with 0.05% refresh drops. All patients had been detected and evaluated by subjective symptoms of dry eye, visual acuity,corneal fluorescent staining(F1), break-up time(BUT) and Schirmer Ⅰ test (SⅠT) at pre-therapy and 3,7,28 d of post-therapy. All groups had been compared and analyzed by F test and sample mean difference (SMD) or median difference (MD) comparison between pre-therapy and post-therapy. Results Except of tear and red eye, the other subjective symptoms of dry eye, F1, BUT and SⅠT of weak dry eye subgroup of both groups had been improved at 7 d after therapy. Only those of middle and severe dry eye subgroup of anethol trithione group had been improved at 7 d after therapy compared with those of pre-therapy: SMD=0.96 (visual tiredness), 1.26 (dry and unsmooth sensation), 0.82 (foreign body sensation), 1.28 (burning sensation), 1.05 (photophobia), 1.48 ( pain ) ; MD=0.30 (visual acuity), 4.00 (F1) ,5.00 (BUT), 5.00 (SⅠT) [F=15.30 (visual tiredness), 15.68 (dry and unsmooth sensation ), 13.56 (foreign body sensation), 20. 91 ( burning sensation ), 18.90 (photophobia), 27.22 ( pain ), 10.54 (visual acuity), 188.21 (F1) ,261.76 (BUT) ,269.05 (SⅠT) ;P<0. 05]. Those of middle and severe dry eye subgroup of control group hadn't significantly been improved at 28 d after therapy: SMD=0.10 (visual tiredness) ,0.16 (dry and unsmooth sensation) ,0.09 (foreign body sensation) ,0.38 ( burning sensation ), 0.24(photophobia) ,0.36 (pain) ,0.23 (red eye) ; MD=0.10 (visual acuity) ,0.50(F1) ,0.50(BUT), 0.50(SⅠT) [F=1.76 (visual tiredness), 1.61 (dry and unsmooth sensation), 1.02 (foreign body sensation),2.39 (burning sensation), 2.42 (photophobia), 2.73 ( pain ), 2.55 ( red eye ), 1.46 ( visual acuity) ,2.35 (F1) ,2.90 (BUT) ,2.76 (SⅠT) ; P>0.05]. SⅠT of anethol trithione group had been improved more significantly after therapy (F=13.77, P<0.05). Conclusion Anethol trithione could significantly improve middle and severe dry eye patients' symptoms and signs whose lacrimal gland function survival and it has clinical application value.

Objective To evaluate the therapeutic efficacy of lacrimal endoscope treatment for lacrimal passage obstruction, and to compare the effectiveness of endoscopically controlled laser surgery and micro-drill surgery for lacrimal passage obstruction. Methods It was a prospective random controlled trial. Eighty nine patients (104 eyes) with lacrimal passage obstruction, including presaccal canalicular obstruction (PSCO) and nasolacrimal duct obstruction (NLDO), were collected from September 2006 to December 2006 in Department of Ophthalmology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. Patients were examined by endoscopy of the lacrimal drainage system under local anesthesia to detect the obstruction and changes of lacrimal mucous membrane. The obstructions were treated with laser or microdrill. Irrigation was performed to prove the recanalization of the lacrimal passage followed by injected ointment with 0.3% tobramycin and 0.1% dexamethasone into the lacrimal passage. All patients were followed up after the operation for 9-12 months. The difference between the laser and the microdrill treatment was observed. Chi-square test was used to evaluate the curative effect and complications differences between these two groups. Results The obstruction scene in the lacrimal passage of 89 patients could be observed effectively. All obstructions (104/104 eyes) were eliminated after the operation. Through the follow-up, the cure rate reached 78.85% (82/104 eyes). The cure rate of PSCO group and NLDO group, reached 77.78% (42/54 eyes) and 80.00% (40/50 eyes), respectively (χ2=0.077,P=0.782). The cure rate of laser group and micro-drill group, was 80.43% (37/46 eyes) and 77.59% (45/58 eyes), respectively (χ2=0.125,P=0.724). The cure rate of laser treatment was 89.66% (26/29 eyes) in the PSCO group and 64.71% (11/17 eyes) in the NLDO group (P=0.040). The cure rate of micro-drill treatment was 64.00% (16/25 eyes) in the PSCO group and 87.88% (29/33 eyes) in the NLDO group (χ2=4.664,P=0.031). Hemorrhage and palpebral edema occurred in 10.87% (5/46 eyes) and 4.35% (2/46 eyes) after laser treatment, respectively. Percentage of hemorrhage and palpebral edema after the micro-drill treatment was 55.17% (32/58 eyes) (compared to the laser group, χ2=21.969,P=0.000) and 6.90% (4/58 eyes) (compared to the laser group, χ2=0.017 ,P=0.896). Conclusions Lacrimal passage obstruction can be observed and treated directly through the endoscopy of lacrimal drainage system. Choosing an appropriate surgical procedure according to the locations of the obstruction can be helpful for improving the effectiveness of the operation.

