Docstoc

clincal report

Document Sample
clincal report Powered By Docstoc
					CLINICAL SERVICES REPORT 2005
                                The knowledge explosion in the past two decades has helped
                                ophthalmologists gain new insights in the understanding and
                                treatment of ocular diseases. This branch of medical sciences has
                                evolved into a truly multi disciplinary speciality. It would be practi-
                                cally impossible for general ophthalmologists to keep abreast of all
                                recent developments in treatment of eye diseases. The emergence of
                                tertiary eye care centres like the Aravind Eye Care System with
                                ophthalmologists trained in subspecialities is truly relevant in
                                providing a holistic approach to eye care service delivery. Aravind
                                continues to provide immense career opportunities for young
                                ophthalmologists in the realms of training, education and research
                                in ophthalmology. With an ageing population, incidence of diseases
                                like glaucoma, diabetic retinopathy and age related macular
                                degeneration is expected to be on the increase and Aravind is
                                poised to train the ophthalmic manpower to optimally utilise the
                                available resources and infrastructure to tackle avoidable blindness
                                from these causes. Although the thrust in the near future would be
                                on combating blindness from many of these diseases of the
                                posterior segment, Aravind will continue to lay stress on community
                                outreach and preventive ophthalmology. Eye Screening in Schools
                                to prevent and treat ocular morbidity in children and training mid-
                                level ophthalmic personnel to man the Vision Centres to cater to the
                                primary eye care needs of the community would continue to
                                receive utmost priority at Aravind. With its mission to
                                eliminate needless blindness by providing
                                appropriate, compassionate and high quality eye care
                                to all, Aravind renews its commitment to play a
                                major role in realising the objectives of the
                                global initiative VISION 2020 – The Right to
                                Sight.

                                Dr. M. Srinivasan
                                Director, Aravind Eye Hospitals
                                & Postgraduate Institute of
                                Ophthalmology




                                                                                                     1
2
ARAVIND EYE HOSPITALS
& POSTGRADUATE INSTITUTE OF OPHTHALMOLOGY

Madurai, Theni, Tirunelveli, Coimbatore, Pondicherry




Clinical Services Report 2005
Cataract & General Ophthalmology Services                6
Glaucoma Services                                        13
Paediatric Ophthalmology and Adult Strabismus Services   19
Cornea and Refractive Surgery Services                   26
Retina and Vitreous Services                             29
Uvea Services                                            37
Orbit and Oculoplasty Services                           39
Neuro-ophthalmology Services                             42
Vision Rehabilitation Services                           44
Laboratory Services                                      47




                                                              3
ARAVIND EYE HOSPITALS PERFORMANCE 2005
In 2005, across all Aravind Eye Hospitals, 1,721,898 outpatient visits were handled, while 247,235 surgical and
laser procedures were performed. Eye Camps have been productive as a strategy for bringing in patients, and
they account for 437,224 patients examined and 97,292 patients operated in 2005.




                                            MADURAI TIRUNELVELI      THENI COIMBATORE      PONDY       TOTAL
OUT PATIENT VISITS
     Paying                                   330,913      171040 54,427        234,935   137,470     928,785
     Free (Direct & Camp)                     274,304     134,506 49,127        217,928   117,248     793,113
     Total Out Patient visits                 605,217     305,546 103,554       452,863   254,718   1,721,898
SURGERIES
     Paying                                    42,341      14,170    2,961       22,930    10,732     93,134
     Free (Direct & Camp)                      61,734      22,842    7,326       40,472    21,727    154,101
     Total Surgeries                          104,075      37,012   10,287       63,402    32,459    247,235
CAMPS                                             368         250       91          382       244      1,335

Surgery Details
Cataract Surgery
  (ECCE) & Other Procedures without IOL         1,047         363      306          888       744      3,348
  (ECCE) & Other Procedures with IOL           72,094      26,968    8,213       44,576    23,740    175,591
Total Cataract Surgeries                       73,141      27,331    8,519       45,464    24,484    178,939
Trabeculectomy & Combined Procedure             2,458         919       20        1,172       510       5079
Retina & Vitreous Surgery                       1,572         204        1        1,095       306      3,178
Squint Correction                                 768         105        0          231        68      1,172
Keratoplasty                                      397          37        0          240        71        745
Pterygium                                         695          89       41          549       267      1,641
Ocular Injuries                                   261         110        2          405       134        912
Lacrimal Surgeries                              2,351         789      229          752       834      4,955
Other Orbit & Oculoplasty Surgeries             2,871         604      151        1,292       607      5,525
Others                                          2,762         566      206        2,448     1,221       7342
Laser Procedures                               15,437       6,026    1,118        9,354     3,957     35,892
LASIK Refractive Surgery                        1,362         232        0          400         0      1,994
TOTAL                                         104,075      37,012   10,287       63,402    32,459    247,235




4
OUTPATIENT VISITS (1976-2005) SURGERIES (1976-2005)




                                                      5
CATARACT & GENERAL OPHTHALMOLOGY SERVICES




Dr. Haripriya performing cataract surgery at Aravind-Madurai


                                             Being the largest provider of eye care services, and cataract being the
                                             major cause of blindness in India, the cataract & IOL Services cater to the
                                             vast majority of Aravind patients. In 2005, the services across all five
                                             hospitals have performed about 180,000 cataract surgeries.
                                                  In 1993, Aravind pioneered the setting up of a centre where practising
                                             ophthalmologists can come for training to transition from intracapsular to
                                             extracapsular cataract extraction with IOL implantation technique. The
                                             large volume and state-of-the-art infrastructure attracts ophthalmologists
                                             around the world for this training programme. So far a total of 1,166
                                             ophthalmologists have received training in ECCE/SICS with IOL implanta-
                                             tion. Today the transition is from extra capsular cataract extraction to
                                             Phacoemulsification. The Aravind Eye Hospital in its endeavour to train
                                             practicing ophthalmologists in this technique started a Phacoemulsification
                                             training programme. Now the training is offered by Aravind Eye Hospitals
                                             at Madurai, Tirunelveli, Coimbatore and Pondicherry.
                                                  The cataract and IOL Services function as an independent unit at
                                             Aravind-Madurai whereas in Aravind Eye Hospitals at Theni, Tirunelveli,
                                             Coimbatore and Pondicherry, it is part of the General Ophthalmology
                                             Services.

PERFORMANCE 2005
OUTPATIENT VISITS

Madurai                                      Theni, Tirunelveli, Coimbatore & Pondicherry (Cataract & General Ophthalmology)
Paying: Cataract      - 76,680                           Theni          Tirunelveli          Coimbatore Pondicherry
General Ophthalmology - 143,532              Paying        54,427        73,397             160,706            137,466
Free (Direct & Camp) - 274,304               Free          49,127        45,340              99,322             44,363


CATARACT SURGERIES
                                      Madurai             Theni        Tirunelveli       Coimbatore          Pondicherry
Paying                                   18,854                1,856      7,274              10,626              5,724
Free (Direct & Camp)                     54,287                6,663     20,057              34,838             18,760
Total Surgeries                          73,141                8,519     27,331              45,464             24,484


6
7
Cataract Retreat team
                                                    In order to standardise clinical care, surgical interventions as well as
                                               training and education, a cataract retreat was organised by the cataract
                                               Services at Madurai and co-facilitated by the Human Resource
                                               Department. The retreat brought together the entire key personnel of the
                                               cataract services across all five hospitals. The cataract retreat was con-
                                               ducted on July 30th & 31st 2005 and the follow up meet on August 21st at
                                               Aravind-Madurai. The meeting also facilitated discussions regarding
                                               possible clinical and epidemiological research.


                                               TRAINING PROGRAMMES
                                               LONG TERM IOL MICROSURGERY TRAINING
                                               This course was started in the year 1989. The course is offered at
                                               Aravind- Madurai, Tirunelveli, Coimbatore, and Pondicherry. The duration
                                               of the course is twenty-four months. Twenty four (8 Madurai, 6
                                               Pondicherry, 6 Coimbatore, 4 Tirunelveli) candidates are recruited each
                                               year. In addition this fellowship also offers training in orbit and oculoplasty
                                               surgery. Totally eighteen (Thirteen from Madurai and five from
                                               Coimbatore) ophthalmologists were trained in 2005.

                                               SHORT TERM IOL MICROSURGERY TRAINING
Dr. Apoorva Sharma examining a patient in
the Cataract Services at Aravind-Tirunelveli   There are only a few centres where the practising ophthalmologists can
                                               undergo training for transition from intracapsular to extracapsular cataract
                                               extraction with IOL implantation technique. In order to meet this training
                                               need, Aravind established short term microsurgery training in June 1993 to
                                               provide a structured and high quality training course for ECCE/IOL
                                               surgery. Till date 983 candidates have been trained at Aravind Eye Hospitals
                                               - Madurai, Tirunelveli, Coimbatore and Pondicherry.


8
9
In the year 2005, 150 ophthalmologists
have undergone one of the above
trainings across all Aravind Eye Hospitals.




At the Wet lab at Aravind-Coimbatore


                                              Manual Small Incision Cataract Surgery
                                              Started in March 2003, Manual SICS provides the ideal stepping stone for
                                              mastering Phacoemulsification. So far around 140 candidates have been
                                              trained in SICS at Aravind Eye Hospitals - Madurai, Tirunelveli and Coim-
                                              batore.

                                              Phacoemulsification
                                              The aim of this training programme is to train candidates in
                                              Phacoemulsification surgery as well as in understanding the technology
                                              behind the functioning of the Phacoemulsification equipment. The candi-
                                              date initially performs Phacoemulsification on goat’s eye with a human
                                              nucleus in a well equipped wet lab. Each candidate gets to do a few
                                              temporal Manual SICS and a good number of Phacoemulsification surger-
                                              ies during this course. Phacoemulsification training programme was started
                                              in March 2005 at Aravind-Madurai. Now the course is offered at Aravind-
                                              Coimbatore, Tirunelveli, and Pondicherry. Each centre trains around 2
                                              candidates per month. Till date Aravind has trained 43 candidates in
Short-Term IOL trainees at the inauguration
                                              Phacoemulsification.
of wetlab at Aravind-Tirunelveli
                                              ONGOING RESEARCH STUDIES
                                              •   Study to evaluate the Acrysof IQ IOL
                                              •   Visual experience during cataract surgery under topical anaesthesia
                                                  with and without preoperative counselling
                                              •   Bimanual Phacoemulsification in Posterior Polar Cataract
                                              •   Long term outcome of CTR in eyes with zonular loss
                                              •   To evaluate the incidence and outcome of late post-op iritis
                                              •   Visual outcome following cataract extraction for traumatic cataracts –
                                                  Retrospective Study
                                              •   To evaluate the surgical outcome of trainee surgeons in
                                                  Phacoemulsification and the efficacy of the training programme
                                              •   Incidence of PCO in high myopia
                                              •   To evaluate the use of flexible iris hooks in performing capsulorhexis
                                                  in subluxated cataracts
                                              •   Learning curve SICS, Phaco
                                              •   Participation in multicentric trial of FSM IOL


10
ARTICLES PUBLISHED IN PEER                        CONFERENCES ATTENDED ELSEWHERE
REVIEWED JOURNALS                                 Phacoemulsification Conference             DR. ANAND DEV
                                                  Bangalore, January 2005                    - SICS in Difficult Situations
BRITISH JOURNAL OF OPHTHALMOLOGY                                                             DR. VENKATESH
                                                  DR. ARAVIND SRINIVASAN                     - Microphacoemulsification Complica-
VOL: 89 (9) 2005 SEP. P.1079-1082                 - Learning Bimanual                            tions
VENKATESH, R; MURALIKRISHNAN, R; BALENT, LC;           Phacoemulsification                   DR. SHIVAKUMAR
KARTHIK, P; PRAJNA, NV                            - Phacoemulsification Dynamics             - Visual outcome and complications of
- Outcomes of High Volume Cataract                DR. R.D. RAVINDRAN                             SICS
    Surgeries in a Developing Country             - Learning Phacoemulsification
                                                                                             Fifth International Congress of
VOL: 89 (10) 2005 OCT. P.1386                     63rd All India Ophthalmological Society
                                                                                             Ophthalmologists and Optometrists of
EONG, K-G AU TAN, C S H; ANG, C L; LEE, S S; G;   Conference
VENKATESH, R; MURALIKRISHNAN, R; FANNING, G L;    Bhuvaneshwar, Orissa, January 13-16        China (COOC 2005)
KUMAR, C M                                                                                   Shanghai, China, April 8-11
                                                  High Volume, High quality, Cost -
- Intraoperative Visual Experiences of            effective Small Incision Cataract          DR. R. RAMAKRISHNAN
    Cataract Patients can be Both Pleasant        Surgery- Instruction Course                - Aravind Management
    and Unpleasant                                                                           - SICS technology – Aravind Method
                                                  DR. G. NATCHIAR
INDIAN JOURNAL OF OPHTHALMOLOGY                   - Relevance of SICS
                                                  DR. USHA KIM
VOL: 53(3) 2005 SEP. P. 173-176                   - Tunnel Construction and Capsulorhexis
VENKATESH, R; MANORANJAN, D; PRASHANTH, S;        DR. HARIPRIYA ARAVIND
MURALIKRISHNAN, R                                 - SICS in Challenging Situations
- Manual small incision cataract surgery          - Nocardia Endophthalmitis following
    in eyes with white cataracts                       cataract surgery
                                                  DR. R. RAMAKRISHNAN
OPHTHALMOLOGICA                                   -     Nucleus Management in SICS
VOL: 219(6) 2005. P. 416                          DR. C.SHIVAKUMAR
TAN CS, AU EONG KG, KUMAR CM, RENGARAJ V,         - Complications of SICS (at the SICS
RADHAKRISHNAN M                                        symposium)                            Dr. R. Ramakrishnan at the COOC 2005 in
- Fear from visual experiences during             - Visual outcome following                 China
    cataract surgery                                   Phacoemulsification for complicated
                                                       cataracts secondary to intermediate   Recent Vision Enhancement and
AMERICAN JOURNAL OF                                    uveitis
                                                  DR. VENKATESH                              Advancement League
OPHTHALMOLOGY                                     - Instruction course on Manual SICS        Fisherman’s Cove Meeting, Chennai,
VOL: 139(5) 2005 MAY. P. 837-46.                  - Nucleus Prolapse in Manual SICS          May 21-22
HARIPRIYA, A; LALITHA, P; MATHEN, M; PRAJNA,           Symposium                             DR. HARIPRIYA ARAVIND
NV; KIM, R; SHUKLA, D; NATCHIAR, G;                                                          - Science behind Acrysof Natural IOL
SRINIVASAN, M                                     3rd Sumatera Ophthalmology Meeting
- Nocardia endophthalmitis after                  Medan, Indonesia, February 24–25           Lumbini Eye Hospital Planning Workshop
     cataract surgery:                            DR. VENKATESH                              Lumbini, Nepal, June
     clinicomicrobiological study                 - Manual SICS - Instrumentation & Steps    DR. VENKATESH
                                                  - Manual SICS - Difficult Situations
JOURNAL OF CATARACT & REFRACTIVE                  - Learning Bimanual Phaco
                                                                                             – Quality Assurance in Cataract Surgery
SURGERY                                           - Newer Phacoemulsification Technolo-      First Indo Israel Ophthalmology Meet
VOL: 31 (6) 2005 JUN. P.1085-1086                      gies
                                                                                             Chennai, November 19-20
VENKATESH, R; VEENA, K; THIRUVENGADAM , K
                                                                                             Symposium on Manual SICS - Aravind
- Cortical Removal Simplified by J-
                                                                                             Technique
    Cannula Irrigation
                                                                                             DR. HARIPRIYA ARAVIND
RENGARAJ V, MURALIKRISHNAN R, AU EONG KG                                                     - Manual SICS in Challenging Situations
VOL: 31 2005 OCT. P. 1855- 1856                                                              DR. R.D.RAVINDRAN
-   Visual sensation during                                                                  - Steps of Manual SICS
    phacoemulsification using topical                                                        DR. VENKATESH
    versus regional anaesthesia                   Dr. Venkatesh at the Third Sumatera        – Visual Results of Manual SICS
                                                  Ophthalmology Meeting in Indonesia         DR. SHAMIT MEHROTRA
                                                                                             - Long term outcome of CTR in adult
                                                  53rd Annual conference of the TNOA-             cataract surgery (Poster)
                                                  sight@height 2005                          DR. VYANKATESH PHARANDE
                                                  Kodaikanal, August 12-14                   - Incidence of Spontaneous dislocation
                                                  DR. HARIPRIYA ARAVIND                           of IOL and Comparison of prevalence
                                                  - Fluidics in Bimanual                          of systemic complications in PXF
                                                                                                  patients (poster)
                                                      Phacoemulsification
                                                                                                                                    11
STAFF - CATARACT SERVICES   MEDICAL OFFICERS                  FELLOWS
                            ARAVIND - MADURAI                 ARAVIND - MADURAI
                            DR. HARIPRIYA ARAVIND             DR. VYANKATESH PHARANDE
                            DR. ANAND DEV                     DR. NOLETTE MARIA
                            DR. KAVITA VADI                   DR. NAVEEN GUPTA
                                                              DR. SHAMIT MEHROTRA
                            ARAVIND - TIRUNELVELI             DR. ANANT VIR JAIN
                            DR. C. SHIVAKUMAR                 DR. ASHUTOSH KHANDELWAL
                            DR. APOORVA SHARMA                DR. PRAJAKTHA
                            ARAVIND - COIMBATORE              DR. MANJUNATH
                            DR. KALPANA NARENDRAN             DR. REENA
                            DR. KAVITHA YUVARAJAN             DR. CHANDRAKANTH REDDY
                            DR. PADMA                         DR. SUMIT RASTOGI
                            DR. SRI SHANKAR                   DR. SHARAD KUMAR
                                                              DR. SYED SAMARA
                            ARAVIND - PONDICHERRY
                            DR. R.D. RAVINDRAN
                                                              ARAVIND - TIRUNELVELI
                            DR. R. VENKATESH                  DR. SADHASIVAM
                            DR. K. TIRUVENGADAKRISHNAN        DR. XIOJEN HAO
                            DR. K. VEENA                      DR. HARINDRA PAUL SINGH
                            DR. T. THIRUMALAIKUMAR            ARAVIND - COIMBATORE
                            DR. SHARAD JOSHI                  DR. E.V. SUMESH RAY
                            DR. EZHILVADANI                   DR. NIKHIL GUPTA
                            DR. KAVITHA                       DR. SANDEEP PAL BANSAL
                            DR. MANJU
                            DR. SAMUEL CORNELIUS GNANADURAI   ARAVIND - PONDICHERRY
                            DR. T. VIJAYAPRIYA                DR. BADRINATH TALWAR
                            DR. K. NIRMALA DEVY               DR. GOPI P.
                            DR. BADRINATH TALWAR              DR. GURTEJ PAL SINGH RANDHAWA




