YOTiMES15 PDF

OFFICIAL PUBLICATION OF THE YOUNG OPHTHALMOLOGISTS SOCIETY OF INDIA
YO TiMES
 
ISSUE 15, AUG 2019
Dr SUBER HUANG
GUEST EDITORIAL
Dr HARRY W FLYNN Dr S. NATARAJAN

5 QUESTIONS MASTERING YOUR MIND
Dr F. BANDELLO Dr H. BHATTACHARJEE
TIPS FOR A YOUNG VR SURGEON MAXIMISING YOUR VR FELLOWSHIP
Dr SUBHADRA JALALI Dr JOSEPH MAGUIRE:

Dr PARVEEN SEN FINAL LESSONS
WOMEN IN RETINA - DR NEHA GOEL -DR. JAYANTH SRIDHAR
Dr BERTHOLD SEITZ
CORDULA GABEL-OBERMAIER
ICO FELLOWSHIP PROGRAM
MENTORS PANEL ON VITREO-RETINA TRAINING

• Dr ANAND RAJENDRAN • Dr ATUL KUMAR • Dr GURUPRASAD AYACHIT
• Dr MAHESH SHANMUGAM • Dr MANABJYOTI BARMAN • Dr MANISH NAGPAL
• Dr RAJA NARAYANAN • Dr SHOBHIT CHAWLA • Dr VISHALI GUPTA
MENTOR’S PERSPECTIVE THE BIG QUESTIONS NEW FRONTIERS FELLOWSHIP PEARLS
DETAILED INFORMATION ON RETINA TRAINING PROGRAMS IN INDIA & ABROAD
VITREO-RETINA TRAINING SPECIAL

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E DI TOR I A L
Dear Friends,
After completing residency, once the initial euphoria wears off , one is hit by a fresh wave of
panic thinking of ‘What Next’? During this time few questions haunt the mind, whether to go
for a fellowship or not? If yes, then one has to make very important decisions regarding the
choice of sub speciality and institute. Then starts a series of frenzied internet searches,
multiple phone calls, emails and queries to collect information. The problems don’t end there!
Most often the realisation that the fellowship/training period is one of the most crucial phases
in a surgeons’s life, comes towards the fag end of the fellowship. One needs and seeks a lot of
guidance not only in choosing but also in the execution of the fellowship/training.
Often in such exasperating moments, one wishes that there were a ‘go to’ single resource
which could make this herculean task simple. So, when my co-editor Dr Apoorva Ayachit and
I were brainstorming over ideas for the next issue, we thought of attempting to develop a
resource which every aspiring vitreoretina surgeon could find useful.
The issue has been divided into seven segments:
The segment Mentors Perspective is full of words of wisdom from the doyens of vitreoretina.
The highlight of this issue is the Mentors Panel on VR Training. We urge all aspiring VR
surgeons to read and imbibe each word carefully, as it will give them a precious insight into
the thought process of the Mentors and their expectations from a trainee.
Our Segment The Big Question deals with several burning dilemmas, which are often
debated but rarely answered. New Frontiers will bring to you the latest in the world of VR.
We have collected a bunch of wonderfully written articles in the segment Fellowship Pearls,
which deal with various aspects of vitreoretina training.
An International fellowship gives one the opportunity to learn from international masters and
gain invaluable exposure. So, we have added a segment on International
Training, which will make you aware of various long and short term
international training opportunities in vitreoretina.
In the segment Institute watch, we have put together relevant information
about institutes that offer vitreoretina training in India along with
fellowship interview experiences and tips from successful candidates.
 
Though we understand that by no means is this an exhaustive resource, but we hope it will
provide some guidance to aspiring VR Surgeons, Fellows in Training & Young Retina
Surgeons. To keep the information in this issue relevant and current, we plan to update it
regularly. Any ideas, suggestions or contributions in this regard are most welcome. As an
Dr Aniruddha
extension Agarwal
to this Dr Apoorva
issue and other forthcoming Ayachit
training Dr Ashish Ahuja
specials of other sub specialities, we
VR Fellow,
Consultant, VR
Consultant, VR
have PGI,
launched the YOSI FELLOWSHIP
Chandigarh
HELP
MM Joshi DESK.
Eye Hospital, Hubli
It is a uniqueSadhu
service
Kamalthat will Mumbai
Eye Hospital,
allow YOSI members to seek fellowship advise from a panel of experts.
We are indebted to our seniors and mentors for their whole hearted support to this
endeavour of ours. Everybody we approached was very forthcoming and encouraging, and
for this we thank them from the bottom of our hearts. This issue is dedicated to our mentors,
to whom we owe all our knowledge and skill. The cover represents the same spirit, where Dr
Dr Awaneesh Upadhyay Dr Bhavik Panchal Dr Chintan Desai
Ronel Soibam (Senior Vitreoretina Consultant,
Consultant,VR
Sri Sankardeva Nethralaya) is seenVRcarefully
Consultant,VR
Fellow,
Sri Sankaradeva Nethralaya, Guwahati

LVPEI, Visakhapatnam
guiding a young surgeon through a buckling procedure, while another trainee looks on.
Each and every contribution has been carefully crafted and lot of effort has gone into all the
articles. We applaud the contributors for their excellent articles and timely submissions.
This issue has been a tremendous team effort and it would not have been possible without
Druntiring
the Diva Kant Misraof the Editorial Team. Dr
efforts Jay Sheth
I thank all of them for taking out Dr Mayank
time Bansal
from their
VR Fellow
Consultant,VR
Consultant,VR
Sri busy schedules

Sankaradeva and
Nethralaya, being part of this issue.
Guwahati
Surya Eye Institute, Mumbai
Fortis Memorial Research Institute,
Gurgaon
I hope you find this issue useful and interesting. Please feel free to send us your feedback.
Dr. DIVA KANT MISRA

DO, Dr
DNB,Neha
MNAMS,Goel
FVRS Dr Samendra Karkhur Dr Sahil Bhandari
Senior Consultant, VR
Assistant Professor( Ophthalmology)
ICARE Eye Hospital & PG Institute, AIIMS Bhopal

Guru Hasti Chikitsalya, Pipar
CHIEF EDITOR
NOIDA
City(Jodhpur)
Young Ophthalmologists Times
GENERAL SECRETARY
Young Ophthalmologists Society of India
VITREORETINA FELLOW
Ph No: +91 9670964875 / +91 7002180323

Email: [email protected] / [email protected]
Website:
Dr Tanyawww.yosi.in
Jain Dr Vedang Shah
VR Fellow
Consultant, VR
Sadguru Netra Chikitsalaya, Chitrakoot

Shree Netra Eye Foundation, Kolkata.
ii
S I
O
 
Y F E L L O W S H I P
YOSI FELLOWSHIP HELP DESK

YOSI announces a dedicated help desk for
counselling & information related to various
fellowship opportunities (all specialities) in India
and abroad. It is a free service available to all YOSI
Members.
The process is simple, write a mail to

[email protected] with the subject “YOSI
FELLOWSHIP HELP DESK”. Along with
your query, kindly provide all relevant
information and contact detail for prompt
redressal.
The email will be replied by a FELLOWSHIP

HELP DESK team member of the concerned
sub speciality, within 48 hours. 
iii
EDITORIAL TEAM YOT 15
 
Dr Aniruddha Agarwal Dr Apoorva Ayachit Dr Ashish Ahuja

Assistant Professor
Consultant, VR
Consultant, VR
PGI, Chandigarh
MM Joshi Eye Hospital, Hubli
Sadhu Kamal Eye Hospital, Mumbai
Dr Awaneesh Upadhyay Dr Bhavik Panchal Dr Chintan Desai

Consultant,VR
Consultant,VR
VR Fellow,

LVPEI, Visakhapatnam
Dr Diva Kant Misra Dr Jay Sheth Dr Mayank Bansal

VR Fellow
Consultant,VR
Consultant,VR

Surya Eye Institute, Mumbai
Fortis Memorial Research Institute,
Gurgaon
Dr Neha Goel Dr Samendra Karkhur Dr Sahil Bhandari

Assistant Professor
ICARE Eye Hospital & PG Institute, AIIMS, Bhopal

Guru Hasti Chikitsalya, Pipar
NOIDA
City(Jodhpur)
Dr Tanya Jain Dr Vedang Shah

VR Fellow
Consultant, VR
Dr Shroff Charity Eye Hospital, Delhi

Shree Netra Eye Foundation, Kolkata.
iv
YO TiMES I AUG 2019
 
EDITORS AT WORK
YOSI OFFICE BEARERS
 
Dr Digvijay Singh Dr Sonal Kalia Dr Diva Kant Misra

President, YOSI
Vice President, YOSI
General Secretary, YOSI
Director, Noble Eye Care

Assistant Professor
Vitreoretina Fellow
HOD (Ophthal), Narayana SMS Medical College, Jaipur

Sri Sankaradeva Nethralaya
Hospital , Gurgaon Guwahati
Dr Karan Bhatia Dr Apoorva Ayachit Dr Indeevar V Mishra

Jt. Secretary, YOSI
Academic Incharge, YOSI
Treasurer, YOSI
Assistant Professor,
Consultant, Vitreoretina
Proprietor, Bhalanetra Super-
RIO, Sitapur
MM Joshi Eye Hospital, Hubbali
Eye Hospital
speciality Eye Hospital
Mumbai
Dr Awaneesh Upadhyay
Jt. Treasurer, YOSI
Consultant, Vitreoretina
vi
YO TiMES I AUG 2019
YOSI EXECUTIVE MEMBERS
 
Dr Akshay G Nair Dr Aniruddha Agarwal Dr Annu Joon Dr Ashish Ahuja
Dr Bhavik Panchal Dr Biswajit Dey Dr Chintan Desai Dr Jay Sheth
Dr Mayank Bansal Dr Mainak Bhattacharyya Dr Nandini Chandak Dr Neha Goel
Dr Nilutparna Deori Dr Ronak Solanki Dr Sahil Bhandari Dr Samendra Karkhur
Dr Saurabh Agrawal Dr Sumit Grover Dr Vaitheeswaran L G Dr Vedang Shah
vii
YO TiMES I AUG 2019
Y O S I R E P O R T
YOUNG OPHTHALMOLOGISTS SOCIETY OF INDIA

(YOSI)
- Dr DIVA KANT MISRA
The Young Ophthalmologists Society of India (YOSI) was established on 1st January
2014 under the able leadership of Dr Tarun Arora & Dr Vijay Sharma. It is a registered
society affiliated to All India Ophthalmological Society (AIOS) that caters exclusively to
the needs of ophthalmologists in training , within five years of training or ophthalmologists
under 40 years of age. At present, it has a membership of over 2,700 and has risen as a
platform for the for Young Ophthalmologists(YO) to voice their concerns and get guidance
for a successful and balanced career. It also aims to act as a bridge between the senior
leadership and the young ophthalmologists.
YOSI had humble beginnings and started as an online platform. The power of social media
was used to connect young ophthalmologists. Online platforms like Facebook and twitter
were utilised for information sharing, case discussions, job opportunities, emotional sup-
port and other relevant issues. YO Central , a Dropbox based distribution platform was
established which housed hundreds of e-books and journals for the use of our members.
YOSI Executive members at AIOS YO LOUNGE, AIOC2019. L to R Dr Vedang Shah (Executive Member),
Dr Vaitheeswaran LG (Executive Member), Dr Ashish Ahuja (Executive Member), Dr Nilutparna Deori
(Executive Member), Dr Apoorva Ayachit (Academic Incharge), Dr Diva Kant Misra ( Secretary), Dr Karan
Bhatia (Jt. Secretary), Dr Digvijay Sigh(President).
viii
YO TiMES I AUG 2019
YOSI started a quarterly magazine, the YO Times, which gave YOs the opportunity to see
their work in print. It also contains words of wisdom form our leaders, senior
ophthalmologists and clinically relevant articles as well. We have published 14 issues till
date, and all have been highly successful. YO Tube ( Chief Editor : Dr Karan Bhatia) a
YouTube channel was created to generate educational content in video format. It is
regularly updated with high quality ophthalmic videos. Another project by YOSI is the YOSI
Flashnotes (Editors : Dr Awaneesh Upadhyay & Dr Chintan Desai). The flash notes
aid in understanding and memorising ophthalmic facts and knowledge quickly. YOSI is
working on a Mentor Mentee program, which will help YOs to connect directly with the
masters.
YOSI has been very active in conducting physical meetings as well. We conducted our first
meeting YES(Young Eye Surgeons) meet in Delhi in 2015. We have been part of sessions
at an international level like in EURETINA, Vienna 2018 & APAO Bangkok 2019. Under
the guidance of Dr Namrata Sharma, we conducted our first international meeting the
AIOS-YOSI Forum in November 2018 in collaboration with All India Ophthalmological
Society & Singapore Society of Ophthalmology.
YOSI O!ce Bearers : Standing L to R Dr. Sonal Kalia ( Vice President ) Dr. Vijay Sharma ( Immediate Past Presi-
dent), Dr Lalit Verma (Chairman Scientific Committee, AIOS), Dr Rajesh Sinha (Treasurer , AIOS), Dr Namrata
Sharma (Secretary, AIOS), Dr Diva Kant Misra ( Secretary) , Dr Awanessh Upadhyay ( Jt. Treasurer), Dr Apoorva
Ayachit ( Academic Incharge). Sitting L to R Dr Karan Bhatia ( Jt. Secretary) , Dr Indeevar V Mishra ( Treasurer).
ix
YO TiMES I AUG 2019
For the first time in the history of AIOC a dedicated YO Lounge was created during
AIOC2019, Indore. It was packed with YO Centric activities ( Meet the Mentors, YOSI
HACKATHON, YORCC(Young Ophthalmolo- gists Retina Case Competition), Young
Ophthalmologists Oculoplasty Case Competition, Extempore Speech Competitions
etc) and was very popular amongst the young surgeons. YOSI also conducted two
Instruction Courses in AIOC2019 under the supervision of Dr Lalit Verma. In collaboration
with AIOS ARC and under guidance of Dr Partha Biswas , YOSI conducted the AIOS
ARC YOSI QUIZ at AIOC2019 which had prizes upto 2 Lakh Rupees.Under guidance of
Dr S Natarajan, YOSI conducted the AIOS YOSI Writing Competition on the theme of
Diabetic Retinopathy Screening. The competition was judged by Dr Suber Huang, Dr
Harsha Bhattacharjee, Dr Vishal Agarwal & Dr Neha Goel. It received a record number
of entries & ten winners were awarded travel grants for AIOC2020, free registration for
AIOC2020 and ophthalmic text books at AIOC2019.
Our seniors have been extremely supportive and granted us sessions in the major nation-
al level conferences like AIOC, ISCKRS, KERACON, EIZOCON, IIRSI, iFOCUS, OPAI
etc. Major state societies like Delhi (DOS), Maharshatra (MOS), ( West Bengal
(OSWB), Orissa(OSSA) , Karnataka (KOS), Punjab (POS), Uttar Pradesh (UPSOS),
Bihar (VRSB) have welcomed YOSI with open arms to conduct sessions in their state
conferences. These session have been very well attended have received a lot of apprecia-
tion.
The first ever YOSI elections were conducted in November 2018 and a young and ener-
getic team was elected ( President : Dr Digvijay Singh, Vice President : Dr Sonal Kalia,
Secretary : Dr Diva Kant Misra, Jt. Secretary : Dr Karan Bhatia, Treasurer : Dr Indeevar
Mishra, Jt. Treasurer : Dr Awaneesh Upadhyay, Academic Incharge : Dr Apoorva Aya-
chit.). A team of Executive Members were also elected: Dr. Akshay Nair, Dr. Aniruddha-
YOSI Executive Members and Speakers at the AIOS YOSI Young Ophthalmologists Forum, New Delhi 2018
x
YO TiMES I AUG 2019
Agarwal, Dr. Annu Joon, Dr. Ashish Ahuja, Dr. Bhavik Panchal, Dr. Biswajit Dey,Dr.
Chintan Desai, Dr. Jay Sheth, Dr. Sahil Bhandari, Dr. Mainak Bhattacharyya, Dr.
Mayank Bansal, Dr. Neha Goel, Dr. Nandini Chandak, Dr. Nilutparna Deori, Dr. Ronak
Solanki, Dr Samendra Kharkur, Dr. Saurabh Agarwal, Dr. Sumit Grover, Dr.
Vaitheeswaran L G, Dr. Vedang Shah.
YOSI has been very active in collaborating with international ophthalmic societies. Our
executive member Dr Aniruddha Agarwal officially represented YOSI at AAO2018,
Chicago. Dr Diva Kant Misra was invited to represent YOSI at EURETINA 2019, Vienna.
Dr Diva Kant Misra represented YOSI in a APAO-AAO-SOE (European Society of Oph-
thalmology)-YOSI joint session at APAO2019, Bangkok.
YOSI @KOS2019 Busan (South Korea), APAO2019 Bangkok (Thailand) & EURETINA2019 Vienna (Austria)
A YOSI delegation ( Dr Diva Kant Misra, Dr Karan Bhatia, Dr Ashish Ahuja & Dr
Mainak Bhattacharyya ) was given travel grants and invited by the Korean Ophthalmo-
logical Society to participate in their 121st Annual Congress in Busan, South Korea.
YOSI has established strong ties with American Academy of Ophthalmology (AAO YO)
European Society of Ophthalmology (SOE YO), Singapore Society of
Ophthalmology (SSO YO), Hong Kong Society of Ophthalmology YO,
Ophthalmological Society of South Africa (OSSA YO), Turkish Ophthalmic
Association (TOA YO) and other prominent societies.
Dr Diva Kant Misra has been invited to speak in the YO Session of American Academy
of Ophthalmology 2019, San Francisco. Dr Samendra Karkhur & Dr Diva Kant Misra
have been invited to speak in the Turkish Ophthalmic Association annual conference
2019, Antalya, Turkey.
xi
YO TiMES I AUG 2019
In an attempt to decentralise its activities and to manage the increasing number of its
members, YOSI has decided to form state chapters. Maharashtra Ophthalmic Society
(MOS) has allowed us to create the first state YOSI chapter and we have formed a joint
committee of ten members to cater to the needs of Young Ophthalmologists in Maharash-
tra. Additionally, MOS has given dedicated slots to YOSI in the upcoming MOSCON2019.
Similarly Odisha YOSI chapter was launched on 16th June in Bhubhaneshwar under the
leadership of Dr Biswajit Dey. Jammu & Kashmir, Assam, New Delhi and many other
state chapters are in the pipeline.
YOSI ODISHA State Chapter Installation Ceremony: Back row (left to right) Dr. Pramod Sharma, Dr. BNR Subudhi,
Dr. Ashok Nanda, Dr. Biswajit Dey, Dr. Praveen Subudhi, Dr. Sudeep Das, Dr.Sushil Kar. Front row (left to right)
Dr. Devdutta Nayak, Dr. Sindhunandini Sahoo, Dr. Aparna Dwibedi, Dr. Amrita, Dr. Sweta Patro, Dr. Deepak
Chaudhry, Dr. Chandrasekhar Sahoo
In collaboration with AIOS, YOSI is in the process of formulating Travel & Research
grants for young ophthalmologists who have interest in research related activities.
With the strong foundations laid by our founders, support of our senior leaders & backing
of a strong team, YOSI has reached a place where it can actually support and guide YOs
in their careers and beyond. We hope to continue doing good work & make a positive im-
pact in the lives of young ophthalmologists.
To become a YOSI member visit http://www.yosi.in or send an email to

[email protected]
xii
YO TiMES I AUG 2019
 
ii
P A G E
Mentor’s perspective
1. Guest Editorial : Role of a Mentor

Dr Suber Huang 1
2. 5 Questions with Dr Flynn
Dr Harry W. Flynn 3
3. Mastering Your Mind
Dr S Natarajan 6
4. Maximising your VR Fellowship
Dr Harsha Bhattacharjee 10
5. Tips for a Young Retina Surgeon
Dr F. Bandello 14
6. Final Lessons from a Mentor
Dr Jayanth Sridhar 16
7. Women in Retina
Dr Subhadra Jalali, Dr Parveen Sen, Dr Neha Goel 19
8. Mentors Panel on V R Training 30
P A G E
the BIGquestion
9. Fellowship: To Do or Not To Do ? 59
Dr Manoj Khatri
10. S e n i o r R e s i d e n c y
Fellowship ?
or 63
Dr Samendra Karkhur
11. Medical Retina or Surgical

Retina ?
66
Dr Chintan Desai
Dr Saurabh S. Mistry
Dr Amit Palkar
12. How to find the right Fit ? 76

Dr Chintan Desa
Dr Smriti Mishra
Dr Vishal Govindhari
Dr Tanya Jain
P A G E
NEW FRONTIERS
13. Research & fellowship: Can they go hand in hand?

Dr Sabyasachi Sengupta
83
14.How to be Innovative during Training phase ?
Dr Ashish Ahuja
87
15. PhD (Doctorate of Philosophy): the path less
trodden
91
Dr Chaitra Jayadev
16.My Artificial Intelligence Journey: And How to

write good AI papers in Ophthalmology?
95
Dr Daniel SW Ting & Dr Aaron Y Lee
17. Precision Medicine & CRISPR Genomic Editing in

Retina
100
Dr Mayank Bansal
18.Role of simulators in surgical training

Dr Vedang Shah
102
P A G E
 
FELLOWSHIP PEARLS
tips to succeed as a VR fellow and beyond…
19. What’s behind a proper Vitreoretina training ?

