Prepared by: Dr. N Radhika
Reviewed by: Dr. Rama Rajagopal
Updated on: June 2023

Cornea, External Disease & Anterior Segment Fellowship offered by C J Shah Cornea Services, Sankara Nethralaya, is designed to provide a comprehensive training in medical and surgical management of disorders of the ocular surface, cornea, and anterior segment.

CJ Shah Cornea Services of Sankara Nethralaya caters to large number of patients with diverse corneal and external diseases from all over India.

The department is actively involved in the management of various corneal infections, aided by the department of Microbiology. A wide spectrum of corneal infections are seen in the cornea emergency department and many present in the advanced state with perforation. Such cases are taken up on an emergency basis for tectonic procedures or therapeutic penetrating keratoplasty.

C U Shah Eye Bank of Sankara Nethralaya is well established. The eye bank collects more than 1200 eyes every year and is equipped with eye bank specular microscope. More than 650 corneal transplant surgeries are preformed routinely every year. Main indications for keratoplasty include aphakic and pseudophakic bullous keratopathy, corneal opacity secondary to infection or trauma and corneal dystrophies. Lamellar keratoplasties like deep anterior lamellar keratoplasty and endothelial keratoplasty are routinely being performed.

Ocular surface disorders are a common referral to the cornea services. Our Ocular Surface Diseases Clinic offers comprehensive care to these patients. Proper evaluation of the patient including various staining techniques and rational treatment approach is practiced. Procedures like punctal occlusion, surface reconstruction with limbal autograft and allograft, amniotic membrane transplantations are regularly performed. In the end stage ocular surface disorders, the only option left is a keratoprosthesis. This is also one of the centres in Asia for Boston Keratoprosthesis. The department is doing Osteo-Odonto Keratoprosthesis for such patients.Late Prof. G. Falcinellei of Italy, who is the pioneer in this field, was instrumental in initiating OOKP.

The department is also actively involved in the management of ocular surface neoplasms, aided by the department of Pathology and the department of Oculoplasty. A large number of keratoconus patients are seen and Collagen Cross Linking performed.

There is a designated refractive surgery suite and meticulous pre-refractive surgery evaluation if performed here. Facilities include microkeratome LASIK, Femto-second LASIK, SMILE, epi-LASIK, Photorefractive keratectomy and ICL. The department is equipped with Allegretto excimer laser system. It also has corneal topography – TMS 4, non-contact specular microscope – Konan, Wavefront aberrometer and an ultrasonic pachymeter. 20 to 25 refractive surgical procedures are performed every week.

The fellowship program is for a duration of two years.

This encompasses intensive training in corneal and external diseases. During this period, the fellow will be exposed to patients with a variety of corneal and external diseases, ranging from complex refractive errors to unusual ocular complications of systemic disease.

At the end of one year, the fellow is posted in diagnostics for learning the basics of contact lenses and for learning the technical know-how of the various investigation modalities available for aiding in diagnosis of corneal diseases. In this month. the fellow also receives posting in glaucoma department for one week.

During the last six months the fellow is independent in the evaluation and management of patients, and is responsible for running the cornea emergency clinic under consultant supervision.

The fellow is expected to develop clinical judgment and surgical skills in an environment devoted to excellence in patient care. He/she is supervised in the clinical and laboratory evaluation of patients and participates in surgery. Emphasis is placed on the appropriate evaluation of various disorders, including careful history taking, thorough clinical examination, appropriate diagnostic testing and rational therapeutic planning. He/she is expected to gain experience in various investigative modalities like corneal scrapings for infective keratitis, basic staining techniques, specular microscopy, corneal topography, pachymetry, outpatient procedures etc. The fellow will be posted to handle cornea E independently with necessary help from consultants.

The fellow is expected to be trained in proper evaluation and medical and surgical management of corneal infections. He/she will be exposed to evaluation and management of patients undergoing keratoplasty and is expected to manage dry eye patients and patients with other ocular surface disorders. The fellow will be actively involved in counseling patients undergoing refractive surgery and also in pre-procedure assessment and post- procedure evaluation and management of these patients.

The cornea fellow will attend all academic sessions offered by Sankara Nethralaya. There will be academic meeting once a week. He/she is expected to give seminars, present interesting and difficult cases in these meetings. He/she will have to keep himself/herself updated about the newer developments in the field by reading all the latest journals that are available, and present interesting articles in the weekly departmental meetings.

The fellow is expected to be actively involved in the training of postgraduates. He/she will have to train postgraduates in the basics of cornea from slit lamp examination to various diagnostic tests like corneal scraping, pachymetry, and specular microscopy and also in diagnosis and management of various corneal and external eye diseases.

Candidates who have DNB/MS/MD in ophthalmology are eligible.

Age Limit: Upto 40 years

Clinical cornea fellowship program
Duration: 2 Years

Fellowship program includes :
Orientation
Posting with Consultants
Jaslok Community Ophthalmic Center (JCOC) posting
Emergency clinic posting
Senior Residency

Stipend
Current stipend is 30,000 INR per month (subject to change)
Annually, 14 days of paid vacation