STAFF - GENERAL             MEDICAL OFFICERS                  ARAVIND - TIRUNELVELI
                                                              DR. MANEKSHA
OPHTHALMOLOGY SERVICES      ARAVIND - MADURAI                 DR. PADMAVATHY
                            DR. G. NATCHIAR                   DR. APOORVA SHARMA
                            DR. S. ARAVIND                    DR. LIONAL RAJ
                            DR. ILANGO
                            DR. PRAVEEN KRISHNA               ARAVIND - COIMBATORE
                            DR. S. MAHESH KUMAR               DR. SANJAY JACOB MALAYIL
                            DR. KAMAL PREET                   DR. MAHESH
                            DR. KOWSALYA
                            DR. G. SEETHAPATHY                ARAVIND - PONDICHERRY
                            DR. DEEPAK AGARWAL                DR. R.D. RAVINDRAN
                            DR. PAMONA                        FELLOWS
                            DR. S. VIDYA
                            DR. RUPA                          ARAVIND - PONDICHERRY
                                                              DR. PUNITH KUMAR
                            ARAVIND - THENI                   DR. GAYATHRI
                            DR. DIPANKAR DATTA
12
GLAUCOMA SERVICES




Dr. R. Ramakrishnan, Chief Medical Officer, Aravind-Tirunelveli examining a patient at Aravind-Tirunelveli


                                                The Glaucoma Services have registered about 10-15% overall growth in
                                                its outpatient and surgery services across all the hospitals over the past
                                                year. In the research front, the Indian National Glaucoma Treatment Trial
                                                had randomised a little over 350 patients and preliminary results are being
                                                analysed. The study, conducted in collaboration with Wilmer Eye Institute,
                                                aims to compare the initial medical and surgical treatment on outcome of
                                                glaucoma and vision related quality of life. Preliminary results have been
                                                submitted for possible presentation at the ARVO this year. As outcome of
                                                the Indo-US joint research group meeting, two grant proposals have been
                                                submitted - Organ perfusion study to assess newer drugs likely to influence
                                                aqueous outflow and study of the role of statins in prevention of glaucoma
                                                progression. Our work on Helicobacter pylori infection in glaucoma
                                                received recognition as the best poster in the first Indo-Israel Ophthalmol-
                                                ogy conference held in Chennai. With the glaucoma services poised for
                                                significant growth in patient services, research and training, a need based
                                                assessment of human and other resources are planned. A Glaucoma Con-
                                                sensus group meeting of all the consultants in glaucoma is to be held to
                                                evolve standardised norms for patient care and education and training.


Automated Visual Field Analyser                 PERFORMANCE 2005
                                                                              Madurai        Tirunelveli     Coimbatore   Pondy
                                                Outpatient Visits
                                                Paying                         35,960          29,203         29,444      10,989
                                                Free                            6,066           4,452          7,585       2,061
                                                Total Outpatient Visits        42,026          33,655         37,029      13,050
                                                Surgeries
                                                Paying                          1,354              520           930        261
                                                Free                            1,085              380           476        186
                                                Total Surgeries                 2,439              900          1406        447




                                                                                                                               13
14
                                              TRAINING PROGRAMMES
                                              Both the short term and long term fellowship in glaucoma is offered at
                                              Aravind-Madurai, Tirunelveli and Coimbatore.

                                              Long Term Fellowship Programme
                                              The course was started in 1992. Three candidates are recruited for this
                                              course every year. This course offers wide exposure to diagnosis and
                                              management of all clinical types of glaucoma.
                                              Total No. of Ophthalmologists trained in 2005 – 9

                                              Short Term Fellowship Programme - Diagnosis and Management of Glaucoma
Dr. Manju R. Pillai with the fellows in the   This course offers an intensive training in diagnostic methods and a limited
Glaucoma Services at Aravind-Madurai          hands on experience in laser and surgical techniques. It is open to all
                                              practicing ophthalmologists and postgraduates in ophthalmology. Four
                                              candidates are recruited each month.
                                              Total No. of Ophthalmologists trained in 2005 – 49

                                              ONGOING RESEARCH STUDIES
                                              -   Randomised Clinical Trial and study on Vision related QOL of Medical
                                                  and Primary Surgical Therapy in POAG with and without cataracts-
                                                  The India National Glaucoma Treatment Trial (INGOTT).
                                                  Collaboration: Johns Hopkins’ University, USA
                                              -   “A Twelve-week, Multicenter, Double-masked, Parallal Group,
                                                  Primary Therapy Study of the Safety and Efficacy of BETOPTIC®S
                                                  0.25% Compared to Timolol Gel Forming Solution 0.25% and 0.5% in
                                                  Paediatric Patients with Glaucoma or Ocular Hypertension.”
                                              -   “A Twelve-week, Multicenter, Double-masked, Parallal Group,
                                                  Primary Therapy Study and Efficacy of BETAXONTM 0.5% compared
                                                  to AZOPT® 1% in Paediatric Patients with Glaucoma or Ocular
                                                  Hypertension.”
                                              -   “A Multicenter, Open label, Non-comparative study of the Efficacy
                                                  and Safety of 0.2% Brimonidine Tartarate 0.5% Timolol Ophthalmic
                                                  Combination Bid in Patients with Elevated IOP on Monotherapy.”
                                              -   Aqueous and Serum H Pylori Antibodies in POAG and Exfoliative
                                                  glaucomas.
                                              -   Correlation of RNFL thickness by OCT with visual fields by achro-
                                                  matic perimetry in POAG (Primary Open Angle Closure)
                                              -   RNFL thickness measurements by OCT in early POAG and Glaucoma
                                                  suspects with Normal SWAP
                                              -   Macular Volume thickness by OCT in Glaucoma Suspects and POAG
                                              -   Correlation of central corneal thickness with visual field abnormalities
                                                  in POAG
                                              -   Ultrasound Biomicroscopy Study in Spherophakia
                                              -   Risk factors for failure of Glaucoma filtering surgery
                                              -   Safety and Efficacy of Mitomycin C and 5 flurouracil in glaucoma
                                                  filtering surgery.
                                              -   Optic disc morphometry
                                              -   RNFL thickness in South Indian adults by OCT
                                              -   Central corneal thickness in South Indian population
                                              -   RNFL thickness in POAG, OHT and Glaucoma suspect by OCT

                                                                                                                        15
-    Comparative analysis of phaco trab with SICS trab - a 5 years follow up
-    Long term results of trabeculectomy with MMC in congenital glaucoma
-    Central corneal thickness in paediatric population
-    Effect of topical dorzolamide on CCT
-    Primary trabeculectomy – an analysis
-    Long term effect of trabeculectomy with MMC
-    Success of trabeculectomy in POAG and PACG


ARTICLES PUBLISHED IN PEER                        CME PROGRAMMES CONDUCTED AT ARAVIND
REVIEWED JOURNALS                                 GLUCONS 2005 - Glaucoma CME on Newer Trends & Surgical Management
                                                  Aravind-Coimbatore, June 11-12
GLAUCOMA
VOL: 14 (2) 2005 APR. P.128-134
                                                  Over 150 delegates participated in the conference. Dr. Alan L. Robin from
MANSBERGER, STEVEN L JOHNSON, CHRIS A;            Wilmer Eye Institute, USA, Dr. V. Velayutham from RIO, Govt.
CIOFFI, GEORGE A; CHOI, DONGSEOK; KRISHNADAS, S   Ophthalmic Hospital, Chennai, Dr. L. Vijaya, from Sankara Nethralaya
R; SRINIVASAN, M; BALAMURUGAN, V; USHA, K;        Chennai, and Dr. Sridhar B. Rao, from Su-Darshan Eye Hospital, Chennai
SMITH, SCOTT D; WILKINS, JOHN H; GRITZ, DAVID C
- Predictive Value of Frequency Doubling          were the Guest Faculty. The Aravind faculty was comprised of
     Technology Perimetry for Detecting           Dr. R. Ramakrishnan, Dr. SR. Krishnadas, Dr. Sathyan, Dr. Venkatesh,
     Glaucoma in a Developing Country
                                                  Dr. Sundaresan, Dr. Michael, Dr. Mohideen, Dr. George, Dr. Sharmila and
WORLD GLAUCOMA CONGRESS                           Dr. Ganesh V. Raman.
July 2005; Abstract number P317
VENKATESH R, SATHYAN P, AU EONG KG
- Visual experience during
    phacoemulsification-trabeculectomy
    under peribulbar anaesthesia

INVESTIGATIVE OPHTHALMOLOGY AND
VISUAL SCIENCE
VOL: 46(7) 2005 JULY .P. 2308-12
NIRMALAN PK, TIELSCH JM, KATZ J, THULASIRAJ
RD, KRISHNADAS SR, RAMAKRISHNAN R, ROBIN AL
- Relationship between Vision Impair-
    ment and Eye Disease to Vision-               Dr. Venkatesh, Dr. Ganesh V. Raman, Dr. Sathyan and Dr. Surjit with Dr. Alan Robin at
    Specific Quality of Life and Function in      GLUCONS 2005
    Rural India: The Aravind Comprehen-
    sive Eye Survey
                                                  Dr. S.R. Krishnadas, Dr. R. Ramakrishnan and Dr. Sathyan at GLUCONS 2005
INDIAN JOURNAL OF OPHTHALMOLOGY
VOL: 53(3) 2005 SEP.P. 187-191
RAMAKRISHNAN R, KADER MA, BUDDE WM
- Optic disc morphometry with optical
   coherence tomography: Comparison
   with planimetry of fundus photo-
   graphs and influence of parapapillary
   atrophy and pigmentary conus

BRITISH JOURNAL OF OPHTHALMOLOGY
(ONLINE ISSUE)
VOL: 89 (12) DEC 2005
G SINGH, K MYINT, P SATHYAN, S MON, R
MANIKANDAN, B DHILLON
- Subtenons infection by Dirofilaria
    repens (video)