Objective To study the clinical features, diagnosis and treatment of non-tuberculous mycobacterial keratitis (NTMK). Methods It was retrospective case series study. Twelve eyes in 12 patients with NTMK following corneal foreign body trauma in 2007 were studied retrospectively including the case histories, clinical findings, laboratory examinations, diagnosis, treatment and prognosis. The main laboratory examination included corneal scrapings by culturing, polymerase chain reaction (PCR) and transmission electron microscopy (TEM), corneal lesions by histopathologic examinations and TEM. The patients received local and systemic antibiotics therapy, lesion cleaning followed by cauterization with tincture of iodine (5%) and (or) keratoplasty. Results All cases had a history of corneal trauma, there was corneal metallic foreign body removal at one hospital in 11 cases, corneal reed trauma in 1 case. The characteristic signs involved grayish-blue crystalloid keratopathy, multifocal infiltrates, satellites,radiatiform changes in the Descement's membrane. The results of laboratory examinations of the scrapings of the cornea infection were as follows: all cultures (12/12) were positive for rapidly growing mycobacteria, and isolates from 5 patients were all diagnosed as mycobacterium chelonae subspecies abscess; acid-fast staining revealed positive bacilli in all the 4 patients ; seven of 8 patients were positive for bacterium by PCR. Transmission electron microscopy in all the 3 specimens showed many slender red-shaped or short coarse-shaped bacteria which were phagocytized by monocytes, and some necrotic tissue. Infections in 10 eyes were resolved by combined treatment regimen including a combination of antimicrobial agents (amikacin, rifampin, gatifloxation, ciprofloxacin, azithromycin and/or ofloxacin, etc. ) and local lesion cleaning followed by cauterization with 5% tincture of iodine within 2-5 months; two cases resolved by keratoplasty which poorly responded to antibiotic therapy for 6 months. Conclusions NTMK is a rare, recalcitrant opportunistic infection which can occur in an epidemic fashion following corneal foreign body trauma. The diagnosis of NTMK is difficult, and may easily be misdiagnosed as fungal keratitis. Acid-fast staining, TEM, especially bacterial culture can help to obtain definitive diagnosis. NTMK has a long response period to medical management. The majority of patients can be cured by local and systemic antibiotics therapy, and the recalcitrant infections could be resolved by keratoplasty.