Dr. Rodolfo Mastropasqua
105
20.Try! Try! Try! Till you succeed
Dr. Pritam Bawankar
106
21. Step by Step Vitreoretina Surgical Training
DrDrMayank
Mayank Bansal
Bansal, Dr&Vinod
Dr Vinod Kumar
Kumar Aggarwal
109
22.Ergonomics in our ophthalmic World
Dr R Krishnaprasad
113
23.How to study as a Young Vitreoretina Student ?
116
24.Online Resources for a Vitreoretina Trainee
Dr Jay Sheth
122
25.FAICO Examinations : All you need to know!
Dr. Mahima Jhingan
129
26.Tips for FAICO preparation and wider reading
during a VR Fellowship.
133
Dr. Apoorva Ayachit
P A G E
FELLOWSHIP PEARLS
27. Nuances of Retinal Imaging : A case based

discussion
140
Dr. Mohit Dogra
28.Conferences and Travel Grants

Dr Diva Kant Misra
147
29.Retina Conferences : 2019 - 2020
Dr Tanya Jain
150
30.Establishing an Independent Retina Practice
Dr Bikramjit P Pal
155
31. Best Comebacks to things people say to women in
vitreoretina: A comprehensive manual
163
Dr. Apoorva Ayachit
32.Differential Wars
Dr Mahima Jhingan,
167
Dr Jay Chabblani
Dr Komal Agarwal
P A G E
INTERNATIONALTraining
33. The ICO Three Month/One Year Fellowship Program
Prof. Dr. Berthold Seitz & Cordula Gabel-Obermaier

172
34. FICO exams & ICO fellowships: My experience
Dr Chintan Dedhia
178
35. Vitreoretina Fellowship in Korea
Dr Jeeyun Ahn
183
36. US Fellowship experience
Dr Aniruddha Agarwal
188
37. International Fellowship Programme in Hong Kong
Dr Lawrence Pui-Leung IU
194
38. Fellowship Experience in Hong Kong
Dr Ahmed Al Satrawi
196
39. Vitreoretina Training & Working in Germany : An Overview
Dr Aditya Sudhalkar
199
40. International fellowship program, Singapore National Eye Centre
Dr. Thiyagarajan Jayabaskar
204
41. SNEC-AIOS-ARC-Fellowship Interview Experience
Dr Sahil Bhandari
210
42. EURETINA—Young Retina Specialists
Dr. Fischer M. Dominik
215
43. ESASO
Dr Sahil Bhandari
216
44. GOAP Fellowship Award: My Experience
Dr Prerna Shah
221
P A G E
INSTITUTE WATCH
SENIOR RESIDENCY
45. GNEC, New Delhi 225
46. PGI, Chandigarh 229
47. McH Vitreoretina, PGI, Chandigarh 231
48. RP Centre, AIIMS, Delhi 233
FELLOWSHIPS
49. Aditya Jyot Eye Hospital, Mumbai 235
50. Aravind Eye Hospital, Madurai 238
51. Centre for Sight Eye Institute, New Delhi 242
52. Chaithanya Eye Hospital And Research Institute, 247
Thiruvananthapuram
53. C.H. Nagri Eye Hospital, Ahmedabad 251

54. C.L. Gupta Eye Institute, Moradabad 254
55. Dr. Shroff Charity Eye Hospital, New Delhi 258
56. Eye Foundation, Coimbatore 261
57. Giridhar Eye Institute, Kochi 265
58. Haji Bachooali Charitable Ophthalmic & ENT
269
Hospital, Mumbai
59. HV Desai Eye Institute, Pune 271

60. Indra Gandhi Eye Hospital, Lucknow 275
61. LV Prasad Eye Institute 277
P A G E
INSTITUTE WATCH
62. ROP Training, LVPEI, Hyderabad 281
63. MGM Eye Institute, Raipur 284
64. Minto Eye Hospital, Bangaluru 287
65. MM Joshi Eye Hospital, Hubbali 290
66. Nandadeep Eye Hospital, Sangli 294
67. Narayana Nethralaya, Bangaluru 297
68. National Institute of Ophthalmology, Pune 300
69. Nethradhama Super Speciality Eye Hospital, 303
Bangaluru
70. Prakash Netra Kendra, Lucknow 306

71. Raj Eye Hospital, Gorakhpur 309
72. Retina Foundation, Ahmedabad 311
73. Retina Hospital, Rajkot, Gujarat 315
74. Retina Institute of Karnataka, Bangaluru 318
75. Sadguru Netra Chikitsalaya, Chitrakoot 321
76. Sankara Eye Hospital 324
77. Sankara Nethralaya, Chennai 328
78. Shanti Saroj Netralay, Miraj 331
79. Shri Ganapati Netralaya, Jalna 333
80. Sri Sankaradeva Nethralaya, Guwahati 337
81. Susrut Eye Foundation & Research Centre, Kolkata 341
GUEST EDITORIAL
THE ROLE OF A MENTOR

I have had some of the greatest mentors one could wish for, so I cannot deny the impact
they have had on my life. I hold them in the highest esteem knowing that I can only try to
emulate them but that I will never exceed their accomplishments. I consider myself fortunate
beyond words. Most people reading this will not have the benefit of an internationally
recognised Guru. They may be jealous of those that do, or worse, blame their lot in life to
their inability to have had one. We all know of people who blame their own shortcomings on
“having a bad teacher.” Perhaps it is so. It is much more important to understand that
everyone and anyone can be your Guru. Your friends, family, colleagues, and especially your
patients teach you about medicine, life, and what is truly important. Even those (perhaps
especially those) who live lives much more difficult can be inspirational. The single mother,
the chai-walla, and or the elderly neighbour may each have priceless lessons on living with
dignity, purpose, and meaning.
Dr. William Osler, considered widely to be the father of modern medicine, said “Listen to
your patients, they are dying to tell you what is wrong with them.” This powerful quote
well illustrates how important it is to listen and learn not just to see and do. Your patients
have a world of experience and accomplishments. You have but to ask.
Learning is a lifelong process. It should be in the life-sustaining flame of every physician. A

mentor is also one who can re-light the spark of inspiration when
the light has dimmed. Indeed, teachers have likened to
candles sharing their illumination with others until their own
light is extinguished. It is my hope that you will fan the
flame of inspiration for yourself and others.
Gratitude is the virtue from which all others spring. It is

powerfully ingrained in our culture. Do not let yourself
be imprisoned by self-deprecation, diminishment of self,
or loss of self-worth. It is your task to be worthy of the
life you live, to be joyful in your tasks, and to selflessly
share yourself with others. Hold high standards to
honour those who have come before you.
Live your own unique life.
Be inspired. Be an inspiration to
others. Be well.
- Dr. SUBER HUANG  

YO TiMES I AUG 2019
Dr. Suber S. Huang, MD, MBA is CEO of
the Retina Center of Ohio in Cleveland,
Ohio and Voluntary Assistant Clinical
Professor of Ophthalmology at the Bascom
Palmer Eye Institute, University of Miami.
He founded the Retina Diseases Image
Analysis Reading Center and was Director
of the Visual Sciences Research Center.
Dr. Huang has served as Convenor for the
APAO Surgical Retina program since 2015,
President and Scientific Program Director
for the ASRS, faculty for AAO Retina
Subspecialty day, and Chair, NEI/NIH
National Eye Health Education Program. He
is the former AAO Associate Secretariat of
F e d e r a l A f f a i r s ; C h a i r, R e s e a r c h ,
Regulatory, and External Scientific Affairs
Committee.
Dr. Huang has extensive clinical trial
experience, is Founder of the Retina Image
bank and Editor-in-Chief of the ASRS On-
line Retina Atlas. He is the IMSM for the
Argus II retina prosthesis programs, DMC
Chair for NVAMD gene therapy and for stem
cell transplant trials for atrophic AMD. He
has 4 chapters on aspects of retina surgery.
He was inducted into the Retina Hall of
Fame in 2017 and received the 2018 APAO
Jose Rizal International Award. He has
received the “Top Doctors” and “Best
Doctors in America” award annually since
2003, the AAO Secretariat Award (twice),
and AAO and ASRS Senior Achievement
and Honor Awards. He also received the
Rainbow Babies and Children’s Hospital
Pediatric Innovation, OPS J. Donald M.
Gass MD, ICOP, National Diversity Council
Leadership Excellence, Cleveland Sight
Center Person of the Year, and the CWRU
Humanism in Medicine award given to the
faculty member who most demonstrates
compassion and professionalism in the care
of patients and their families.
YO TiMES IAUG 2019

2
5
MENTOR’s PERSPECTIVE
QUESTIONS WITH
D R . F LY N N
Q WHY SHOULD OPHTHALMOLOGY TRAINEES CONSIDER A CAREER IN
VITREO-RETINAL SURGERY?
A There are many strong reasons for a career choice in Vitreo-Retinal surgery. In
talking with colleagues around the world, Vitreo-Retinal surgeons enjoy the
opportunity to help patients regain or improve vision when they are confronted with
serious blinding conditions. The surgery requires meticulous attention to detail and
no two cases are exactly alike. In talking with senior Vitreo-Retinal surgeons, they
all seem very happy with their retinal surgery subspecialty choice. Vitreo-Retinal
surgery offers not only the opportunity to help patients but it also allows
collaboration with colleagues in clinical research projects and the
opportunity for a good income.
Q TELL US A LITTLE BIT ABOUT YOUR RETINA FELLOWSHIP EXPERIENCE?
A Following my residency of the University of Virginia in Charlottesville, VA, I was a

Vitreo-Retinal surgical fellow, at California Pacific Medical Center in San
Francisco. During the day hours, I operated primarily with 2 Vitreo-Retinal surgeons
but in the evenings, I also operated with some of the private
attendings. I had a chance to use many different
vitrectomy instruments but especially with the
Ocutome, which was a 20-gauge 3 port system,
(relatively new at the time of my fellowship).
Retinal drawings were expected on all retinal
detachment cases, which often took time and
effort. The advantage of this process was gaining
better skills with the indirect ophthalmoscope.
Following my 1-year surgical retina fellowship, I
was an “obligated volunteer” to join the United
States Army. I was fortunately stationed at Brooke
Army Medical Center in San Antonio, as a Vitreo-
Retinal surgeon for 2 years and I had the
pleasure of working with residents in the
Army and at UTHSC-SA.
YO TiMES I AUG 2019

Q WHAT ARE THE MOST IMPORTANT QUALITIES YOU LOOK FOR IN
PROSPECTIVE RETINA FELLOWS?
A Humility, honesty, and willingness to accept hard work are the key qualities.It is
difficult to evaluate these qualities in a short interview. For sure, all the applicants
are very smart. Often, phone calls to prior mentors of the individual will help to
clarify these aspects.
Q WHAT ARE THE MOST COMMON MISTAKES FELLOWS MAKE EARLY IN

FELLOWSHIP?
A Slacking off and laziness are unacceptable. The fellows need to be the first to
arrive in the clinic and last to leave at the end of the day. They need to treat the
staff with respect and work as a team. Likewise, they must have empathy with
patients and be through in their clinical examinations.
Q SURGICALLY, WHAT ARE THE MOST IMPORTANT PRINCIPLES TO

UNDERSTAND?
A Taking a conservative approach towards surgery is generally the preferred

approach. Aggressive surgical recommendations to patients with minimal disease
can land a person in big trouble. The risks and benefits of surgery should be
carefully discussed with the patient especially with family members in the room.
The surgeon should always help the patient make the best decision, but should not
coerce patients into surgery simply because the surgeons schedule that week is
somewhat light.
The fellows should be well versed in the significant issues of individual patients
such as previous operations, allergies, special needs, etc. In addition, fellows
should be very familiar with the operating microscope and the operating room set-
up. These principles can be mastered early in the year.
DR JAYANTH SRIDHAR
(YO TIMES SPECIAL CORRESPONDENT)
DR. SRIDHAR is a Vitreo-Retinal surgeon on faculty at the Bascom Palmer Eye

Institute. He is also the host and creator of "Straight From The Cutter's Mouth: A
Retina Podcast” found at http://www.retinapodcast.com. Dr. Sridhar can be reached at
[email protected]
YO TiMES I AUG 2019 4

 
HARRY W. FLYNN Jr., M.D is the J. Donald M.

Gass Distinguished Chair in Ophthalmology at the
University of Miami, Miller School of Medicine. He is
Professor of Ophthalmology at the Bascom Palmer Eye
Institute. Dr. Flynn has been author or co-author of more
than 594 peer-reviewed publications as well as 119 book
chapters. He has edited or co-edited 8 books including 1)
Diabetes and Ocular Diseases: Past, Current, and Future
Therapies (2010) 2) Vitreoretinal Disease: The Essentials
(2018) 3) Endophthalmitis in Clinical Practice (2018). Dr.
Flynn had held numerous administrative positions
including President: The Vitreous Society (now ASRS)
(1992-1993), President: The Miami Ophthalmological
Society (1999) and President: The Retina Society
(2002-2003). Dr. Flynn has served as Senior Editor for
Section 12 (Retina) of the Basic and Clinical Science
Course for the American Academy of Ophthalmology
(AAO). He has also served as Director and Co-Director of
the Retina Subspecialty Day for the American Academy of
Ophthalmology. He serves on the Editorial Board of
numerous journals including the American Journal of
Ophthalmology, RETINA, OSLI: RETINA, and Evidence
Based Ophthalmology. He has served on the Data and
Safety Monitoring Committees for DRCR Network, SCORE
Study, Regeneron VIEW 1 and VIEW 2 Studies and
Neurotech MacTel Study. He received the AAO “Life
Achievement Honor Award” in 2008. Dr. Flynn received
the Shaler Richardson, M.D “Service to Medicine Award”
from the Florida Society of Ophthalmology. He received
the “Hermann Wacker Award” from the Club Jules Gonin
in 2012. He has delivered 31 named lectures including the
“J. Donald M. Gass Lecture” at the Retina Society in
2012. In 2014, he received the “Honorary Alumnus”
recognition from AOA of UVA School of Medicine. In
October 2016, he delivered “The Charles L. Schepens,
MD Award Lectureship” at the AAO annual meeting. In
September 2017, he delivered “The Relja Zivojnovic
Award Lecture” at the European Vitreoretinal Society. In
November 2017, he received the “Secretariat Award”
from the AAO. In 2018, he was honored to be among “The
Top 100 Most Influential People in the World of
Ophthalmology.” He was the keynote speaker at the 2018
Ophthalmology Times Research Scholar Symposium. In
2019, he received the Distinguished Faculty Scholar Award
from the University of Miami, Miller School of Medicine.
5
MASTERING YOUR MIND

- DR S NATARAJAN
I grew up in the Government Ophthalmic Hospital Quarters, Egmore, Chennai in

1957- 1969, a treasure trove of knowledge. I had the opportunity to learn from
enlightened individuals including my grandfather, Dr .S. Nataraja Pillai and my
father, Dr. N.S. Sundaram. I was born with a passion for Ophthalmology and went
on to continue the proud family tradition as a third generation Ophthalmologist.
During my childhood, I had the opportunity to observe a number of eye surgeries; I

used a case-based approach and learned from each surgery. I accompanied my
father to a number of Ophthalmology conferences. My father encouraged me to be
a volunteer for writing operation notes, shifting patients and for assisting him during
a number of free eye camps.
I value my experience at Sankara Nethralaya (SN), Chennai. It was my

Gurukulam. I was a part of the First Retina Course in Sankara Nethralaya with Dr.
S. S. Badrinath & Dr. M. M. Kini in 1985. I assisted Dr. Badrinath in complicated
Vitreo-Retinal surgeries and performed surgeries independently as well. I also
learnt the importance of hard work, honesty and sincerity and viewed every patient
as God. I was fortunate to be the youngest consultant at SN in my early days. While
pursuing my residency in ophthalmology, I tried to imbibe knowledge from all
quarters - from my Chief of Ophthalmology to the OT staff, who taught me finer
nuances of surgery.
Vitreo-Retina training starts during your ophthalmology

residency when you are exposed to cases of the posterior
segment. It is of utmost importance to have stereopsis to
perform Vitreo-Retinal surgery. It may not be of prime
importance in other sub-specialities in Ophthalmology.
Colour blindness, red-green blindness can pose a
challenge in identifying retinal lesions. It is advisable for a
Vitreo-Retina surgeon to work on improving his/her
dexterity. I would advise that one should rule out physical
restrictions before taking up a fellowship in Vitreo-Retina
surgery.
YO TiMES I AUG 2019

Doing VR surgery is like working on a treadmill – being on the move is a must and
skill sharpening is essential. Standard operating procedure (SOP) is important and
must be followed. It can be modified according to an individual, once you have
understood it.
Choose your mentor. I believe that teachers and students shape each other equally
and that good teachers prepare good surgeons for future but good students also
make their teachers better in several ways. You should be able to master what your
mentor is thinking.
I never think of anything to be impossible and strive to do what catches my interest.

Our perception is what matters and an obstacle can be turned into an opportunity. I
believe in five “P’s” – Perseverance, Perfection, Patience, Prayer and Precision.
The patient is of utmost importance to the doctor. Patient satisfaction is a skill which
should be developed. Value work over money. The work will speak for itself. Keep
learning, keep innovating, keep upgrading. Make friends, develop a network of
people who you can rely on.
It is important to take care of your health, both physical and mental. I exercise
regularly and try to be fit and this has helped me stay sharper and more efficient
and manage the challenges that often arise in life. Having faith in Almighty has
guided me and has given me an inner strength.
But as I look back at my 'young ophthalmologist' days, I think the one thing that
stands out was my quest for learning, the constant urge to do better and better and
the resolution to not stop and rest on my achievements but to keep marching ahead
and creating bigger targets to achieve and giving it all I had. I would like to quote
what Robert Greene mentions in the book ‘The Concise Mastery’: “The potential
for mastery lies within each of us. Learn the secrets of the path you must
follow. Unlock the passion within you and become a Master”
What separates Masters from others is often something surprisingly simple. When
learning a new skill, there comes a point of frustration, where we quit on ourselves
before we actually give up. Learning and mastering a skill requires practice and
therefore time. As humans, we tend to shy away from anything that seems painful
or overtly difficult. We have to overcome this feeling of boredom, panic, frustration
and insecurity. The secret is to have faith in the process and keep practising the

skill till it becomes hardwired and your mind is no more mired in details and you can
see the larger picture.
The difference between those who succeed and those who do not is not simply a
matter of determination, but more of trust and faith. Many who succeed in life have
the experience in their youth of having mastered some skill- a sport or game,
musical instrument, a foreign language and so on. Buried in their minds in the
sensation of overcoming their frustration and entering the cycle of accelerated
returns. In moments of doubt in the present, the memory of the past experience
rises to the surface. Filled with trust in the process, they trudge on well past the
point at which others slow down or mentally quit.
When it comes to mastering a skill, time is the magic ingredient. Assuming your
practice proceeds at a steady level, over days and weeks certain elements of the
skill become hardwired. Slowly, the entire skill becomes internalized, part of your
nervous system. The mind is no longer mired in the details, but can see the larger
picture. It is miraculous sensation and practice will lead you to that point, no matter
the talent you are born with. The only real impediment to this is yourself and your
emotions: boredom, panic, frustration, insecurity. You cannot suppress such
emotions, they are normal to the process and are experienced by everyone,
including Masters. What you can do is have faith in the process. The boredom will
go away once you enter the cycle. The panic disappears after repeated exposure.
The frustration is a sign of progress- the signal that your mind is processing
complexity and requires more practice. The insecurities will transform into their
opposites when you gain mastery. Trusting this will all happen; you will allow the
natural learning process to move forward and everything else will fall into place.
From the same book, Robert Greene mentioned as rightly quoted by ‘Albert
Einstein’, “The intuitive mind is a sacred gift and the rational mind is a faithful
servant. We have created a society that honors the servant and has forgotten
the gift”
My advice to youngsters is to keep working to gain experience; always look at Best

surgeons, visit them and update your knowledge and skills. I hope all of you can
create even greater marvels in ophthalmic science and surgery.

Prof. Dr. S. Natarajan, has been honoured with
the Padmashree Award, one of the highest
civilian awards. He has been globally acclaimed
for his precision in Vitreo-Retinal surgery and has
been inducted in the RETINA HALL OF FAME .
Dr. Natarajan is a distinguished member of the
Board of Trustees of the International Council
of Ophthalmology. He is also President of All
India Ophthalmological Society (AIOS) , Asia
Pacific Ophthalmic Trauma Society (APOTS) ,
Sankara Nethralaya Alumni Association, Editor
for Eye World India , Secretary General for
Global eye genetics consortium. He has195
peer reviewed publications, 5 books, 38 book
chapters, 62 IJO Editorials and more than 2000
presentations and orations to his credit. He has
performed more than 600 live surgeries
worldwide. He has received Senior
Achievement Award from AAO, Achievement
award from APAO, P Siva Reddy Award from
AIOS, 1st Bicentenary Medal by Regional
Institute of Ophthalmology, Govt.
Ophthalmology hospital, Chennai. He was
awarded the “State Award for Meritorious
Public Service” by the Govt. of J&K for
performing over 200 complicated VR surgeries
on pellet injury patients. He attended the
Leadership Development Program of the
American Academy of Ophthalmology in
Nov’06 and started the Leadership
Development Programs in AIOS.
Dr. Natarajan established a non-profitable Public
Charitable Trust, Aditya Jyot Foundation for
Twinkling Little Eyes in 2005. The Foundation
has conducted thousands of Diabetic Retinopathy
camps and screened over 70,000 diabetics and
over 200,000 children in school screening
programs. Under ONE INDIA – ONE AIOS –
ONE VISION, His desire is to unite the various
wings of AIOS towards a common goal of seeing
our country blindness-free, where every individual
has access to eye care without any discrimination
on caste, creed or wealth. He has taken up the
challenge of a Nationwide diabetic retinopathy
MAXIMISING
screening program coined as “S.T.O.P
Blindness” . "Jyot Se Jyot Jalao” will be the
theme of this campaign over the next five years
implementedYOUR
through AIOS.
YO TiMESI AUG 2019

MAXIMISING YOUR VITREORETINA FELLOWSHIP

- DR HARSHA BHATTACHARJEE
Sub-specialisation is required for optimal career development of an

Ophthalmologist. Vitreoretina as a subspecialty is challenging but rewarding in the
long run. Fellowship is a period of transition between residency to clinics and it
aims to transform a general ophthalmologist into a safe and independent
vitreoretinal surgeon. To achieve this goal, combined clinical and surgical is a must.
Vitreoretinal training thirty years before and now is completely different. Small
gauge vitrectomy and myriad of surgical tools empower a VR surgeon to perform
the surgery with more precision and perfection with lesser surgical training time.
Learning curve is not as long and tedious as it was before. It is an interesting and
joyful experience with opportunity for expansion of clinical knowledge and surgical
skills. Complications during modern VR surgery is less so observations of more
number of procedures can help to gain experience in complication management.
Time is of utmost importance. Proper utilisation of time during the fellowship

programme makes all the difference. Time is limited, hard work and enthusiastic
participation in academics, training and scientific research gives a better yield.
Career selection before joining a fellowship programme depends primarily on the

candidate ’s choice. What interests more? Self assessment for aptitude of learning?
Evaluation of individual strength and weakness helps to take
correct action and decision. Decision is to be essentially
realistic otherwise a trained VR surgeon may ultimately
land up performing only intravitreal injection or cataract
surgery.
Certain fundamental knowledge is to be acquired

before joining a fellowship programme. To understand the
advance concept of VR specialty, one should be well
YO TiMES I AUG 2019

versed with anatomy, physiology and pathophysiology of various vitreoretinal as
well as macular diseases. Without mastering these building blocks, VR knowledge
and skill development may become extremely challenging. Only sufficient
background knowledge would make the fellowship more interesting and productive.
Choice of fellowship should be competency based, target oriented and based on

measurable outputs. Hybrid model of fellowship combining optimum proportions of
academics and surgical hands-on is most rewarding. Other points of consideration
for evaluating a fellowship could be, Number of faculty and their reputation, scope
of research and mentor guided/independent surgical opportunities in the
programme. It is good if all of these are in perfect combination. Outpatient or
surgical load should not be the only consideration, rather the training schedule and
the efficiency of the programme determines the final output. At the completion of
training a fellow should be skilful, confident and safe for service delivery and
develop the potential for future capacity enhancement.
Patients are like open books and can teach a lot. Learning, understanding and
confidence building depends upon how much a fellow would attend the clinic, the
operation theatre, observe the procedures and attend & execute investigation
session. A sincere involvement towards patient’s care helps one to understand the
need of the patients.
Learning process includes clinical evaluation, short listing, investigation, diagnosis

and action plan. Regular verification of individual assessment with that of the
mentor is required. If there is disagreement, logical evaluation of opinions would
improve the understanding. Take active part in decision making and follow the result
of action taken. Vitreoretinal service is a teamwork, one should master that skill too.
Developing soft skills for patient management and connecting with patient following
legal, moral and ethical standards are encouraged. The medical business,
administration, billing and legal matters should also be learnt from the mentor.