16
CME PROGRAMMES ATTENDED ELSEWHERE
63rd All India Ophthalmological Society      Ahmedabad Ophthalmological Society          Visakha Ophthalmic Association
Conference 2005                              Ahmedabad, July 2-3                         Visakhapattinam, August 21
Bhuvaneshwar, Orissa, January 13-16          DR. P. SATHYAN                              DR. MOHIDEEN ABDUL KADER WAS INVITED AS A
                                             - Medical management,Target IOP,            GUEST
DR. S.R. KRISHNADAS
                                                  Visual fields                          - Use of OCT in Glaucoma management
- Steroid Induced Glaucoma (Instruction
     Course on Common Problems in                                                        The meeting was arranged by Carl-
     Glaucoma)
                                             World Glaucoma Congress 2005                Zeiss, India.
- Newer Perimetry techniques (Sympo-         Vienna, Austria, July 6-9
     sium on Newer trends in Glaucoma)       DR. VENKATESH
- Central Corneal Thickness in Glaucoma      – Visual Experience in Phaco Trabeculec-
     (Free Paper)                                 tomy (Poster Presentation)
DR. R. RAMAKRISHNAN                          Dr. R. Ramakrishnan represented
Organised National Symposium                 Glaucoma Society of India in inaugural
- Current concept in Medical treatment       assembly.
     of glaucoma
- Land mark studies in glaucoma – in a
     session on changing paradigms in
     glaucoma management
- Combination therapy in glaucoma                                                        Dr. Mohideen Abdul Kader at the Visakha
     management - Instruction course on                                                  Opthalmic Association meeting
     glaucoma surgery and management
- Nucleus management techniques –
     Instruction course on SICS                                                          Annamalai Alumni Meeting
DR. P. SATHYAN                                                                           Chidambaram, Tamilnadu, September
- Role of central corneal thickness – A
     recent addition in glaucoma diagnosis                                               DR. VENKATESH
     and management                                                                      - Recent Advances in Management of
                                             Dr. Venkatesh and Dr. R. Ramakrishnan at         Glaucoma
Glau-com 2005                                the World Glaucoma Congress in Vienna
Calicut, February 13
                                                                                         Puthiya Parvai Association
                                             Sundaram Medical Foundation CME on          Sankarankovil, October 30
(Organised by Comtrust Eye Hospital)
                                             Glaucoma                                    DR. R. RAMAKRISHNAN
DR. R. RAMAKRISHNAN
                                             Chennai, July 26                            - Common Eye Diseases
- ONH changes in glaucoma
- Primary congenital glaucoma –              DR. VENKATESH
    Diagnosis and Management                 – ONH Changes in Glaucoma                   Focus 2005 - Silver Jubilee Conference of
- Role of OCT in early diagnosis of                                                      Maharashtra Ophthalmological Society
    Glaucoma                                 53rd Annual conference of the TNOA -        Mumbai, November 4-5
DR. P. SATHYAN                               Sight@Height 2005                           Dr. R. Ramakrishnan was invited as a
- Medical management and target IOP          Sterling Holiday Resorts, Kodaikanal,       guest faculty for Maharashtra State
                                             August 12-14                                Ophthalmic Association conference and
Indo US Joint Research Collaborators                                                     he delivered following lectures
                                             DR. SHARMILA
Meeting                                      - Silicon Oil Induced Glaucoma              - Wound healing in glaucoma filtering
Fort Lauderdale, USA, April 29-30            - IOP response to Intravitreal Triamcino-       surgery
Annual meeting of Association of                  lone in Posterior segment diseases     - ONH changes in glaucoma
Research in Vision and Ophthalmology,        DR. RAKHI MEHTA
Fort Lauderdale, USA.                        - Diode Laser cilioablation in Refractory   24th Annual Karnataka State Ophthalmic
                                                  glaucomas in a South Indian Popula-    Conference
DR. S.R. KRISHNADAS
                                                  tion
Moderator- Free Papers session in                                                        Bangalore, November 4-6
                                             - Study of ciliary body abnormalities by
Glaucoma                                                                                 DR. P. SATHYAN
                                                  UBM in Spherophakia
                                             DR. R. RAMAKRISHNAN                         - Visual fields when and why
Mangalore Ophthalmological Society           - Glaucoma management – The future          - Newer glaucoma medications
Meeting                                      DR. P. SATHYAN                              - Management of refractory glaucomas
Mangalore, June 26                           - Overview of glaucoma
DR. P. SATHYAN                               DR. GANESH V. RAMAN
- Prostaglandin’s in glaucoma                - Comparision of GAT, NCT, Tonopen with
    management                                    CCT in glaucoma patients and
                                                  glaucoma suspects
                                             - Followup of paediatric glaucoma
                                                  surgery patients


                                                                                                                                     17
40th Annual Conference of U.P State        AWARDS                              STAFF - GLAUCOMA SERVICES
Ophthalmological Association(UP            •   Dr. Nitin Deshpande was
EYECON)                                                                        MEDICAL OFFICERS
                                               awarded the Best Poster Award
Ghaziabad, November 12-13
                                               for his work on Aqueous         ARAVIND - MADURAI
DR. P. SATHYAN
- Current concepts in medical manage-
                                               Humor and Serum H Pylori        DR. S.R. KRISHNADAS
     ment of glaucoma                          antibodies in POAG and          DR. GEORGE V PUTHURAN
- Visual field analysis in glaucoma            Exfoliative glaucoma in the     DR. MANJU R
First Indo-Israel Ophthalmology Meet           Indo Israel Meeting held in     DR. SHARMILA
Chennai, Tamilnadu, November 19-20             Chennai in November 2005.
                                           •   Dr. Venkatesh was awarded the
                                                                               ARAVIND - PONDICHERRY
DR . NITIN DESHPANDE, DR RAKHI MEHTA
- Aqueous and Serum H Pylori Anti              Travel Grant Award for his      DR. RENGARAJ VENKATESH
     bodies in POAG and Exfoliative
                                               poster on Visual experience     ARAVIND - TIRUNELVELI
     glaucoma
- Study of ciliary body abnormalities by       during phacoemulsification-     DR. R. RAMAKRISHNAN
     UBM in Spherophakia                       trabeculectomy under peribul-   DR. MOHIDEEN ABDUL KADER
DR.MOHIDEEN ABDUL KADER ALSO ATTENDED
                                               bar anaesthesia at the World    DR. NEETU ASHER
Madras City Ophthalmological Association       Glaucoma Congress 2005 held
Chennai, December 11                           in Vienna, Austria.             ARAVIND - COIMBATORE
DR. P. SATHYAN                                                                 DR. P. SATHYAN
- How to manage glaucoma effectively?                                          DR. GANESH. V. RAMAN
- Target IOP                                                                   DR. SURAJITH
Glaucoma Society of India
                                                                               FELLOWS
Annual Meeting 2005
Ahmedabad, Gujarat, December 17-18                                             ARAVIND - MADURAI
DR. VENKATESH                                                                  DR. NITIN DESHPANDE
– Non-Compliance in Medical therapy
DR. RAKHI MEHTA
                                                                               DR. RAKHI MEHTA
- Imaging ciliary zonular abnormalities                                        DR. MONICA
     by UBM in spherophakia                                                    DR. ABDUL WAJITH
- Macular Volume by OCT in POAG and
     Glaucoma Suspects (poster)                                                ARAVIND - TIRUNELVELI
DR. R. RAMAKRISHNAN
- Releasable suture technique                                                  DR. SHOBHANA
- Primary surgery is the way to go                                             DR. RITA SINGH
- Non-penetrating filtering surgery
DR. P. SATHYAN                                                                 ARAVIND - COIMBATORE
- Mitomycin-C trab in limbal Vs fornix                                         DR. PARAG VISHWAKARMA
     based conjunctival flap
- Post V.R surgery glaucoma                                                    DR. VINAY JOSHI
                                                                               DR. MADHURI
Glaucoma Update 2005
Mumbai, December 25
DR. P. SATHYAN
- What is new in glaucoma? An update




18
PAEDIATRIC OPHTHALMOLOGY & ADULT STRABISMUS SERVICES




Dr.Meenakshi in the Paediatric Ophthalmology & Adult Strabismus Services at Aravind-Tirunelveli


                                              The Paediatric ophthalmology services at Aravind-Madurai, Tirunelveli,
                                              Coimbatore and Pondicherry provide comprehensive services to all chil-
                                              dren aged 15 years and below. Recognised as one of the best centres,
                                              patients are referred to the Aravind Paediatric Ophthalmology centres from
                                              all parts of India and neighbouring countries. With support from the
                                              ORBIS International, the Paediatric Ophthalmology Centre at Aravind-
                                              Madurai is emerging as a world class training centre offering comprehen-
                                              sive training in all the fields necessary to practice paediatric ophthalmology
                                              as a team. Towards developing more centres providing quality eye services
                                              to children, the Aravind team is actively involved in identifying potential
                                              hospitals in India and other developing nations and helping them in training
                                              their human resource which include ophthalmologist, orthoptist, nurses,
Dr. Kalpana Narendran performing a            counsellors, and community workers.
surgery on a child’s eye at Aravind-
Coimbatore                                         The WHO-sponsored Aravind Eye Hospital study of Congenital Rubella
                                              Syndrome (CRS) concluded in the year 2005, was the largest prospective
                                              study of CRS conducted anywhere in the world during the past 30 years,
                                              and a huge amount of data has been obtained during the 4 years of the
                                              study. In continuation of this study, a new project has been submitted to
                                              ICMR which has been accepted. Jointly with the Department of Genetics,
                                              the research on congenital cataract and globe anomalies are being carried
                                              out.
                                                   To enhance the learning process, the department is in the process of
                                              developing manuals on common practices on Paediatric cataract, a refer-
                                              ence manual for paediatricians on common eye diseases, and an Handbook
                                              on Orthoptics meant both for Orthoptists and ophthalmologists. Through
                                              ORBIS International, the department is involved in preparing patient
                                              information brochures on common children’s eye diseases for distributing
                                              to all the newly developed centres. Efforts are underway to develop
                                              training video series on counselling and outreach.




                                                                                                                         19
20
Dr. P. Vijayalakshmi and Dr. A. Ravichandar performing surgery on a child’s eye at Aravind-Madurai



                                                 PERFORMANCE 2005
                                                                             Madurai        Tirunelveli Coimbatore       Pondy
                                                 Outpatient Visits
                                                 Paying                       38,723          21,543        29,067       14,337
                                                 Free                          1,416             542         3,781        3,113
                                                 Total Outpatient Visits      40,139          22,085        32,848       17,450
                                                 Surgeries
                                                 Paying                        2,964                 420       420          170
                                                 Free                            921                  94       290           85
                                                 Total Surgeries               3,885                 514       710          255
Dr. Veena examining a paediatric patient at
Aravind-Pondicherry
                                                 TRAINING PROGRAMMES
                                                 Since 2003, training programmes in Paediatric Ophthalmology at Aravind-
                                                 Madurai is offered with support from ORBIS International. Apart from
                                                 this, fellowship in Paeditric ophthalmology is offered at Aravind-
                                                 Coimbatore also.
                                                      To strengthen the Fellowship Programme and the skills of existing
                                                 staff across all Aravind Eye Hospitals, the following hospital based special
                                                 training programmes were offered in 2005 with support from ORBIS
                                                 International.

                                                 Hospital Based Programme (HBP) for Strabismus
Dr. Stephen Kraft in the Paediatric eye clinic
at Aravind-Madurai
                                                 February 6-11
                                                                                              Dr. Stephen Kraft, Professor,
                                                                                              Department of Ophthalmology and
                                                                                              Vision Services, University of
                                                                                              Toronto, Canada was at Aravind-
                                                                                              Madurai to provide a week long
                                                                                              training to the Fellows and Medical
                                                                                              officers in Strabismus Management
                                                                                              with the following objectives:
                                                                                              - to update the junior consultants
                                                                                                   and strengthen them in their
                                                                                                   weaker areas,
                                                                                              - to standardise and strengthen
                                                                                                   the fellowship programme,

                                                                                                                               21
                                               -   to learn the recent developments in the sub speciality and to make
                                                   them more confident in surgical skills.

                                               Hospital Based Programme (HBP) for Retinopathy of Prematurity (ROP)
                                               December 19-23
                                               Dr. Rosalind A. Stevens, Retina/Vitreous Surgeon, Chief of Ophthalmology,
                                               Dartmouth Medical School, Dartmouth-Hitchcock Medical Centre, Leba-
                                               non, New Hampshire, Canada came to provide a week long training to the
                                               Fellows and Medical officers in ROP Management.

                                                    Around 14 participants comprising of medical officers, paediatric
                                               fellows and residents posted in the department participated in the two
                                               programmes. In both the programmes the volunteer faculty detailed case
                                               discussions in the OPD, examined pre-op and post-op patients along with
                                               the Fellows and Consultants. They handled theory classes every day to the
                                               department staff apart from the lectures given for the Residents over
                                               videoconferencing linking Aravind – Madurai with other Aravind centres
                                               located in Pondicherry and Tirunelveli.

                                               Other Visiting Faculty for the fellowship programme
                                               Dr. Robert Peterson, Consultant, Sick Children Hospital, Boston was at
                                               Aravind-Madurai from January 20 – 29. During his visit, he performed and
                                               also assisted Medical Officers and Fellows in strabismus surgeries.
                                               Fellows and Consultants had detailed case discussions relating to Strabis-
                                               mus in the OPD that included both outpatients and also the patients who
                                               underwent surgeries. As part of training, he handled two sessions to the
                                               postgraduate residents on “Vision testing in Children” and “Special forms
                                               of Strabismus, Pupil Abnormalities and Pupil Testing” and a session to the
Mr. Mohan Jacob Thazhahtu, Chief               Paediatric Ophthalmology Fellows on “The Evaluation of Strabismus and
Operating Officer, ORBIS International, New
                                               Amblyopia”. He also visited Aravind-Coimbatore for two days between
York, USA, Ms. Deepa Gupta and Mr. G.V. Rao,
ORBIS International, India with Mr. R.D.       January 30 to February 1.
Thulasiraj, Mr. Bikash and Ms. Sashi Priya




22
                                                ONGOING RESEARCH ACTIVITIES
                                                1. Screening and service delivery for Retinopathy of Prematurity (ROP).
                                                2. Effect of Intraocular lens on the growth of eyeball (Long term) in
                                                    children.
                                                3. Sensory strabismus secondary to senile cataract - A prospective non-
                                                    randomised interventional study.
                                                4. A Prospective non-randomised Study on Vernal Kerato-conjunctivitis.
                                                5. Electrophysiological assessment of children with congenital rubella
Dr. Clare Gilbert, Senior Lecturer,                 syndrome.
International Centre for Eye Health, Clinical   6. ERG in congenital motor nystagmus.
Research Unit, London School of Hygiene
                                                7. Comparing 5-hydroxytryptamine antagonist drugs for PONV in
and Tropical Medicine, UK with the team at
Aravind-Madurai Paediatric                          children undergoing strabismus surgery.
Ophthalmology Service.                          8. Changes in corneal topography in patients undergoing comitant
                                                    strabismus surgery.
                                                9. Comparison of Fluorine Surface Modified (FSM) intraocular lens
                                                    (IOLs) with Poly Methyl Metha Acrylate (PMMA) IOLs in children
                                                    undergoing surgery for traumatic cataract.
                                                10. Long term follow-up of esotropia patients.
                                                11. Course and outcomes in bilateral Persistent Hyperplastic Primary
                                                    Vitreous (PHPV).
                                                12. Quality of life in teenage myopic children.
                                                13. Fellow eye comparitive analysis of square edge verses round edge
                                                    single piece PMMA in paediatric population.
                                                14. Part time occlusion therapy in uniocular amblyopia in children above 9
                                                    years age.
                                                15. Effect of occlusion therapy in unilateral amblyopic children.
                                                16. Normal RNFL and macular thickness in Paediatric population on OCT.