Objective To compare the corneal hysteresis (CH) and corneal resistance factor (CRF) measured with the Ocular Response Analyzer (ORA) in normal and keratoconic eyes. Methods It was a case-control study. Random selected 96 normal eyes and 46 keratoconic eyes in the same period were included in this study. Normal eyes were divided into 2 groups: high corneal astigmatism (≥3.00 D) and low-to-moderate corneal astigmatism (<3.00 D). Keratoconic eyes were also divided into 3 groups based on Amsler-Krumeich classification: mild (stage Ⅰ), moderate (stage Ⅱ) and severe (stage Ⅲ/Ⅳ). CH and CRF were compared between groups and the areas under ROC curves of the CH and CRF were calculated. Results The mean CH and CRF were (7.1±1.6) mm Hg and (6.3±1.5) mm Hg in keratoconic eyes compared with (10.1±1.3) mm Hg and (10.5±1.6) mm Hg in normal eyes. The difference were statistically significant(t=-11.813, -14.943 ;P<0.001). In normal eyes, there was no difference of CH or CRF between the high corneal astigmatism and low-to- moderate corneal astigmatism (t=0.373,0.095; P>0.05). In keratoconic eyes, there was a significant negative correlation between CH and the keratoconus grade (r=-0.627, P<0.001) and the same relationship was found between CRF and the keratoconus grade (r=-0.587, P<0.001). In multiple linear regression analysis, CH was correlated with central corneal thickness (CCT) and corneal curvature (r=0.320, -0.375;P<0.05) and CRF was correlated with corneal curvature in keratoconic eyes (r=-0.441 ,P<0.01), while they were only correlated with CCT in normal eyes (r=0.367,0.459;P<0.001). The areas under ROC curves of the CH and CRF were 0.9282 and 0.9731 (Z=20.462,38.305 ;P<0.0001), the difference between them was significant (Z =7.134,P=0.008). Conclusions The CH and CRF were significantly lower in keratoconic eyes than in normal eyes, especially on CRF. The long-term follow-up of CH and CRF may provide information for evaluation of progression of keratoconus. They may be included as indicators for detecting keratoconus.

Objective To evaluate the 23-item scale of Quality of Life (QOL) for patients with primary congenital glaucoma (PCG). Methods It was a cross-sectional study. The QOL scale specific for patients with PCG was firstly evaluated on 51 patients with PCG following antiglaucomat surgery at last follow-up visit (7.80 years±2.93 years with a median at 7 years) and 50 participants with normal visual acuity (VA) as control. All participants were aged 5-20 years old. The QOL of PCG was evaluated with type of disease, severity, surgical outcome, postoperative VA, age, gender and personality by using single-factor correlation analysis and multiple-factor stepwise regression analysis. Results The PCG-QOL scale achieved good reliability, validity and responsibility for PCG and 23-item were all qualified for QOL evaluation of PCG. The total scores of QOL in patients with PCG were significantly lower than those of normal individuals (PCG 60.22±10.02,normal individuals 71.41±10.11;t=5.682, P=0.000). Single-factor correlation analysis showed that the total scores of QOL were associated significantly with the severity of glaucoma (F=24.026, P=0.000), surgical outcome (t=2.638, P=0.009) and postoperative VA (F=11.248, P=0.000) ; The visual function scores were associated significantly with the severity (F=12.677, P=0. 000) and postoperative VA (F=10.369, P=0.000) ; The self-care ability scores were associated significantly with the severity (F=11.064, P=0.000) and surgical outcome (t=2.297, P=0.042) ; The social and mental scores were all correlated significantly with the severity (F=6.869, P=0.020; F=5.721, P=0.019) and personality (t=4.352, P=0.009 ; t=2.297, P=0.042). Multiple-factor stepwise regression analysis showed that there were significant correlations between total scores and the severity (β=-6.985, P=0.001 ), postoperative VA (β=-4.978, P=0.003 ) and personality (β=-5.201, P=0.020). Conclusions The PCG-QOL scale could be used for evaluating the QOL of PCG patients aged 5-20 years. The main factors that influence on the QOL of patients with PCG are severity of the disease, postoperative VA and personality. Preventing progression of glaucoma, improving VA and giving right psychological guidance may improve the QOL of patients with PCG.