Success depends upon how one fulfils the expectation of the patients and proves
his or her efficiency in decision making, diagnosis, investigation plan and skill. Mind
set for progress is to change along with time towards perfection.
“ “A mentor is someone who sees more talent and ability

within you, than you see in yourself, and helps bring it
out of you.”
Bob Proctor

DR HARSHA BHATTACHARJEE , MS, FRCP,
FRCS is the Founder, Medical Director and Trustee of
Sri Sankaradeva Nethralaya (SSN)
An MS in Ophthalmology, Dr Bhattacharjee is
also a Fellow of the Royal Colleges of Surgeons
(FRCS). After a stint in the government where he grew
to the post of Associate Professor at the Regional
Institute of Ophthalmology in Assam, Dr Bhattacharjee
went on to found SSN in 1994.
In addition to offering comprehensive eye health
care for all key blinding conditions, SSN trains local
eye health teams and engages in research.
Community eye health for vulnerable groups is a core
element of their ethos, with over 60% of patients being
treated free of cost. In 2004, SSN was declared a
Centre of Excellence by Dr Manmohan Singh,
former Prime Minister of India. Over the years, SSN
has impacted on over 25, 24,952 persons in the base
hospital excepting outreach patients.
Dr Bhattacharjee has pioneered services such as
intra-ocular lens implantation, vitreoretinal care,
paediatric eye care, occuloplasty and laser surgery in
the region. He has performed over 200,000 cataract
and anterior segment eye surgeries and over 200,000
other surgeries and ocular cancer treatment
interventions till date.
He has authored over 250 scientific papers and
has co-authored several text books on ophthalmology.
His work has been presented in numerous scientific
forums and he has chaired several prestigious
scientific sessions, both nationally and internationally.
Some of the awards and honours that he has received
include: Achievement Award by South Asian
Academy of Ophthalmology; Achievement Award
by Asia Pacific Academy of Ophthalmology;
Excellence in Medicine Award conferred by Down
Town Hospital, Guwahati and felicitations by
Rotary International, among others.
Dr Bhattacharjee assists several universities and
is a lifetime member of prestigious bodies like
American Academy of Ophthalmology, American
Society for Cataract & Refractive Surgery and ICEH
among others. His pioneering efforts have helped
significantly strengthen eye health care in Northeast
India.
T I P S F O R A YO U N G R E T I N A S U R G E O N :
PROFESSOR BANDELLO
Vitreo-Retinal surgery is one of the most important subspecialties of

ophthalmology, treating a large percentage of ophthalmology patients. After
completing a full training in general ophthalmology the willing Vitreo-Retinal
surgeon will undergo a sub-specialty training of at least 2 years.
The learning process combines surgical expertise with clinical skills, surgical
strategy development, and ability in communications with colleagues and
patients. The above skills wave together being liked one to the other.
As for many surgical specialties, the technological support is becoming more

essential therefore developing a practice with latest and advanced instruments is
an unmet need for a Vitreo-Retinal surgery trainee.
If available, it is useful to spend time with a simulator and completing the full
course offered by this tool. This shortens significantly the learning curve and
makes the supervisor’s role more productive.
Receiving supervision by different mentors is a key factor to enrich technical and

personal progress.
Passion, commitment and perseverance are the ingredients of success.
A forward-thinking country should take into consideration the

amount of resources needed by a teaching hospital. Dedicated staff and
technologies are critically important in the development and maintenance of an
adequate training system, which is indeed money consuming. T h e
economic support of these centres should be a priority for the
National Health System. Nowadays, only few European
governments provide solid funding for teaching hospitals
and hopefully, this example will be followed by the other
countries.
YO TiMES I AUG 2019

FRANCESCO BANDELLO MD FEBO, is
Professor and Chairman at the Department of
Ophthalmology University Vita-Salute, Scientific
Institute San Raffaele, Milan, Italy & Academic
Dean “Corso di Laurea Specialistica/Magistrale in
Medicina e Chirurgia” University Vita Salute,
Scientific Institute San Raffaele, Milan.
He is the National Institute of Health (N.I.H. –

U.S.A.) Peer Reviewer for grant-applications
since 2006, President Academia Ophthalmologica
Europea, Member Academia Ophthalmologica
Internationalis,Fellow of the European Leadership
Development Programme (EuLDP) of the
American Academy of Ophthalmology, President
of the Scientific Committee of the “IAPB Italia
Onlus”, Executive Board Member of ESASO
Foundation, Coordinator of the “Gruppo di Studio
SID Complicanze Oculari del Diabete”,Member of
the Board of Directors of Retina Global,Novartis
Ophthalmology Vision Award (XOVA) Committee
Member, Member of the Subspecialty Jury of the
ICO-Allergan Research Fellowship, Member of
the Grants Review and Awards Committee
(GRAC) of the Bayer Ophthalmology Awards
Program (BOAP), Editor in Chief of the European
Journal of Ophthalmology
Prof. Bandello is co-author of several books and

he serves as a peer reviewer for grant
applications for the NEI. He has authored or co-
authored over 555 articles and he served as
trained Principal Investigator in several clinical
trials performed following ICH/GCP and mainly
concerning retinal diseases.
YO TiMES IAUG 2019

FINAL LESSONS FROM A

MENTOR
- DR JAYANTH SRIDHAR
Dr. Joseph I. Maguire, a Vitreo-Retinal surgeon at Mid-Atlantic Retina and

Wills Eye Hospital and one of my fellowship attendings and role models,
passed away over last year after a long battle with cancer. I wrote this article
to pay tribute to a few of the lessons he taught me and countless fellows and
residents over the years at Wills:
1) Take time: In his own practice and in his teachings, Dr. Maguire emphasised the
importance of taking the necessary time to sit down with patients and explain.
Explain what is going on, why it is happening, and what the goals of therapy are. I
remember once presenting to him a patient with a diabetic tractional retinal
detachment from the fellow clinic. Dr. Maguire, despite being very busy in his own
private clinic, took the time to sit down with this patient to go over her blood sugar
and insulin regimen, emphasising the impact that her systemic disease was having
not just on her vision, but also her life as a whole. That experience has always
stuck with me and since then, I always try to make enough time for my initial
encounters with patients suffering from significant diabetic eye disease.
2) Be a doctor, not just an eye specialist: Dr. Maguire had

almost an encyclopaedic knowledge of systemic diseases
with retinal findings, whether it was Purtscher-like
retinopathy or crystalline retinopathy. It reflected in his day
to day patient care; he took thorough, comprehensive
medical histories that put me, as the fellow working in his
clinic, to shame on more than one occasion. As he liked to
say to me, ‘the ‘MD’ stands for ‘medical doctor’ for a
reason’.
YO TiMES I AUG 2019

3) Movement equals error: One of Dr. Maguire’s favourite expressions in the
operating room was ‘movement equals error’. It was his caution for the excited,
rapidly improving surgical fellow that being an efficient and skilled surgeon is
not about how fast you move while operating, but about preparing and
planning in advance, understanding surgical principles, and avoiding wasted
movement. There were surgical specifics that I personally learned first from him,
like how to imbricate sutures on a scleral buckle or the concept of ‘oar-locking’
instruments in vitrectomy cannula, but the concept that moving faster is not better
will stick with all of his former fellows.
4) Give feedback: Dr. Maguire gave direct, honest, and constructive feedback
frequently to me and I appreciated every bit of it. Early on in fellowship I remember
doing (what I thought was) a thorough retinal examination on a patient with new
floaters on call and finding no issues. Dr. Maguire saw the patient two days later in
follow-up and found a retinal tear. He picked up the phone and called me, not to
berate me or scold me, but to simply tell me what he had found and where so I
could learn. Giving feedback seems like a simple thing to do, but for many of us it
can be difficult to tell someone to improve in a compassionate enough way to avoid
hurt feelings. He also would give positive feedback unsolicited. When he
once called me after a long day in the OR together, I assumed it would be about a
patient-related medication prescription or paperwork that I had forgotten to fill out.
Instead, he simply told me that I had done a great job and that he was very proud of
me. We cannot forget to let our trainees and colleagues know when they are
doing well.
5) Pick up the phone: The examples in #4 above were classic Dr. Maguire
because he was ‘old school,’ and he picked up the phone and called you when he
needed to talk. We live in the digital age of text messages, Instagram DMs, and
retweets, but so much can be misconstrued when sent in a few words without any
sense of inflection or context. If a conversation is important, pick up the phone.
Two minutes of talking can get a lot more across than fifteen minutes of back and
forth cryptic emojis.
6) Be loyal to your team: No one would stand up for his fellows, residents, and
staff more than Dr. Maguire. No matter what his schedule commitments were
like, he always came to fellow presentations and conferences. He was
generous to all those around him; in fact, the last time I saw him in person he
quietly picked up the check for fifteen former and current fellows out for lunch after
a reunion in Philadelphia. I also remember once there was a patient being
extremely rude to one of the front desk staff. Before anyone else could intervene,

Dr. Maguire arrived at the scene and quietly but concisely reminded the patient his
responsibility as a patient of the practice to be as respectful to the staff as he would
be to any of the doctors. Being loyal to the people around you is not only the
right thing to do, but it inspires loyalty back that will build priceless
relationships and an A+ working environment.
7) Be honest: I remember as a fellow writing a research paper with several

attending surgeons including Dr. Maguire as a co-author. When I emailed a draft to
him, he called me (see point #5 above!) and asked to not be listed as an author, not
because he was not keen in supporting me, but because he felt that he had not
contributed enough to merit a spot on the authorship docket. While I explained and
eventually convinced him that the research would have been impossible without his
help, I was always struck about how principled he was about academic honesty that
his initial instinct was to call and ask not to be included. Let’s all be honest with
ourselves, because in the end it is more important we respect the person we
see in the mirror every morning than to have a couple extra lines on a CV.
8) Be a good person: Dr. Maguire was an exceptional doctor and surgeon, but
more than that, he was one of the best people I have ever met. The first word that
comes to mind when his colleagues and fellows think of him is ‘gentleman.’ He was
respectful and kind to everyone, without any ulterior motives. It was simply the
way he was built.
I will miss him tremendously and I know I am not alone among my friends and
family from Wills. I feel for his family, and I hope that they can take solace
that Dr. Maguire was regarded by all who worked with him as an amazing
husband, father, doctor, surgeon, mentor, role model, and friend. RIP Dr. M.
We all love you.
Dr. Jay Sridhar is a Vitreo-Retinal surgeon on faculty at the Bascom Palmer

Eye Institute. He is also the host and creator of "Straight From The Cutter's
Mouth: A Retina Podcast” found at http://www.retinapodcast.com. Dr.
Sridhar can be reached at [email protected] 

WOMEN IN RETINA
ALL ARE WINNERS!!
- Dr NEHA GOEL
Vitreoretinal surgery has traditionally been a male-centered subspecialty, since the days of
lengthy retinal detachment surgeries. Whenever I attend a vitreoretina conference, I realize
the painfully obvious disproportion: this remains a male-dominated field. Looking at the
speakers and moderators I find a few women scattered in the majority of men, usually less
than 20%. This leads me to the inevitable question – what is holding us back and how do we
overcome “it”?
The American Society of Retina Specialists (ASRS) has a group called “Women in
Retina” (WinR) which focuses on peer connection, mentoring and uplifting other women
within the field. Our field has been a “boys club” for decades, where men mentor men,
elevate men, and encourage men. It’s time for women to come together and do the same.
We asked two leading female vitreoretinal surgeons their thoughts, experiences and
perspective on this aspect. These women are at the top of the field, something that required
exceptional talent and effort. They chose to pursue vitreoretina at a time when they were the
only females to do so. We rely on these great female role models to guide us towards
establishing our place in the filed and maintaining it.
Dr Subhadra Jalai (Dr SJ) Dr Parveen Sen (Dr PS) Dr Neha Goel

1.
1. Vitreoretinal
Vitreoretinal(VR)
(VR)surgery
surgeryhas
hastraditionally
traditionallybeen
beena amale-centered
male-centered subspecialty and
subspecialty and
continues
continues totobebeso. so.
WhatWhat
made made you this
you pursue pursue this field
field despite this despite this obvious
obvious disproportion?
disproportion? Did you feel a male preponderance and any hindrance due to it
Did you feel a male preponderance and any hindrance due to it during your training in
during your training in VR?
VR?
Dr SJ: I was possibly the second or so dedicated VR surgeon aspirant in

India. (Kairobi Lahiri from Mumbai ahead of me; maybe few others). It was
sort of ‘News of the day’ at LVPEI in 1991, that a woman aspirant had
applied and was selected on merit, for retina training! My HOD appeared
not too happy at this news as for ten years as a trainer he had never
considered a woman trainee. I was told that “women are not fit for retina, will you cut your
hair to wear indirect Ophthalmoscope? How will you take care of your four year old child
while doing ‘tough work’ of VR surgeries? You are sure to take lots of unplanned leaves for
family care and the department work will suffer. Women are very good, but are suited for
contact lens department etc.” I was amused and not hurt. My reply was ‘Thanks for the
Welcome; I hope I will make you change your mind about women”.
The huge amount of hard work, naïve sincerity, focus of purpose, scientific vigour, excellent
knowledge and keen learning desires were what changed the perception of my male teachers
about me and possibly about other women in Retina. I neither cut my hair nor have almost
ever taken any ‘unplanned leaves’! Seeing my work from close quarters, gave them new
insights, I believe, about how women work both for patients and for family. Within six
months, the same HOD, whom I had already declared and considered as my Guru from the
day of joining, became my staunch supporter, mentor, guide, friend and has been
encouraging and supporting me ever since. Whatever I am today is because of his ever
forthcoming faith in my work and my values, and his remarkable encouragement over last
nearly three decades at LVPEI.
I fell in love with ‘’Retina’’ the first time I used an Ophthalmoscope, as a medical student,
and saw this mystic, hidden, beautiful pink, irreplaceable delicate organ inside our eyes,
from which we ‘see’ this whole world! That day I dreamt of being a retina specialist. It is a
male dominated world or that avenues for learning and practicing were really severely
limited, I came to know only later- but true love always prevails and so did mine!

Dr PS: It’s destiny. As a postgraduate the first conference that I attended
was on Vitreoretinal Surgery. This was attended by stalwarts like Dr. S.S
Badrinath, Dr.Lingam Gopal and Dr.George Hilton to name a few. So
much was the influence of all these great Retinal surgeons on my mind that
the decision was made instantly in my mind at that moment that I have to
specialise in Vitreoretina. Being a woman and that it could be difficult for me as a women
didn’t even occur to me. This passion brought me to Sankara Nethralaya, Chennai.
In Sankara Nethralaya, I was the only female Vitreoretina fellow in my batch. I was
fortunate to be in Sankara Nethralaya which provides an excellent working environment for
all including women. The long hours of work, with surgeries going into the night was
exhausting but enjoyable. Lot of support from my family and friends helped me sail
through.
2. Do you feel career opportunities for women retina surgeons differ from their male
counterparts? Employers and even patients have been known to prefer male
surgeons as they appear more “committed”. Studies in the USA have also revealed
a wage gap as far as women are concerned – why do you think this gap exists, if at
all, in India?
Dr SJ: Except for the initial skepticism by my HOD, I have never felt
discriminated by my patients or fellow retina surgeons, due to my gender.
With more and more dedicated and excellent surgeons, both males and
females in my institute, patients are quite comfortable with both genders.
In fact many patients perceive the compassion and care and patience and
fineness exhibited by women retinal surgeons a great reason to ask for them.
As regards Pay scale gaps, in our institute these do not happen as everyone is treated equally
and starting salary is based on qualification and years of experience so everyone gets the
same to begin with. Performance linked promotions ensure similar pay-scales as women
move higher up. This may be different in other organizations.
However, it is true that if we see overall earnings, women may be earning less because
1. They may not be asking for more and let the system decide, so this may not give them the
best of what they deserve 2. They do take a slower route to promotions during few years of
child care and so reach the male pay levels slower as they go higher 3. Due to actual
performance issues because I do not believe that all women (and all men) perform equally
well and so this may not always be a gender issue. 4. Perceptions that the women can be
given lesser pay or delayed pay because anyway their male spouses are earning for them!!

(this was actually told by an organization to their female surgeons!! Of course the female
surgeons resigned urgently!) 5. Lack of confidence or conviction that they should get same
pay as their male colleagues. I remember when Dr. Rao asked me how much pay you expect
(my first job and I had no idea what a doctor earns) I just blurted out, ‘give me same as you
are giving to Dr. Bansal who joined few months before me!”
Dr PS: The career opportunities in general are lesser for vitreoretinal

specialists because of the nature of work as well as the higher cost of initial
investment. It may be further limited for women in India because of the
challenge of having to manage both the home front as well as the
professional life. The challenge is to find a good set up close to where the
family is. But I think with lot of private hospitals coming up, things are improving. The
wage gap in India probably is not as bad as in the USA; unless the women choose to work
for lesser hours.
But you rightly mentioned, the patients may prefer a male surgeon. All these problems are
more in the initial stages of your career but if you continue to treat your patients with
kindness, empathy and most importantly efficiently, the patients will come to you. In a
surgical branch probably one advantage is that your results speak for you. A well done
retinal surgery speaks volumes about the surgeon (male or female). The value of the word of
mouth is unbelievable even in this era of internet. As a woman you may have to work harder
than your male colleagues but let that not deter you; the respect you will earn for your good
work is worth it all.
3. Have you faced any challenges professionally that are specific to your being a
woman? How did you overcome them to outshine clinically, surgically and
academically?
Dr SJ: In early years of my career, I did not feel any challenges as a

woman retinal surgeon-in fact many would respect me and be awe-struck
just for being that unique person in a crowd of men! My Scientific vigour,
meticulous work, integrity, honesty, compassion and love for truth and
justice helped me to outshine many of my peers in all areas: clinical/
surgical and academic. Excellence was what I pursued with single minded
determination and this was what brought in all the achievements.

Only later, as I moved up the administrative responsibilities becoming the Head of
department and participating in policy and decision making bodies did I have a problem.
Problem was that my perspective of looking at problems, offering solutions and discussing
issues was not always the same as others on the panels (most panels had only me as the lone
woman). These differences were of course partly because I looked at issues from a woman’s
perspective (safety, justice, effect on family and society, legal aspects) and less from
financial and disciplinary aspects- which was reverse of some of the male thought process
and priorities or solutions; but differences were also due to non-gender perspectives like
being ahead of times, listening less and talking more, sometimes not planning well so I
cannot blame it on gender discrimination alone. Over the years, my colleagues have learnt
to respect and accept my perspectives and also I have made continuous attempts to improve
the flaws in my approach and in my personality so as to become more effective and
acceptable. This journey of self improvement continues even now and is helping to move
forward.
One area I have found discrimination/challenge is from some of the invitations at

conferences and especially at industry sponsored symposia. Corporate world needs huge
changes in mindset about strategies to get valuable, sincere and excellent women speakers
into their seminars! The Women Ophthalmological Society of India supported by Allergan
is a nice beginning , but still there is a challenge to find women in mainstream corporate
symposia. Same is true for many seminars and workshops where usually complicated
surgical topics are rarely given to women!
Dr PS: The most challenging thing is to be able to have a good balance

between the professional life and personal life. Again the struggle is more
in the early years; your professional career is also demanding because you
are new to a lot of things and the learning curve in a surgical branch can
be really steep; the children also are small demanding more of your time
and attention. The key is to just “hang on there”. Taking a decision to quit
one for the other should not be taken in a haste. Continue working at whatever pace
possible. You may win on one day and lose on another day.
I wasn’t able to travel for many meetings or conferences and observerships abroad in early
years; but that also meant I could give more time to improve my surgical skills and involve
myself in research activities. And of course keep reading so that you are up-to-date with the
latest.

4. While the presence of women at the podium and in leadership positions in
ophthalmology and in VR, in particular has increased over the years, it still remains
male-dominated. How would you motivate newcomers in VR to make a place for
themselves despite this glaring disadvantage?
Dr SJ: Believe in yourself and work hard with values and convictions.
There are no short cuts to success-success is a beautiful journey and every
human being can strive to this journey of Excellence! As mentioned
above, gender related issues become much smaller when we are inside
rather than outside of the problem and we continuously look inside to
improve ourselves. I do not believe that there is any ‘glaring disadvantage’ for women VR
surgeons in India or in many other countries. Scores of outstanding Women-in-Retina, Role
models are all around us both Nationally and globally. It is all in the mind. We have to
remove negative thoughts from our mind, as Tagore said and I strongly believe, “Where the
mind is without fear and the head is held high.” If your heart and soul are in vitreoretina,
you will definitely outshine, no matter what!
Dr PS: Leadership can be bestowed but more importantly is earned. The

best way to make a beginning is to keep working on presenting papers.
Don’t wait for “invites”. Things have improved and increasingly people
do notice your publications and see what you have worked on and invite
you to share your published work.
As the number of females will increase at the podium, this glaring disadvantage will
decrease. There are difficulties but none that cannot be overcome. The women have to be
ready to put that much more hard work that is necessary to attend conferences. To prepare
your talks and keep up-to–date with the ever evolving field of medicine requires a lot of
commitment and can eat into your private time or time for relaxation. Sometimes having
less meetings to attend is also nice; it allows you more time to do quality work and more
quality time for yourself!
For new comers I would say start early. Don’t postpone your professional aspirations.
And don’t be scared to ask for help.
24
5. As women we face the unique additional challenge of being responsible for our
home and family. What tips would you give to maintain a work-life balance?
Dr SJ: I do not like the term ‘WORK-LIFE Balance”. It connotes that we

have to compartmentalize our lives into ‘work’ and ‘life’! For me ‘work is
life and life is work’ and my life is intertwined in a tight beautiful tapestry
of work that makes the amazing tapestry of ‘ME” very beautiful and
‘Beingful’. Patients, extended family, husband, children, colleagues, my
Institute, my staff, my neighbours, my country, the bountiful nature, the amazing heritage of
literature, music, dance, history and geography, my society and so much more- each one of
these completely fills up every moment of my life. Each is given due priority, yet the ‘ME”
remains detached while being attached- this is due to a lot of spiritual training I had in my
childhood in Kashmir. Hence the joy of LIFE is from within and I share it all around me
with full energy and Joy! Yes some practical tips of how I did this: Always had my House
next to the children's’ school so that they did not have to waste precious time and energy in
travel through traffic, organised my children's’ post school schedule in such a way that we
always had one to two hours of QUALITY unhindered Mother-child time together. Full time
housekeeper to share the household work and ‘Mother-in Law’ is always right and she is an
essential and very affectionate partner in my journey of life were key decisions I made very
early in my life. I was very sensitive to the fact that society looks down upon working
women, and I was determined to be the very Best! I became a voracious reader of non-
fiction on topics like human relationships, child upbringing, mid- life blues, our epics,
Upanishads and Puranas and a lot more and all this reading helped me to take pragmatic
decisions during innumerable challenges in my life.
Doing Homework and project work was completely the responsibility of the children and I
empowered/encouraged them from early childhood to take this responsibility- I never had to
sit for homework with them; time spent with Children was for building bonds of love, care,
values, telling stories, having fun, solving conflicts of teenage and adolescence, broadening
horizons of mind and making them capable to follow a life ‘where the mind is without fear
and the head is held high… ’. There are a large number of instances to depict my ‘’SINGLE
LIFE”- that is for next time!

Dr PS: You need to prioritize your goals and remember, it’s not possible
to do it all.
Take your personal life responsibilities as another facet of your life; and
life is so much more interesting and enjoyable when you have multiple
facets than just wearing a “tie and a business suit” and be present in all
possible meetings!
Be proud to be a good surgeon, a good teacher, a good researcher, a good friend and a great
mother. But don’t use your personal commitments as an excuse to find an easy way
around your professional career.
6. If you could offer advice to your younger self, what would it be?
Dr SJ: I am still young, but anyway will answer this!

a. In early years of my life, I was very lean and thin as I was a very active
sportsperson and did significant physical work at home with kids and
kitchen. I put on weight later on as I did not pay attention that these
activities were dropping off my life, when kids became older and
housekeeper managed everything. I would advice my early life self to watch weight and not
let it go beyond control. I would certainly advise not to reduce weight by diet restrictions
but to continue alternate daily physical activity with changes in years of life.
b. Continue some introspection into leadership development and personality development as
you move from junior to senior levels and learn to listen more and more. Learn to Speak in
more crisp and clear manner. Keep to the time and space allotted to You! Should stop now
on my own advice!
Dr PS: “Look at the larger picture”. Don’t fret about small things in life.
The pleasure is in the journey; there is no “destination”. Slow and steady
really does work and helps you emerge a winner.
And remember the most important thing is to take care of your health
especially your physical fitness. Retinal surgery is physically demanding
and literally “back breaking” especially for women. Take out time for yourself to keep
physically fit and enjoy whatever you do.

 
Dr Neha Goel MS, DNB, FRCS, MNAMS, has worked as vitreo-retina and uvea
consultant and in-charge electrophysiology services at ICARE eye hospital and
postgraduate institute, NOIDA, U.P for 7 years.
She has keen interest in academics with over 100 publications in various journals. She
has presented over 90 papers at various levels. She is a co-author of “Handbook of
clinical trials in ophthalmology” and has authored several chapters in books. She is
currently Assistant editor, research methodology and clinical research, innovation and
translational research of Indian journal of Ophthlamology and was the assistant editor of
Delhi Journal of Ophthalmology from 2015-2017. She also serves as a reviewer for
several international journals. She has received numerous awards, including “Young
Researcher’s (PG) Award” for thesis from All India Ophthalmological Society (AIOS) in
2011, Dr. A.C. Agarwal trophy for best paper from the Delhi Ophthalmological Society
(DOS) in 2011 and 2012, Best Paper Award at Joint Meeting of Asia-Pacific Academy of
Ophthalmology and AIOS in 2013.