ARTICLES PUBLISHED IN PEER                      CME PROGRAMMES CONDUCTED AT ARAVIND
REVIEWED JOURNALS                               STRABISMOLOGICAL SOCIETY OF INDIA’S 12TH ANNUAL CONFERENCE
                                                Aravind - Coimbatore, October 1-2
COMMUNITY EYE HEALTH
VOL: 18 (53) 2005 MAR. P.S58-S60
                                                Two days ophthalmic panorama on Strabismus and Amblyopia was
JETHANI, JITENDRA; VIJAYALAKSHMI, P             organised by Dr. Kalpana Narendran, Chief, Paediatric Ophthalmology,
- Eye Safety and Prevention of Visual           Aravind-Coimbatore, with lectures and presentations, videos and enlighten-
    Disability in the Paediatric Age Group
                                                ing discussions on almost every aspect of strabismus and amblyopia with
MOLECULAR VISION                                recent advances in the field of strabismology and amblyopia. A total of 250
VOL: 11 2005 OCT. P.846-852                     delegates and 20 guest speakers both national and international participated
RAMYA DEVI, RAMACHANDRAN; REENA,
CHANDRASHEKAR AND PERUMALSAMY                   At the inauguration of 12th Annual Conference of Strabismological Society of India
VIJAYALAKSHMI
- Novel Mutations in GJA3 Associated
     with Autosomal Dominant Congenital
     Cataract in the Indian Population

GRAEFE’S ARCHIVE FOR CLINICAL AND
EXPERIMENTAL OPHTHALMOLOGY
DEC 2005
 J. JETHANI, K. PRAKASH, P. VIJAYALAKSHMI, S.
PARIJA
- Changes in astigmatism in children
      with congenital Nystagmus


                                                                                                                                     23
                                             in the event. The highlight of the conference was the guest lecture by the
                                             Guest Faculty, Dr. Marilyn T. Miller, Professor, and Kimberlee Curnyn,
                                             Clinical Assistant Professor, Paediatric Ophthalmology & Adult Strabis-
                                             mus, University of Illinos, Eye and Infirmary Training – Chicago, US.
                                             DR. P. VIJAYALAKSHMI
                                             - Diagnosis and surgical options for treatment of Dissociated Vertical Deviation (DVD)
                                             - Basic Esotropic component in partially refractive accommodative Esotropia:
                                                 diagnosis and surgical plan and results
                                             DR. THOMAS MATHEW
                                             - Clinical assessment of extraocular movements: Normal and Abnormal
                                             DR. KALPANA NARENDRAN
                                             - Commonly used methods for measurement of ocular deviation and their pitfalls
                                             DR. YASH S SHAH
Dr. Kalpana Narendran at the Conference      - Occlusion treatment in children 10 –15 years – Prospective analysis (Free paper)




CONFERENCES ATTENDED ELSEWHERE
ICMR National Symposium                      DR. THOMAS MATHEW                             -   Rehabilitation of children with low
                                             - Fresnel prisms answer for intrac-               vision
(Organised by Indian Alumni group of
                                                  table diplopia (Instruction Course,      - Visual acuity estimation in children
ICEH, London)                                                                              - Attention! Calling for ROP awareness
                                                  paper)
Konark, Orissa, January 11-12                DR. GURDEEP SINGH                             - Sequelae of ROP
Dr. P. Vijayalakshmi presented a             - Epidemiological profile of Ocular           - Prevalence of amblyopia in school
                                                  toxoplasmosis in children                    children (Free paper)
Poster at the Childhood Blindness            - Randomized, double blind, placebo           - Fresnel Prisms: Answer for intractable
Annual Meeting                                    controlled comparative study                 diplopia (Poster)
-    Congenital Rubella Syndrome (CRS)-           between the brinsondine & placebo        - Secondary PC IOL implantation in
     Prevalence and it’s various clinical         on shunting post YAG capsulotomy             children
     presentations in South India                 IOP levels                               DR. KALPANA NARENDRAN
                                             DR.PARAG K.SHAH                               - Instruction course on paediatric
63rd All India Ophthalmological Society      - ROP – Clinical Characteristics and              ophthalmology for practicing general
                                                  Laser outcome                                ophthalmologists
Conference–2005                                                                            - Attention! Calling for ROP awareness
Bhuvaneshwar, Orissa, January 13-16          OCULI 2005- Update on Paediatric              - Sequelae of ROP
DR. P. VIJAYALAKSHMI                                                                       - Paediatric cataract challenges
- Infantile Esotropia
                                             Ophthalmology                                 - Refractive errors in children- How and
- Surgery on inferior oblique muscle         Medical College, Kottayam, February 20            when to prescribe
- Are we geared up to tackle the entire      DR. P. VIJAYALAKSHMI                          - Ocular manifestations in prematurity
    spectrum of diseases under the banner    - Visual acuity estimation in children        - Myopic shift following paediatric
    of paediatric Ophthalmology?             - Management of paediatric cataract-              cataract surgery with IOL implantation
- Introduction about the prism use in            Newer trends                                  (poster)
    ophthalmology                            - Management of retinoblastoma –
DR.SHASHIKANT SHETTY DR. JITENDRA, DR. K.        Recent trends                             ORBIS International Sight Saving Training
SUNDARESH,                                                                                 Programme
DR. P. VIJAYALAKSHMI                         20th Asia Pacific Academy of                  New Delhi, March 10-24
- Postoperative secondary divergent          Ophthalmology Congress (APAO)                 DR.P.VIJAYALAKSHMI
    strabismus : Retrospective analysis of   Kuala Lumpur, March 27-31
    17 patients                                                                            - Magnitude and causes of Childhood
- IOL in Traumatic Cataract in children      DR.PARAG K SHAH                                   Blindness
    and its long term followup               - General ophthalmology in paediatric
                                                 retinal disorders                         Dr. P. Vijayalakshmi participated as a guest
DR. MEENAKSHI                                                                              faculty in the National Workshop on
- Myopic shift after PCIOL implantation      DR.V.R.SARAVANAN
                                             - ROP awareness                               Childhood Blindness at the ORBIS
    in congenital / developmental cataract                                                 International Sight Saving Programme
DR. KALPANA NARENDRAN                        DR. THOMAS MATHEW
- Fresnel prisms answer for intractable      - Instruction courses on paediatric
    diplopia (Instruction Course)                ophthalmology for practicing general
DR. SAURABH MITTAL                               ophthalmologist
- Optical coherence tomography in optic      - Visual development and visual acuity
    nerve head diseases (Free Paper and          estimation in children
    Poster)                                  - Amblyopia - Recent advances in
- Optical coherence tomography in                management
    macular diseases (Poster)                - A refresher course for the general
                                                 ophthalmologist in paediatric retinal
                                                 disorders
24
53rd Annual conference of the TNOA -              WHO Steering Committee Subgroup                 STAFF : PAEDIATRIC OPHTHALMOLOGY
Sight@Height 2005                                 Meeting                                         SERVICES
Sterling Holiday Resorts, Kodaikanal,             London, October 12-13
August 12-14                                      The Subgroup Meeting of the WHO                 MEDICAL OFFICERS
DR. JITENDRA JETHANI, DR. P. VIJAYALAKSHMI,       Steering Committee on Epidemiology
DR.ABHISHEK, DR. SHETTY                           and Field Research was convened at the          ARAVIND - MADURAI
- Ophthalmic spectrum of                          Health Protection Agency (HPA), London          DR. P. VIJAYALAKSHMI
     Periventricular Leukomalacia in South        to review findings of the WHO-spon-
     Indian population                            sored Aravind Eye Hospital study of
                                                                                                  DR. SHASHIKANT SHETTY
- Comparison of effect of selective 5 HT          Congenital Rubella Syndrome (CRS).              DR. SUNDARESH
     antagonists with/ without dexametha-         This is the largest prospective study of
     sone on the POstoperative Nausea and                                                         ARAVIND - PONDICHERRY
                                                  CRS conducted anywhere in the world
     Vomiting (PONV) undergoing muscle
     surgeries in children
                                                  during the past 30 years, and a huge            DR. K. VEENA
DR. JITENDRA JETHANI, DR. P. VIJAYALAKSHMI,       amount of data has been obtained
DR.ABHISHEK, DR. SHETTY, DR. SUNDARESH            during the 5 years of the study.                ARAVIND - TIRUNELVELI
- Plagiocephaly with contralateral                For this meeting, Steering Committee            DR. R. MEENAKSHI
     superior oblique dysfunction                 officers who served in their usual              DR. SAURABH MITTAL
DR. ABHISHEK, DR. JITENDRA JETHANI,               capacities were: Dr. Vesikari, Chair;
DR. P. VIJAYALAKSHMI, DR. SUNDARESH               Dr Slack, Rapporteur; Dr. Robertson,            ARAVIND - COIMBATORE
- Vertical misalignment and its compari-          Secretary. The delegation from Aravind
     son with head tilt in lateral rectus palsy   consisted of Dr Vijayalakshmi, Principal        DR. KALPANA NARENDRAN
- Congenital aphakia – Rare case report           Investigator of the Aravind CRS study;          DR. THOMAS MATHEW
- Radiation Cataract with Strabismus –            Mr. Karthick Prakash, the biostatistician       DR. GURDEEP SINGH
     Report and Management                        for the study; and Miss Amala, Ph.D
- Bilateral PHPV & Secondary glaucoma
DR. YASH S SHAH
                                                  student, who has conducted the                  FELLOWS
                                                  serological testing at the Aravind
- Occlusion treatment in children aged
                                                  Rubella Research Laboratory.                    ARAVIND - MADURAI
     > 10 years
- Probing in children 1-7 years - A                                                               DR. JITENDRA JETHANI
     prospective analysis                         World Sight Day Celebration - Scientific
                                                                                                  DR. ABHISHEK DAGAR
- Surgical results of exodeviations               Session
- Paediatric Rhegmatogenous Retinal                                                               DR. SUCHETA
                                                  LVPEI, Hyderabad, October 14
     detachment
                                                  Dr. Sundaresh participated in the
                                                                                                  DR. KARTHIKEYAN
DR. GURDEEP SINGH                                                                                 DR. ANURAG MISHRA
- Bacterial keratitis in Children                 scientific session. The focus was on
DR. THOMAS MATHEW                                 Diabetic Retinopathy & Paediatric               DR. SHOBANA
- Results of inferior oblique anterior            Ophthalmology. Dr. Sundaresh gave a             DR. RAKHI MEHTA
     transposition                                talk on Congenital Cataract.
DR. KALPANA NARENDRAN                                                                             ARAVIND - COIMBATORE
- Innovative and advancement of                   109th American Academy of                       DR. YASH S SHAH
     paediatric cataract                          Ophthalmology Meeting                           DR. RINKLE S GAWANDE
Ophthalmology Update for paramedical              Chicago, USA, October 17
                                                                                                  DR. BIRENDRA JHA
                                                  Dr. P. Vijayalakshmi participated in the
Ophthalmic Assistants “The Earliest, the          meeting.
Best”
                                                  Dr. P. Vijayalakshmi, Mr. Karthick Prakash, Ms. Amala with Dr. Susan Robertson and others in
LAICO, September 10-11
                                                  the WHO Steering Committee Meeting
DR. SUNDARESH
- Paediatric Eye diseases

International Conference on Paediatric
Ophthalmology
H.V.Desai Eye Hospital, Pune, September
24-25
DR. P. VIJAYALAKSHMI WAS INVITED AS A FACULTY
- Paralytic Strabismus Evaluation and
    Management Strategies




                                                                                                                                           25
CORNEA AND REFRACTIVE SURGERY SERVICES




Dr. Thiruvengada Krishnan examining a patient in the Cornea and Refractive Surgery Services at Aravind-Pondicherry


                                               The Cornea Services at Aravind-Madurai, Tirunelveli, Coimbatore and
                                               Pondicherry have registered a growth of about 15% of the overall outpa-
                                               tient services and surgery across all the hospitals. There is a significant
                                               increase in the number of corneal transplants performed, about 28% owing
                                               to the succesful awareness created among the public about eye donation.
                                                    With the support of the Ocular Microbiology department, the Cornea
                                               Services treat perhaps the world’s largest number of corneal ulcers and
                                               injuries.
                                                    A new customised LASIK laser facility (Bausch & Lomb - Z100
                                               (Zyoptix)) was installed at Aravind-Madurai. Aravind-Tirunelveli has
                                               installed Bausch & Lomb Technolas 217 C Laser, making it the third
                                               Aravind facility to acquire a LASIK laser. Various drug trials have been
                                               commissioned at these facilities, one of the kinds being Gatifloxacin
                                               therapy in bacterial keratitis (Aravind-Madurai and Coimbatore) and
                                               steroid therapy in bacterial keratitis. Special emphasis was given on basic
Dr. Prajna performing a LASIK Surgery at
Aravind-Madurai                                research facilities including stem cell characterisation using confocal
                                               microscope and estimation of cytokine levels and matrix metalloproteinase
                                               studies in fungal keratitis.

                                               PERFORMANCE 2005
                                                                             Madurai       Tirunelveli      Coimbatore     Pondy
                                               Outpatients
Dr. Revathy examining a patient at             Paying                        36,268          14,135            18,757       7,990
Aravind-Coimbatore                             Free                           5,393           2,266             7,224       3,252
                                               Total Outpatients             41,661          16,401            25,981      11,242
                                               Surgeries
                                               Pterygium                         695             107                 549     267
                                               Keratoplasty                      397              43                 240      71
                                               LASIK Surgery                   1,362             231                 400       *
                                               Other Surgeries                    56             136                 178      56
                                               * LASIK facility yet not available




26
                                               TRAINING PROGRAMMES
                                               LONG TERM FELLOWSHIP PROGRAMME
                                               This one year course is offered at Aravind-Madurai and Coimbatore. The
                                               course was started in 1989. Four candidates are recruited for this course
                                               every year. This fellowship provides extensive training in all medical and
                                               surgical aspects of corneal pathology.



                                               ONGOING RESEARCH STUDIES
Dr. Jack Whitcher, Proctor Foundation,         -   Corneal topographic changes following pterygium surgery with autograft
San Francisco at the Clinic during a Study     -   Effect of Lasik Surgery on increase in Intraocular pressure
Follow up visit                                -   Effect on RNFL and Macular thickness recordings from OCT following
                                                   corneal curvature change due to LASIK
                                               -   Prognostic clinical and microbiological factors in fungal keratitis
                                               -   Evaluation of efficacy and safety of Genteal Gel in the treatment of
                                                   Indian patients with dry eye
                                               -   Evaluation of efficacy of gamma irradiated amniotic membrane in ocular
                                                   surface disorders
                                               -   Powerloom injuries – An analysis
                                               -   DALK in the management of acute Mooren’s ulcer
                                               -   Traumatic Lenticular Abscess – Clinicopathological analysis
                                               -   Incidence of sympathetic ophthalmia in ruptured globe
                                               -   Evaluation of efficacy of cryotherapy in Nocardia scleritis with
                                                   clinicopathalogical correlation
                                               -   Efficacy of Bowman’s membrane cautery in Bullous keratopathy.
                                               -   Study for estimation of cytokine activity in case of fungal keratitis.
                                               -   Study looking at characterisation of stem cells in cadaveric limbal tissue
                                               -   Principal investigator in a randomised control trial comparing the safety
                                                   and efficacy of gatifloxacin and ciprofloxacin in the treatment of
                                                   bacterial keratitis.
                                               -   Epidemiological study of eye injury in Indian children
                                               -   SCUT study - Efficacy of steroids in the treatment of bacterial keratitis
                                               -   Study on the prevention of corneal ulcer in the community - Vadipatti
                                                   Taluk

