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Glaucoma Fellowship Training Programme
Prepared by : Dr Aditya Neog Reviewed by : Dr L Vijaya Date : 17/03/08
Faculty in the department:
Dr L. Vijaya (Director)
Dr B. Shantha(Deputy Director)
Dr M. Baskaran
Dr Arun Kumar Narayanaswamy
Dr Vineet Ratra
Dr Hemamalini Arvind
Dr Ronnie George
Dr Aditya Neog
Dr Sachi Devi
Dr G. T. Sunil
Dr. Nikhil Choudhari
Dr M.B. Madhuri
Department: Sri Jadhavbhai Nathmal Singhvi glaucoma department of Sankara Nethralaya, is part of specialty departments equipped with complete instrumentation for management of glaucoma.
Instruments available: Apart from the equipment available for routine evaluation of glaucoma (Applanation tonometer, 3 and 4 mirror gonioscopes, 90 D stereoscopic evaluation of the disc), other specialized equipments include
Tonopen
Perkins handheld Applanation tonometer
Koeppe direct gonioscopes (for pediatric angle assessment)
Humphrey visual field analyzer
Frequency Doubling Perimeter
Nerve fiber analyzer (GDx)
Zeiss fundus photography unit (for stereoscopic disc photography)
Ultrasound Biomicroscopy
Heidelberg Retinal tomography
Optical coherence tomography
Outpatient activities include
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 include
Nd: YAG peripheral Iridotomy
Argon Laser Trabeculoplasty
Argon Laser Iridoplasty
Argon Laser Suturelysis
Postoperative 5FU injections
Inpatient procedures include
Major
External trabeculectomy for congenital glaucomas
Combined cataract and glaucoma filtering surgery including phacoemulsification
Trabeculectomy with use of antimetabolites
Use of releasable suture technique
Filtering surgeries with vitreoretinal surgeries (along with the retinal surgeons)
Aqueous drainage (Ahmed glaucoma valve and Baervaldt valve) implant
Surgery for complications following filtering procedures include
AC reformation + choroidal drainage
Needling of blebs
Revision of blebs
Management of overfiltering and leaking blebs
Cataract surgery (ECCE or Phacoemulsification) in post filter situations
Minor
Evaluation under anaesthesia for pediatric glaucomas
Diode cyclophotocoagulation
Cyclocryotherapy
Research activities include
Glaucoma epidemiology project
Antiglaucoma drug trials
Basic and clinical research
Fellowship programme:
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.
Summary:
First 3 months: General ophthalmology.
Next 9 months: Glaucoma department.
Last 6 months: Independent consultations.
First 3 months: The fellow will be oriented to the routine practice in the institute with postings in community ophthalmology department, uvea, trauma, and cornea departments. This period will serve to prepare the fellow for the forthcoming glaucoma training.
During this tenure, the fellow, after consultation with the director, glaucoma 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 9 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 6 months: The fellows 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 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
Ultrasound Biomicroscopy (observation only)
HRT
OCT
Level 2
YAG peripheral iridotomy
Cyclodestructive procedures
Postoperative wound modulation in glaucoma surgeries
Evaluation under GA in pediatric glaucomas
Trabeculectomy
Combined 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.
Duration: 18 months
Please click here to download Application Form
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