 
Dr. Subhadra Jalali, did her MBBS
from Govt. Medical College Jammu in
1986 and MS from PGI Chandigarh in
1989. She completed two year
fellowship from LVPEI in 1993, and
further fellowships in USA in Ocular
genetics, Visual Electrophysiology and
Posterior Uveitis (1995) and in
Retinopathy of Prematurity (1998).
Presently she is at LVPEI since 1993

and currently runs an exclusive
Paediatric retina service. She was
amongst the first group of pioneering
women in India to go for exclusive
Retinal surgery practice that was an
exclusive male domain at that time. She
has over 600 presentations including
orations and 165 publications in
National and International journals and
15 book chapters. She is a Co-
investigator in various multicentric
international studies. She is the
recipient of State, National and
International awards including the AAO
and APAO Achievement awards, ISCEV
travel grant, P. Siva Reddy award to
name a few. Her crowning glory is
however the more than 350 fellows
trained by her in ROP from Mexico to
Azerbaijan to Indonesia and
Bangladesh besides all over India
through one of the first dedicated one
month hands-on ROP training program.
She also conducted the first ever
paediatric retinal surgery hands-on
workshop. The IJO platinum award is
for her pioneering work published on
outcomes of setting up a city-wide ROP
program, the first one in India and in
most of the countries. She is now
working for setting up similar programs
in cities and towns of India and also in
neighbouring countries. She loves
dancing and enjoying various cultures
around the world. She can be reached
at [email protected]
28
Dr. Parveen Sen trained at Sankara
Nethralaya has been working at
Sankara Nethralaya since as a
vitreoretinal surgeon since 2000 and
currently a Senior Consultant at the
institute. She has more than 80
publications and several book chapters
and has coedited 3 books. She has
made many presentations at National
and International Conferences.
Her special interest is pediatric retinal

surgery especially surgery for
Retinopathy of Prematurity. She heads
the electrodiagnostic department at
Sankara Nethralaya with several years
of experience in Genetic disorders of
the retina. Her other areas of interest
are AMD, polypoidal choroidal
Vasculopathy, and Retinal Imaging.
She has been actively involved in the

teaching and training of the
postgraduates, Vitreoretina fellows and
optometrists. Has been involved in
many research projects including
multicentric international trials.
She is also a reviewer for several

National and International Journals.
She can be reached at

[email protected]
29
 
MENTORS PANEL ON
VITREORETINA TRAINING
गुरुब्रर्ह्मा ग्रुरुिवर् ष्णुः गुरुदेर्वो महेश्वरः । 

गुरुः साक्षात्परंब्रह्म तस्मैश्री गुरवेनमः ॥
Fellowship directors of prominent programs in the country

share their candid opinions on an ideal VR fellowship, qualities
they seek in fellows and advice on how to make the best of
your fellowship.
We wholeheartedly thank the mentors for sharing their vast

experience in vitreoretina training and their invaluable advice
to all young vitreoretina surgeons in training across the globe.
We dedicate this issue to all the mentors who have

trained scores of students directly or indirectly.
Dr Diva Kant Misra Dr Apoorva Ayachit Dr Tanya Jain

Compilation & Design Compilation Design
YO TiMES I AUG 2019

 
MENTORS PANEL
Dr. Anand Rajendran Dr. Atul Kumar
Professor & Head

Chief & Professor of
Ophthalmology
Vitreo-Retinal Service
Aravind Eye Hospital, Chennai

Dr. R.P. Centre for Ophthalmic
Sciences
Convener
All India Institute of Medical
Scientific Committee
Sciences, New Delhi
Vitreo-Retinal Society - India
Dr. Guruprasad Ayachit Dr. Manabjyoti Barman
Medical Director &

Head & Senior Consultant
Head - Vitreo Retinal Service
Vitreo-Retinal Service &

M M Joshi Eye Institute
Ocular Oncology Service
Hubballi
Guwahati
Dr. Manish Nagpal Dr. P. Mahesh Shanmugam
Senior Consultant
Head, Vitreo Retinal &
Ocular Oncology Service
Vitreo-Retina Service
Sankara Eye Hospitals
Retina Foundation
Ahmedabad
Dr. Raja Narayanan Dr. Shobhit Chawla
Director - Head
Medical Director
Clinical Research Consultant

Chief - Vitreo Retinal Services
Smt. Kanuri Santhamma Centre Prakash Netra Kendr
for Vitreo Retinal Diseases

Lucknow
Kallam Anji Reddy Campus,

Hyderabad
President,
Hon. Secretary
Dr. Vishali Gupta
Professor in Ophthalmology
Retina & Uveitis Service
Advanced Eye Hospital
Post Graduate Institute of

Medical Education & Research
(PGIMER), Chandigarh
Vice President
Uveitis Society of India

1
  Q Do you think most of your fellows are equipped to dive into a full-fledged
Vitreo-Retina fellowship right after residency? What are the prerequisites a
resident must bear in mind before embarking on the journey? Do you feel
Vitreo-Retina fellowship is different from other subspecialties?
Dr. Manabjyoti Barman
The most important thing before starting any residency program is candidate’s
interest in the particular specialty and knowledge about future perspective.
Residents should bear in mind that Vitreo- Retina sub-speciality is slightly different
from other sub-specialities due to its relatively long learning curve, unpredictable
treatment outcomes and higher machine dependency. However a Vitreo- Retinal
surgeon has the advantage in career as he/she can deal with both anterior as well as
posterior segment pathologies.
Dr. Mahesh Shanmugam
I would say, yes, most of my fellows do come equipped to cope with the vitreoretinal
fellowship after residency. The inclination to become a VR surgeon probably makes
them acquire the requisite knowledge during the residency itself in preparation for the
fellowship.
What they understandably lack is the basic VR surgical expertise, either because a VR
set up was not there at their centre or even if available, VR fellows get the chance and
not the postgraduates.
I would not be in favor of another bridge course between the residency and fellowship
– the long journey of becoming a specialist would just get longer – there are other
things in life other than the profession one has to attend to as well!
Vitreoretina is a rewarding field – not financially but to the inner fire that made one
become a doctor in the first place. When a blind person who had to be led in to the
room at the initial visit, walks in by himself after surgery, the satisfaction one
feels is the ultimate reward – it is his and his family’s livelihood that one has
saved.
The struggle, the frustration, the despair felt when battling the retina in to place
during the surgery was all worth that one moment.
On the other hand, there will be many moments of dejection one will feel as a VR
surgeon – despite the best efforts, the disease can defeat you and at times, it may
happen once too often, making one wonder if it is all worth it. When faced with
repeated failures, one has to strike a balance between attributing all failures to the
disease vs. taking the blame for all failures on oneself. Both are bad, the first will lead
to an ultimate failure as a VR surgeon and the second to persistent heartburn and
depression.
Some patients’ expectations also run rather high – when we struggle to give them
ambulant vision, their expectation is 6/4, N6 vision, the resultant heartburn is to the
surgeon!
Being a VR surgeon is being a student for life - each surgery, every day teaches
something – if one refuses to learn, one will fade professionally with surgical failures
piling up. The long surgeries and poor ergonomics will also take a toll on your
orthopedic health.
One should
One should figure out
in all
allthese
theseaspects
aspectsbefore pursuing
before VR
pursuing VRasasa acareer.
career.
YO TiMES IAUG 2019 32
1
Q
Do you think most of your fellows are equipped to dive into a full-fledged
  Vitreo-Retina fellowship right after residency? What are the prerequisites a
Dr. Manish Nagpal
Whether fellows are well equipped to do fellowship right after residency depends on
the place or institute from where they have finished their training since in India there
is no uniformity on the training imparted at different places. However we require a
minimum of three year residency program and in case they have done 2 year
diploma program then we do ask them to get another year of experience before
applying to us. Regarding pre requisites, the most important aspect is personal
interest in the particular sub-speciality. Because otherwise to spend two years in a
field without any interest in it would not do justice to the whole program. Moreover
they should also have some clarity on how they would utilize the training post
fellowship and preferably have some place in mind which has good facilities and
equipments with a existing patient volume to be able to do further your training and
gain confidence. Every speciality is different from each other and VR requires a lot
of patience and skill to face a large variety of cases. Every case is different than the
other as compared to a cataract speciality where the diversity of cases is much less
Dr. Guruprasad Ayachit
No. The pre requisites are –

Proper motivation for doing the fellowship in the specialty, e.g. Did not learn during
residency and want to learn now, taking on the challenge of a difficult sub
specialty , wanting to serve an underserved population or geographic location, starting
a department in a hitherto busy hospital previously not equipped.
An aspiring VR fellow must be good at SICS and preferably Phacoemulsification too.

A good cataract surgeon can mature into a good surgeon in any specialty because
of the skill involved, the awareness about the low safety margins during certain steps
and the necessity to handle tissue appropriately.
Vitreoretina is certainly different from other specialties.

1. It is not taught like other specialties in residency and usually needs to be taught
from basics during fellowship.
2. It needs weeks of practice to master basic examination techniques,
3. The findings in the vitreous and retina are so subtle, similar and diverse that it takes
long to familiarise with even the common signs.
4. Safety margin for certain steps of surgery is so little that it is only in the later part
of residency that they can be allowed to be done by the resident.
5. The diagnostics and surgical equipment are prohibitively expensive that it is
difficult for most to start full-fledged.
Dr. Atul Kumar
I feel Vitreo-retina fellowship is more complex than other fellowships. It is labor

intensive, exhaustive and requires a lot of commitment from the fellow. It has a slow
and steep learning curve. The resident should be well versed in finer aspects of tissue
handling and surgical skills to become a successful fellow.
33
1
Q
Do you think most of your fellows are equipped to dive into a full-fledged
  Vitreo-Retina fellowship right after residency? What are the prerequisites a
Dr. Anand Rajendran
Three questions in one here.
First, Residents differ, in my experience, in capability at the end of residency. For the
average ones, a period of at least 6 months as a General Ophthalmology junior
consultant helps them get perspective and learn the art of managing a patient as
a whole , grasp the nuances of empathetic counselling, handle difficult situations etc
and generally become more aware of ground realities compared to a raw resident. It
matures them for the grind and allows gives them time to truly determine if they wish
to take on a tough fellowship.
Second, prerequisites are

a) do they have the passion to sustain a career in retina ( rewards being the only joy
of the job rather than instantaneous material benefits for at least 5 years post
fellowship)
b) b) are they willing to spend as much time ( or more) reading as they did during
their residency?
c) c) they will never have the same level of surgical confidence as an IOL
counterpart – it will require more effort post fellowship
d) d) is setting up a practice post fellowship their priority ( tougher option) or do
they wish to continue in their institution (more suited for those with an academic
mindset)
Third – Of course , vastly different - the reading, effort is more, hands-on surgical
opportunity is less, but the reward and pride of belonging to a true superspeciality is
more.
Dr. Raja Narayanan
This is a great question. India has more than 3000 residents in Ophthalmology at any
point of time. However, historically, training in retina and exposure to retinal
procedures is grossly inadequate in most programs. Theoretical knowledge is quite
good in many candidates, but this is largely dependent on the Resident’s passion
rather than the program. Basic training in indirect ophthalmoscopy, biomicroscopy,
interpretation of OCT, B-scan and fluorescein angiography is quite limited in many
residency programs. Fellowship programs in Retina are of 1 to 2 years duration, and
lack of basic practical knowledge can be a significant hurdle in attaining proficiency
of various surgical procedures at the end of the fellowship. It would be unjust to
group all candidates in one basket, and I think fellowship interviews and exams
should be designed in a way that they can differentiate those with just good
theoretical knowledge from those with adequate practical knowledge of retina. Retina
is not ‘different’ from other specialties, rather the training in residency is
inadequate.
1
  Q Do you think most of your fellows are equipped to dive into a full-fledged
Vitreo-Retina fellowship right after residency? What are the prerequisites a
x
Dr. Shobhit Chawala
I would like to answer this question by rewinding back into time. I feel the mindset
and passion to pursue a VR fellowship comes from the time when you first pick up an
indirect ophthalmoscope and view the fundus in a totally different perspective. So the
only prerequisite I see is a passion for VR work and the capacity to give it a few
years of hard work even post fellowship.
The difference lies in that the learning curve in VR surgery is longer
Vishali Gupta
Dr. Vaishali
We run a three year Mch course in Vitreo-retina that is equivalent to Mch in other
surgical specialties. Ours is the first institute in the country to start this course, thus
bringing VR surgery at par with specialties like Neurosurgery, plastic surgery etc.
Prior to initiation of this course, we used to have three years of senior residency in
VR Surgery. During the third year of their training, our trainees get hands on
experience to do most complicated of the cases independently and are competent to
dive in full fledged retina practice. I feel that VR surgery training should be at par
with other surgical super-speciality training so that you don’t need to ask this
question. I can proudly say that our residents who get trained in VR practice VR after
leaving and not revert back to anterior segment.

2
  Q How have you designed the fellowship teaching program in your
institute? What are the different protocols and disciplines you follow in
OPD, OR & bedside clinics in grooming the fellows?
Dr. Atul Kumar
We have the largest ophthalmology residency training programme at R.P. Centre,

AIIMS, Delhi. After residency, we have dedicated, extensive 3 year sub-speciality
training in all the major disciplines. We have state of the art Vitreo-Retinal setup and
provide exhaustive training in medical, surgical Vitreo-Retina, ROP and Uvea. In
OPDs and dedicated afternoon speciality clinics, the fellow is exposed to variety of
complicated cases referred from all over India. With the help of latest multimodal
imaging facilities like Optos, SS-OCT, OCT-A, Retcam, MFERG, fellows manage the
cases under direct guidance from faculty. In evenings, they do detailed preoperative
workups of various cases admitted in wards.
They are also encouraged to teach and discuss among themselves. Case based bedside
teaching is given utmost importance. Symposiums and Live surgery workshops are
held routinely on difficult topics. They perform VR surgery under supervision in a
graded manner. Fellows are encouraged to pursue research and present in various
conferences.

Formal classes wherein the fellows present are scheduled at least 2-3 times in a
month. Most teaching however is informal, a small group discussion in the morning
of the OR’s, discussion on latest literature in the OPD etc., In the OPD, on rotation,
one fellow is with the consultant the other working up the patients. There is always
something to be learnt from each case – the person working up learns from the case
file and also in the examination of the patient; the fellow posted with the consultant
sees each patient the consultant sees, learning the art of interacting with the patient,
clinical findings, treatment protocols and management of that particular patient.
Fellows are posted to assist in the OR – they examine the patient pre-op and assist in
that patient’s surgery. The teaching will pivot on the particular surgical plan the fellow
has envisaged for the patient vs. how the consultant manages the patient and learn
from this experience.
Senior fellows do independently examine patients in the OPD and dispose them.
Surgical expertise is gained initially by doing surgical steps, then simple surgeries
such as silicone oil removal, dislocated lens removal, SF IOL, macular hole etc.,
independently before progressing to independently managing complex cases such as
rhegmatogenous retinal detachments with PVR, diabetic TRD’s and CRD’s etc., Of
course, a consultant or senior fellow will supervise / take over and manage in case of
difficulties.

2
institute? What are the different protocols and disciplines you follow in
OPD, OR & bedside clinics in grooming the fellows?
Dr. Manish Nagpal
We have a two year program and they go through a certain sequence of training and
gradually increase their independence over the period. How fast they pick up also
depends on individual skill and determination and can vary from person to person. We
have weekly classes in which cases are presented by the fellows and are discussed in
details apart from discussing recorded surgical videos from that week to learn about
the techniques and management of complications. Each fellow takes up one or more
clinical project which is furthered over the period and can formulate into a peer
reviewed publication and also for submission at various retinal forums for
presentation as free papers. Similarly surgical videos are also made a periodic
intervals for teaching as well as participating in various surgical forums and
competitions. In the operation theatre also they have a sequence of how they observe,
assist and do assisted procedure over the tenure. We do not have a fixed number of
surgeries that they need to do and it all depends on their individual skill set as well the
type of patients being operated. They become well versed with all the diagnostic
procedures as well as lasers and intravitreal injections.They are also trained to setup
vitrectomy machines for the surgical procedures and to trouble shoot when something
is not working. In the outpatient they work up new cases and come up with a probable
diagnosis to the consultant which is then confirmed or redefined based on final
impression by consultant or after carrying out diagnostics thus enhancing their skills.
Yes there is a structured teaching program in our Institute.

Protocols in OPD- In the first three months of fellowship the fellow is asked to
shadow a senior fellow/junior consultant /director by rotation. He/She is taught and
asked to take fundus pictures with the fundus camera of patients having abnormal
fundus. The diagnosis is mandatorily entered in the patient information.. Cases with
typical signs seen by seniors are shared with the new fellows. Lot of importance is
given to retinal drawings. The fellow is required to have his drawing verified and
validated by a consultant. Class room teaching is done twice a week. The fellow is
asked to present a seminar or a case. A moderator/faculty is assigned the discussion
but the entire class is encouraged to participate.
Imaging is an important aspect of diagnostic methods. A fundus picture,

OCT,FFA,ICGA, B scan, electrophysiology etc are discussed between juniors and
seniors/faculty.
In the OR the newly joined fellows are allowed from month 2 onwards. They are
taught scrubbing, gowning and gloving to orient them to the institute’s methods. They
are taught OT etiquette and gradually allowed to assist in the surgery. Steps of surgery
are discussed in detail. The fellow is taught as to why a particular step is done in a
certain way and rationale behind it. As the fellows become seniors they are asked to
start surgery independently. Initially they are allowed to do steps of surgery with a
wider safety margin and as they become adept at these are allowed more and more
YO TiMES IAUG 2019 challenging steps.
37
2
Q How have you designed the fellowship teaching program in your
institute? What are the different protocols and disciplines you
follow in OPD, OR & bedside clinics in grooming the fellows?
 
Dr. Anand Rajendran
This demands an exhaustive answer.
The 2-year fellowship programme at our centre, in brief, is graded and divided into 4
segments of 6 months - where they go through basic orientation of clinical skills ,
diagnostics, lasers, injections and surgeries with a continued upgradation through the
segments. In the last 6 months, they get to perform a greater amount of surgeries,
mostly independently with assistance.
In the OPD too, they are to see cases and show consultants with increasing, graded
independence in treating patients as the course progresses.
Dr. Raja Narayanan

I have not directly designed fellowship program, but have been glad to be part of a
collaborative team under the leadership of our Director of the Academy of Eye Care
Education. We devote the first month of fellowship in brushing up basic clinical skills,
irrespective of which residency program they graduated from.
We have a rigorous schedule of classes, which includes basics of surgical machines,

viewing systems and diagnostic equipment.
We have regular assessments of fellows in clinical skills, including surgical

competency, as well as research skills. Each fellow is assigned a faculty mentor, who
is typically of another specialty. This helps them in having frank discussion about
their progress during fellowship.
Dr. Shobhit Chawla
We take in two VR fellows at a time at a difference of six months .
We have them start with medical retina and attend the imaging area with every patient
they see and generate reports. At the same time they read from the library and other
resources , whatever they encounter in Outpatients , Besides this they workup all
the patients and that’s our OPD procedure.
The first 12 weeks are thrice a week with one retina consultant in Operating Room to
observe machine set up and the procedures . the next twelve weeks they assist and
thereafter the start the cases in operating room under full supervision , basic steps at
first.
On the academic front is a grand round day shared by VR fellows and DNB students.

2
institute? What are the different protocols and disciplines you
x
follow in OPD, OR & bedside clinics in grooming the fellows?
Fellowship teaching program should be designed with plenty of opportunities to learn

under supervision with aim to groom the fellow to become an independent and
complete VR surgeon by the end of the program. It is divided
into 3 phases (though sometimes customized, depending upon the skill and previous
clinical exposure of the resident) .
Phase 1: Orientation, obtaining skills in OPD work-up as per Institutional protocol,

obtaining skills in posterior segment examination and imaging procedures including
laser and minor surgical procedures like intravitreal injections. At the same time some
research project is given to the resident.
Phase 2: Learning OR protocols, knowledge about OR equipments and sterilization,

OR preparation, Observing surgeries and working with equipments, post –operative
patient care and record keeping are expected to learn during this phase. In OPD, case
examination, diagnosis, documentation, counseling and patient disposal should be
learned under supervision.
Phase 3: Performing some surgeries and patient disposal independently under

supervision by the mentor. Also he / she is expected to gain sufficient knowledge and
skill to guide juniors and to work in a team.
During the course of fellowship fellows are expected to maintain their log-book and
actively participate in regular academic classes. Also they are expected to write and
publish paper/ case report in journals, attend conferences and to participate in other
Institutional activities for overall development
Dr. Vishali Gupta
As mentioned previously, we have a structured teaching program for Mch. Each

resident is rotated through different disciplines like ROP training; peadatric retina
training; retina imaging lab posting comprising of FFA, ICG, USG, OCT, UBM,
OCTA etc, laser posting and surgical training. They also participate in regular
teaching including grand rounds, CPC, surgical videos, journal club etc. They are
involved in doing emergencies and taking care of indoor patients as well as teaching
junior residents.

3
  Q What is the best way to grasp the nuances of Vitreo-Retina & do you
recommend any mandatory reading sources for medical and surgical retina?
Dr. Atul Kumar
The best way to learn is to observe and assist live surgeries being done by the mentor
and understand finer nuances. We perform Digitally Assisted Vitreoretinal Surgery
using NGenuity at RPC. It gives a major boost to teach multiple fellows at the same
time. One has to be thorough with the latest volume of Ryan’s Retina. I have also
authored a book on retina which encompasses my personal experience. It is a concise
book focused on diagnosis and management pertaining to Indian settings. The title of
the book is Retina: Medical and Surgical Management, Edition 2018, Jaypee
Publishers. The fellows can also learn from online resources like AAO, ASRS
websites.
One should not become impatient and rush to do new things. Regular study, positive
attitude, self confidence and respect to patient is must. In my opinion best way to
grasp the nuances of VR is by a combination of regular reading from standard
text books ( like Ryan’s or Peyman) reviewed journals and in clinic discussing
cases with colleagues and mentor. Small tips during surgical steps or in OPD may
go a long way, for which one should be observant and attentive as well.
Dr. Vishali Gupta

The best way to learn is to see your patients meticulously and go back home and
read everything about that particular disease that you have seen in your patient.
The resources have to be a combination of text book with latest journal articles as
many a times the information given in the text book may be outdated.
Dr. Mahesh Shamugam
The focus is on learning about a particular finding in a given patient or a particular

diagnostic or surgical issue we face in the course of an OPD or surgical case. This is
achieved by searching the literature then and there using the mobile Internet or
any other resource such as digital textbooks or journals– this tends to stay etched in
the memory.
Preparing for classes, presentations in conferences, writing manuscripts are all

avenues for learning and all these are encouraged.
The fellows do read standard textbooks and seminal articles in due course as part of
their preparation for the fellowship theory exams.

3 What is the best way to grasp the nuances of Vitreo-Retina & do you
  Q recommend any mandatory reading sources for medical and surgical retina?
Nuances of Vitreoretina – I feel that a fellow must learn from his seniors. However
shadowing a consultant who is experienced (clinically and in teaching) is a must to
draw inspiration and learn the nuances of the specialty. The approach to a patient to
arrive at a diagnosis and customising the treatment for a given patient can be learnt
only from an experienced clinician. Reading material – Besides text book (Kanski/
AAO BCSC series/Ryan retina/ Yanoff/Jackobiec/Steve Charles VR surgery), the
fellow must also know how to do article search from journals and must read these
articles. A lot of information not available in text books can be got from reading
journals.
Dr. Shobhit Chawla
With the change in informatics and availability of reading resources times have
moved. In our time as fellows mandatory reading used to be Howard Schatz book on
fundus fluorescein angiography and Atlas of macular diseases by Donald Gass. These
were the mainstay along with Charles Schephen’s book on retinal detachment and
allied disorders. Now of course I would rate Stephen Ryan’s retina as a
comprehensive resource with lot of add on reading on imaging etc from net resources.
The old books by Schepens and Gass were not only information but moreover were
inspirational for a young fellow and showed the path to diligence and perfection.
Dr. Anand Rajendran
It has to be an amalgamation of continuous, intense reading as well as discussion,

presentation of cases, journal perusal. We make it mandatory to read Ryan,
Yannuzzi , Peyman’s Surgical text. We also recommend a number of
atlas’ (especially Gass Atlas).