                                               STUDIES COMPLETED
                                               -   Microbial keratitis in South India - influence of risk factors, climate
                                                   and geographical location.
Dr. M. Srinivasan with Dr. Jack Whitcher and
Dr. Richard Abbott having discussions on       -   A Study of the spectrum of Acanthamoeba keratitis - a three-year study
SCUT project at the Proctor Foundation, US         at tertiary eye care referral Centre in South India.
                                               -   Contact lens – induced microbial keratitis: A three years study.
                                               -   Trends in the Etiology and epidemiology of microbial keratitis in South
                                                   India: A three year study at a tertiary Eye Care referral centre.
                                               -   A 21 day Pilot, multicenter, investigator-masked, randomised, parallel
                                                   comparison of the safety & efficacy of Gatifloxacin 0.3% ophthalmic
                                                   solution compared with Ciprofloxacin 0.3% Ophthalmic solution in
                                                   patients with acute bacterial corneal ulcers.
                                               -   An analysis of clinical presentation, risk factors, diagnosis, manage-
                                                   ment and outcome of fungal keratitis in tertiary eye care centre in
                                                   South Tamil Nadu.
                                                                                                                            27
ARTICLES PUBLISHED IN PEER                                                            STAFF - CORNEA SERVICES
REVIEWED JOURNALS                                                                     MEDICAL OFFICERS
INDIAN JOURNAL OF OPHTHALMOLOGY                                                       ARAVIND - MADURAI
VOL: 53 (1) 2005 MAR. P. 67-68                                                        DR. M. SRINIVASAN
SRINIVASAN, M; LALITHA, P; PRAJNA, NV
- A Cluster of Cases of Mycobacterium                                                 DR. N. VENKATESH PRAJNA
    Chelonei Keratitis following                                                      DR. MANORANJAN DAS
    Penetrating Keratoplasty
                                                                                      ARAVIND - COIMBATORE
                                                                                      DR. REVATHI
CONFERENCES ATTENDED ELSEWHERE                                                        DR. ANITHA RAGHAVAN
63rd All India Ophthalmological Society     20th Asia Pacific Academy of              DR. SIDHARDHAN
Conference                                  Ophthalmology Congress (APAO)             ARAVIND-TIRUNELVELI
Bhuvaneshwar, Orissa, January 13-16         Kuala Lumpur, March 27-31                 DR. R. MEENAKSHI
DR. MEENAKSHI                               DR.PRAJNA                                 DR. SAURABH MITTAL
- Management of pterygium with              - Management of corneal ulcer
    conjunctival autograft                  - Innovative Ways to Reduce Cost in
DR.R.REVATHI, DR.SACHIN MATHEW, DR.GEORGE       Elimination of Cataract Blindness
                                                                                      ARAVIND-PONDICHERRY
- Timing of open globe injuries repair –        Worldwide                             DR. THIRUVENGADA KRISHNAN
    visual outcome and complications                                                  DR. RAVINDRANATH REDDY
DR.R.REVATHI, DR.RAVINDRANATH REDDY         The American Society of Cataract and
- Treatment outcome in Nocardia             Refractive Surgery (ASOA) 2005            FELLOWS
    Keratitis
DR.R.REVATHI, DR.SACHIN MATHEW              Symposium and Congress
                                            Washington, DC, April 15- 20              ARAVIND - MADURAI
- A randomised trial comparing
    intraoperative MMC and conjunctival     DR. REVATHI RAJA RAMAN, DR.RAVINDRANATH   DR. VEERESH
    autograft in Pterygium excision         REDDY                                     DR. VINAY MURTHY
DR.R.REVATHI, DR.RAVINDRANATH REDDY         - Analysis of Wound infections after      DR. SUSHIL TRIPATHI
- Surgical debridement and Cryo                 Cataract Surgery in South India
    therapy in management of microbial                                                DR. JEGAN MOHAN
    scleral abscess                         DR.R.REVATHI
                                            - Descemet’s membrane detachment -        ARAVIND - COIMBATORE
CME Programmes - ORBIS                          an analysis
                                                                                      DR. AMAR ARUN KARHANIS
Disha Hospital, Kolkata, February 19-20                                               DR. SACHIN DEV
Dr.M.Srinivasan was invited speaker and     AWARDS                                    DR. JOSEPH MATHEW
chairperson for ORBIS DC-10 programme
at Disha Hospital. He co-ordinated a        DR. N. VENKATESH PRAJNA, MEDICAL
session on Corneal grafting for the
delegates and ORBIS surgeons at the         OFFICER, CORNEA CLINIC
hospital. He also chaired the session on    •   He is nominated as member of
eye banking organised by ORBIS and              the international advisory
EBAI at the hospital.                           council of the International
ORBIS Eye Banking Training Programme            Council of Ophthalmology
LV Prasad Eye Institute, Hyderabad,             (ICO) which will review and
February 21-22                                  advise ICO accordingly.
Dr.M.Srinivasan served as an evaluator      •   He is also selected as a member
for ORBIS eye banking training                  of the assessment committee of
programme at LVPEI/Hyderabad.
                                                ICO and will participate in
CME                                             question selection and evalua-
Dr. P. N. Nagpals’ Eye Hospital,                tion of the ICO examinations
Ahmedabad, March 19                             held worldwide.
Dr. M. Srinivasan was invited speaker for
the conference.
- Ocular surface disorders and refractive
     surgery


28
RETINA – VITREOUS SERVICES




TIFAC-CORE in Diabetic Retinopathy at Aravind-Madurai


                                           Retina services at all Aravind Eye Hospitals have registered about 8 to 10%
                                           growth in outpatient and 4-5% growth in surgical procedure in the past 1
                                           year. Currently it is managing the teaching programmes for post graduates;
                                           short term fellowship on Lasers in Diabetic Retinopathy course; FFA &
                                           USG short term course; Long term retina fellowship programmes. In the
                                           research front, currently 26 research projects are being conducted in the
                                           department. In future research projects sponsored by Allergan, Alcon and
                                           NEI are going to be handled by the department.


                                           PERFORMANCE 2005
                                                                       Madurai       Tirunelveli   Coimbatore   Pondy
                                           Outpatient Visits
                                           Paying                      48,268         25,853        37,714      18,036
                                           Free                          5,357          4,057        9,373       4,553
                                           Total Outpatient Visits     53,625         29,910        47,087      22,589
                                           Total Surgeries               1,922            249        1,654        447
                                           Laser                       10,098           3,195        5,466       2,738
                                           FFA                          3,597           1,285        3,277       1,058
                                           USG                          5,257           2,513        4,605       2,046

Dr. Dhananjay Shukla examining a patient
at Aravind-Madurai                         TRAINING PROGRAMMES
                                           LONG TERM TRAINING PROGRAMME
                                           Fellowship in Diabetic Retinopathy and Medical Retina
                                           Aravind Eye Hospital in partnership with Technology Information, Fore-
                                           casting and Assessment Council and Centre of Relevance and Excellence
                                           (TIFAC - CORE) has established this long-term Fellowship training
                                           programme to provide high quality training for the general ophthalmologists
                                           as well as postgraduates in ophthalmology. TIFAC-CORE has the entire
                                           necessary infrastructure and a well established Retina - Vitreous centre
                                           with a high patient volume to provide excellent hands-on training.

                                           Number of Candidates trained in 2005:
                                           2 Years Fellowship – 4 fellows
                                           1 Year Programme – 1 fellow
                                                                                                                     29
                                           SHORT TERM TRAINING PROGRAMMES
                                           Aravind eye hospital and postgraduate institute of ophthalmology in
                                           collaboration with Technology Information, Forecasting and Assessment
                                           Council (TIFAC) - Department of Science and Technology, Government of
                                           India, has created TIFAC - CORE (Centre Of Relevance and Excellence) in
                                           Diabetic Retinopathy which would move towards better management of
                                           diabetic retinopathy. This centre imparts high quality education and training
                                           with State-of-the-art facilities for research in the areas of diabetic retinopa-
Dr. Anand Rajendran examining a patient    thy and provides leadership, faculty and infrastructure facilities coupled
with the Short term fellows
                                           with training and academic expertise. This TIFAC-CORE is mandated to
                                           develop into an international centre of excellence in research, training and
                                           develop changes in treatment patterns to prevent blindness due to diabetic
                                           retinopathy.

                                           Indirect Ophthalmoscopy and Lasers in the Management of Diabetic Retinopathy
                                           This course is offered at Aravind-Madurai and Coimbatore and is open to
                                           all ophthalmologists and postgraduates. A total of fifty-nine
                                           ophthalmologists were trained at Aravind-Madurai and Coimbatore in 2005.

                                           Fundus Fluorescein Angiography (FFA) and Ultrasonography (USG)
                                           TIFAC - CORE Aravind Eye Hospital is offering two months Certificate
                                           Course in Fundus Fluorescein Angiography (FFA) and Ultrasonography
                                           (USG). In 2005, eight candidates were trained.


                                           ONGOING RESEARCH STUDIES
Candidates undergoing training for the     1. Radial optic neurotomy for ischemic central retinal vein occlusion:
Certificate Course in Fundus Fluorescein       immediate results.
Angiography & Ultrasonography
                                           2. Radial optic neurotomy for ischemic central retinal vein occlusion.
                                           3. Familial Exudative vitreoretinopathy (FEVR) – Clinical profile and
                                               genetic associations.
                                           4. Familial Exudative vitreoretinopathy (FEVR) – Genetic study.
                                           5. Clinical profile of Juvenile X-linked Retinoschisis (JXLR).
                                           6. Atypical manifestations of X-linked retinoschisis.
                                           7. Macular ischemia as a marker for diabetic nephropathy.
                                           8. Comparison of argon and diode laser in scatter photocoagulation
                                               treatment of fibrovascular PDR.
                                           9. Anchoring photocoagulation for fibrovascular proliferative diabetic
                                               retinopathy.
                                           10. Association of featureless retina and macular ischemia in diabetic
                                               retinopathy.
                                           11. APMPPE – Harada variant: profile and management.
                                           12. Optic disc pit and serous macular detachment. OCT profile and
                                               management.
                                           13. Retinopathy of Prematurity: A clinico epidemiological study.
                                           14. Intravitreal triamcinolone in diabetic macular edema.
                                           15. Diabetic retinopathy vitrectomy study.
                                           16. ARMD – Genetic study.
                                           17. Immunulogy of Eales disease vis-à-vis diabetic retinopathy.
                                           18. Macular ischemia and diabetic nephropathy.


30
19. Serum lipid profile in part with CSME and without CSME.
20. Prevalence of diabetic retinopathy in a tertiary eye care centre.
21. Vitreous and aqueous penetration of orally administered moxifloxacin
     in humans.
22. Transpupillary thermotherapy for subfoveal leaks in central serous
     chorioretinopathy.
23. Correlation between clinical, angiographic and optical coherence.
     Tomographic feature in CSME and their role in its management.
24. Relation and progression of Diabetic Retinopathy with lipid profiles.
25. Prevalence of Diabetic Retinopathy in patients with POAG.
26. Argon laser and double frequency Nd-Yag laser in treating DR.
27. Culture of vitreous aspirates after vitrectomy surgery.
28. CSR patients - Outcome and epidemiological profiles.
29. IOFB removal and outcome.
30. Prospective randomised trial on the efficacy of IVTA in CRVO
     macular edema.
31. Retrospective study of open globe injury repair - effect of timing of
     surgery, visual outcome and traumatic endophthalmitis.
32. Needle sub retinal fluid drainage assisted pneumatic retinopexy - a
     new approach.
33. Anatomical outcome of stage 4 & 5 ROP.
34. Comparison of threshold ROP between Southern India & Southern
     California.
35. A Single center, Unmasked Clinical Trial examining the Effect of 1.25
     Mg of Intravitreal Bevacizumab (Avastin, Genentech) for Retinal
     Neovascularisation with Vitreous Haemorrhage Secondary to
     Proliferative Diabetic Retinopathy.
36. A single center, Randomised Clinical Trial examining the effect of
     Intravitreal Bevacizumab (Avastin, Genentech) with reduced
     Panretinal Photocoagulation for High Risk Retinal Neovascularisation
     Secondary to Proliferative Diabetic Retinopathy as compared to
     Standard Panretinal Photocoagulation.
37. Prospective randomised trial comparing intravitreal triamicinolone and
     Avastin injections in the treatment of macular oedema due to central
     retinal vein occlusion.


CASE REPORTS
1. Familial foveal schisis in 2 female patients.
2. Surgical management of combined macular tractional retinal detach-
   ment and macular hole in diabetic retinopathy.
3. OCT in atypical leakage in CSCR.
4. Nodular posterior scleritis mimicking choroidal melanoma.
5. Combined occlusion secondary to systemic non-hodgkin’s lymphoma.




                                                                        31
ARTICLES PUBLISHED IN PEER                       EYE                                                 INDIAN JOURNAL OF OPHTHALMOLOGY
                                                 VOL: 19 (1) 2005 JAN. P.107-108                     VOL: 53 (1) 2005 MAR. P.65-66
REVIEWED JOURNALS                                SHUKLA, D; ARORA, A; AMBATKAR, S; KIM, R;           VASUMATHY, V; KOLLURU, CHANDRAMOHAN; KIM, R
                                                 NAMPERUMALSAMY, P                                   - Persistent Depot of Triamcinolone
BRITISH JOURNAL OF OPHTHALMOLOGY                 - Optical Coherence Tomography                          Acetonide after a Single Intravitreal
VOL: 89 (2) 2005 FEB. P.249-250                     Findings in Acute Macular                            Injection
                                                    Neuroretinopathy
VASUMATHY, V
- Ciprofloxacin in Endophthalmitis: an                                                               VOL: 53 (2) 2005 JUN. P.126-128
    alternative to ceftazidime and               VOL: 19 (1) 2005 JAN. P.113-114                     VASUMATHY, V; KIM, R; NAMPERUMALSAMY, P;
    amikacin                                     VASUMATHY, V                                        CUNNINGHAM JR., EMMETT T
                                                 - Endophthalmitis following                         - Double Prepapillary Arterial Loops
AMERICAN JOURNAL OF                                  Phacoemulsification                                 Associated with Superior Branch
                                                                                                         Macular Artery Occlusion
OPHTHALMOLOGY                                    VOL: 19 (3) 2005 MAR. P.353-356
VOL: 139 (2) 2005 FEB. P. 351-353                VASUMATHY, V; KIM, R; GANESAN, S; USHA, K           VOL: 53 (2) 2005 JUN. P.128-130
VASUMATHY, V; KIM, R                             - Hemiretinal Vein Occlusion Associated             VASUMATHY, V; DEEPAK, A; KIM, R
- Optical Coherence Tomography in                    with Pseudotumour Orbit: an observa-            - Premacular Haemorrhage Associated
    Best’s Disease: an observational case            tional case report                                  with Arteriovenous Communications
    report                                                                                               of the Retina Induced by a Valsalva-
                                                 VOL: 19 (5) 2005 MAY p.596-599                          Like Mechanism: an observational case
VOL: 139 (2) 2005 FEB. P. 389-390                VASUMATHY, V; KIM, R                                    report
VASUMATHY, V                                     - Spontaneous Improvement of Serous
- Indocyanine Green-Assisted Internal                Maculopathy Associated with                     2005 SEP; Vol. 53 (3): 212-213
    Limiting Membrane Removal in                     Congenital Optic Disc Pit: an OCT study         VASUMATHY, V; RAJAGOPAL, JYOTHSNA; RATNAGIRI,
    Epiretinal Membrane Surgery                                                                      PRAVEEN KRISHNA
                                                 VOL: 19 (8) 2005 AUG. P.915-917                     - Bilateral Simulataneous Anterior and
VOL: 139 (3) 2005 MAR. P.575                     VASUMATHY, V; KOLLURU, C; KIM, R                        Posterior Lenticonus in Alport’s
VASUMATHY, V                                     - Treatment of Polypoidal Choroidal                     Syndrome
- Intraocular Pressure Rise after                    Vasculopathy with Transpupillary
    Intravitreal Triamcinolone                       Thermotherapy: an interventional case           VOL: 53 2005 Dec; P. 261-265
                                                     report
                                                                                                     K SHAH,PARAG ; NARENDRAN, V; SARAVANAN,V.R;
2005 MAY; VOL: 139(5): 945-7
                                                                                                     RAGHURAM, A; CHATTOPADHAYAY, ABJITH; JOHN
SHUKLA,D; AMBATKAR, S; JETHANI, J; KIM, R        2005 Nov 25; E-publication
                                                                                                     MORRIS, RODNEY; VIJAY, N; KASHYAP, MAITHREYI;
- Optical coherence tomography in                SHUKLA,D; RAO, NV; KIM, R
                                                                                                     RAGHURAMAN, V; SHAH, VIRNA
   presumed congenital simple hamar-             - Massive haemorrhagic retinal
   toma of retinal pigment epithelium                                                                - Fulminate type of ROP - Clinical
                                                    detachment after transpupillary
                                                                                                         characteristics and laser outcome
                                                    thermotherapy for choroidal
VOL: 134(1) JULY 2005 P134-136                      neovascularisation
SHUKLA, D; KANNAN BN; KIM, R
- Optical Coherence Tomography                   2005 Oct 21; E-publication
   Findings in Valsalva Retinopathy              SHUKLA,D; TANAWADE, RG; KIM,R
                                                 - Transpupillary thermotherapy for
OPHTHALMIC SURG LASERS IMAGING                      subfoveal choroidal neovascular
2005 MAY-JUNE; VOL: 36(3):240-4.                    membrane in choroidal osteoma
VASUMATHY, V; PRAVEENKRISHNA RATNAGIRI; KIM, R
- Hypotensive retinopathy in Takayasu’s          2005 SEP; E-publication
    arteritis                                    VASUMATHY, V; LALITHA,P; VELPANDIAN, T; GHOSE, S;
                                                 MAHALAKSHMI, R; KIM, R
INVESTIGATIVE OPHTHALMOLOGY AND                  - Vitreous and aqueous penetration of
VISUAL SCIENCE                                       orally administered moxifloxacin in
2005 OCT; Vol. 46 (10):3631-3636                     humans
ARPITHA, P; NAMPERUMALSAMY, P; PRAJNA, NV;
SRINIVASAN, M; MUTHUKKARUPPAN, VR
- High Expression of p63 Combined with
    a Large N/C Ratio Defines a Subset of
    Human Limbal Epithelial Cells:
    Implications on Epithelial Stem Cells

