2015年 · 第51卷第10期

The patient was a 25-year-old male. Due to abnormal fundus found in physical examination, he went to the Department of Ophthalmology of the 401 Hospital of the People's Liberation Army. No previous symptoms of night blindness, denying the history of close marriage of parents. Eye examination: visual acuity in both eyes 1.5, normal intraocular pressure; No obvious abnormalities were observed in the anterior segment of both eyes; Dilated pupil examination fundus condition seeQuintessence Picture 1。 Objectively, the rapid dark adaptation time was 58 s, which was close to the upper limit of normal value (the normal value range was 6~60 s). No obvious abnormality was found in visual evoked potential and visual field examination. Clinical diagnosis: White dotted fundus in both eyes combined with myelinated nerve fibers in the right eye.

The patient was a 31-year-old female. He went to the Department of Ophthalmology, Affiliated Hospital of Qingdao University because of the decrease of visual acuity in his right eye for 3 years. Eye examination: the visual acuity of the right eye was 0.4, which could not be corrected, and no obvious abnormalities were found in the anterior segment of the eye; The infratemporal branch of the fundus retinal vein runs abnormally and invades the macular area (Essence Picture 1A、Quintessence Picture 1B）。 FFA examination: abnormally running retinal vein without leakage (Quintessence Picture 1C）。 OCT examination is presented inQuintessence Picture 2。 Clinical diagnosis: congenital retinal vascular abnormalities in the macular area of the right eye.

The patient was a 22-year-old male, Pakistani. Because of blurred vision in both eyes for 1 week, he went to the Department of Ophthalmology of Peking Union Medical College Hospital. Previous history of anemia. Eye examination: visual acuity in both eyes was 0.25, which could not be corrected; The intraocular pressure in both eyes was normal, and the refractive interstitial was clear; For both fundus examinations, seeQuintessence Picture 1。 Clinical diagnosis: anemia-associated retinopathy in both eyes.

The 16th National Academic Conference on Strabismus and Pediatric Ophthalmology, sponsored by Ophthalmology Branch of Chinese Medical Association, and hosted by Strabismus and Pediatric Ophthalmology Group of Ophthalmology Branch of Chinese Medical Association and Peking University People's Hospital, will be held in Beijing from October 16 to 18, 2015. This academic conference will invite well-known experts at home and abroad to give academic lectures on basic and clinical research on strabismus, amblyopia, childhood optometry, congenital cataract, congenital glaucoma, infantile vitreoretinal diseases, childhood eye trauma, childhood hereditary eye diseases and childhood eye health care.

The Asian Association of Neuroophthalmology (ASNOS) was founded in 2002 in Tokyo, Japan. The Asian Neuroophthalmology Congress, hosted every two years by the Asian Neuroophthalmology Association, is a large-scale international neuro-ophthalmology conference, representing the highest level of basic and clinical research in neuro-ophthalmology in Asia. In previous conferences, hundreds of neuro-ophthalmology professionals from various countries conducted academic exchanges, introduced and discussed the recent international neuro-ophthalmology new technologies and academic frontiers. The Asian Neuroophthalmology Congress provides an international platform for participants from around the world to exchange ideas on cutting-edge neuroophthalmology research topics, discuss the latest advances and promote future cooperation. in Walsh in Asia, a particularly well-known and important case discussion section of the Asian Congress of Neuroophthalmology, it is very challenging to select outstanding cases with pathological findings from various countries for in-depth analysis.