Objective To study the cell membrane of T-lymphocytes in thyroid associated ophthalmopathy (TAO) by using atomic force microscopy (AFM). Methods Case-control study. Forty-two patients were selected as the subjects, and divided into two groups: acute stage (18) and stationary stage(24) ones on the basis of symptom. Ninety-two healthy persons were in the normal groups. Dynal immunomagnetic beads isolation method was used to separate the T cells. CD3+ was chosen as a surface molecule marker of T cells to determine the purity of cells isolated. Cultivated T cells were observed by AFM. Amplitude and height images were obtained in the tapping mode with a scan rate of 2 Hz and an integral gain of 0.3 to 0.5. Statistical analysis was performed using single-factor analysis of variance and the P value was calculated. Results The topographies of these three groups of T cells showed significant difference(F=28.809,58.213,169.789,35.933,121.325;P<0.05). Average diameter and roughness of T cells in acute stage of TAO were significantly greater than those of the other two groups. One way analysis of variance showed that significant differences in various parameters (Ra, Peak count, Rpm, Rvm, Surface area diff) were found between these three groups (P=0.047,0.002). Conclusions The morphology and ultrastructure of lymphocytes in TAO are different from the normal subjects by observation with AFM. Lymphocytes in acute stage of TAO are also different from those in stationary stage.

Objective To investigate the protective effects of melatonin on the retinal pigment epithelium (RPE) against oxidative damage induced by hydrogen dioxide (H2O2) and its mechanism. Methods The RPE cells were seeded and divided into normol control group, oxidative damage group and the treatment group (treated with melatonin at the concentration of 1×10.7 mol/L,1×10-6 mol/L, 1×10-5 mol/L and 1×10-4 mol/L). The model of oxidative damage on the RPE cells was established by culturing the RPE cells with H2O2 at the concentration of 600 μmol/L for 1 hour in vitro. The cell viability of RPE cells was detected by the methyl thiazolyl tetrazolium (MTT) method. The degree of oxidative damage was evaluated by detecting the superoxide dismutase (SOD) and maleic dialdehyde (MDA). Apoptosis was detected qualitatively using the DNA Ladders electrophoretic mothed, and quantitatively using the Annexin V-FITC/PI double staining flow cytometry. Results Compared with normal control group, the oxidative damage group had low cell viability, low SOD and high MDA contents, and high apoptosis rate(t=2.25,39.50,68.42;P<0.05). Compared with oxidative damage group, the treatment group had high cell viability, high SOD and low M DA contents, and low apoptosis rate (P<0.05). Conclusions Melatonin has a protective effect on the RPE against oxidative damage induced by H2O2. The mechanism may involve in reinforcing the cell viability, strengthening the activity of antioxidase, and reducing the apoptosis.

Objective To explore the effect of L-canosine in preventing and treating rat cataract induced by sodium selenite. Methods This was an experimental study. Cataract was induced in the rats by sodium selenite. Rats were divided into 3 groups and each group has 3 ones. L-canosine eye drops (50 g/L or 20 g/L) and 0.9% normal saline were respectively instilled to the rat eye for 3 weeks and examined. L-canosine was added to the medium of cultured rat cataract lens at 1.00, 0.10 and 0.01 g/L for 1 week and then examined. Cataract lens were studied by using two-dimensional eletrophoresis. Results One week after instillation of L-canosine, the scores of rat cataract were 2.22±0.65, 2.39±0.98 and 2.83±0.38 in 50 g/L, 20 g/L L-canosine and control groups, respectively. The lesion in 50 g/l, L-canosine group was lighter than that of the control group. There was significant difference between these two groups (P=0.013). On the 2nd and 3rd weeks, there was no difference among these three groups. After 1 week for culturing cataract lens, there was no difference between these three groups. The results of two-dimensional eletrophoresis showed that the protein number was 182 and 161 in the L-carnosine and control groups, respectively. High molecular weight protein decreased and low molecular weight protein increased in L-carnosine group. Conclusions L-carnosine at 50 g/L could restrain the development of early stage rat cataract. L-camosine could modulate the rat lens protein in vitro, but could not affect lens cataract scores.