ARCHIVES OF OPHTHALMOLOGY
2005; VOL:123: 1450-1452
VASUMATHY, V
- Double Optic Discs, Optic Disc
    Coloboma, and Pit: Spectrum of Hybrid
    Disc Anomalies in a Single Eye
32
CME PROGRAMMES CONDUCTED AT ARAVIND                                                    CONFERENCES ATTENDED
13th Annual conference of Vitreo Retinal        Gupta, Dr. Annie Mathai, Dr. Cyrus     ELSEWHERE
Society of India                                Shroff and Dr. Mangat Dogra were
                                                                                       63rd All India Ophthalmological Society
Ooty, February 24-27                            the guest faculty for the
                                                                                       Conference
The conference was organised by                 conference. The highlight of the       Bhuvaneshwar, Orissa, January 13-16
the Department of Vitreo Retinal                meeting was the teleconferencing       DR. P. NAMPERUMALSAMY
Services, Aravind Eye Hospital,                 with Dr. Tom Lee from Cornell          - Keynote address on Translating
Coimbatore. Over 250 delegates                  University on “The Recent Emerg-            programs into action- Diabetic
                                                                                            Retinopathy VISION 2020
from all over the country partici-              ing Trends in the Management of        CHAIRMAN FOR THE UPDATE COURSE ON DIABETIC
pated in the conference.                        Retinoblastoma.                        RETINOPATHY FOR THE PRACTICING OPHTHALMOLOGISTS
Dr. Au Eong Kah Guan, Dr. Rajiv                                                        - Magnitude and challenges of DR
                                                International Symposium on Diabetic    - Screening strategies, methodology of
Anand, Dr.Tara Prasad Das,                                                                  Aravind initiatives
Dr. Pramod Bande, Dr. Mune
                                                Retinopathy                            DR. R. KIM
                                                September 3-4                          - Moderator for the Instruction Course on
Bhende, Dr. Sangeet Mittal,                                                                 “Masters in indirect Ophthalmoscopy”
                                                The symposium was organised by
Dr. Gopal Verma, Dr.N.S.                                                                    and gave lecture on “Peripheral retinal
                                                TIFAC-CORE in Diabetic                      degeneration”
Muralidhar, Dr. S.Natarajan,
                                                Retinopathy in collaboration with      - Telemedicine- my dream
Dr. Atul Kumar, Dr. Nitin Shetty,                                                      - Principles of vitreous surgery in DR
                                                leading institutions like University
Dr. Rajvardhan Azad, Dr. Amod                                                          - Complications of vitrectomy
                                                of Wisconsin - Madison, Joslin         - Scleral buckling- surgical technique
                                                Diabetes Centre, USA. Around 148       DR. DHANANJAY SHUKLA
                                                                                       - Grading of diabetic retinopathy at the
                                                participants including                      update course on Diabetic retinopathy
                                                ophthalmologists, diabetologists,      - Optics on indirect ophthalmoscopy at
                                                postgraduates, consultants from             the instruction course on “Mastering
                                                                                            indirect ophthalmoscopy”
                                                various hospitals and institutions
                                                                                       DR. ANAND RAJENDRAN
                                                from all over India participated.      - The visual outcome of cataract surgery
                                                     Dr. Lyoyd Paul Aiello,                 in ocular leptospirosis (Free paper)
                                                                                       - Radial optic neurotomy for ischemic
                                                Dr. Sabera T. Shah, Dr. Haytham             central retinal vein occlusion- initial
                                                I.S. Salti, Dr. Matt Feinsod,               experience (Free paper)
                                                Dr. Nigel H. Timothy, Dr. Gaurv Y.     DR. VASUMATHY VEDANTHAM
                                                                                       · Free papers on
                                                Shah, Dr. Jerry Cavellerano,           - Clinical microbiological profile of post
                                                Dr. A. J. Asirvatham, Dr. Amod              traumatic endophthalmitis at a
                                                Gupta, Dr. Chandra Abraham,                 teritiary care centre in South India
                                                                                       - Antibiotics in endophthalmitis
Dr. Narendran at the 13th Annual                Dr. S. Natarajan and Dr. V.M.          - ROP screening strategy-how to screen
conference of Vitreo Retinal Society of India   Loganathan were the guest faculty           and when to screen
                                                                                       DR. S. MANOJ
                                                for the symposium.                     - Nocardial scleral abscess (FREE PAPER)
                                                                                       DR. SANDEEP ASHER
                                                                                       - Instruction course on “Mastering
Participants of 1st International Symposium on Diabetic Retinopathy                         Indirect Ophthalmology”
                                                                                       DR. NARENDRAN
                                                                                       - Instruction course on Indirect
                                                                                            ophthalmoscopy
                                                                                       DR.PARAG K SHAH
                                                                                       - Fulminate type of ROP. Clinical
                                                                                            characteristics and laser outcome
                                                                                       DR. GEORGE J.MANAYATH
                                                                                       - Timing of open globe injury repair
                                                                                            Visual outcome and complications
                                                                                       DR. RODNEY JOHN MORRIS
                                                                                       - Anatomical & visual outcome followed
                                                                                            IOFB removal




                                                                                                                                   33
DR.A.RAGHURAM                                   53rd Annual conference of the TNOA-            DR. RODNEY JOHN MORRIS
- Rhegmatogenous retinal detachment                                                            - Anatomical & visual outcome followed
    following lasik in myopic Indian eyes –2    sight@height 2005                                  IOFB removal
    years followup results                      Kodaikanal, August 12-14, 2005
DR. N.VIJAY                                     Dr. P. Namperumalsamy participated in          Retina Congress
- DUSN manifestation and management             the inaugural function and handed              L.V. Prasad Eye Institute on August 26–
                                                over the charge of Vice-President of the       28
4th World Congress on Prevention of             society to Dr. K. Ravi.                        DR.R.KIM
Diabetes and its Complications                  DR. R. KIM                                     - Screening of diabetic retinopathy –
Chennai, February 11-13, 2005                   - Multifocal ERG                                    clinical vs non-clinical setting
DR. R. KIM                                      DR. D. SHUKLA                                  - Intraoperative hemostatis
Symposium on Prevention projects in the         - OCT in retinal disorders: indication &
developing world- diabetes action now               interpretation                             Ahmedabad Academy International Meet
- Diabetes eye care in India                    DR. K. CHANDRAMOHAN                            Ahmedabad, September 23-25
                                                - Guidelines for intravitreous (IVT)           DR. R. KIM
CII conference on “Building partnerships            injections (steroid)                       - Parafoveal Telangiectasia
                                                DR. NARESH BABU
between society & corporate sector”             - Validation for DRAGON (Diabetic
Mumbai, February 16, 2005
                                                                                               CME on Retinoblastoma
                                                    Retinopathy Assessment Grading Over        Adayar Cancer Institute, Chennai,
DR. P. NAMPERUMALSAMY                               Network)
                                                                                               September 25
- Lecture on “Sustainable social                - Community Outreach for diabetic
    development through innovation and              retinopathy                                DR.PARAG K SHAH
    collaboration-public-private partner-       DR. KOSHAL RAM                                 - Diagnosis & radiotherapy of retino-
    ship in social projects/health”             - Trans pupillary thermotherapy for                blastoma
                                                    myopic choroidal neovascularisation
Seminar at the Indian Institute of              DR. S. MANOJ                                   10th RK Seth Memorial Symposium on
Management                                      - Clinical profile and management of           Community Ophthalmology
                                                    vegetable foreign body induced             Venu Eye Institute, New Delhi, October 1-
Ahmedabad, February 17                              endophthalmitis. (FREE PAPER)              2
DR. P. NAMPERUMALSAMY                           - Clinico-microbiological profile of
- A role of information technology in eye           infectious scleritis (FREE PAPER)          DR. P. NAMPERUMALSAMY
    care / health                               - Microbiological spectrum in                  - Strategies in diabetic retinopathy
                                                    endolphthalmitis isolates- a 2 yr review       screening
INTELEMEDIA 2000 Conference                         of culture proven cases (FREE PAPER)
Bangalore, March 17-19                          Symposium on recent advances in Retina         109th American Academy of
DR. P. NAMPERUMALSAMY                           - Recent trends in the management of           Ophthalmology
- Virtual university (e-Education and               CRVO                                       Chicago, USA – October 17-21
    training session)                           DR.V.NARENDRAN
                                                _ Intravitreal Triamcinolone in Cystoid        Two posters were presented in the
DR. R. KIM (MEMBER OF THE NATIONAL ORGANISING
                                                    Macular Edema                              conference
COMMITTEE OF THE CONFERENCE)
- Tele-ophthalmology                            DR.ABHIJITH                                    DR. R. KIM
                                                - Outcome and patient profile of CSR           - Diabetic retinopathy screening using an
20th Asia Pacific Academy of                        patients in a small subset of Indian           integrated telemedicine approach in
                                                    population                                     South India
Ophthalomology Congress (APAO)                  DR.PARAG K SHAH
Malaysia, March 26-31                           - Anatomical Outcome of stage 4&5 ROP
Dr.V.Narendran, Dr.V.R.Saravanan,               Poster presentation at the 109th American Academy of Ophthalmology meeting,
Dr.Parag K Shah conducted Instruction           Chicago, USA
Courses on Attention Calling for ROP
awareness and Paediatric retinal
disorders – A refresher course for
general ophthalmologist.

Seminar on bridging the digital divide:
Toward developing CSR strategy and
business model in strengthening socio-
economic development
New Delhi, April 14-15, 2005
DR. R. KIM
- Tele-ophthalmology




34
DR. S. MANOJ, DR. CHANDRAMOHAN, DR. KIM AND      Consultation on Prevention of Blindness      XIV Annual Conference of VRSI
DR. VIGNESH RAJA                                                                              Khajuraho, Madhya Pradesh,
- Transpupillary thermotherapy in the            from Diabetes Mellitus – WHO
                                                                                              December 8-10
     management of subfoveal CNVM in             Programme
     South Indian population                                                                  DR. SHUKLA
                                                 Geneva, Switzerland, November 9 – 11
 DR. A. RAGHURAM ALSO ATTENDED THE CONFERENCE.                                                - Transpupillary thermotherapy (TTT) for
                                                 DR. P. NAMPERUMALSAMY                            subfoveal leaks in central serous
                                                 - Core content of patient and public             chorioretinopathy (CSC) (Free Paper)
FOCUS 2005 - Silver Jubilee Conference of             Diabetic Retinopathy education          DR. NARESH BABU
Maharashtra Ophthalmological Society                  materials                               - A new technique for removing the
Mumbai, November 4-5                              - Production and dissemination of               anterior segment exudative membrane
                                                      Diabetic Retinopathy education              in endophthalmitis (Video)
DR. P. NAMPERUMALSAMY
                                                      materials                               DR. ANAND RAJENDRAN
- Management of macular disorders –
                                                 - Community-based screening models           - The immediate effects of radial optic
     introduction to macular disorder
                                                 HE ALSO PARTICIPATED AS DISCUSSANT FOR THE       neurotomy- support for the decompres-
- Role of Information technology in eye
                                                 FOLLOWING LECTURES:                              sive theory? (poster)
     care / tele-ophthalmology
- Focus – Diabetic Retinopathy                   - Eye care deficiencies contributing to      DR. S. MANOJ
                                                      blindness from DR                       - Traumatic endophthalmitis caused by
Proximity Course on Intraocular                  - Detection within eye care clinics -            vegetable foreign body injury - clinical
                                                      primary, secondary, tertiary                profile and management (Free paper)
Neovascularisation and Role of Thermal           - Technological issues - imaging,            DR.V.NARENDRAN
Lasers                                                mydriasis, telecommunication reading    - Moderator for a session
                                                      centres                                 DR. PARAG K. SHAH
Delhi, November 6– 7
DR. P. NAMPERUMALSAMY                                                                         - Comparison of threshold ROP between
                                                 First Indo Israel Ophthalmology Meet             Southern India & Southern California
- Diabetic Retinopathy – Introduction of
                                                 Chennai, November 19-20                      DR. ABIJITH
     DR the great challenge
                                                 DR. P. NAMPERUMALSAMY                        - Retinal detachment in retinitis
                                                 - Recent trends in the management of             pigmentosa
                                                     diabetic retinopathy                     DR.A.RAGHURAM
                                                 DR. DHANANJAY SHUKLA                         - Needle sub retinal fluid drainage
                                                 - Newer pharmacological therapies in DR          assisted pneumatic retinopexy – a new
                                                 DR. K. CHANDRAMOHAN                              approach – results of the pilot study.
                                                 - Epidemiology of Risk factors
                                                                                              CME Programme
                                                                                              Pondicherry ophthalmic association,
                                                                                              December
                                                                                              DR. S. MANOJ
                                                                                              - Antioxidants in retinal diseases




                                                 INTERNAL CAPACITY BUILDING - SPECIALITY TRAINING
Dr.Raghuram with Dr.Julia Haller                 Dr.A.Raghuram, Consultant, Retina Clinic, Aravind-Coimbatore visited Retinal
                                                 consultants of Arizona at phoenix,USA. There he observed the clinical and surgical
                                                 work of Dr.Sipperely and Dr.Park. Then he visited Wilmer Eye Institute and Johns
                                                 Hopkins School of Medicine, Baltimore. There he did one month of observership
                                                 under the guidance of Dr.Julia Haller who is an eminent Vitreo Retinal Surgeon.
                                                 During the observership he had the opportunity to observe various vitreo retinal
                                                 surgeries and different management aspects of Retinal disorders. He also attended
                                                 the weekly Fluorescein Conferences conducted by Dr.Andrew Shachet and Dr.Neil
                                                 Bressler.He also had the opportunity to interact and learn from Dr.Peter
                                                 Campochiaro, Dr.Ingrid Zimmer Haller and Dr.Diano Do.
                                                 Dr.Raghuram also visited the Retina Vitreous Macula consultants of NewYork and
Dr.Raghuram with Dr.Spaide                       did observership for two weeks under the guidance of eminent Vitreo Retinal
                                                 Surgeon Dr.Richard Fredrick Spaide. He also had the opportunity to interact and
                                                 learn from eminent Retinal specialists like Dr.Lawrence Yannuzzi, Dr.Slackter and
                                                 Dr.Yale Fischer. Dr.Spaide and Dr.Yannuzzi gave him the opportunity to present a
                                                 paper at the Retina conference conduted at Wills Eye Hospital, Philadelphia.
                                                 Dr.Spaide also helped him to start a study on Avastin in PDR cases. Then he visited
                                                 Dr.Abramson at the Memorial Sloan Kettering Cancer Institute and observed him
                                                 treating patients with retinoblastoma and other ocular malignancies.
                                                 Finally he visited Dr.Khaled Tawancy, a well known paediatric vitreo retinal
                                                 surgeon, at LA and observed him treat various paediatric vitreo retinal disorders.