3
Q
What is the best way to grasp the nuances of Vitreo-Retina & do you
  recommend any mandatory reading sources for medical and surgical retina?
Dr. Manish Nagpal
Typically we would recommend fellows to read up the Ryan Retina volumes as well
as Steve Charles surgical books as well as diagnostic texts on imaging of all sorts.
However nowadays there is so much available online as well for them to refer all the
time. There are websites of the AAO, ASRS and Eye Tube etc which have a lot of
video and imaging content apart from all the new updates in medical and surgical
retina . In fact I encourage all fellows to refer to them as well as be a part of them by
uploading interesting images on sites like the Retina Image Bank etc which allows
them to get noticed globally and also contribute to such online libraries of
information.
Dr. Raja Narayanan
My focus is on applied learning, rather than cover to cover reading. Cases seen in
the clinics should be flagged for discussion at the end of the day with the faculty,
and those cases should be read from text books (Ryan is usually what I would
recommend), and updates from Pubmed search should be incorporated. Additional
reading is also recommended, such as from Atlases (Gass , Yannuzzi are my
favourites). There is no point seeing a patient of Coats disease in the clinic and
reading a chapter on Retinitis Pigmentosa in the evening.
Similarly, for surgical cases, the reading should happen the previous day, such
that the fellow is able to understand the nuances of surgical steps during the surgery.
I send off fellows to the library during clinics to read up cases if they are unable to
answer basic questions, and ask them to bring back written notes. Fellows are also
encouraged to do extra reading in their passionate areas, which may culminate in a
manuscript.
Finally, I spend many hours (over many days) with fellows reviewing their case
presentations and journal clubs.

4
  Q Apart from the theoretical knowledge, fellow’s ability to think and adapt
during a surgical case, decision making and technical dexterity play an
important role. How do you go about teaching these ?
Dr. Atul Kumar
A fellow works directly under supervision of faculty members. They learn observing
faculty members and their seniors.
Detailed planning of the approach towards a case should be made before hand and
should be discussed by the mentor with the fellow. Any change in surgical steps or
treatment plan should be explained. For this a healthy mentor – mentee relation is a
must. Before starting surgery, one should try to spend some time in the wet lab to
improve technical dexterity and hand-eye co-ordination. Always start OR practice
with simple surgical steps. Record your surgical steps and see these later to find out
the difficulties and scope of improvement.
As mentioned earlier, the fellow is encouraged to draw up a game plan for the surgical
case he / she is to assist the surgeon and discuss it with the surgeon. I would also
encourage them to wonder why I did a particular step in that particular way in a given
case, thereby encouraging the ability to think on the trot and devise solutions. I would
also do a surgical audit of my own surgery that went wrong. Doing this with the
fellows allows them to learn from it and also encourages them to do the same –
review their own surgical videos and learn from them. Technical dexterity is
individual but most can be trained to overcome their limitations and become decent
surgeons. The multiple complete surgeries they perform, initially under supervision
and subsequently completely independently allows them to realise their potential.
Junior fellows are encouraged to assist senior fellows as well thereby breaking the
barriers to learning and also to learn from the mistakes their colleagues make.
We do a surgical audit as well, particularly when a given surgery performed by a

fellow did not go as per plan. The surgical video is dissected by the consultants,
guiding them to improve their techniques – the whole team participates in this
exercise allowing all to learn from each other’s mistakes. The bottom line is that each
should take responsibility for their own actions – not that they are penalised, but then
assuming this responsibility results in one giving their best to their patients, for life.

4
Dr. Vishali Gupta
Simulators and wet labs are the best way to acquire these surgical skills.
Dr. Manish Nagpal
This is the most important aspect of a long term fellowship. The fellows are
constantly assisting you or working up your cases and you are constantly discussing
every nuance. They constantly ask why I choose to do this or that for a particular
reason in a given situation and why I have chosen to do something different in exactly
the same diagnosis in a different patient. The beauty of any pathology is that they
don’t read books and hence we have to build on our experience to diagnose and
treat and vary our treatment strategies as per what we feel might be more
effective in that particular scenario. During surgery also the fellows constantly
discuss the reasoning behind doing a particular step etc and when they watch that
again and again in different situations its easy for them to remember these treatment
strategies as well as surgical steps and nuances. Dexterity is a boon for any surgeon.
However the amount of dexterity and finesse would of course vary with every
individual. Hence they are always asked to practice using both hands and
interchange the tools with both to gain as much dexterity from practice as
possible.
As I already said - Surgery is taught in a phased manner and initially the steps
which can be delegated should not be intricate. As the fellow gains confidence
more difficult steps can be allowed independently. The entire process is to be done
under supervision and akin to a sports coach, mistakes are to be highlighted without
dampening the confidence of the fellow. During surgery the consultant has to know
exactly when to take over from the fellow. In the interest of patient safety the
threshold for taking over v/s allowing the fellow to continue has to be judiciously
balanced.

4
Dr. Shobhit Chawla
The best approach to adapt to a particular surgical case is surgical planning ,

discussion to approach in OR and keen observation. For surgical dexterity we
follow the approach of teaching and making the fellows do a one step at a time in a
particular case, way back Prof Arthur Lim a great teacher in the Asian context
advocated teach but do no harm , so navigating a path of surgical skill transfer
should be a very systematic , stepwise and a well supervised process. Complications
a natural partare
Complications of athe learning
natural process
part of shouldprocess
the learning be dealt
andwith by the
should supervising
be dealt with by
consultant.
the supervising consultant.
Dr. Anand Rajendran

Ensuring that fellows watch cases - at least a few of the challenging ones, during OTs
and then engaging and encouraging them to discuss and voice their doubts helps
improve their thought process, decision making and technique choices at critical
situations. Creating an atmosphere where the fellow feels uninhibited in asking
and clearing their doubts is vital to their learning process. Also having them see
recorded surgical videos also helps them analyse the surgeries as well as learn how to
manage complications.
Dr. Raja Narayanan
This is a tricky point. This is best taught during surgery, but it is not easy when a
patient is being operated under local anaesthesia(LA). A lot of problems can be
avoided by doing an indirect ophthalmoscopy just before giving LA, or going through
relevant scans. A plan should be discussed with the fellow, but the fellow should
be allowed to make the plan. Examples include using a 6 mm infusion cannula
because of various reasons, or planning a bimanual surgery with Chandelier
illumination. Most fellows understand instructions during surgery. Some of them can
have a mental block of not being able to listen and operate. In such cases, I take over
if there is a threat to safety. But it is always a good point to go over the video and
teach the fellow after the case.

5
  Q Is there a magic number for surgeries and other procedures to declare that a
fellow is competent to deal in Vitreo-Retina? Are there any other yardsticks
you use to assess surgical competence of your fellows?
Dr. Anand Rajendran
We believe a minimum of 30 independently performed vitrectomies, and 5 buckles

should help achieve an acceptable degree of competence to perform the basic and
slightly complex cases. Of the vitrectomies, at least 5 should be independently ( or
with minimal watchful assistance) settled Retinal detachments. All this , however ,
comes on the backdrop of at least 100 assisted vitrectomies, in which they do parts of
the surgeries in a graded manner over the 2 years.
Dr. Atul Kumar
There is no magic number. The fellow should be well versed in theoretical knowledge
and finer surgical skills to become successful. He should be able to manage the
postoperative complications. Patient satisfaction defines your competence.
No, there is no magic number as such. It depends on several factors such as, number
of live surgeries watched, number of surgeries assisted, number of steps of surgery
performed, number of independent surgeries performed, number of videos watched
and above all the comprehension and inherent creativity and dexterity of the
fellow.
But on an average 10 independent successful complex surgeries can be considered the
“magic number”.
Yardsticks to assess surgical competence of a fellow:
1. Doing the basics consistently right.

2. Safe surgery at a reasonable speed
3. Knowing when to blame an instrument or machine
4. Adapting to and overcoming special and difficult situations,
I wish I knew what this magic number was!
Our fellows would do 100-200 or more independent surgeries of different

complexities during the course of their fellowship. The surgical and visual outcomes
are monitored and as mentioned above, a surgical audit within the department
YO TiMES IAUG 2019
allows each to learn from the other’s mistake.
46
5
  Q Is there a magic number for surgeries and other procedures to declare that a
Dr. Manish Nagpal
Don’t think it can be defined by a magic number and moreover with centres like ours
which are totally private its difficult to keep a fixed number for each program. We do
not take exams of any sorts and this program is a voluntary fellowship program where
it’s the internal integrity and interest and skill of the fellow to take as much from
the institute as possible.
Over a period of time we do know in a few months after a fellow has joined the
particular strengths and weaknesses they have. Some are well prepared and very clear
in their ideas about how they go about and some of them constantly need to be
guided. Some have a lot of academic interest apart from enhancing clinical skills and
some have a better or poorer combination of both. Frankly speaking fellowship
program is the only time of your life when you can freely ask any questions and take
up as many academic projects as possible .You can leave the entire responsibility of
outcomes on your guide. This would not be possible once you are independently
working in the future. So we encourage all fellows to be as curious as possible, ask
the silliest of questions wherever in doubt and constantly prod the guide with
ideas. It would go a long way in building their experience which will help them
throughout their life.
I don’t think so. It is not the quantity but the quality matters. Competence to do
surgery depends on the individuals interest, knowledge, confidence and grasping
power. While each fellows have different capabilities, customized training schedule
with ample opportunities under supervision should be given to each of them to
improve on the skill set and areas needing improvement should be
communicated.
Surgical competence can be assessed either by directly watching the fellow while
doing surgeries or by seeing the outcome in post-operative period. A monthly surgical
stepwise competence based analysis and appraisal report can be handed to the fellow
with some grading system .
Dr. Vishali Gupta

There is no magic number though the residents do keep a log book. I think the biggest
yardstick is the confidence of mentor to give independent surgeries to his or her
fellow.

5 there a magic number for surgeries and other procedures to declare that a
  Q Is
Dr. Raja Narayanan
I do not believe in a magic number, and I can vouch for this with personal experience.
There is also a huge variation in the number of surgeries offered in different
fellowship programs. Wrong skills get magnified by doing them in more number of
cases! One should assess the following – is the Fellow’s hand following the thoughts
of his/her mind, and is their thought process correct? Having said this, I also don’t
believe in programs which give 10 cases in 2 years.
Dr. Shobhit Chawala
There is no magic number, it is a more of a continuum of surgical exposure which

we focus on with our fellows. Once satisfied with the development in skill levels we
give them the liberty and confidence to commence every VR surgery and then take
over at the most complex parts. This not only is a great skill builder but watching and
assisting in the most complex dissections and peelings leads them up the scale.
The only yardstick which we personally take into account are the pre-surgical
planning done in the OR before cases and that determines the approach of the fellow
which is more important than just the core surgical skills, which can happen to all
with time.

6
  Q What qualities do you value most in your fellows? What sets an
extraordinary fellow apart from the rest?
Dr. Anand Rajendran
The basic requisites of a fellow that are non-negotiable for us are – honesty,
integrity, empathy for patients, sincerity in doing their duties, a high degree of
diligence and an acceptable level of theoretical knowledge and surgical
capability. An outstanding fellow, and we have had quite a few, is one who
consistently goes beyond the call of his duty in doing that extra bit in serving patients,
demonstrates high surgical competence, high theoretical knowledge and is able to
make excellent , confident presentations, execute projects & do high quality research.
Dr. Atul Kumar
Dedication and commitment towards work is must. He should be a patient learner. He

should focus on concepts and basics of surgery. He should learn from the seniors.
• Sincerity and Hard work.

• Discipline in documentation
• Following general departmental etiquette
• Focus, Quest and yearning to learn.
• Inclination to research.
Honesty, integrity, owning up responsibility for one’s own actions, compassion,

innovation, enthusiasm to learn and positive energy.
Dr. Vishali Gupta

Honesty and dedication. Nothing else matters to me.

6 What qualities do you value most in your fellows? What sets an
  Q
extraordinary fellow apart from the rest?
Dr. Manish Nagpal
Curiosity is quality what I think I would value most in a fellow. He/she needs to
be inquisitive about everything around. They should be able to question and
constantly ask why this is so and why not so and also why are we treating this patient
differently as compared to another patient with a similar diagnosis. They should not
work mechanically. They should not presume a diagnosis just because somewhere in
the patients past papers someone else has mentioned some diagnosis. When one has
worked with so many fellows it is easy to gauge in a few months whether the fellows
has these qualities or not. Some of them have in built curiosity whilst in many one
has to make them curious or teach them the value of curiosity by giving
examples in the daily routine. The other quality I also would like in my fellow
would be to look at every case they see as something unique. They should try to find
out what the given literature says and why this case may be different, whether it be
imaging, be the follow up or some clinical manifestation which may be unique. As
they say “Diseases don’t read books” and that’s the best part because it stops
making you mechanical and think and correlate so many different clues to arrive at a
diagnosis
Being focused, dedicated and sincere are important qualities. One’s will to learn new
things and the inherent curiosity to understand the subject make a difference.
Dr. Raja Narayanan
Fellows who are excellent with their head, hands, and not the least, their heart.
Dr. Shobhit Chwala
Honesty and recognizing his limitations when he is dealing with situations in this new
challenging speciality and off course the desire to learn and continuously improve.
What sets an extraordinary fellow is the ability to analyse and question and off course
papersetc.
extraordinary hard work To take on responsibility of analyzing data for paers etc.

7
  Q You must be faced with situations where fellows do not follow
instructions or fail to keep up with deadlines for projects that a mentor
has assigned. How do you deal with such a fellow?
Dr. Anand Rajendran
Fellows who do not meet the mark are immediately apprised of their shortcomings – I
believe that being candid with them is important as it is important to know if
there are some mitigating , personal issues that are limiting them. Once that is
clarified, non-compliant fellows should be dealt with firmly – they will be told that
their non-performance would affect their clinical and surgical opportunity. Repeat ,
serial offenders , especially if they are serious, are given one final warning and
may even be terminated.
Prof. Atul Kumar
We have strict working atmosphere. Every case is dealt in a personalised manner

based on institute’s guidelines.
Strong warning and if no effect withhold his/ her completion certificate. However this
is a very rare occurrence.
The basic ethos of the department reflects in the fellows’ behaviour. It is thus
imperative that the mentors practice what they preach thus setting the tone for the
fellows to follow. There are usually no penalties but then the environment in the
department is such that everyone understands their role and strive to give their best. In
extreme situations where patient safety and care are compromised, penalties may
follow – from not being allowed to participate in patient care for a period of time, to
warnings etc. Not meeting deadlines is dealt with by repeated reminders, which if
ignored, are dealt with by assigning responsibility to another person. The more
serious offshoot of this behaviour is the loss of trust with that particular fellow which
will have long lasting consequences. For instance when there is an enquiry in the
future for a job reference for that particular fellow, the consultant may be less
forthcoming. Hence it is in their own interest that fellows own up the responsibility
and act as expected out of them during the fellowship.
7
  Q You must be faced with situations where fellows do not follow
instructions or fail to keep up with deadlines for projects that a mentor
has assigned. How do you deal with such a fellow?
Dr. Manish Nagpal
I strongly believe that unlike a residency program, a fellowship program is

absolutely voluntary. When a fellow joins you he is sacrificing two years plus of the
most important years of his life to come and learn and imbibe all that you have to
offer. So most of them are extremely sincere and make a lot of efforts to define and
complete their tasks. It would be rare to see someone constantly failing to do so. What
usually happens is that as a mentor you start giving more responsible and
important work to the fellow who is efficient and curious and is constantly
driven to perform. That way the work gets done efficiently and is productive for the
whole team. The fellow who has time and again shown laxity would slowly be given
less and less responsible aspects of the work, be it clinical or academic. Since this is a
voluntary fellowship program we do not have any penalties or punishments but in the
long run they would realise what they have missed out on in the crucial two years of
the fellowship program.
A fellow should understand that working on projects and meeting deadlines is as

important as acquiring outpatient and surgical skills. Some leverage should be
given within reasonable amounts as long there is sincere effort in the part of the
fellow. If it can be worked out, good enough. If someone intentionally pushes the
deadline due to lack of interest or other reasons, an honest confrontation with some
disciplinary action as permitted by institutional protocol may become necessary.
Dr. Vaishali
Vishali Gupta
Gupta
I don’t take it to heart. I help them in understanding the importance of doing it

right and leave it to them. I don’t believe in spoon feeding and I have not come
across a fellow who has not met deadlines. Fortunately, all the thesis that I have
guided has resulted in publications.
ShobhitChawala
Dr. Shobhit Chawla
Frankly speaking have had very few such situations and have been blessed with
great hard working fellows.
Dr. Raja Narayanan
If a fellow is sincere in work, work on them with kindness and get them on track.
They deserve a teacher’s kindness. If a fellow is not sincere in work, they need lots
of talking, and reprimand. If a fellow is not sincere, has lots of ego, show them the
door.
52
8
  Q At the end of the tenure, on what benchmarks do you define a
successful Vitreo-Retina fellowship ?
Dr. Anand Rajendran
A successful fellow would be one who emerges confident and has achieved a high
level of clinical, theoretical and surgical knowledge and competence coupled with
an ability to make the right practical as well as compassionate decisions for
patients. They should also have gained the affection and respect of all their
colleagues, paramedical staff as well as consultants.
Dr. Atul Kumar
There should be total dedication and commitment towards one’s speciality. We

should perform result oriented surgery and do personalised patient care.
Mastery over examination techniques.

Proper interpretation of Imaging modalities.
The routine benchmarks are the marks they obtain in the theory paper and the
practical exam, conducted at the end of the fellowship. The true benchmark is the
confidence with which they go out in to the real world – the day the call me back
to tell me that they have successfully operated on their first case outside the
boundaries of their alma mater.
I will deem a fellowship program successful, if at the end of the tenure the fellow
can independently handle the Retina outpatient department, confident on
diagnosis and management plan and perform common VR surgeries
independently and successfully. Having at least 2-3 good publications is also
equally important.

8
  Q At the end of the tenure, on what benchmarks do you define a
successful Vitreo-Retina fellowship ?
Dr. Manish Nagpal
I think when a fellow has spent two crucial years of their life on a daily basis to be
with you and be a part of every clinical, surgical, diagnostic and academic activity at
the hospital , it’s a privilege to give completion to that tenure. Completing the
fellowship does not mean that the learning is complete. It actually means that
you have a very good foundation laid on which you could go out and build a
strong future for your self. We do not have any exams which define a benchmark
and it’s the tenure which defines a completion of fellowship. After completion the
fellow is a part of the alumni and begins a new life knowing that its alma matter is
always there to constantly support them for their future endeavours . Moreover
during a fellowship period the fellow is exposed to a particular school of thought of
that institution and I would always encourage them to go out and observe other
experts from different schools of thoughts which may help them to truly find their
own.
Dr. Raja Narayanan
Fellows who are excellent with their head, hands, and not the least, their heart.
Dr. Vishali Gupta

An honest physician, good researcher with curiosity for learning, capable of
leading and good surgeon.
Dr. Shobhit Chawla
The ability to diagnose routine situations and competently manage these cases
with confidence , skill and proper counseling. Nothing less than that should be
defined as a successful VR fellowship. Most of all also to recognize limitations and
cross consult.

9
  Q If you were to do a fellowship in todays era, how differently
would you approach it?
Dr. Anand Rajendran
I would have been delighted to do a fellowship in this era as for one, reading
material is so easily accessible and available in this cyber-age, secondly there is an
explosion of excellent Retina Meets all around the country where great information
exchange and discussion with stalwarts in the field are available. Additionally, clinical
and surgical outcomes, given the antiVEGF and MIVS era, have improved, making
the Retinal branch far more gratifying than in our time. I would have devoted
more energy to reading more journals of the net as this was not as accessible earlier,
perhaps been able to focus more on the complex vitrectomy cases, especially the
Dr. Atul Kumar

I would start from the basics. I would first learn basics of instrumentation,
microscope handling and tissue dissection. I would then perform Vitreo-Retinal
surgeries starting from basic to complex cases. I would read latest advances in retina
including imaging. I would learn by observing/assisting others.
I would choose a proper fellowship center after a lot of research / compilation of facts
from reliable sources/past fellows. Given a choice I would list my priorities keeping
in mind my training requirements for the practice type. e.g mainly medical retina
practice or comprehensive Vitreo-Retinal practice. Teaching Vs Private Vs group vs
family practice. I will make a choice for concentrating further and honing my
skills on medical/ surgical aspects depending on my inherent abilities.
All the above are my take on how I would like my fellowship to be!
Dr. Vishali Gupta

I have not done any fellowship nor I have gone abroad to train. I have done my three
years of VR training as senior residency under Prof Amod Gupta and I would not
like to change a thing about it. Given a chance, I will repeat those three years even
today.

9
  Q
If you were to do a fellowship in todays era, how differently
would you approach it?
Dr. Manish Nagpal
I don’t think it would be very different today as far as the approach is concerned. You
have to dedicate two years of your life to a program and you want to master it as
much as possible in that tenure. You want to imbibe everything that your alma mater
can give you. So approach is based on sacrifice, dedication , ambition and a
inherent curiosity to know more and more. When a fellow applies for a particular
fellowship program they should have visited the place and seen its functioning for a
few days or a week before finalising the program. Because sometimes you go with a
certain intent and expectation and every place is different in its approach. So I would
always advice any fellow to make sure they know what they are getting into, right
from the institute, its mentors, the city, logistics because if you have to go away from
your own comfort zone and spend two years you have to make sure that you reduce
the variables that may affect the quality of your fellowship program. Moreover
fellowship program is also about a team work.. There are already senior fellows when
you join and some may be starting with you and its always best if you work in a team.
The learning becomes much easier as a team and knowledge multiplies easily.
Mentor should be friendly and interested in teaching fellows and should make them
feel relaxed through professionalism at the work place. With massive growth of
technology and rapidly evolving science, mentors are also expected to be up- to- date
with the changes and ready to accept new things and ideas.
Dr. Shobhit Chawla
I feel the fellowship we did was very adequate in training and direction. I feel
today the mandatory requirement is more towards data analysis and publication which
was quite nascent in our times as the speciality was slowly getting more established in
the country and training norms were still getting defined. This is an area which needs
to catch up to fellowship programmes available internationally.

10
Q Final word, or any other comment?
Dr. Anand Rajendran
I believe, setting up a basic minimum standards draft, is a welcome idea as it will

help standardize the fellowship programmes of the country. Additionally there needs
to be a greater effort to upgrade exposure of postgraduates to the retinal branch so that
bright talent is attracted to this field as a higher density of retinal surgeons around
the country is the need of the hour. We also need to ensure that support
programmes from parent institutes for their fellows, once they pass out and are
finding their way in the world, are also encouraged.
Dr. Atul Kumar

Vitreo-Retina is a complex fellowship which demands commitment and patient
learning. Surgery should be result oriented.
A fellow in Vitreo-Retina must realise that as it stands today the specialty is very
satisfying in terms of the challenge that it poses. However investment to start a
basic set up is heavy. Monetary reward and matching patient satisfaction is difficult to
achieve. A judicious counselling is required, given the unpredictability of results
which however can sometimes result in losing the patient and frustration to the
novice. The fellow should also learn from the mentors the art of not falling into the
net of litigation.
At the end of it all, it can be frustrating if one is not able to practice the craft one has
pursued with passion. Opportunities are difficult to come by for VR specialists in
cities but this should not be a dampener – one should be ready to relocate to a
smaller place which would allow him / her to pursue their love for VR
Dr. Vishali Gupta

Just be honest and follow your heart always.

