目的：研究短时间内大量摄入咖啡因对健康成年人眼表泪膜动力学的影响。方法：受试者为12名健康的成年人(20~30岁)，没有既往眼表疾病史。受试者在恒定的常规条件下摄入5.0 mg/kg咖啡因(取咖啡粉剂按浓度预调)。在摄入咖啡因前后2 h进行泪膜参数评估和泪液收集。受试者接受了泪河高度、泪膜破裂时间、Schirmer I试验、眼压和平均脂质层厚度的测量。结果：摄入大量咖啡因后，泪河高度、泪膜破裂时间和眼压的检测值显著增加，而平均脂质层厚度的检测值与摄入咖啡因之前相比显著下降。摄入咖啡因后，Schirmer试纸收集的泪液量改变无明显统计学意义，未观察到咖啡因对泪液分泌的影响中的性别差异。结论：在大量摄入咖啡因后，眼表泪液动力学发生显著改变且咖啡因可以刺激健康的非干眼受试者的泪液分泌。

Objective: To investigate the effects of high caffeine intake in a short period on tear film dynamics in healthy adults. Methods: The participants were 12 healthy adults (20–30 years old) with no history of ocular surface disease. Participants were given 5.0 mg/kg caffeine (preset the coffee powder according to the concentration)under constant routine conditions. Tear film parameters were assessed and tear collection was performed 2 h before and after caffeine intake. The tear meniscus height, non-invasive tear break-up time, Schirmer I test, intraocular pressure and average lipid layer thickness were all measured after a large amount of caffeine intake. Results: The tear meniscus height, non-invasive tear break-up time and intraocular pressure were significantly increased after caffeine intake, while the average lipid layer thickness was significantly lower than that before caffeine intake. The amount of  tear fluid collected by Schirmer’s I test paper was not statistically significant, and there was no gender difference in the effects of caffeine on tear secretion. Conclusion: After high caffeine intake, ocular tear dynamics are significantly altered and caffeine can stimulate tear secretion in healthy, non-dry-eyed subjects.

    霍纳综合征是一种由眼交感神经传出通路中任意部分中断所造成的临床综合征，常以上睑下垂、瞳孔缩小等眼部特征为主要临床表现，往往提示头、颈或胸部严重疾病或术后并发症的发生。现报告1例49岁的男性患者，曾在武汉市中心医院耳鼻喉科行右侧咽旁间隙肿物切除术，术后第1天出现右眼上睑下垂，瞳孔缩小，伴同侧面部无汗。术后随访半年，上述症状未见明显改善。右侧咽旁间隙肿物的病理结果证实为交感干神经鞘瘤，该病例临床较为罕见。

Horner syndrome is caused by damage of the oculosympathetic pathway. It is a common disorder characterized by ocular signs such as ptosis and miosis, and these signs usually indicate the occurrence of severe head, neck and chest diseases or surgical complications. We report a case of 49-year-old male patient who underwent parapharyngeal space tumor resection in the Department of otolaryngology. On postoperative day one, the patient presented right eyelid drooping, the right pupil constricted, and the absence of sweating on the right side of the face.  After six months of follow-up, the above signs still presented and showed no significant change. T??he pathological assessment of the resected parapharyngeal space tumor demonstrated that it is the sympathetic trunk schwannoma, which is relatively rare in clinical practice.