                                                                                                                                      35
                                        STAFF -RETINA VITREOUS
                                        MEDICAL OFFICERS            FELLOWS
                                        ARAVIND - MADURAI           ARAVIND - MADURAI
                                        DR. P. NAMPERUMALSAMY       DR. VEERABHADRA RAO
                                        DR. R. KIM                  DR. RAJKUMAR MAHESWARI
                                        DR. DHANANJAY SHUKLA        DR. MUKESH MOHAN VATS
                                        DR. K. CHANDRAMOHAN         DR. JYOTHSNA RAJAGOPALAN
AWARDS                                  DR. VASUMATHY VEDANTHAM     DR. UMESH CHANDRA BEHERA
Dr. Vasumathy won the Rakesh            DR. NARESH BABU             DR. B. KOSHAL RAM
Sharma Memorial Award for her           DR. ANAND RAJENDRAN         DR. SATHYA J KAKADE
best work in ocular trauma in India.                                DR. SOMNATH CHAKARABORTHY
                                        ARAVIND - PONDICHERRY       DR. T.P. VIGNESH
The title of her work is “Clinical      DR. S. MANOJ
microbiological profile of post                                     DR. SANGHAMITRA KANUNGO
                                        DR. SATISH BADDELA
traumatic endophthalmitis at a                                      ARAVIND - TIRUNELVELI
tertiary care centre in South India”.   ARAVIND - TIRUNELVELI       DR. UMESH CHANDRA
                                        DR. SACHIN BODHALE
                                        DR. ASHER SANDEEP           ARAVIND - COIMBATORE
                                        DR. ANKIT AVATHI            DR. GEORGE J. MANAYATH
                                                                    DR. VIJAY
                                        ARAVIND - COIMBATORE        DR. ASWIN BAFNA
                                        DR. V. NARENDRAN
                                                                    DR. RAJASEKAR
                                        DR. RODNEY JOHN MORRIS
                                        DR. ABHIJIT CHATTOPADHYAY
                                        DR.V.R. SARAVANAN
                                        DR.PARAG K. SHAH
                                        DR. A.RAGHURAM




36
UVEA SERVICES




Dr. Manohar Babu in the Uvea Services at Aravind-Coimbatore


                                             Uveitis services have registered about 10,111 (about 3%) in outpatient
                                             services in Madurai Aravind Eye Hospital in the year 2005. In the Research
                                             side, Uveitis clinic has undertaken the following studies. A study on
                                             clinical presentation, diagnosis and management of infectious uveitis with
                                             respect to leptospirosis; Correlation between lepra reaction and ocular
                                             complications and Aetiopathogenesis of uveitis associated with leptospiro-
                                             sis. International and National publications include, Clinico-pathologic
                                             study on sympathetic ophthalmia following post operative bacterial
                                             endophthalmitis published in AJO 2005; Ocular therapy of leptospirosis in
                                             Murphy Current Ocular therapy Elsevier, London 2005 Ocular manifesta-
                                             tions of leptospirosis in Journal of postgraduate medicine 2005.
                                             Dr.Rathinam was elected as a member-secretary of Institutional Review
Dr. Rathinam examining a young patient at    Board, Aravind Eye Hospital. She is the Vice President of Uveitis Society
Aravind-Madurai
                                             of India.

                                             PERFORMANCE 2005
                                                                      Madurai     Coimbatore Tirunelveli
                                             Total Outpatients        10,111         8112       3584


                                             TRAINING PROGRAMMES
                                             Long term fellowship in Uvea is offered at Aravind-Madurai.

                                             LONG TERM FELLOWSHIP PROGRAMME
                                             The course was started in 1998. Only one candidate is recruited for this
                                             course every year. This fellowship is intended for candidates with a special
                                             interest in internal medicine.


                                             ONGOING RESEARCH STUDIES
                                             1. Study on clinical presentation, diagnosis and management of infectious
                                                Uveitis with reference of leptospirosis
                                             2. Aetiopathogenesis of uveitis associated with leptospirosis
                                             3. Correlation between lepra reaction and ocular complications




                                                                                                                       37
ARTICLES PUBLISHED IN PEER                  CONFERENCES ATTENDED                         STAFF -UVEA SERVICES
REVIEWED JOURNALS                           ELSEWHERE                                    MEDICAL OFFICERS
LEPTOSPIROSIS                               63rd All India Ophthalmological Society      ARAVIND-MADURAI
Ed: Cecilia Murphy Current Ocular therapy   Conference                                   DR. S.R.RATHINAM
Elsevier Ltd, London 2005                   Bhuvaneshwar, Orissa, January 13-16
RATHINAM SR, CUNNINGHAM ET
                                                                                         DR. VENU NADELLA
                                            DR. MANOHAR BABU
                                            - Primary Uveal Effusion Syndrome            ARAVIND-COIMBATORE
AMERICAN JOURNAL OF                             (Uvea Symposium)
OPHTHALMOLOGY                                                                            DR. R. MANOHAR BABU
VOL: 141 (3) 2006 MAR. p.498-507            53rd Annual conference of the TNOA-
                                                                                         ARAVIND-TIRUNELVELI
RATHINAM, SIVAKUMAR R; RAO, NARSING A       sight@height 2005
- Sympathetic Ophthalmia following          Kodaikanal, August 12-14
                                                                                         DR. ASHER SANDEEP
    Postoperative Bacterial                                                              DR. ANKIT AVATHI
    Endophthalmitis: a clinicopathologic    Dr. Rathinam was a convenor for a
    study                                   symposium on Update TNOA meet.
JOURNAL OF POST GRADUATE MEDICINE           V Annual Meeting of the Uveitis Society of
(JPGM)                                      India
VOL: 51 (3) 2005 SEP. p.189-194             Jalna, Maharashtra, October 7-8
RATHINAM, S R                               The conference was organised
- Ocular manifestations of leptospirosis
                                            under the aegis of Maharashtra
                                            Ophthalmological Society in
                                            collaboration with Orbis Interna-
                                            tional.
                                            DR.RATHINAM
                                            - Sarcoid uveitis
                                            - Paediatric uveitis
                                            - Intraocular tuberculosis - Interesting
                                                cases
                                            - Scleritis
                                            DR. MANOHAR BABU
                                            - Acquired ocular Toxoplasmosis in a
                                                presumed out break of 252 cases

                                            WHO – sponsored workshop on Good
                                            Clinical Research Practices for Ethics
                                            Committee
                                            JIPMER, Pondicherry, October 18-19
                                            The Central Drugs Standard Control
                                            Organisation (CDSCO), Government of
                                            India in collaboration with WHO
                                            conducted a series of national work-
                                            shops all over the country on various
                                            aspects of “Good Clinical Research
                                                      .
                                            Practices” One such workshop was
                                            exclusively for Ethics Committee
                                            Members.
                                            From Aravind Dr. Rathinam, Member-
                                            Secretary of Institutional review board of
                                            Aravind Eye Hospital attended this
                                            training programme. The areas covered
                                            were Evolution of Ethics, Good Clinical
                                            Practice, Informed Consent, special
                                            ethical issues in clinical research,
                                            Schedule Y. Proper functioning of
                                            committees, responsibilities of investiga-
                                            tors, Standard Operating Procedure
                                            (SOP), legal issues and GCP guidelines.
38
ORBIT & OCULOPLASTY SERVICES




Dr. Hadi.M.Khazei examining a patient in the Orbit & Oculoplasty Services at Aravind-Madurai


                                              The “Orbit and Oculoplasty clinic” has spread its wings and is now the
                                              “Orbit, Oculoplasty and Oncology Clinic.” The clinic has registered an
                                              increase of 21.5% in outpatient services and 25.6% in surgery across all
                                              hospitals in the past year. Numerous steps have been taken forward in the
                                              oncology clinic. Chemotherapy is administered for the relatively common
                                              retinoblastoma, other rarer ocular cancers and orbital cancers. The “Ring of
                                              Hope” fund has helped many to undergo chemotherapy without any
                                              charges. Oncology clinic is now a referral centre. Ocular Prosthetics
                                              Centre is equipped to deal with challenging cases with excellent results and
                                              have witnessed a significant growth in the number of custom made
                                              prostheses. Botulinum Toxin has been administered to patients of Essential
                                              Blepharospasm and other indications, with promising results. At the Indo
Dr. Viji Rengarajan examining a patient at    Israel Ophthalmology conference held in Chennai, a poster on
Aravind-Coimbatore
                                              “Anophthalmic sockets” received the best poster award. Also the clinic had
                                              the honour of a visit by Dr. William B. Stewart, who evaluated patients and
                                              chaired clinical discussions. It is expected to show further increase in the
                                              services and are in the process of standardising protocols for enhanced
                                              patient care, research and training.

                                              PERFORMANCE 2005
                                                                            Madurai       Tirunelveli Coimbatore    Pondy
                                              Outpatient Visits
Dr. Maneksha examining a patient at
                                              Paying                        16,960             3,892   3,852       2,759
Aravind-Tirunelveli
                                              Free                            3791               902   1,638         978
Dr. Usha Kim performing an Oculoplasty
                                              Total Outpatients             20,751             4,794   5,590       3,737
surgery at Aravind-Madurai

                                              Surgeries
                                              Ocular injuries                   261             110     405         134
                                              Orbitotomy                         76               0       4           0
                                              Ptosis                            182              66       0          29
                                              Lid & Socket
                                              reconstruction                  1,019               66     406         209
                                              Lacrimal surgeries              2,351              715     752         834
                                              Other surgeries                 1,594              660     882         369
                                              Total Surgeries                 5,483            1,617   2,449       1,575
                                                                                                                           39
                                            RING OF HOPE PROJECT
                                            Complete Oncology work-up and treatment of cancer cases using local
                                            therapy, chemotherapy and radiotherapy.
                                            Total No. of malignant Cases seen-109
                                            Of which 69 were treated totally free of cost using the Ring of Hope Fund.

                                            PATHOLOGY FACILITY
                                            Specimens received- 1578

                                            OCULAR PROSTHETICS LABORATORY
                                            Ocular Prosthetics lab was started as a part of the Orbit Clinic in August
                                            2004. This state-of –the-art lab was started with the help of Dr. Mark Duffy
                                            and Ms. Dori, an ocularist from US. Ms. Dori who brought the technol-
                                            ogy, trained a few staff at Aravind. Further training was given by Dr.
                                            Chandrasekar Chawan from Mumbai. This is one of the few labs in India
                                            where custom made artificial eyes are produced using the latest techniques.
                                            An impression of the patient’s socket is taken and a wax model is made.
                                            The wax model, which reflects the exact contour of the patient’s socket, is
                                            used to make a mold. The acrylic is cast into this mold resulting in an
                                            artificial eye which has the exact contour of the patient’s socket. After
                                            casting, these artificial eyes are hand painted matching with the other eye.
                                            Once lacquered and cured these artificial eyes have a three dimensional
                                            effect and look very much like the other eye giving patients a very natural
                                            look.
                                                 Such custom made artificial eye offers lot of benefits over the ready
                                            made eyes. Much more than the comfort these naturally looking eye gives
Mrs. Mahalakshmi fitting a prosthetic eye
for a young patient                         back the self esteem and confidence to the patients. Now 35 to 40 acrylic
                                            eyes are being made every month. So far 373 artificial eyes have been
                                            made since its inception. Efforts are being made to carry out facial prosthe-
                                            sis in future for patients with exenterated socket.


                                            TRAINING PROGRAMMES
                                            Long Term Fellowship Programme
                                            Long term fellowship in Orbit is offered at Aravind-Madurai since 1993.
                                            Three candidates are recruited for this course every year. This fellowship
                                            offers wide exposure to orbital disorders and external diseases of the eye.
                                            It also provides training in medical and surgical management of these
                                            disorders.