10 Final word, or any other comment?
Q
Dr. Manish Nagpal
I had joined Retina Foundation in 1997 as a fellow. My father has been my mentor
along with other consultants and senior fellows. At that time our program used to be
for 6 months. But for me there was no time frame and hence it went on for a few
years. This made me realise the value of a longer fellowship period. Eventually we
extended our program to 1 year and then to a two year program which is what it is
even today. And for me the learning has come from our own centre as well as visiting
almost all the premier teaching places within India and many wonderful surgeons
abroad. I would advise every fellow that after the fellowship please take every
opportunity to visit a good teacher/surgeon in your field wherever you get a
chance to travel. You may be going to a place for an annual meeting and you should
find out who is a good surgeon practicing there and make sure you plan to see some
surgical work before or after the meeting. Keep yourself open to different people,
different ideas, different ways of doing the same thing and you ware bound to
find what you can call your own.
Selection procedure for the fellowship should be transparent and should be

based on attitude, knowledge and his/ her future perspective in the particular
speciality. Number of publication during post graduation should not be an important
criteria. A healthy relationship and a good academic environment proves beneficial for
both the mentor and the mentee.
Dr. Shobhit Chawla
I feel the time has come for fellowship programmes to be standardized among all
institutions in the country and an optional certification examination to be offered
nationally, this may not be mandatory but will be a great indicator to quality of
fellowship programmes

P A G E
the BIGquestion
9. Fellowship: To Do or Not To Do ? 59
Dr Manoj Khatri
10. S e n i o r R e s i d e n c y
Fellowship ?
or 63
Dr Samendra Karkhur
11. Medical Retina or Surgical

Retina ?
66
Dr Chintan Desai
Dr Saurabh S. Mistry
Dr Amit Palkar
12. How to find the right Fit ? 76

Dr Chintan Desa
Dr Smriti Mishra
Dr Vishal Govindhari
Dr Tanya Jain
the BIG Questions
FELLOWSHIP :
TO DO OR NOT TO DO?
- Dr MANOJ KHATRI
WHAT IS A FELLOWSHIP ?
Fellowship for doctors is an additional period of training after completion of a

specialty-training program, which is now called “residency” in various parts of the
world. A typical fellowship is 1 to 2 years during which one undergoes focused
training in a particular area within a specialty and develops expertise in the
management of a certain patient population.
WHAT ARE THE PROS AND CONS OF PURSUING A FELLOWSHIP ?
After 4 to 5 years of medical school, 1 year of housemanship, 1 or more years of

non-trainee MOship (medical officer), and at least 3 to 6 years of residency, more
years to remain as a trainee may sound daunting and unattractive. A fellow’s life is
definitely not easy. One is expected to be the first point of contact for referrals to
the sub-specialty. This will translate into dealing with complex or urgent cases and
most likely the need to be on duty after office hours. In addition to clinical work,
research output and scholarly activities are also standard requirements for most
programs that a fellow needs to excel on. Salary during fellowship is usually very
basic if there is any. Most people will need support from his/her home institution,
which comes with waiting time and period of service obligation. Most if not all
fellowships are only available in distant places/ states, which may be difficult for
those with family and young children.
On the other side, there are certainly benefits in pursuing fellowship.

After fellowship training, one should be able to offer expert level of
care to a certain patient population and to perform certain
specialized procedures independently. A sub-specialist is allowed to
focus his/her time in one specific area of interest in clinical work
and research so there is a potential to be a knowledge
expert or even an opinion leader. The compensation
for sub-specialist is generally
59
higher than generalist according to published reports, although the opportunity
cost from the additional training should be considered.
WHAT ARE THE CONSIDERATIONS BEFORE COMMITTING TO A

FELLOWSHIP ?
As discussed above, fellowship training has pros and cons. It may not be suitable
for everyone and is dependent on one’s overall professional and personal goals. It
is also a major career and life decision that should not be taken lightly. It is
essential to think through the following questions before committing to a
fellowship.
• Do you have a strong passion or deep interest in a particular subspecialty?
• If you think you are, have you had enough exposure in this
subspecialty to know what it is really like?
• Are you satisfied clinically to care primarily for patients with problems
within a particular subspecialty?
• Are you interested and comfortable in performing procedures in some

subspecialties?
• Will the particular fellowship program help you achieve your goals?
• Are you comfortable with the lifestyle and financial compensation of a

particular subspecialty?
WHAT SHOULD YOU DO TO PREPARE YOURSELF FOR A FELLOWSHIP ?
After careful consideration of your professional and personal goals, long-term

professional satisfaction, financial liability, and family considerations, do act early if
you are thinking of pursuing fellowship training. Gain as much exposure as
possible in your subspecialty of interest to avoid any uninformed decisions. Find a
mentor who can inspire you to go further in the subspecialty, help you develop
research projects and introduce you to others in the specialty. Go for specialty

conferences and do your research on which are the reputable fellowship programs
that fit your goals.
SHOULD I DO A FELLOWSHIP ?
If provided with an opportunity, I will always and always do fellowship – it will allow
me much needed exposure in the subspecialty of my choice. The fellowship will
allow me to make independent decision for better patient care and outcome. The
fellowship will provide me with the much-needed window into what will be lying
ahead for me in future. It will also allow me to explore certain key topics in greater
details and an appropriate platform for research. To be completely independent
physician or surgeon, one definitely need to take the path of fellowship and I
believe there is no short cut into one’s clinical or academic career without prior
fellowship.
WHY RETINA OR UVEITIS FELLOWSHIP ?
I will like to use this opportunity to throw insight into why I ventured into retina and
uveitis fellowship – I really enjoy challenges and the mere thought of salvaging
one’s vision by tamponading the most important layer of the eye gives me greatest
joy and sense of fulfilment at the end of the day. Retina fellowship strengthens a
surgeon mentally and allows him to be in total control of patients vision (and to a
certain extent life) – likewise clearing the inflammation and infection from eyes is
again a tough enduring task but witnessing the smile back on patients and his
family is the most important goal in life of a uveitis specialist.
On similar lines, is the need of the hour is to train people globally on the work/
specialization related to Ocular trauma. It is indeed a very challenging work to give
the optimal outcomes both anatomically and visually for a severely traumatized eye
and even more daunting task is to manage the patient at the point of contact along
with the hyper anxious attenders/relatives.
VRSI (Vitreo Retinal society of India) and USI (Uveitis Society of India) are
taking huge strides forward in shaping the future of the upcoming trained Vitreo
Retinal and Uveitis specialists in India and they will have a very bright future ahead
for Clinical work, Academics and Research and the opportunities galore will widen
further.

So, folks don’t think twice and make up your mind and get into the fellowship
programme of your choice and dedicate yourself for the best to bestest patient
care!! As the future lies in the expertise delivered by the super specialists…
All the very best!!!

DR MANOJ KHATRI MBBS, DO, DNB, FICO (UK), FLVPEI, FMRF, FRCS (GLASG, UK), FAICO, FIAMS is the
Principal Consultant Ophthalmologist and Vitreo-Retinal Surgeon
Founder and Managing Director, EYDOX EYE HOSPITAL, Chennai. Senior Consultant
Ophthalmologist and Chief of Rajan Retina Foundation at Rajan Eye Care Hospital, Chennai.
Senior Consultant Ophthalmologist at Apollo Hospitals, Westminster Healthcare, Chennai.
A well-trained actively practicing Ophthalmologist in both anterior and posterior segment of

the Eye over a decade. His academic achievements comprises of a Vitreo-Retina fellowship
(short term) from the prestigious L V Prasad Eye Institute, Hyderabad followed by a Clinical
and Research fellowship in Vitreo-Retina and Uveitis from the esteemed Sankara Nethralaya,
Chennai. Dr Khatri has published several papers in peer reviewed scientific journals, presented
widely nationally and internationally at various scientific forums.
He is on board as a Principal investigator and Co-investigator of various drug trials in
Ophthalmology. He is assiduously engaged as a DNB (Diplomate Of National Board in
Ophthalmology) teaching cum thesis guide. Principal areas of interest include – Cataract and
Vitreo-Retinal Surgeries as well as Uveitis/Ocular trauma and Neuro-ophthalmology.
His special interests rests in - Retinopathy of prematurity, Diabetic retinopathy and challenging
Vitreo-Retinal surgeries.
He can be contacted at [email protected]

the BIG Questions
SENIOR RESIDENCY
or
CLINICAL FELLOWSHIP?
-Dr. SAMENDRA KARKHUR
Ophthalmology is one of those branches in Medicine which until now did not have a
super-specialty degree like DM or MCh. Now PGIMER, Chandigarh is the only
institute in India which offers MCh in Vitreo-retina Surgery. However, this does not
meet the requirement of several hundred diploma and degree holding
ophthalmologists passing out each year in India. These young ophthalmologists
seek sub-specialty training in various fields like Vitreo-Retina, Uveitis, Glaucoma,
Oculoplasty, Ocular Oncology, Cornea and Refractive, Neuro-Ophthalmology,
Pediatric Ophthalmology and Squint.
The reasons are firstly the lack of adequate sub-specialty rotation, limited
availability of equipment/training in majority of government or private medical
colleges in the country that offer post-graduate courses in ophthalmology. Secondly,
increasing awareness and rising demand among patients who seek specialty care
in ophthalmic problems similar to other fields in medicine.
Currently, after post-graduation or diploma in ophthalmology a candidate takes two

routes to achieve the sub-specialty training in various fields. These are senior
residency (henceforth called ‘SRship’) and clinical fellowships (henceforth called
‘fellowship’). I will discuss these two paths in detail and the advantages/
disadvantages of each; this may help many of my colleague standing at
crossroads, in making an informed decision.
SRship is termed as the gateway to academic medicine in India. The duration may
vary from one to three years and needs to be completed before one can
apply for teaching or faculty position in a state or central government
institution. In general, state medical colleges accept a candidate for the
post of lecturer or assistant professor with one year of SRship from an
MCI recognized institution. In central government institutions like AIIMS
(New Delhi & all the other AIIMS), PGI Chandigarh, JIPMER
Pondicherry, SGPGI Lucknow etc.; three years SRship is usually
required before one can be considered for the post of assistant
YO TiMES I AUG 2019

professor. This period is counted as a teaching experience and need not
necessarily be consecutive i.e. a cumulative period of three years in different
institutions is sufficient. Also, three years of research experience in a recognized
institution or a combination of both teaching and research is equally valid to begin
your journey towards becoming a professor.
Now, what I have elaborated above is – what you get at the ‘completion’ of your
SRship; which of course is equally important to what you get ‘during’ SRship!
So, the experience you receive during your SRship fully depends on the institution
that you are associated with. If the institution has sub-specialty fragmentation in the
department (which unfortunately very few eye departments in the government
institutions, have in our country) then you may have the option of attaching yourself
to a particular sub-specialty of your liking. If this is not the case, then you will end
up gaining teaching experience but not necessarily the specialization. However,
keep in mind that most places do perform basic cataract/refractive, oculoplasty and
glaucoma to say the least and you possess a choice to either embark upon an
academic career with a satisfying institutional life or a good comprehensive
ophthalmologist with thriving private practice. Public sector in India has its
challenges; but if you want to have a broader impact on society, bring about a
change in the public health sector or want ‘professor’ prefixed to your name, then
this option may be well worth it!
When we look at fellowships vis-a-vis an SRship, the most obvious difference is the
lack of teaching experience at the end of a fellowship program. Very rarely are the
fellowship programs counted as teaching experience and one must enquire about
the same from MCI. Another difference that stands out is the great variety and
flexibility in pursuing a fellowship of your choice. For example, there are well
structured programs across country in private and charitable institutes of great
repute like LVPEI Hyderabad, SN Chennai, NN Bangalore to name a few prominent
ones. These institutions provide fellowships for a period of 1.5 – 3 years in sub-
specialties like Cataract, Refractive, Vitreo-Retina, Glaucoma, Oculoplasty, Ocular
Oncology, Pediatric ophthalmology and Neuro-ophthalmology. A vast majority of
ophthalmologists in the country today are trained at these institutes and have
established great careers. At the completion of fellowship program, one has the
option of working in similar academic institution for a great academic and research
career. On the other hand, a private practice is an equally good option.
One important thing to be noted here is that over the past few years, there has
been an increasing trend towards diminishing number of surgeries and hands on

experience, in several reputed institutions in our country. This makes it difficult for a
fellow to establish a private practice at the end of two years fellowship, which may
be owing to lack of confidence in managing an independent surgical case. This
situation is worsened by a signed ‘service bond’ after fellowship on meagre
salaries. On an average with or without post-fellowship bond, the time spent by a
fellow at an institution can range from 3 to 5 years before one is confident of
starting an independent private practice. This model of retaining a trained hand by
institutions does not bode well for several fellows who might want to move back to
their home town at the completion of fellowship. They may be unwilling to stay away
from families and spouse due to inability to pay off hefty amounts, which makes the
signed bond a compulsion rather than an option. YOSI is making efforts in this
direction which should help bring about a change, to this unhealthy bond culture,
raising its head in the ophthalmology training in India.
In the end, choosing a fellowship or SRship depends on an individual’s post-

graduate training, sub-specialty of interest, future career choice – private/
institutional practice and the city or town one would like to settle in. The most
important factor is discussing with your mentors, seniors and colleagues; who will
be able to guide you in taking a decision which is very crucial at this juncture. All
things considered, an individual makes his or her own destiny; where
institutions and programs can only assist you in achieving your goal in life.
 
Dr. SAMENDRA KARKHUR MS, DNB, FICO, FAICO (UVEA), MNAMS, is presently appointed as an
Assistant Professor in Ophthalmology, AIIMS Bhopal, Madhya Pradesh. He has completed his
training in Vitreo-Retina, ROP & Uvea from PGI, Chandigarh. He is a visiting instructor at Byers Eye
Stanfor University School of Medicine, Palo, Alto, CA, USA.
Institute, Stanford
He can be reached at [email protected]

the BIG Questions
MEDICAL RETINA
or
SURGICAL RETINA?
There are some questions that have forever plagued the minds of young
ophthalmologists, taking a leap into the world of retina fellowships.
“Does medical retina and cataract suffice? “After all, doesn’t these form the
bulk of our patients?”
“How do I justify the steep and infinitely long learning curve as well as the
financial burden of pursuing a surgical retina fellowship?”
"Wouldn’t a surgical retina fellowship also aid me in dealing with my own

cataract complications?”
“Wouldn’t one feel handicapped in handling various retina patients without

a surgical fellowship?”
These are endless questions, which definitely need precise answers.
We have with us Dr Sourabh Mistry, a practising Medical retina, Uvea and cataract
consultant and Dr Amit Palkar, a final year Surgical retina fellow, who started pursuing
his training in surgical retina after completion of his Medical retina and uvea fellowship;
fellows from the same tree, trained at Sankara Nethralaya and Medical Research
Foundation, Chennai.
They will offer their respective perspectives on this very important topic, and may be offer
some relief to our never ending questions.
- DR CHINTAN DESAI

MEDICAL RETINA

WHY I CHOSE A MEDICAL RETINA

FELLOWSHIP?
- Dr Saurabh S. Mistry
A comprehensive ophthalmologist is someone who provides primary care for all

diseases and conditions in and around the eye. For many ophthalmologists working
in individual practice, who depend on cataract surgery for their bread and butter;
missing a retina finding and proceeding with cataract surgery without explaining
guarded prognosis may have serious medicolwegal implications! Thus, having a
thorough knowledge of medical retina in the current world practice assumes
significant importance.
Also, India is set to emerge as the diabetic capital of the world. According to the
WHO, 31.7 million people were affected by diabetes mellitus (DM) in India in the
year 2000. This figure is estimated to rise to 79.4 million by 2030, the largest
number in any nation in the world. Almost two-third of all Type 2 and almost all Type
1 diabetics are expected to develop diabetic retinopathy (DR) over a period of time.
[1] Sooner than later, the number of diabetic retinopathy patients attending our OPD
services will become greater than cataract. Having an accurate knowledge of

managing such patients becomes primordial. Ability to carry out retinal lasers and
intravitreal injections can enhance your general practice.
Why is it easy to get a medical retina fellowship?
Unlike other clinical fellowship programmes like cornea, glaucoma, surgical retina
and oculoplasty where the duration of course is ranging from 1.5
to 2 years, medical retina fellowship on the other hand, offers
basic course which starts with 1 month as minimum duration.
Sankara Nethralaya, Chennai offers Basic course for 1
month, Advanced course for 12 months, and Medical retina
combined with Uvea for 24 months. [2] Aravind Eye Care,
Madurai offers Lasers in Diabetic Retinopathy for 2 months
and Management of Retinopathy of Prematurity and
Paediatric Retinal Disorders for 1 month. [3,4] Dr Agarwals Eye

Hospital, Chennai offers medical retina course for 6 months duration. [5] Of course,
duration may vary in various institutes which one needs to find out prior to sending
in an application.
What does the advanced medical retina course offer?
The fellow will gain an in-depth exposure to both diagnostic and therapeutic
approaches to all medical retinal conditions including retinal vascular disorders,
macular degeneration, inherited retinal degenerations, posterior uveitis and
intraocular tumours.
Fellowship will include the comprehensive evaluation of patients as well as the
review of ancillary tests, such as angiography, ultrasonography and
electrophysiology.
Competency in the use and interpretation of fluorescein and ICG angiography,
optical coherence tomography (OCT), ultrasonography, and visual function tests will
be achieved during this training. In addition to evaluation and management of
patients in the clinic, the fellow will gain expertise in intraocular injection therapy,
retinal lasers, ultrasonography, and retinal imaging. The fellowship is structured to
provide the fellow with maximal responsibility in the performance of clinical and
medical retina procedures, depending on the skill level of the fellow.
Surgical Exposure - Not Applicable
Research Exposure – Yes, if candidate is interested.
For whom is the medical retina fellowship suitable?

Basically for any candidate, who is interested in managing medical aspect of retina
can opt for the fellowship. Irrespective of whether you have completed glaucoma
fellowship or oculoplasty fellowship, knowledge of medical retina is to transform you
into a comprehensive ophthalmologist.
For candidates who wish to do only private practice after MS or DNB with primary
aim of having a cataract setup, the basic knowledge of medical retina can play a
very important role as emphasized earlier.
Candidates with time constraints due to age or other factors, in search for a shorter
duration of fellowship may also find a medical retina fellowship attractive as it is not
shorthanded by a long duration of fellowship with a longer learning curve
associated with a surgical retina fellowship.

Can it be opted as a bridge course? Yes definitely!
Getting a surgical retina fellowship is even tougher than other clinical fellowships,
due to greater demand than supply. For candidates being unable to make it through
the fellowship interviews, can opt for a short term medical retina course for 2
months added with or without ROP screening course for a month, which can act as
a bridge and facilitate the chances of selection in the next round of interviews on
account of a stronger CV.
References:
1. Gadkari
1. Gadkari SS,
SS,Maskati QB,QB,
Maskati Nayak BK. Prevalence
Nayak of diabetic
BK. Prevalence retinopathy
of diabetic in India: The
retinopathy All India
in India: The All India
Ophthalmological Society
Ophthalmological Society Diabetic
DiabeticRetinopathy
RetinopathyEye
EyeScreening
ScreeningStudy
Study2014.
2014.Indian
IndianJJOphthalmol.
Ophthalmol.2016;64(1):
2016;64(1):
38–44. doi:10.4103/0301-4738.178144
38–44. doi:10.4103/0301-4738.178144
2. https://www.sankaranethralaya.org/education-vitreoretinal-services.html
2. https://www.sankaranethralaya.org/education-vitreoretinal-services.html
3 . h t t p : / / w w w . a u r o v i k a s . c o . i n / w e b c o u r s e p r o f i l e . a s p x ?
enc=fyq6wyBc4igc8+RKI1WXZU19tAkzm3VBMdV6rNRM141DfkvKQJmWpBT4QAZqEpz2Wfg+QmVDZfQE
3.http://www.aurovikas.co.in/webcourseprofile.aspx?
KmfJRkBtCCz18OAvUcq6NaQFg8k0JuG2jeoae70Fu90HAt90e0ng
enc=fyq6wyBc4igc8+RKI1WXZU19tAkzm3VBMdV6rNRM141DfkvKQJmWpBT4QAZqEpz2Wfg+QmVDZfQE
4KmfJRkBtCCz18OAvUcq6NaQFg8k0JuG2jeoae70Fu90HAt90e0ng
. h t t p : / / w w w . a u r o v i k a s . c o . i n / w e b c o u r s e p r o f i l e . a s p x ?
enc=7UvMY9WwUxsByRyQJDXunpSmLyqwEHFwg5BYwvPwWmvxXZGIVzcDRhlhtQZIO094XQQQbYvsqa
4.http://www.aurovikas.co.in/webcourseprofile.aspx?
LCBDMukvHXnY7LUBh/Y1p5w2m1f2BcplNmGWSVLnU6xeH2rOj7Yn52
enc=7UvMY9WwUxsByRyQJDXunpSmLyqwEHFwg5BYwvPwWmvxXZGIVzcDRhlhtQZIO094XQQQbYvsqa
5. http://www.dragarwal.com/study/fellowship/
LCBDMukvHXnY7LUBh/Y1p5w2m1f2BcplNmGWSVLnU6xeH2rOj7Yn52
5. http://www.dragarwal.com/study/fellowship/
DR SAURABH S. MISTRY, DNB, FICO(UK), FAICO (Uvea), MRCS (Edinburg), FMRF (Medical Retina &
Uvea) - Sankara Nethralaya, Chennai, is a consultant at Dr Agarwals Eye Hospital, Tamil Nadu

SURGICAL RETINA

WHY TO CHOSE A SURGICAL RETINA

FELLOWSHIP?
- DR. AMIT PALKAR
If you are at this question in your life, then it’s already 8 to 10 years, at the least,
from the day you entered medical school. You find yourself in a turmoil, where
feeling to go out there and begin, brings anxiety and excitement at the same time,
but also the notion of continuing training is daunting and frustrating. The process of
making this decision taxes you and drains a lot of energy. So, feel completely
normal if you find yourself sailing in this boat.
I found myself in a similar dilemma at the conclusion of my Uvea and Medical

Retina fellowship. In the quest to find a solution, I scribbled rough sheets, writing
pros and cons, conversed with numerous friends, colleagues, seniors, and
faculties; discussed with beloved ones and finally had a word with myself. There
were 5 questions, that needed an answer, before I plunged into a Surgical Retina
(Vitreo-Retina) fellowship. If you can address these questions for yourself, then you
are very close to your decision.
• Why a Vitreo-Retina(VR) fellowship?

• What are the pre-requisites of pursuing a VR fellowship?
• How much time and money are you investing?
• Where do you want to pursue your fellowship?
• Where do you see yourself in the next 5 years?
“I am planning to pursue a VR fellowship in India. Hold on! Let me first ask

myself....
1. Why a Vitreo-Retina fellowship?
Any fellowship program is pursued to acquire new sub

specialty skills, to augment the residency training with a strong
interest in a subspecialty, to experience a different system or to
live somewhere new. But an important aspect that needs
introspection is whether you WANT or NEED a fellowship?
Often wanting to do a fellowship is influenced by peer pressure

or herd behaviour. A lot is accounted to the feeling of prestige and grandiose,
falsely attributed to be a Vitreo-Retina surgeon. Quite frequently, residents involved
in Vitreoretina services in their residency tenure are coaxed by their faculty into this
subspecialty fellowship.
However, “I want to, or wish to do a VR fellowship” is completely different from “I

need a VR fellowship.” A good residency training in comprehensive ophthalmology
and a brief duration of post- qualification senior residency, often makes one realise
this need for career augmentation. It is the underlying motivation arising from a
feeling of inadequacy, drives the NEED for a VR fellowship.
2. What are the pre-requisites of pursuing a VitreoRetina fellowship?
In other words, “Am I primed enough for the fellowship?”

In India, VR fellowships are commonly, a 2-year program. They are majorly focused
on clinical training, research and academic activities. A lot of clinical attendings
during a VR fellowships in India involves medical retina, unlike the West, where
Medical retina is a separate sub-specialty. So, a fellow may find it a formidable task
to keep up to learning both sub specialties together in the span of two years. And it
is indeed a short duration to fathom this.
Preparing oneself well with basics of Medical retina and Vitreo-Retina prior to a
fellowship may help you in early orientation and better equipped in the program.
Not only does it prime you but makes the entry prelims and interview process
towards enrolment into the fellowship program, less intimidating.
3. How much time and money are you investing?
These are two crucial deciding factors that should not be undermined. After a
decade of education, time may be a limiting factor. After all we all have personal
and family commitments. A delay in marriage proposition, spending quality time
with your partner, children, taking care of parents or their health concerns and many
other, may take a back foot. A healthy discussion with your loved ones is as
important as your fellowship decision.
Rest taken care, if age is deterring you from pursuing a fellowship, then remember
“Age is just a number”. Your determination and perseverance can circumvent this
number. Although taking care of your health is as much paramount in a fellowship
program.
Extending subspecialty training has costs involved, that could be rather spent,
investing for financial independence, support to the family or practice development.