Objective To study the inhibitory effects of recombinant adeno-associated virus 2 (rAAV2)-mediated herpes simplex virus thymidine kinase/ganciclovir (HSV-tk/GCV) system on the rabbit lens epithelial cells(N/N1003A) in vitro and to investigate the mechanism of cell death. Methods After N/N1003A cells had been transfected with rAAV2-EGFP, expression of enhanced green fluorescent protein (EGFP) were observed by inverted fluorescent microscope and the transfection efficiency was detected by flow cytometry. N/N1003A cells were infected by recombinant virus rAAV2/HSV-tk as the treated group, and the uninfected N/N1003A cells were used as the controls. The dose- and time-dependent efficiency and bystander effect of HSV-tk/GCV system on the cells were studied by MTT assay. Apoptosis and necrosis were observed by phase contrast microscope, electron microscope and Hoechst33258 stain. Apoptotic cell rate and cell cycle were detected by flow cytometry. Results rAAV2 vector encoding EGFP gene could be transfected into N/N1003A cells stably and efficiently. The effects of GCV on these two groups were dose-dependent (F=13 076.239 ,P<0.001 ). The difference of percentages of survival cells between the study group and the control group at various doses of GCV was statistically signifieant(F=53 947.119, P<0.001). The 50% of the inhibitory concentration(IC50) of GCV in the study group was 2 mg/L and was 524 mg/L in the control group. The killing efficiency of GCV increased with the prolongation of time and showed significant bystander effect. Cell apeptosis and necrosis were observed in N/N1003A-tk cells transfected by GCV, and the percentage of apoptotic cells was significantly higher than that of the control group (t=3.83, P<0.01). The percentages of N/N1003A-tk cells in the S phase of the cell cycle was significantly higher than that of the control group (t=3.55, P<0.01). Whereas the percentages of the G0/G1 phase in GCV treated cells was significantly lower than that of the centrol group(t=4.29,P<0.01). Conclusions GCV can kill efficiently the N/N1003A cells infected by recombinant virus rAAV2/HSV-tk, and there is strong bystander effect. Recombinant adeno-associated vires-mediated HSV-tk/GCV suicide gene system may provide an effective approach for the treatment of lens posterior capsular opacification.

Glaucoma drainage device (GDD) is moderately successful in patients with refractory glaucoma. However, bleb fibrosis appears to be the major cause of long-term GDD failure. In recent years, many researchers tried to explain the cause of fibrosis and its influence on the clinical effects of GDD from histopathological study. It has reported that antifibrotic agents are effective in controlling capsule fibrosis around GDD, but this view has been challenged recently. Although GDD can effectively reduce the intraocular pressure (IOP) in refractory glaucoma, it is associated with many serious complications, such as endophthalmitis, corneal decompensation and hypotony. Because of the disadvantages of GDD, many new implant and modified surgical technique emerged in recent years. The anterior segment OCT is able to visualize the whole outline and the position of the tube, therefore it is useful for guiding the postoperative treatment. Furthermore, the application of novel materials and nanotechnolagy could open up new avenues for GDD.

Necrotizing scleritis is a kind of anterior scleritis. Although it is rare in clinic, it is extremely destructive. It is often because the necrosis cannot be controlled, and finally the whole anterior part of the eyeball is damaged, resulting in serious visual damage. There are still lack of effective treatment measures and poor prognosis. From July to December 2007, two patients with necrotizing scleritis were treated with allogeneic scleral transplantation combined with tacrolimus eye drops in Sun Yat-sen Ophthalmology Center of Sun Yat-sen University.

Takayasu arteritis is a common systemic vascular disease, which refers to chronic progressive non-specific inflammation of the aorta, its main branches and pulmonary arteries. Because Takayasu arteritis can involve arteries in different parts and different organs, other clinical manifestations can occur besides weakening or disappearing pulse. Most patients go to other departments with fatigue, dizziness, headache and low fever as the main complaints, while relatively few patients with ocular discomfort as the main complaints are diagnosed for the first time. In 2008, we treated a patient with Takayasu arteritis with ocular symptoms for the first time. The diagnosis and treatment are analyzed as follows.