                                            ONGOING RESEARCH STUDIES
                                            1.   Prospective study of Retinoblastoma and its management
                                            2.   Spectrum of orbital disorder with histopathological correlation
                                            3.   Prospective study of Adnexal malignancies
                                            4.   Prospective study of orbital trauma
                                            5.   Prospective study of orbital infection
                                            6.   Comparison of endoscopic, endonasal DCR with conventional DCR
                                            7.   Comparison of Implant materials used in enucleation

                                            Ongoing Genetic Studies
40                                          Blepharophimosis Syndrome
CONFERENCES ATTENDED                          First Indo Israel Ophthalmology Meet     STAFF - ORBIT & OCULOPLASTY
                                              Chennai, November 19-20
ELSEWHERE                                     DR. USHA KIM                             MEDICAL OFFICERS
                                              - Dacryocystitis in Adults
63rd All India Ophthalmological Society       POSTER PRESENTATION                      Aravind – Madurai
Conference                                    - Prospective Evaluation of Contracted   DR. USHA KIM
                                                  Anophthalmic Sockets
Bhuvaneshwar, Orissa, January 13-16           - Lymphoma of the Orbit                  DR.HADI.M.KHAZEI
DR. USHA KIM                                  - Adenoid cystic Carcinoma
- Cicatricial ectropion                       - Blepharophimosis syndrome (Poster)     Aravind-Tirunelveli
- External –DCR-I believe it (Debate)                                                  DR. V. MANEKSHA
- Moderator for free paper session-2 on
    orbit and oculoplasty                     AWARDS                                   Aravind-Coimbatore
- Panelist for symposium on                   Dr. Usha Kim was awarded the Best
    demystifying orbit Instruction Course                                              DR. VIJI RENGARAJAN
                                              Poster Award for her work on
53rd Annual conference of the TNOA-           Prospective Evaluation of Con-           FELLOWS
sight@height 2005                             tracted Anophthalmic Sockets in the
Kodaikanal, August 12-14, 2005                                                         Aravind – Madurai
                                              Indo Israel Meeting held in Chennai
DR. MANEKSHA                                                                           DR. ISHAN ACHARYA
                                              in November 2005.
- Orbital infections                                                                   DR. RUPALI SINHA
- Analysis of success rate of paediatric                                               DR. DEVJOTHY
    DCR
DR. USHA KIM                                                                           DR. AUDREY QUADROS FELICIA
- Paediatric –Lacrimal surgery When                                                    DR. RISHIKANT ADHIKARI
    and How?
- Orbital Disease - In Diabetes Mellitus
- Recent Trends in the Management of
    Retinoblastoma
DR.ISHAN ACHARYA
- Blow out fracture
DR. VIJI RENGARAJAN
- Investigations that help in the
    diagnosis of orbital disorders

Aesthetic Ocular Prosthetic Meeting
M.N.Eye Hospital, Chennai, August 28
DR. USHA KIM
- Management of Facial palsy
- Pearls and Pitfalls in Ptosis Surgery

Salem Ophthalmic Association 2005
DR. VIJI RENGARAJAN
– External DCR versus Endoscopic DCR

XVI Annual Meet of the Oculoplastics
Association of India
Chandigarh, October 1- 2
DR. USHA KIM
- Anophthalmic Socket
- Endonasal DCR
DR. RAHUL KELKAR
- Microbiological spectrum and their
    antibiotic sensitivity in adult Dacryo-
    cystitis




                                                                                                                     41
NEURO-OPHTHALMOLOGY SERVICES




Dr. Mahesh Kumar in the Neuro -Ophthalmology Services at Aravind-Madurai


                                            The Neuro-ophthalmology Service is available at Aravind-Madurai,
                                            Tirunelveli, Coimbatore and Pondicherry. The Service department has
                                            registered about 10-15% of growth in terms of overall outpatient services.
                                            There has been an increase in the referrals over the last 1 year from General
                                            ophthalmologists, neurologists, neurosurgeons and other general physicians
                                            from both within the state and outside.

                                            PERFORMANCE 2005
                                                                             Madurai   Tirunelveli     Coimbatore        Pondy
                                            Paying patients                   6,267       3,561          3,631            1,330
                                            Free Patients                       164         416            815              380
Dr. S. Padmavathy examining a patient at
                                            Total Outpatients                 6,431       3,977          4,446            1,764
Aravind-Tirunelveli

                                            ONGOING RESEARCH STUDIES
                                            1. Temporal pallor in Tobacco workers
                                            2. Outcome of Traumatic Optic Neuropathy with IV steroids
                                            3. Use of OCT in Neuro-ophthalmology

                                            ARTICLES PUBLISHED IN PEER REVIEWED JOURNALS
                                            INDIAN JOURNAL OF OPHTHALMOLOGY
Dr. Kiruba J. Evangeline examining a
                                            2005 SEP; Vol. 53 (3): 200-201
patient at Aravind-Coimbatore               VENUGOPAL, N; RAMAKRISHNAN, R; SARAVANAN; EAPEN, PRINCE
                                            - Tonic Eye Deviation Due to Nonketotic Hyperglycaemia Induced Focal Seizures: case
                                                report


                                            INTERNAL CAPACITY BUILDING - SPECIALITY TRAINING
                                            Dr. Mahesh kumar visited Wilmer Eye Institute and John’s Hopkins
                                            University, Baltimore, USA. He worked with Dr.Neil Miller in the depart-
                                            ment of Neuro-ophthalmology. During this period he observed his clinical
                                            work in the outpatient department, attending his lectures and observing his
                                            surgeries. He gained lot of exposure in the methodology of work up of
                                            neuro-ophthalmology cases, latest investigations and treatment modalities.
                                            Dr.Neil Miller also gave his valuable comments on the upcoming Atlas of
                                            radiology in neuro-ophthalmology and orbital diseases containing images
                                            from the clinical cases at Aravind. He also visited Presbyterian hospital,
42
                                        Columbia University, New York         STAFF - NEURO-
                                        observing Dr.Myles Behrens of the
                                        Neuro-ophthalmology department in
                                                                              OPHTHALMOLOGY SERVICES
                                        his clinical work. He also observed   MEDICAL OFFICERS
                                        eminent Neuro-ophthalmologists
                                        like Dr. Jacqueline WinterKorn,       Aravind - Madurai
                                        Dr.Barett Katz and Dr.Floyd Warren    DR. G. NATCHIAR
                                        at work. At the 109th Annual          DR. S. MAHESH KUMAR
Dr. Mahesh Kumar with Dr. Neil Miller   American Academy of Ophthalmol-
                                                                              Aravind - Coimbatore
                                        ogy meeting in Chicago between        DR. KIRUBA J. EVANGELINE
                                        October 15-18, he attended the
                                        Neuro-ophthalmology subspeciality     Aravind-Tirunelveli
                                        day instruction courses and sympo-    DR. S. PADMAVATHY
                                        sia. Finally he spent a day with
                                                                              Aravind-Pondicherry
                                        Dr.David Chang, eminent cataract
                                                                              DR. SHARAD JOSHI
                                        surgeon at Mountain view, Califor-
                                        nia observing his surgical tech-      Neurosurgeon
                                        niques.                               DR. P. SUBBURAM


Dr. Mahesh Kumar with Dr. David Chang




                                                                                                         43
VISION REHABILITATION SERVICES




A young low vision patient


                                                  The Low Vision Service was established in the year 2000 with the vision of
                                                  helping the vision impaired and in accordance with the global initiative of
                                                  VISION 2020 to eliminate needless blindness with low vision as one of the
                                                  priority areas identified. The Low Vision Service has established a steady
                                                  and sustained growth of 48.16% from 2000 till 2005 and a growth of
                                                  6.58% from 2004 to 2005. Replication of Vision Rehabilitation Service
                                                  model as existing at Aravind-Madurai has been setup at Aravind-
                                                  Pondicherry and Coimbatore and the basic low vision assessment kit is
                                                  made available at Aravind-Theni and Tirunelveli.

                                                  PERFORMANCE 2005                      SHORT TERM TRAINING PROGRAMME
                                                  New Patients              2,951       This course is offered to
                                                  Review Patients           1,996       Ophthalmologist, Optometrist,
                                                                                        Orthoptist, Rehabilitationist who
                                                  Total Outpatients         4,947
                                                                                        are involved in Low Vision. Three
An old patient using a stand magnifier                                                  international candidates one each
                                                                                        from South Africa, Nepal and
                                                                                        Afghanistan which lacked basic low
                                                                                        vision service and one from India
                                                                                        were provided training in low vision
Dr. Ilango examining a young low vision patient                                         this year.

                                                                                        GRANT & ACTIVITY
                                                                                        The Light House International with
                                                                                        a grant from International Eye
                                                                                        Foundation provided low vision
                                                                                        assessment equipment for the low
                                                                                        vision clinics at Madurai and other
                                                                                        low vision clinics in Tirunelveli,
                                                                                        Theni, Coimbatore and Pondicherry
                                                                                        hospitals.Vision rehabilitation centre
                                                                                        at Madurai trained staff of the
                                                                                        satellite hospitals at Coimbatore and
                                                                                        Pondicherry in low vision skills and
                                                                                        service.



44
45
Training a patient to use a hand held magnifier


CME PROGRAMMES CONDUCTED CONFERENCES ATTENDED                                                 STAFF:VISION REHABILITATION
AT ARAVIND               ELSEWHERE                                                            SERVICES
Workshop on Low Vision                            63rd All India Ophthalmological Society     Medical Officer
April 3                                           Conference 2005                             DR. K. ILANGO
This workshop was held in collabo-                Bhuvaneshwar, Orissa, January 13-16
ration with integrated education                  DR. K. ILANGO                               OPTOMETRIST
implementation committee &
                                                  - Functional Vision in Low Vision (at the   SR. PITCHAI MEENA
                                                      Low Vision Symposium)
Uphaar Madurai for orienting the                  Chief Faculty Instructor-Low Vision
special teachers working in inte-                 Instruction Course
                                                  - Low Vision Aids for Macular Pathology
grated education schools.                             Disorders
Dr. P. Namperumalsamy delivered
the keynote address.                              VISITORS
DR. P. VIJAYALAKSHMI                              Mrs. Karan, CBM Advisor for Asia
- Clinical Implications of Low Vision in
    Children                                      visited Vision Rehabilitation Centre,
DR. K. ILANGO                                     Madurai and Observed the activities
- Choosing Low Vision Aids
                                                  of Low Vision Clinic along with
DR. P. SUNDARESH
- Ocular Disorders Causing Low Vision in          staff from the Low Vision Clinic,
    Children                                      Joseph Eye Hospital.
MRS. BENITTA RETNA
- Clinical Assessment in Low Vision
     Mr. Shanmugam, Secretary,
Integrated Education Committee
organised the workshop. More than
150 teachers from 6 districts
participated in the workshop. Mr.
Shanmugasundaram, joint director
office of the commissioner of
rehabilitation for the disabled, Dr.
M. Latheef Sathar, Smt.K. Sridevi,
Chief Education Officer, Madurai
participated.




46
LABORATORY SERVICES




Biochemistry laboratory Services at Aravind-Madurai


                                                  The Microbiology and Biochemistry laboratory at Madurai has been
                                             accreditated to the National Accreditation Board for Testing and
                                             Calibration Laboratories (NABL). The accreditation is in accordance with
                                             the standard ISO/IEC 17025:1999 in the field of clinical testing in
                                             Microbiology, Serology, haematology, pathology, and biochemistry. This is
                                             the highest accreditation body in India for testing laboratories.
                                                  Newer diagnostic modalities have been introduced using latest molecu-
Clinical specimen process in the Pathology   lar based methods for all the ocular infectious diseases. In the research
Department
                                             front, the etiopathogenesis of leprosy uveitis is being studied. Another
                                             research project underway is the field of fungal corneal ulcers titled “Host
                                             pathogen interaction in Human Mycotic keratitis.”
                                                  The Ocular Pathology Laboratory receives and processes samples
                                             from all four Aravind Eye Hospitals. For the year 2005, 1669 ocular
                                             samples were processed, among which retinoblastoma, squamous cell
                                             carcinoma and meibomian cell carcinoma were some of the more common
                                             tumors.

Dr. Lalitha Prajna in the Microbiology       ONGOING RESEARCH ACTIVITIES                 ARTICLES PUBLISHED IN PEER
Laboratory                                   •    Etiopathogenesis of Leprosy
                                                  Uveitis
                                                                                         REVIEWED JOURNALS
                                             •    PCR based diagnosis of infectious      INDIAN JOURNAL OF OPHTHALMOLOGY
                                                  keratitis and Endophthalmitis          VOL: 53 (1) 2005 MAR. P. 59-60
                                             •    Host pathogen interaction in           MANIKANDAN, P; BHASKAR, M; REVATHY, R; JOHN,
                                                  Human Mycotic Keratitis                RK; KALPANA, N; NARENDRAN, V
                                                                                         - Speciation of coagulase negative
Biochemistry Laboratory at                                                                   staphylococcus causing bacterial
Aravind-Tirunelveli
                                             STUDIES COMPLETED                               keratitis
                                             •    Ulcerative keratitis associated with
                                                  contact lens wear                      INDIAN JOURNAL OF MEDICAL
                                             •    Microbiological diagnosis of           MICROBIOLOGY
                                                  infective keratitis: Comparative       VOL. 23(3) 2005 JULY. P. 168-171
                                                  evaluation of direct microscopy        SMITHA, S; LALITHA, P; PRAJNA, NV; SRINIVASAN, M
                                                  and culture results                    - Susceptibility trends of Pseudomonas
                                                                                             species from corneal ulcers
                                             •    Prevalence of the bacterial
                                                  pathogens causing ophthalmic           OPHTHALMOLOGY
                                                  infections in South India              VOL: 112 (11) 2005 NOV. P. 1885-1890
                                                                                         LALITHA P, RAJAGOPALAN J, PRAKASH K, KIM, R,
                                                                                         PRAJNA NV, SRINIVASAN M;
                                                                                         - Postcataract Endophthalmitis in South
                                                                                              India: Incidence and Outcome
                                                                                                                                       47
                                      CONFERENCE ATTENDED                            STAFF - LABORATORY SERVICES
                                      ELSEWHERE                                      MICROBIOLOGY
                                      63rd All India Ophthalmological Society        MADURAI
                                      Conference 2005                                DR. LALITHA PRAJNA
                                      Bhuvaneshwar, Orissa, January 13-16
                                                                                     S. ANANTHI
                                      DR LALITHA PRAJNA
                                      - Instruction course on Sterilisation and      TIRUNELVELI
                                          Aseptic practices in ophthalmic theatres
                                      DR.M.JAYAHAR BHARATHI                          DR.JAYAHAR BHARATHI
                                      – Trends in contact lens associated
                                          Microbial Keratitis in South India         COIMBATORE
Microbiology laboratory at Aravind-
                                                                                     MANIKANDAN
Coimbatore                            Indian Eye Research Meeting
                                      Hyderabad, July 29                             PONDICHERRY
                                      DR LALITHA PRAJNA                              VIJAYAKUMAR
                                      - Susceptibility of filamentous fungi
                                          isolated from corneal keratitis to         BIOCHEMISTRY
                                          Amphotericin B, Natamycin, C               R.CHANDRASEKAR
                                          aspofungin, Itraconazole, Voriconazole
                                          and Posaconazole (poster)                  PATHOLOGY
                                      MS. S. ANANTHI
                                      - Antibacterial activity of the fourth         DR.S. SUBRAMANIAM
                                          generation fluoroquinolones against
                                          Ocular pathogens (poster)

                                      53rd Annual conference of the TNOA-
                                      sight@height 2005
                                      Kodaikanal, August 12-14, 2005
                                      MR. MANIKANDAN
                                      - Detection of Beta lactamase mediated
                                          resistance in Pseudomonas aeruginosa
                                          from ocular infections
                                      DR. M. JAYAHAR BHARATHI
Biochemistry laboratory at Aravind-   - A Comparative analysis of the spectrum
Madurai                                   of microbial keratitis in paediatric vs
                                          adults in South India
                                      - Spectrum of fungal keratitis in South
                                          India

                                      All India Conference of Medical
                                      Microbiology
                                      Chennai, October 20-22
                                      DR LALITHA PRAJNA
                                      – Speciation of Nocardia from Corneal
                                          ulcers by Molecular methods and the
                                          drug susceptibility patterns

                                      AWARDS
                                      Dr Lalitha Prajna was confered an
                                      award for the best published paper
                                      in Bacteriology in the Indian Journal
                                      of Medical Microbiology 2004 –
                                      2005. The title of the work was
                                      Non-Tuberculous Mycobacterial
                                      ocular infections.



48

				
DOCUMENT INFO