Sri Jadhavbhai Nathmal Singhvi Department of Glaucoma:

Sri Jadhavbhai Nathmal Singhvi Glaucoma Department of Sankara Nethralaya is part of specialty departments equipped with complete instrumentation for management of glaucoma.

Available Instruments in the Department:

Apart from the equipments available for routine evaluation of glaucoma (Applanation tonometer, 3 and 4 mirror gonioscopes, 90 D stereoscopic evaluation of the disc), other specialized equipments include

Outpatient activities:

Routine screening for glaucoma patients (Applanation tonometry, gonioscopic angle evaluation, optic disc evaluation with 90 D)

Visual field analysis

Gonioscopic and Disc photography – wherever necessary

Management of common and rare glaucoma entities including pediatric glaucomas

Cross consultations from other departments include complicated and post surgical glaucomas (such as post penetrating keratoplasty, post vitreo-retinal surgeries, post uveitic, post traumatic) and their management.

Interactions with glaucomologists through glaucoma net on difficult cases wherever necessary

Minor OPD procedures:

Inpatient procedures:

Major

Minor

Research activities:

Fellowship program:

The glaucoma fellowship program is meant to train the ophthalmologists in the subspecialty of glaucoma, in both medical and surgical management of common and complicated glaucomas

Training period: 18 months

Eligibility: D.O. or M.S. or DNB from a recognized institute with adequate surgical exposure to routine cataract surgery with IOL implantation under microscope. Preferable to have personal interest to pursue a career in the sub specialty of glaucoma, at least as part of his/her clinical practice.

Break up of training period:

First 4 months: The fellow will be oriented to the routine practices of the institute in the first month. Subsequently the fellow will be posted in the Neuro-Ophthalmology department for 15 days, Glaucoma Diagnostics for 15 days and Community Ophthalmology Department for a month. In the forth month, the fellow can choose any 2 posting of 15 day each in the Vitreo-Retina, Cornea, Uvea or Emergency Ophthalmology Departments. This period will serve to prepare the fellow for the forthcoming glaucoma training.

During this tenure, the fellow, after consultation with the director of the department has to formulate a prospective research proposal for his/her period of stay (minimum of one year) which needs to be approved by the research / ethics committees of the hospital.

Next 7 months: The fellow will be rotated and will have postings with glaucoma consultants. The fellow will be trained in basic OPD evaluation, visual field evaluation, postoperative care and follow up of patients along with observation of minor OPD and OT procedures and major OT procedures. The fellow will actively assist in OT procedures. The fellow will also be responsible for inpatients of the consultant under whom he/she is posted. The fellow will be allowed to perform OPD and OT procedures as mentioned above under the consultants' supervision.

The fellow should start on the research schedule he/she has prepared under the guidance of one of the senior glaucoma consultants. The fellow is encouraged to do combined cataract and glaucoma procedures and trabeculectomies under supervision on selected patients. The fellow will have training with all the instruments mentioned above (excluding UBM) during this period.

Last 7 months: In the 12th Month of the fellowship program, the fellow will do glaucoma emergency and cross consultations under the supervision of a glaucoma consultant. In the last 6 months, the fellow will be encouraged to have independent consultations in the outpatient department. They will continue to perform surgeries and are also encouraged to supervise their junior colleagues. They have to present and publish their research work in a scientific meeting and journal during this period.

Summary of clinical training:

Level 1

Basic evaluation of glaucoma patient (AT, Gonioscopy, Disc evaluation)
Operation of Humphrey visual field analyzer
Nerve fiber analyzer
HRT
OCT
Ultrasound Biomicroscopy (Observation)

Level 2

YAG peripheral iridotomy
Cyclodestructive procedures
Postoperative wound modulation in glaucoma surgeries
Evaluation under general anesthesia in pediatric glaucomas
Trabeculectomy
Combined cataract and glaucoma procedures

Level 3

Basic research methodology

Disc photography

Apart from clinical and surgical training, active participation in journal clubs and clinical presentations in department meetings and academic sessions of the institute will be encouraged.

Evaluation of performance of fellows will be done by internal assessment tests conducted once in 6 months.