Working out finances- savings and expenditures is prudent to pull you through,
during the fellowship tenure.
4. Where do you want to pursue your fellowship?
The Vitreoretina Society of India (VRSI) and Indian Journal of Ophthalmology (IJO)
are good sources to search for VR fellowships in India. Besides, friends and
colleagues currently in a fellowship program or alumni members can be informal
sources of information.
Unlike universities in the US or Europe, in India, we have eye institutes, private
practices and few medical colleges offering VR fellowships. And only a handful of
them affiliated to a University. All have varied degrees of academic, research and
surgical exposure. Getting into a VR fellowship program is fairly competitive and
depends on the number of candidates appearing for the positions. The program
may have an associated exclusive mandatory research semester or comprehensive
Ophthalmology or community ophthalmology rotation or mandatory service towards
the institute as a junior consultant post fellowship.
The most common expectation an aspirant has, is the volume of surgical hands-on
in a VR fellowship, followed by the renumeration, working hours, proximity to the
hometown and often language barrier. However, not to undermine, there should be
bigger considerations when evaluating a fellowship program.
Independent learning vs Mentor based learning1
Most of the high-volume centers have busy retina clinics. They may provide
opportunities for independent management of patients, sometimes unsupervised.
For a novice fellow, this may either cause undue apprehension with an
inappropriate management plan or motivate the fellow to discuss with the faculty, go
back read, and plan a treatment for the patient. Unsupervised activities may
hamper quality patient care, especially when it involves surgical management.
Vitreoretinal surgery is learned in four steps:2
Step 1- Observation
Step 2- Performing sections of the procedure and then the entire surgery under
supervision
Step 3- Performing the surgery without supervision but with an experienced
surgeon as a backup
Step 4- Performing surgeries independently

Understanding this, the first thing that becomes clear is, the timeframe. To achieve
these milestones in a span of 2 years is unrealistic. Though fellowship program
trains for 2 years, but when you decide to subspecialize in VR, one should add
another 2 years, at the least, to become a competent VR surgeon. The second
thing is that a mentor is quintessential. A mentor-based learning becomes far more
rewarding compared to independent learning. However, there is a caveat to this. All
mentors may not assure you a quality mentor ship. The prestige and fame of a
mentor is not always the only parameter to be considered. Their inclination to
academic medicine, clinical teaching, research, connections among faculty at
different centers, industry connections and often personality traits, heavily influence
the quality of training you receive. We seldom research into these aspects when
applying for a fellowship program.
Faculty members
The number of faculty members in the institute have a distinct advantage over
practices with fewer number. In addition to the exposure to clinical and surgical
volume, one is also exposed to a variety of approaches and surgical techniques to
manage one single clinical condition. This certainly enhances learning from multiple
faculty members. Finding a mentor who guides you through the intricacies of the
subspecialty, open up new insights, and also helps you prepare for practice, may
not always be easy and often not under your control.
Surgical Hands-on
Surgery numbers has always been the prime concern amongst aspirants, which is
legitimate to an extent. There are large variations in the surgical volume in VR
fellowship across the country. In a high surgical volume fellowship, one is more
likely to witness complications of surgery and learn how to manage them when they
do occur. This experience provides confidence when you begin a practice on your
own, without a supervising or a backup surgeon. Performing hundreds of
unsupervised procedures to learn a specific technique may not benefit as much as
learning the correct technique under a good and dedicated mentor. Often
unsupervised use of wrong techniques is responsible for surgical complications.
And frequent complications can pull your spirits down as a VR surgeon, very early
in the career.
On the other side, in a low surgical volume fellowship, the course of surgical
training may go snail speed and result in frustration and early exit from the
fellowship. The longing for complete independence in the operating room (OR) puts
the patience of a fellow to test. And patience to sustain long surgical hours, is one
virtue, must for a VR surgeon.

But once your surgical career gets a head start, you will be the lone surgeon in the
OR with no one to guide you. Hence fellowship is the time to do all the learning, ask
all the question, the silliest ones, learn why and how an instrument is used, observe
keenly a specific technique and its modifications, even if for the N’th number of
times. I remember a colleague in initial days post fellowship, narrated how her
mentor’s words were playing in her head when she was doing her first surgery
independently. Boasting the number of a cases you graduate with, has no
credibility, compared to how you spend your OR time and how much you learned in
that time.
Give and Take relationship
Any Fellowship program is a choice made by a student. At the hind ground,

applying to one should be a conscious decision, where you comply to all the rules
and regulations of the institute. The institute is liable to TAKE your services and in
return, GIVE you an experience and certification of fellowship. This is the cost you
pay to get yourself enrolled in a fellowship. Rather than whining the entire duration
of the fellowship, it is prudent to understand this symbiosis and accept it. GIVE your
complete dedication and TAKE the maximum out of the fellowship.
5. Where do you see yourself in the next 5 years?
This is almost always a discounted introspection, when considering a VR

fellowship. And much of it should be given the benefit of doubt, to the lack of
knowledge regarding the type of careers and practice patterns after fellowship. To
begin with, a proportion are fascinated with the institute practice, others enjoy the
thrill of private practices, whereas some have practices waiting for a takeover back
home. One may choose an opportunity with a clinical career, or an academic career
or a research career or an opportunity with combination of any of the three.
However, these choices do change during the fellowship program. So undue
anxiety to answer this question at the beginning of the fellowship may be
inappropriate.
Geographic location, financial expectations, work life pattern become priorities later.
Today, the demand and supply dynamics of a VR surgeon is uneven in Tier-1 and
Tier -2 cities. There are huge number of fellowship trained VR surgeons passing out
every half yearly. Lucrative VR opportunities are handful, and one has to
compromise on either the geographic location, financial gain and long working
hours. A hidden disclaimer is that a VR fellowship at conclusion, may not guarantee

you the dream job, money or life sooner, as you anticipated. Sometimes practicing
general ophthalmology with cataract surgery in a Tier -2 or Tier-3 city may be a
fulfilling opportunity. Despite never get dissuaded if you have a strong calling for
VR. This is an important decision in one’s career.
My Journey so far..
I embarked on the journey of fellowship to train myself in Uvea and medical retina.
As time passed by, I was intrigued by the surgical management of vitreoretinal
disease in a tertiary referral center. The fact that every case needs strategic
planning and individualised approach appealed me. Although, dismal visual
outcomes sometimes dissuaded me. But the satisfaction of even an ambulatory
vision from a non useful vision was something coherent with my purpose. I clearly
had a WANT, but was not convinced with the NEED yet. A surgical VR training
dramatically improves the skills of an anterior segment surgeon. Moreover, I
realised my role as an uveitis specialist was incomplete, without a surgical
expertise in vitreoretina. A referral for management of surgical indications in uveitis
made me feel incomplete as a clinician. With this insight, I discovered my niche in
clinical practice. And the NEED was identified and the WHY answered for me.
I was equipped with the knowledge and clinical skills to camouflage into a VR
fellowship. Time was a factor that bothered me for a while, until I made truce with it.
I had to sit and work out my finances that would support me through the second
fellowship. I chose to live a modest lifestyle. Pursuing a fellowship in the same
institute was a logical option. Familiarity with faculties, structured fellowship
program with an opportunity for mentor-based learning and a reasonable surgical
volume factored positively for me. Although for another spell of rostered hospital
duties and delay in financial and practice independence was taking on my nerves
sometimes. But it is a part of the learning process and sacrifices one make, to
augment your career. I was an ardent believer in a clinical career. But the fellowship
opened avenues for research and academic opportunities and got me interested in
them as well. I see myself at 5 years striking a balance between clinical, research
and academic career.
1. Gerstenblith, Adam. “Considerations In Pursuing Retina Fellowship”. Ophthoquestions [blog], 11 August,

2014, //www.ophthoquestions.com/posts/considerations-in-pursuing-retina-fellowship.
2. Spandau, U. and Heimann, H., 2018. Practical Handbook for Small-gauge Vitrectomy: A Step-by-step
Introduction to Surgical Techniques. Springer. 
DR. AMIT PALKAR, MS, DNB, FICO, is a vitreoretinal surgery fellow at Medical Research Foundation
at the Sankara Nethralaya, Chennai. He is a Uveitis and Medical Retina specialist and alumnus of
Sankara Nethralaya. Reach Dr Amit Palkar at [email protected]

the BIG Questions
HOW TO FIND THE RIGHT FIT ? :

FACTORS INFLUENCING THE CHOICE OF VR FELLOWSHIP
PANEL - DR CHINTAN DESAI
‘’The hardest decisions in life are not between

good and bad or right and wrong, but between
two goods or two rights.’
Joe Andrew

DR. CHINTAN DESAI

Over the years, Vitreo-Retina as a sub-speciality
has experienced a paradigm shift. From the crude
DO, DNB , FICO
Fellow, Vitreo-Retina, SSN, Guwahati and unforgiving era of 20 G vitrectomy we have
entered the age of precision and predictability that
the 25-27 G systems offer. We are witnessing 3D
Viewing capabilities, intra-operative OCTs, newer

and more effective pharmacological agents and

diagnostic modalities. As some may say, there
DR. SMRITI MISHRA
hasn’t been a better time to be a VR surgeon!
MS, FVRS ( AEH, Madurai)
Consultant, Vitreo-Retina & ROP, HV Desai, Pune
From the fellows perspective, both the demand
and supply for VR fellowships have increased
exponentially, with numerous institutes introducing
fellowship programmes to add to the list of
established ones across the country. In this

scenario, the choice of institute to pursue a
fellowship becomes increasingly confusing,
DR. VISHAL GOVINDAHARI especially when compounded by multiple other
DNB, FVRS ( LVPEI, Hyderabad) variables such as the length of fellowship,
Consultant, Vitreo-Retina & Uveitis, LVPEI,
Bhubaneshwar. geographical location, brand value, clinical

exposure, family commitments and even marital
status.
To help us gain objectivity into this discussion, Dr

Smriti Mishra (SM), Dr Tanya Jain (TJ) & Dr Vishal
G o v i n d a h a r i ( V G ) , h a i l i n g f ro m d i ff e re n t
DR. TANYA JAIN backgrounds and different corners of the country,
DNB, FICO talk to Dr Chintan Desai (CD) and discuss their
Fellow, Vitreo-Retina, Sadguru Netra Chikitsalaya,
Chitrakoot perspective
YO TiMES AUG 2019 76

Q1
A variety of factors come into play while choosing a subspecialty fellowship
such as scope, region, financial constrains for setting up one's own practice,
etc. At times, narrowing down the choices for sub-speciality turns out to be
a herculean task as compared to deciding on ophthalmology as a career
choice itself. How did you decide VR was the correct branch for
yourself? You may also want to say something to the fellowship aspirants
to ease their decision making process.
TJ: Passion for the subject is foremost, and one tends to achieve excellence only when
pure passion exists. Speaking for myself, I always found myself driven towards VR
notwithstanding adequate exposure to all other sub-specialities as well during
postgraduation. My consultants too played an important role, by not only sensing my
enthusiasm but also providing opportunities to enhance my understanding of the subject.
There is no doubt that one needs to be patient with VR considering the steep learning
curve and wealth of knowledge, but as they say you never work a day in your life if you do
what you love.
SM: The only factor for deciding a subspecialty is love for the subject, which in turn breeds
true excellence. I understand factors like scope, region and financial constraints may be
important, but nothing matters more than enjoying what you do.
“Passion for the subject is foremost, and one tends to

achieve excellence only when pure passion exists.”
- Dr Tanya Jain
VG: VR is a branch which tests one’s patience, common sense and judgement to the
optimum. The fact that unsalvageable eyes are a VR surgeons daily work, is something
which excites me! If a fellowship aspirant is ready to bite the bullet of a steep learning
curve and experience some of the best innovations in medical science, nothing would be
more fulfilling than VR.
CD: Passion is definitely important, but for the majority the choice might be not be that
straightforward. One may feel passionate about more than one speciality, or may not have
the means to continue with what they feel passionate about.The financial constraints
become important when the long term aim is private practice. It would be prudent to be
practical, collect information about cost of investments, and foresee if it is in sync with
other liabilities. A thorough research is important to know about all possible low cost
equipments as well, not everybody has an OCT angiography machine, or a high end
vitrectomy machine. As for the scope, I believe excellence breeds success irrespective of
the region or the extent of market saturation.
77
YO TiMES I AUG 2019
Q2
Notwithstanding the exciting prospects a better institute
might offer, one cannot really overlook the advantages of
furthering one’s stay in their parent institute for
pursuing a fellowship. What is your take on this?
SM: Better institute is always the best choice. In your parent institute you know how
things work, what are the protocols followed. So opting for a better institute will give
you a different exposure and perspective.
TJ: I agree it can sometimes be a double edged sword. If you have a good rapport
with your seniors and your department is adequately equipped, staying in your
parent Institute would be a boon since the effort to break the ice and get
accustomed reduces significantly in a course, which is inherently long. On the
contrary, a better institute might teach you a few other protocols. Having said that,
protocols can be learnt even later, as one is always a student in this profession!
VG: Unless one’s parent institute offers the best mix of clinics, surgery, research,
academics, conference exposure and community ophthalmology! I believe leaving
your parent institute is wiser.
An uncomfortable, novel and stimulating environment brings the best out of young
fellows and avoids a ‘frog in the well’ scenario. The comfort of a parent institute
developed over 2-3 years can unknowingly become detrimental to ones growth.
“An uncomfortable, novel and stimulating environment brings

out the best out of young fellows and avoids a frog in the well
scenario”
- Dr Vishal Govindahari
CD: No doubt, one saves time in breaking the ice when you continue in your parent
institute. The protocols are well known, and it is far easier to fall into the rhythm
inherent with the place. At the same time, other factors such as adequacy of clinical
exposure, duration of the fellowship and post fellowship prospects are also crucial
factors. If the familiarity of the parent institute falls in conjunction with all other
needs, it would definitely be a wise choice to stay back. On the contrary, it could
prove to be a career defining decision, if all other factors are compromised, only
because one chooses to remain in their comfort zone.
78
YO TiMES I AUG 2019
Q3
Vitreo-Retina training is challenging and developing surgical and
diagnostic skills requires time and dedication. At the same time, some
might feel this sense of urgency to rush into clinical practice due to
financial demands. In that context, how important is the duration
of the fellowship while shortlisting an institute? Especially
considering the fact that post fellowship bonds have been introduced in
some institutes.
VG: I believe that vitreo-retina fellowship should be 4 years in duration. While surgical
retina is a life long run, medical retina and it's surprises are very challenging and it needs
guided training and development of decision making skills for optimum outcomes. The
fourth year of fellowship should encompass independent OPD; which is a very challenging
scenario for any young retina specialist. Clinal research, teaching and interactive sessions
are key to understanding imaging in retina.
TJ: The longer course of settlement is true for any surgical field. It is about priorities and
ambition. A candidate’s choice of the desired fellowship programme should be based upon
the amount of surgical exposure during post-graduation. Someone with adequate cataract
exposure may have a faster learning curve, wherein an 18 to 24 months programme of VR
fellowship in a high volume centre might suffice, as opposed to someone with suboptimal
cataract exposure, who would may have a relatively longer learning curve.
SM: I am totally against any kind of bonds. The choice of continuing the association should
be an individual’s choice, and not a compulsion. An attractive opportunity post a short term
fellowship, with ample opportunities to enhance and sharpen one’s surgical skills, would
definitely help retain a trained fellow. On the other hand, a fair amount of surgical exposure
in a long term fellowship might encourage the fellow to shift base to their area of
permanent settlement and start a practice individually.
CD: The answer depends on three main factors, 1. Exposure to cataract and retina during
post graduation 2. Expected amount of surgical hands on and medical retina exposure in
the choice of institute, and most importantly 3. Time and training required to feel confident
stepping into clinical practice.
An individual who has undergone exhaustive postgraduate training (adequate surgical

hands on / confident with IDO / exposure to latest retinal diagnostics, intravitreal injections
& laser procedures) may need a shorter learning curve. For such a candidate an 18
months of fellowship programme may suffice. On the contrary, those who did not have the
necessary basic training, may opt for a 24 months or longer fellowship, and can even
consider working under a bond to further sharpen their skills. This also depends on the
volume of surgical exposure at the choice of institute, with a shorter learning curve in high
volume centres. Speaking about feeling ready for practice, let’s get one thing straight,
learning in retina is a long process which lasts for years into practice. No fellowship can
potentially train a fellow for all kinds of complicated surgeries and 100% accuracy in
managing medical retina. So, choosing a longer fellowship to feel more confident may
be unwise and counter-productive.
79
YO TiMES I AUG 2019
Q4
After finishing post graduation one might prefer staying closer to home
because of family commitments or for long term prospects. But, the
dream fellowship institute may at times be in a remote location or a place
which is far from home/dream city. How important do you feel the
geographical location and accessibility of an institute is?
Should one opt for the dream city or the dream fellowship?
VG: Dream fellowship always. One should be greedy and desire the best always. In
a country like ours with strong family values, the decision might be a little difficult to
make a choice, but one has to take a step for a better future.
As far as the geographical location is concerned, accessibility of an institute should

not be an issue as long as the patient load for good clinical exposure is maintained.
TJ: This can be a grey zone at times, and a tough choice to make. I believe
numerous candidates, including myself, have gone through this dilemma at some
point. However, after thoughtful weigh of all the pros and cons, I believe the focus
should be on attaining maximal clinical exposure to develop lifelong skills, may it be
in a peripheral institute. Its a short term sacrifice one has make which can have a
lasting effect on long term success.
“Geographical location and accessibility of an institute doesn't matter

as long as the fellowship programme offers you what you are looking
for.”
- Dr Smriti Mishra
SM: It's obviously an individual's choice. But if one opts for the best institute when
pursuing both undergraduation and post graduation then why settle with anything
less than the best for a fellowship. Personally speaking, geographical location and
accessibility of an institute doesn't matter as long as the fellowship programme
offers you what you are looking for.
CD: This is easier said than done, but selecting the best available option
irrespective of the geographical location seems the most apt choice. An exposure to
quality high volume training for a couple of years can facilitate a smoother path in
the future. It’s also important to bear in mind that the graph is skewed in favour of
demand rather than supply of fellowships, so not everyone can get into a premier
institute in the big city. Factors like accessibility, marital status, family pressure,
child responsibilities or ailing parents, cannot be overlooked and can nudge the
decision towards one’s hometown or at least a major city with good connectivity,
and hence may not be a straightforward decision for many.
80
YO TiMES I AUG 2019
Q5
A burning dilemma which most residents face at the end of
post graduation is the institute’s brand value versus the
exposure it offers. It is quite well known that some lesser
known high volume centres devoid of a shining brand name,
do offer excellent clinical exposure. Your perspective on this?
SM: Volume centres are always good for skill development but brand names do
matter a lot, especially if one plans to practice in a metropolitan city. If one intends
to start a private practice then being well versed with the skills required is more
important, and the brand of the institute comes secondary. A balance between
quantity and quality is what is required.
VG: The issue is in knowing what to expect. The better institutes have both value
and exposure. Brand value normally comes from a good mix of exposure,
academics and environmental. On the other hand, brand values can be deceptive
and outdated. So a good pre-exam research from existing fellows, understanding
your surgical curves to decide on exposure needed and a fair brand value should fit
the bill for any new aspiring fellow.
“Brand and adequate clinical (medical & surgical) exposure are not
always mutually exclusive, with a majority of these centres offering a
good mix of both.”
- Dr Chintan Desai
TJ: There is only one logical answer to this. If you are good at what you do, you will
be your own brand. A good branded Institute can open one or two doors for you but
wouldn’t take you a long way if you are not well acquainted with your subject or
adequately trained surgically. Speaking to numerous fellows form various Institutes,
I concluded the grass felt greener on both sides, with those having a higher brand,
were worried about their surgical exposure while those from peripheral centres
were seeking a brand! So, no place is absolutely perfect, all have their pros and
cons, and one must aim for personal excellence.
CD: There are varying opinions on this topic. I think the decision has to be based
on two more important factors than the others
1. Where does one see oneself after 5 years, job versus private practice?
2. Which in the final place of settlement?
81
YO TiMES I AUG 2019
Someone, who is looking towards better institutional job opportunities, should aim
towards a higher brand value, as it does open many doors, and also helps in
forming important networks. It also gives one an opportunity to form a long term
association with the institute. On the other hand, a private practitioner would aim
towards acquiring maximal surgical exposure irrespective of the institute. The same
applies to the place of settlement, as brand may become important in major cities
compared to tier 2-3 cities. However, it is important to address that a brand and
adequate clinical (medical & surgical) exposure are not always mutually exclusive,
with a majority of these centres offering a good mix of both.
At the end of the day, our paths will be decided by the opportunities that are offered
to us and the choices that we make. I hope these varied perspectives will help you
in making the most appropriate and a personalised decision. Where ever you land
up, make the best use of your time, be in pursuit of excellence and that will be
enough to set you apart form the crowd. Best of Luck!
Dr. CHINTAN DESAI, DO, DNB, FICO is working as a Vitreo-Retina Surgery

fellow at Sri Sankaradeva Nethralaya, Guwahati. He has completed his DNB
from Sankara Nethralaya, Chennai. He is a Gold Medal recipient of Dr
Alandur Mehghnathan Selvaraj Endownment Award for Basic Science in
Ophthalmology for the year 2017.
82
YO TiMES I AUG 2019
P A G E
NEW FRONTIERS
13. Research & fellowship: Can they go hand in hand?