A 56-year-old male was admitted to the Department of Ophthalmology of the First Affiliated Hospital of Jiamusi University on April 6, 2007. The patient had been injured in his left eye by a grinding wheel more than 10 years ago, and the specific treatment was unknown at that time. Later, a tumor was found in his left upper eyelid, without redness, swelling, heat, pain and other accompanying symptoms. In the past 2 years, the tumor increased gradually. The patient was in good health before, without history of genetic diseases, infectious diseases or epidemic diseases.

In order to better express the central content of the full text, after discussion and approval by the 12th editorial board of Chinese Journal of Ophthalmology, this journal made appropriate adjustments to the writing of Chinese and English abstracts of the treatise. The abstract format is still divided into four parts: purpose, method, result and conclusion, each part is titled with corresponding titles. However, in "Methods" the author should inform the name of the study design and the main method. I hope the authors will pay attention to the writing standards of Chinese and English abstracts in future submissions.

The main columns of this journal in 2009 include expert reviews, focus forums, academic controversies, treatises, short treatises, technical exchanges, case reports, clinical case discussions, ophthalmology management, picture essence, review, continuing education garden, test questions analysis, historical records of Chinese ophthalmology, conference (discussion) minutes, academic trends, discussion of standards and norms, talent exchanges, book reviews, etc. Among them, the manuscripts of expert reviews and continuing education garden are mainly invited manuscripts, while the manuscripts of other columns are free submissions.

The "fast track" paper must be innovative, important and scientific, and the early publication of the paper will have a significant impact on clinical and scientific research work. Requirements for submission of "Fast Track" papers: (1) The author should provide written application materials explaining the reasons why the paper needs to be published through "Fast Track". (2) The author provides the "novelty search report" issued by provincial and above libraries or medical information research institutes. (3) The author provides written recommendations from two well-known experts in the industry with senior professional titles (experts in the author's unit and the author's tutor should avoid),

At the request of the majority of ophthalmologists, the "First Chinese Ophthalmology Young and Middle-aged Forum" sponsored by this journal and co-organized by Ophthalmology Branch of Zhejiang Medical Association will be held in Hangzhou, Zhejiang Province from June 19 to 23, 2009. The content of this forum integrates the rational application of ophthalmic drugs and the promotion of new technologies and new equipment, focusing on comprehensively improving the diagnosis and treatment level of ophthalmologists. At that time, leaders of ophthalmology in China, such as Zhao Kanxing, Yao Ke, Ge Jian, He Shouzhi, Dong Fangtian, Ma Zhizhong, Sun Xinghuai and Liu Guoguo, will be invited to give wonderful speeches.

With the extensive application of excimer laser refractive corneal surgery in clinical practice, more and more ophthalmologists and researchers not only pay attention to the evaluation of its clinical effect, but also focus on the research of its basic theory. In recent years, ophthalmologists have gained rich experience in excimer laser treatment of ocular refractive errors. In order to further promote the development of excimer laser treatment technology,

In clinical work practice, ophthalmologists' understanding of various neuro-ophthalmic diseases is constantly improving. They no longer only focus on local changes in the eye, but pay more attention to its relationship with systemic diseases, especially nervous system-related diseases. Overall observation, diagnosis and treatment. However, because there are still few ophthalmologists engaged in this specialty in China, and they are only concentrated in a few large ophthalmology institutions, and there is still a lack of professional systematic training as a whole, ophthalmologists' insufficient understanding of neuroophthalmology diseases often leads to clinical missed diagnosis and misdiagnosis.

With the development of society and economy, visual quality has obviously affected the quality of life of patients, which is increasingly concerned by the society. The rapid development of science and technology has laid the foundation for the continuous renewal of ophthalmic equipment and drugs, and improved the level of clinical diagnosis and treatment. Bausch & Lomb Eye Surgery Products Company of the United States continues to provide professional medical equipment for ophthalmology clinics. Among them, the excimer laser 217Z100 refractive correction system has a relatively comprehensive individualized treatment technology, and its clinical effect has been recognized by ophthalmologists and patients;