Compared with general anesthesia, strabismus correction surgery under local anesthesia can complete intraoperative suture adjustment, which significantly improves the success rate of one operation^[1]。 The key of local anesthesia surgery is the inhibition of intraoperative pain. The ideal anesthesia method can not only inhibit the pain caused by pulling muscles during surgery, but also not affect the movement of extraocular muscles. In recent years, people have begun to try strabismus correction under simple topical anesthesia^[2]However, topical anesthetics have difficulty in subconjunctival penetration. Some scholars have combined subconjunctival injection anesthesia or Tenon subcapsular anesthesia to enhance the analgesic effect^[3]However, subconjunctival edema and even subconjunctival hemorrhage caused by subconjunctival anesthesia affect the visual field of surgical operation. However, traditional Tenon subcapsular anesthesia may also cause subconjunctival edema or hemorrhage due to the large dose of anesthetic drugs and the deviation of the administration position, and will also bring restriction of eye movement, which makes it difficult to adjust sutures during surgery^[4]。 We attempted to administer a small amount (1 ml) of 2% lidocaine under the Tenon capsule around the tendon, assisted by topical anesthesia, and achieved good pain suppression effect. On the other hand, monitored anesthesia care (MAC) has been applied to strabismus correction because of its effective sedative and analgesic effects. This has also become our more routine clinical practice. This article compares pain scores under modified Tenon subcapsular + topical anesthesia and MAC + topical anesthesia and is reported below.

The child was a male, 2 years old. Due to the repeated swelling of eyelids 36 days after the welding rod was pierced into the left orbit and removed, he came to the Institute of Orbital Diseases of Armed Police General Hospital on December 10, 2004. The patient was electroded while playing 36 d ago (Figure 1) Through the upper part of the left orbit, the intracranial foreign body was pulled out through the left orbit in the emergency department. He had transient limb mobility disorder and fever after operation, and was admitted to our hospital for treatment after improvement. The physical examination of the whole body showed no significant abnormalities. Eye examination: Left eye vision examination does not cooperate, there is follow-up movement. Soybean-sized breakage and scabs on the middle of the upper eyelid. The eye position is right, the upward rotation of the eyeball is limited, and the movement in other directions is in place. Exophthalmos: right eye 11 mm, left eye 16 mm, orbital distance 86 mm. Orbital CT showed a large number of high-density shadows scattered in the upper part of the orbit, surrounded by soft tissue density shadows, local bone absence at the roof of the orbit, and high-density shadows scattered in the cranium, forming a cord shape (Figure 2）。 Admission diagnosis: left orbit and intracranial foreign body residual; Postoperative removal of left orbital and intracranial foreign bodies. On December 21, 2004, the left orbital foreign body was removed under general anesthesia. During the operation, the orbital septum of the upper eyelid was cut open. The granulation tissue was organized and wrapped in the upper part of the orbit, and yellow-green pus flowed out from the organized membrane. There were more than 10 pieces of gray-black hard foreign bodies in detritus, of different sizes, which were considered to be the shedding of welding electrode coating (Figure 3）。 After removing the intraorbital foreign body, the localized absence of the orbital parietal bone was observed. In order to avoid damage to the intracranial structure or secondary cerebrospinal fluid leakage, no exploration was made above the orbital parietal bone. Postoperative orbital CT revealed a few granular high-density shadows at the top of the left orbit, and the intracranial foreign body shadows were the same as before operation. The postoperative recovery was good, the exophthalmos was 11 mm in the right eye, 12 mm in the left eye, the orbital distance was 86 mm, and the edema at the macula of the fundus resolved.

The traditional view is that lacrimal duct calculi are rare in clinic, and are easily misdiagnosed and misdiagnosed^[1,2]。 In recent years, with the application of lacrimal duct endoscope^[3]People' s understanding of lacrimal duct stones is deepening, and the literature reports on lacrimal duct stones are increasing obviously, and there are literature studies on its pathogenesis factors^[4,5]It is reported, but it is clinically rare for older siblings to suffer from lacrimal canalicular stones successively. We treated two cases, and the report is as follows.

The patient was a 77-year-old female. On July 23, 2013, he was admitted to the local hospital due to a car accident injury in his left eye for 1 day. The patient was admitted to the hospital with clear consciousness and answered the questions. He reported that he was injured in a car accident 1 d before admission. At that time, he suffered multiple deep lacerations on his face and completely lost his vision in his left eye, and was diagnosed as facial avulsion injury. Damage to the left eyeball. After debridement and suture of facial avulsion, he was transferred to the ophthalmology department of Lanzhou General Hospital of Lanzhou Military Region for treatment. The patient denied trauma to other parts of the body, and denied family history and genetic history.

This issue focuses on clinical and basic research related to ocular immunity. The responsible editorial committee responsible for the planning, composition and review of this issue is Professor Yang Peizeng.