As a journal with strong academic strength and extensive academic influence in ophthalmology in China, in order to better serve the majority of ophthalmologists in China, strengthen clinicians' cognition of various ophthalmology surgical concepts, surgical standards and surgical effects, and thus promote the development and improvement of clinical surgical skills in China, Chinese Journal of Ophthalmology will hold a series of select activities of Chinese Journal of Ophthalmology for ophthalmologists all over the country. The participating materials are surgical videos, and the evaluation committee of the activity is composed of the editorial board of relevant majors of Chinese Journal of Ophthalmology. Based on the principle of fairness and impartiality,

In order to strengthen the academic exchange of ophthalmology at home and abroad, expand the international vision of domestic ophthalmologists, and promote the integration of domestic ophthalmology with international standards as soon as possible, the Health Express Training Network (www.lxlearn.com) has been specially established. The training network will serve all domestic ophthalmologists in the form of public welfare.

conjunctivochalasis is a disease caused by excessive relaxation of the bulbar conjunctiva and/or high tension of the lower eyelid, which causes the relaxed bulbar conjunctiva to accumulate on the eyeball and the lower eyelid margin, and form folds between the medial and lateral canthus, resulting in abnormal lacrimogenesis of the ocular surface, accompanied by symptoms of ocular discomfort (such as tearing, dryness, foreign body sensation, etc.) [1]. Some scholars have found that conjunctivochalasis can cause dry eye with abnormal tear dynamics [2-5], and the change of tear function may play a certain role in the occurrence and development of conjunctivochalasis, but the mechanism is still unknown. Therefore, this study examined the change of tear function in conjunctivochalasis to explore the pathogenesis of conjunctivochalasis.

The patient was a 30-year-old female who came to the Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology on April 23, 2008 due to pain in both eyes, photophobia and tearing, with her right eye for more than 20 days and her left eye for 5 days. The patient had no history of trauma; He had a history of red eye 4 years ago, but the diagnosis and treatment were unknown; Occasionally suffering from rhinitis. More than 20 days ago, the patient had sudden red and swollen right eye, photophobia, tearing, eye pain, sparse secretion, accompanied by sneezing, runny nose and pharyngeal discomfort after activities in the wild without obvious inducement. He was diagnosed as acute conjunctivitis in another hospital, and received antibacterial combined antiviral treatment for 1 week. The symptoms once improved and then aggravated.

A 19-year-old female was found to have erythema on her face for more than 2 years, and her visual acuity was reduced for more than 2 months. She had a history of fever. She was diagnosed as systemic lupus erythematosus (active stage) after general physical examination in the internal medicine department. Ocular examination showed that the visual acuity was 0.6 in the right eye and 1.0 in the left eye; the external eyes of both eyes were normal, the anterior chamber and pupil were normal, and the lens was transparent; For both fundus, see essence pictures 1 and 2. Ophthalmological diagnosis: systemic lupus erythematosus fundus lesions.

non-tuberculous mycobacterial keratitis is an inflammatory lesion caused by non-tuberculous mycobacteria (NTM), mainly multifocal infiltration of the corneal stromal layer. The first case of NTM keratitis was reported by Turner and Stinsont [1] in 1965, and the reports of related cases have been increasing since then. With the widespread development of corneal refractive surgery, especially laser in situ keratomileusis (LASIK), NTM keratitis shows a trend of concentrated occurrence. At present, NTM has become the main pathogenic microorganism (53%) of corneal infection after LASIK [2]. Ophthalmologists should pay close attention to it because of insufficient understanding of this disease, it is often impossible to diagnose in time and delay treatment in clinic.

This issue focuses on ocular surface diseases. Dry eye is a type of multi-etiological disease involving multiple parts of the ocular surface, which affects the patient's vision and quality of life. Although dry eye has attracted the attention of most ophthalmologists, how to accurately diagnose dry eye is still a difficult problem for ophthalmologists. Correct diagnosis of dry eye is the prerequisite for proper treatment. In order to improve the level of diagnosing dry eye in China, this journal invited Pan Zhiqiang to write "Expert Review" and "Concern about the Diagnosis of Dry Eye". The authors review the changes in the definition of dry eye and analyze the current,