Dr Sabyasachi Sengupta
83
14.How to be Innovative during Training phase ?
Dr Ashish Ahuja
87
15. PhD (Doctorate of Philosophy): the path less
trodden
91
Dr Chaitra Jayadev
16.My Artificial Intelligence Journey: And How to

write good AI papers in Ophthalmology?
95
Dr Daniel SW Ting & Dr Aaron Y Lee
17. Precision Medicine & CRISPR Genomic Editing in

Retina
100
Dr Mayank Bansal
18.Role of simulators in surgical training

Dr Vedang Shah
102
NEW FRONTIERS
RESEARCH & FELLOWSHIP

CAN THEY GO HAND IN HAND?
- Dr. SABYASACHI SENGUPTA
A fellowship in an ophthalmic subspecialty is something to be proud of. However,

once we join the coveted fellowship, the feeling of elation quickly disappears as we
are immersed in daily clinical chores related to being a fellow. I have gone through
all the rigors of a VR fellowship including a burdening load of patients to be seen in
the OPD, admitting patients in the evenings, attending the OR days with your
consultants, writing surgical notes, discharging patients, and performing your
procedures including lasers, ultrasounds, intravitreal injections and many other
activities that take up as many as 12-15 hours per day. In all this chaos, is it
possible to do any clinical research at all? Publishing papers in this environment
appears to be very hard and is almost the last thing on a fellow’s mind. With this
background, which is a reality for most of us, let us discuss how we can still do
research and publish.
Before we begin, let us briefly delve into why you should be doing clinical research
during your fellowship. For starters, doing research inculcates a very scientific
approach in you which goes a long way in making you an expert clinician as well.
Secondly, with the ever-evolving ophthalmic literature at break-neck speed, what
you learn during your fellowship may become out dated and even obsolete in a few
years. You will have to unlearn, relearn and adapt quickly to stay relevant. The only
way to do this is to keep pace with literature. Having done some research during
fellowship will help you keep up with this pace and more importantly,
interpret the message from published papers and apply it to your
patients, thereby improving their outcomes. Lastly, having published
meaningful papers during fellowship gets you a lot of respect from
your peers leading to better potential job opportunities in the future.
The world is moving quickly towards valuing you for what impact you
have created rather than what your net worth is. Doing research gives
you a great opportunity to make an early impact in life. Now that we
understand that publishing gives us a head start, how do we go about
doing it in a busy VR fellowship? 
YO TiMES I AUG 2019

In one word, the answer could be “prioritize”. Another important quality you must
have is “desire”. We can get everything done in life provided we have the desire
and hence, give it enough priority. Remember that not everyday in a fellowship will
demand 15 hour work days. There will be some down time which you can devote to
your research projects. In my experience, after having published about 30 papers
during my residency and fellowship combined, giving 45 minutes to this on a daily
basis is more than enough to get great results. Once you have the desire and are
willing to prioritize your time, I will give you a framework which you can adopt and
tweak as per your own requirements to do excellent clinical research and publish
right from your fellowship days. The key components of this framework, as are most
things in life, are planning and execution.
THE PLANNING PHASE:
1. Know your stuff: There are many steps you have to go through to do clinical
research, much like learning a surgical procedure. A good literature review,
study design, sample size calculation, and manuscript writing are skills that
can be easily learnt in a few days. I urge you to attend clinical research
workshops if available in your city, or enrol for some online courses that will
give you this knowledge.
2. Biostatistics: It is essential to know some of the basic concepts of

biostatistics so that you have an idea of how your data should be analysed.
There are many sources available for this, including text books, online
courses and workshops. The recent newsletter (April 2019) of the
Vitreoretinal society of India has a write up on “Statistics for Starters” which I
have contributed. You can read it to get a good idea of some basic concepts
in biostatistics.
3. Learn to communicate with a biostatistician: The same biostatistician can

do a fantastic job with one dataset and a very poor job with another. The
main difference is how the clinician communicated his requirements to the
statistician and how he interpreted the results. A basic idea of biostatistics

and looking at how some previous studies were analysed will help you a
great deal in getting the best out of your biostatistician.
4. Have a list of potential topics to study: It is essential to have a list of topics

that you can study, right from the beginning of your fellowship. Subscribing to
e-table of contents of the top journals publishing retina topics can help you
know the latest trends i.e. what topics are hot and what are not. You can
consider choosing some topics based on what is being recently published.
Brainstorming with colleagues and seniors will also get you an idea of what is
possible at your institution. Lastly, looking at the disease profile of patients
visiting the hospital will help you choose relevant topics where you will be
able to get a good sample and a meaningful dataset.
5. Have a notebook in hand: It is advisable that you have a note taking

medium at hand all the time. It could be a notebook or an app like Google
Keep or anything else you choose. If you see a rare case, note the MR
number and the details immediately. Similarly, you can enter details of your
on going study into the notebook as well. Make sure you dump all the
information from the notebook into carefully organised folders in your laptop
or phone for future recall.
6. Have journal clubs regularly: Journal clubs discuss complete articles along
with the nitty-gritties of the study and are a great way to get into the habit of
analysing and dissecting articles for their quality and scientific rigor. Journal
clubs are not only helpful for your own research but also help you in making
sense of scientific literature later in life.
THE EXECUTION PHASE
1. Collect data diligently: When you have your sights on

a particular study, you will need to collect data for analysis.
Think hard about what are the variables you would like to
study and don't miss out on documenting important
confounders that could undermine your results later. For
example, it is always better to record the intraocular
pressure, even for a VR based study. Do a thorough
literature review to see what are all the
things previous studies have
measured and make sure you are
YO TiMES I AUG 2019

85
measuring all of those variables. A good literature review will also tell you the
lacunae in literature which you should aim to plug with your own study. A very
important point to remember while entering data is making the excel sheet
in the best possible way so that it is easy to do statistics with it. In a previous
edition of YO Times (10th), I have enumerated on basic rules to follow while
making an excel sheet.
2. Analyse data thoughtfully: Remember that you need to make every attempt
to identify the hole in literature and plug the hole with your study. So
statistics should be goal directed to plug this hole. This is the key
ingredient which often decides the fate of your paper.
3. Start writing early in fellowship: It is important that, once you have the
desire for research and have prioritised it, you act upon it. The best way is to
start writing case reports and other forms of short communications that don't
require as much scientific rigor as an original article, but still stand a good
chance of getting published if presented well. A few case reports in the early
part of your fellowship will give you the confidence that you can do it and will
set you up for bigger and better things in the future.
As you will notice from the above framework, the planning phase has more steps
and requires a lot more work than the execution phase, something which you feel is
counter intuitive, but is true. So be aware of the importance of clinical research right
from the beginning, have the desire and prioritise it, plan and execute your research
so that you are able to publish meaningful papers even during your fellowship. It is
very much possible to publish at least 5-6 papers before you are done. This will
make your fellowship the most productive phase of your academic career, which it
should be.  
DR SABYASACHI SENGUPTA is a practicing Vitreo-Retinal surgeon at Future Vision Eye Care,

Mumbai. He did his research cum clinical VR fellowship from Sankara Nethralaya, Chennai
followed by a clinical research fellowship at the Wilmer Eye Institute, Johns Hopkins, USA. He is
the current Associate editor of the Indian Journal of Ophthalmology and is a prolific researcher over
his academic career. He is the founder and director of Sengupta’s Research Academy
(www.senguptasresearchacademy.com) which offers online courses on clinical research for
beginners as well as offers services to help you publish.
He can be reached at [email protected] 

NEW FRONTIERS
HOW TO BE INNOVATIVE DURING

TRAINING PHASE ?
-Dr. ASHISH AHUJA
At the start of our residency the common mindset is to incorporate clinical or

surgical skills and the focus is not on research . We don't realize that the impact of
innovative research could be global and could have a chance to change the
preferred practice patterns. We must take the path that is less travelled and strive
to have a big impact .
At the start of the residency one has limited knowledge of what research topic to
select . Doing research is much easier during fellowship than during post
graduation .
How to be innovative??
The process could start with brainstorming of ideas with senior teachers , interact
with engineers and learn about the latest technology advancements in artificial
intelligence, 3D printing and virtual reality . Always question every surgical
technique or procedure and ask yourself if it can be made better, lower the cost or a
technique easier .
During my fellowship period I had worked on several innovative devices inspired by

mentors which included smartphone based high magnification imaging (1), low cost
video indirect ophthalmoscope (2), reduced eye model for fundus simulation (3) and
smartphone based monochromatic green filter based fundus imaging (4). The
technology that we have now days leads to endless possibilities .
YO TiMES I AUG 2019

Figure 1: (a) High magnification clip lens
(x30), (b) Smartphone with the clip lens
attached
Figure 2: (a and b) Papilloma of the

lower lid (×1 and ×30)
Residents and fellows may search for the best research abstracts that are
presented across different state , national and international
conferences , support of the senior mentors is very crucial ,
avoid topics which have already been done, attending
research methodology workshop is a good way to get
oriented .The institute may apply for a grant if they have a
good research project from ICMR or BIG (Biotechnology
Ignition Grant Scheme) .
Collaborate with other institutes or a senior mentor from

another hospital ( residents may interact with the ophthalmologist in their city who
are writing many manuscripts and are actively involved in research to collaborate
with them ) . A manuscript paper usually has upto 6 co-Authors allowed and we
should make good use of this and collaborate with others .

Most important quality needed is the willingness to work and do quality work
passionately , everything else will follow .Residents may start with working on a
case report for a journal or an eposter for a conference in the first year and then
gradually work on bigger research projects . In the USA most of the residents start
working on research work during the MBBS phase itself , a culture we should adopt
in India too .
Each institute has its own pros and cons and if there is a good patient base then
research can be done . Collaboration may also be done across specialities with
other departments ( for example microbiology , pathology , endocrinologist ) The
residents and at times the institute should be ready to shell out money for
innovative research .
To accelerate the innovation process we need to have innovation labs which could
provide collaboration between doctors, engineers, 3d printing experts , virtual reality
app developers and data scientist. Next step would be providing sufficient funding.
I recommend reading the book “ The Kaizen way “ by Robert Maurer ,based on the
Japanese manufacturing philosophy of taking small steps to improve on regular
basis to promote productivity .
Professor Steve Charles has been one of the

most prolific innovator so far in the field of vitreo-
retina surgery having developed innumerable
surgical and diagnostic instruments . He had done
engineering before starting a career in medicine
which helped him to develop and patent many
devices ( and begin several startups) which
changed the way we practice today . In a similar
way if we acquire new skills beyond our speciality ,
believe in yourself , work extremely hard and give
it everything that you have then there is limitless
potential to what one can achieve and leave a legacy behind .
References
1. Ahuja AA, Kohli P, Lomte S. Novel technique of smartphone-based high magnification imaging of the
eyelid lesions. Indian Journal of Ophthalmology. 2017;65(10):1015-1016.
2. Ahuja AA, Kamble A. Commentary: Change in trends of imaging the retina. Indian J Ophthalmol
2018;66:1620-1.

3. Adenuga OO, Ahuja AA. ,Ahuja SA , Do it yourself :Reduced eye for fundus examination . J Clin
Ophthalmol Res 2018;6:35 .
4. Ahuja AA, Adenuga OO. Smartphone-based monochromatic green filter fundus imaging. J Clin
Ophthalmol Res 2019;7:30.
DR. ASHISH AHUJA, MBBS, DNB, FICO, FAICO(Retina), FAICO(UVEA), FVRS (Aravind eye hospital,
Madurai) is a vitreoretinal consultant at Consultant at Sadhu Kamal Eye Hospital, Mumbai. He is an
advisor to AiSeon Healthcare technology. He has several publications and awards to his credit and
he has filed a patent for post vitrectomy recovery system He can be contacted at
[email protected]
“ The history of innovation is the story of ideas that

seemed dumb at the time.
Andy Dunn

NEW FRONTIERS
PHD (DOCTORATE OF PHILOSOPHY)

…the path less trodden
-DR. CHAITRA JAYADEV
Given that we are already doctors and have the coveted ‘Dr’ tag, the other ‘Dr’ or
doctorate does not figure in most of our career paths. While MD, PhD is quite a
common qualification in the West, it is yet to gain popularity in India. With a
Supreme Court ruling in 2018 that a PhD is not required for promotion to the post of
professor in medical colleges attached to central government-funded universities,
there also doesn’t seem to be a need. While this means that fewer medical
professionals would opt for a PhD, there is also likely to be less research output in
the field. On a positive note, in the past few decades, the Indian higher education
system has expanded phenomenally paving the way for PhD research with several
prestigious universities offering doctorates. Some of the key reasons why you can
pursue this higher degree in India are diversity in specialisations on offer,
affordability, English as the language of instruction and increasing global
recognition.
A PhD or doctorate is one of the highest research qualification, and those who have
already completed under graduation and (usually) postgraduate training are
eligible. You need to choose an original topic and conduct independent research
with the support of a guide or supervisor. To complete your doctorate you need
to summarize your research activities and results in a ‘dissertation’.
Depending on your institute requirements and supervisor, you may
also need to have a certain number of peer-reviewed publications.
The Défense, a public examination in front of a committee, marks
the completion of your PhD. While the most important criteria for a
successful outcome is whether your research is original, the
committee will also access your knowledge, interpretation,
extrapolation and social relevance, if any, of your work. The
committee will be chaired by your supervisor and will have
other examiners, either PhD holders themselves or experts in
the field. The public are also allowed to attend the Défense.
YO TiMES I AUG 2019

A requirement for PhD applicants in India is the Research Eligibility Test (RET) :
this is a written exam to ascertain that you have the required knowledge and
expertise to pursue a doctoral research in your chosen subject. Once you are
through this, there will be a round of interviews before the final selection. Choosing
an institute will depend on the specialty you want to pursue. Institutes of National
Importance are premier public higher education centres that play a major role
developing highly skilled personnel within the specified region and churn out the
highest number of PhDs in our country. These include the All India Institutes of
Medical Sciences, Indian Institutes of Technology, National Institutes of
Technology, Indian Institutes of Management, Indian Institutes of Science
Education and Research, National Institutes of Pharmaceutical Education and
Research, and Schools of Planning and Architecture.
A PhD in Medicine would be an interesting degree to pursue given our specialty. It

is a 3 to 5 year full-time Doctoral program in Medicine. The eligibility is a post-
graduation degree in Medicine. The course enables candidates to get an in-depth
insight into specific areas of medicine thereby strengthening their core skills.
Through this program, candidates can improve on their analytical and innovative
skills. Some institutes that offer a Ph.D. in Medicine are Dr. DY Patil Vidyapeet,
Gujarat University, Jawaharlal Institute of Post Graduate Medical Education

and Research, Mahatma Gandhi Institute of Medical Sciences, and BLDE
University. Public health is another field that doctors can pursue a doctorate in.
Those who want to expand their horizons, explore a new research environment, or
work with most experienced in a particular field, should consider studying abroad
for a PhD. There are several premier institutes across the globe offering PhD
programs and can take few years to reach complete. While there are no traditional
tuition fees for doctoral candidates in some centres, the same is not a norm.
Research work itself is very expensive and time consuming. Hence, cost of
education and stay in a foreign country is a major financial concern. One can get a
trainee or faculty position during the program or a scholarship to reduce this
burden. Across the continents there are different education systems. In Europe, the
European Higher Education Area (EHEA) is a network of 48 countries including
28 EU members (including the UK) and other countries in Europe and Eurasia
offers the advantage of acceptability and recognition of academic degrees across
EHEA countries. Netherlands, in particular, is a popular choice for a PhD study
owing to its rich culture, excellent graduate schools, a large variety of research
fields, extensive interdisciplinary collaboration, world-class research and innovation.
Maastricht is particularly close to my heart as I completed my PhD from this

University in Netherlands. This is thanks to my institute, Narayana Nethralaya
Eye Institute, which has a collaboration with Maastricht University. We have three

other doctors who have completed their doctoral degree and some more on the
way. The advantage was that we could carry out our research along with clinical
work at our home institute. While there was no fee as such for the PhD, we only
had to bear the cost of travel for meetings with our guide and the defense. We had
guides from India and the Netherlands, hence got a better and wider perspective.
The ceremonial thesis Défense of a Dutch PhD, with all participants wearing a full
academic dress, is special. The beadle (or pedel), an officer of the university, opens
and closes the ceremony. Two supporters (paranimfen) will also be allowed to
accompany you. They can be your friends or family or can be someone from the
university. While in older times they acted as a backup for the doctoral candidate to
ask for advice when answering questions, in modern times they provide moral
support and encouragement. On the whole it is like a beautiful wedding (albeit
academic) ceremony, followed by a reception.
And finally, what’s in a name? PhDs are termed differently across branches and
countries. It is called Doutorado in Brazil, Filosofian tohtori in Finland, Dottorato di
ricercar in Italy and Daktaras in Lithuania. PhD equivalents are Fellow Programme
in Management, Doctorate in Pharmacy and Master of Philosophy. Some of the
websites from which the above information is collated are below. Please go through
them for more information. Wishing you all the very best for your doctoral
aspirations and do mail me for any queries.
https://collegedunia.com/courses/phd-medicine
https://targetstudy.com/colleges/phd-medicine-degree-colleges-in-india.html
https://www.icmr.nic.in/content/icmr-scheme-mdms-phd-programme
https://iphindia.org/training/phd/
https://www.findaphd.com/study-abroad/asia/phd-study-in-india.aspx
https://www.findaphd.com/study-abroad/
https://www.findaphd.com/study-abroad/europe/phd-study-in-netherlands.aspx 
Dr. Chaitra Jayadev MS, PhD is currently employed as a senior Vitreo-Retinal consultant at
Narayana Nethralaya Eye Institute, Bangalore. In addition to her clinical role, she is actively
involved in editorial management, scientific publications and translational research at her Institute
and beyond. She has served the Indian Journal of Ophthalmology from 2006-17.
Dr. Jayadev is an avid researcher and has close to 85 PubMed indexed articles in subjects even
beyond her core interest. She has contributed to internationally renowned textbooks like Myron
Yanoff's Text Book on Advances in Ophthalmology. She has defended her PhD at the Maastricht
University, Netherlands.
She can be reached at [email protected]

NEW FRONTIERS
MY ARTIFICIAL INTELLIGENCE JOURNEY:

& HOW TO WRITE GOOD AI PAPERS IN OPHTHALMOLOGY?
- Daniel SW TING &

Aaron Y LEE
INTRODUCTION
Over the past few years, there was an enormous surge of interest in deep learning
and big data analytics. Over the past 24 months, we have been asked to review
numerous number of AI papers submitted to various medical and Ophthalmology
journals. Also because of this, Ophthalmology journals, for e.g. Ophthalmology, the
American Journal of Ophthalmology (AJO), British Journal of Ophthalmology (BJO)
and Translational Vision Science and Technology (TVST) have created a position
for AI editor to sit in the editorial board, responsible for performing critical appraisals
on the clinical and technical aspect of the AI papers submitted to the journal. In this
article, we will be sharing our AI journey and the tips of developing sound AI
algorithms on fundus photographs and optical coherence tomographs (OCT).
DANIEL TING’S AI JOURNEY
HOW DID I START MY AI JOURNEY?
I would say, by chance! Six years ago, given my past PhD experience in health
technology innovation for DR screening, I was asked by mentor, Professor Tien
Wong, to take over a machine learning project when another principal investigator
had to go back to her home country due to social reason. During that time, it was
still at the feature-based learning era where we were required to annotate the
features prior to training an algorithm. In 2014, the use of deep learning had
suddenly become popular given the advent of the NVIDIA graphic processing units
(GPUs). We attempted this novel approach and to our surprise, the performance
had unbelievably improved by at least 10 to 15%, reaching the clinically acceptable
level. We were not convinced about the results at first as we thought ‘it may be too
good to be true!’. In order to confirm our findings, we initiated a multi-center
collaborative group, called the DEEP-EYE study group, searching for new external
validation datasets to confirm the diagnostic performance of this algorithm.

THE INITIAL NIGHTMARE OF MY AI JOURNEY!
While we were getting really excited about our AI findings using deep learning (with
the initial 5 datasets), we wrote up the manuscript and submitted to a major medical
journal (1 month prior to the Gulshan et al, JAMA publication on the Google AI
algorithm), without knowing that the Google has also prepared and submitted the
manuscript to JAMA one month before us. When the JAMA article was published in
December 2016, our manuscript was rejected one month later in January 2017,
after rebutting more than 200 comments raised by 5 reviewers, due to the loss of
novelty in our research findings (this reflects the importance of being ‘fast’ to get the
manuscript out). From our submission to the time of ultimate rejection (post
rebuttal), it took a total of 3 months. In the subsequent 3 months, we attempted
another 2 major medical journals which, again, rejected us for the similar reasons.
At that point, our team was already extremely demoralised and almost wanted to
give up. After a rigorous internal discussion, we decided to beef up the datasets,
increasing the external validation datasets from 5 to 10, with addition of 2 more
ocular conditions, namely glaucoma suspect and age-related macular
degeneration, totally up to close to 500,000 retinal images in training and testing.
Following that, we submitted our article to JAMA and was finally accepted/published
in December 2017 after 3 rounds of revisions. This was 1 year later than the 1st
submission to the first major medical journal!
My painful journey did not end as part of the above journey. At the same period, I
have undergone 1 year of draught in securing research funding for the AI team.
Thank you to my mentor, Prof Wong, who has large research grant that is on-going
and supporting this AI team. The term ‘deep learning’ was still very new back then.
In fact, I would say it was an ‘alien’ term that very few understood the novelty of this
technique. Having 2 consecutive rejections by 4 reviewers, once again, made me
think whether our research team is headed in the right direction. In fact, the
confidence of many of the team members were also shaken that time. We went
through a 2-year no papers/publications and research funding period up until our
JAMA publication was published thereafter.
Since the JAMA publication, our research group has made a 180 turn, starting to
get many interest worldwide for potential collaborations and also invited editorials to
many medical and ophthalmology journals. Since 2017, the hype, and also the
understanding, on machine learning and deep learning have continued to rise and
this has pushed the field into a new era. To date, we have published more than 20
AI articles, including JAMA, Nature Medicine, Nature Biomedical Engineering,

Nature Digital Medicine, Lancet Digital Health, Progress in Retinal and Eye
Research, IAAI, ACCV and many ophthalmology journals. We have also
fortunately been invited to many conferences to speak and share our past AI
experience, and until to date, I am still feeling extremely indebted to my entire AI
team (especially my mentor -Tien), who had put their trusts in me despite the ‘dark’
period during the initial 2 years. At present, we are still looking for opportunities to
collaborate with many collaborators worldwide, and would love to take this
opportunity to call for joint projects with the All India Ophthalmological
Society & Young Ophthalmologists Society of India members.
AARON LEE’S AI JOURNEY
My foray into AI was both serendipitous and circuitous. Since the early 2000s, I had
been developing bioinformatic algorithms for next generation sequencing data while
going through my medical training. As more and more clinical data became
electronically codified with the rise of electronic medical records, I began to
transition my research focus towards doing research with large clinical data
repositories. Under the mentorship of Dr. Adnan Tufail at Moorfields, I began to
wrangle with large diverse real-world datasets.
After joining the faculty at the University of Washington, I was able to extract OCT
imaging data en masse from the imaging data repositories while at the same time
using the enterprise data warehouse to generate clinical labels to link with the
imaging. After merging these two large datasets, I was at a loss of what I could do.
Traditional algorithms did not scale well and computer vision algorithms were
mainly semi-automated, requiring large amounts of manual labor.
At around this time, I happened to have dinner with a friend in radiology who had
been deep learning and when he first suggested using deep learning, I was very
skeptical. He encouraged me to apply for a graphics processing unit from NVIDIA,
and within a week of the GPU arriving, I had trained my first deep learning model. I
was shocked at how well the model learned to distinguish age-related macular
degeneration from normal, and I was nervous about publishing the results because
they appeared too good to be true.
After applying occlusion masking and convincing myself that the results were
indeed real, I moved forward with publishing my first paper in using deep learning
for fully automated AMD classification. Since then, my research interests have
grown to attempt to push deep learning models to their limit and aiding in scientific

discoveries. We have shown that deep learning models can predict OCTA from
standard OCT scans as well as predict the HVF 5 years into the future from a single
HVF.
TIPS TO DEVELOP GOOD AI SYSTEMS (DANIEL AND AARON’S

EXPERIENCE)
1. Identify a research need (there is no such thing as a ‘Me 2’ project). If there is a

need to develop a new AI algorithm for self-sustainability for service
implementation in a nation, I would say – Do it! Do not be put off by the big tech
companies (Google, IBM and etc) or us (who have the opportunity to do this first
a few years’ back) – It is always good to develop an AI system in house,
provided there is enough expertise.
2. Source for datasets, either in retrospective manner (fastest), or in prospective

manner (much slower but cleaner).
3. Source for a technical team (either locally or overseas).
4. For every success there are many failures. We had numerous deep learning
experiments fail because there was either not enough data or the null
hypothesis was true.
5. Systematic biases in your data matter more than ever with machine learning.
6. Real-world performance and generalizability to other populations are harder

than most publications would lead you to believe.
7. Deep learning models are lazy. It is very easy to fool yourself into believing that
deep learning models are doing something useful but they instead they may
have overfit your data.
With this, we would like to thank the YOSI for the kind invitation to contribute to this
piece.
Look forward to meeting you all in the future conferences. Please come up to say
hi!

Daniel Ting MD (1st Hons) PhD is currently the Assistant Aaron Y. Lee MD MSCI is an assistant professor and
Professor in Ophthalmology with Duke-NUS Medical vitreoretinal surgeon at University of Washington,
School Singapore, and also a vitreo-retinal consultant at Department of Ophthalmology. He completed his
the Singapore National Eye Center.
undergraduate at Harvard University and his medical
training at Washington University in St Louis.
His main research focus is on artificial intelligence (AI), big

data and digital health innovations in Ophthalmology. He He has served on the American Academy of
was the J. William Fulbright Scholar (2017/2018) who Ophthalmology Medical Information Technology
visited Johns Hopkins University (JHU) School of Committee and the American Academy of Ophthalmology
Medicine and Applied Physics Laboratory to evaluate the IRIS Analytics Task Force. He serves on the Editorial
use of AI in Ophthalmology. To date, he has published > Board for the American Journal of Ophthalmology,
140 peer-reviewed papers, conference abstracts, book Translational Vision Science and Technology, and Nature
chapters and educational articles, including >20 AI Scientific Reports.
articles in JAMA, Nature Medicine, Nature Digital

Medicine, Nature Biomedical Engineering, Lancet Digital He has published over 60 peer reviewed manuscripts and
Health, IAAI, MICCAI and ACCV. As the clinical lead for is known as a leader in the field of artificial intelligence
the AI team in Ophthalmology with the Singapore Eye and ophthalmology.
Research Institute, he has received approximately 1.5

Million USD as the principal investigator and 25 Million Aaron Lee's research is focused on the translation of
USD as co-investigator/collaborator research funding for novel computation techniques in machine learning to
his AI work.
uncover new disease associations or pathophysiologic
mechanisms from routine clinical data from electronic
Academically, he graduated as the Valedictorian of health records and imaging datasets.
SingHealth Residency in 2016 (across all specialties) for
maintaining 1st ranking nationally in the US OKAP
(International) exam for 3 consecutive years, winning the
prestigious UK FRCOphth McCartney Prize and a total of
9 outstanding awards during his residency period. He
was also the Singapore Health Service (SHS)
ophthalmology chief resident in 2014-2015.
Dr Ting serves as the editor in Ophthalmology, and

section editor for AI in British Journal of Ophthalmology.
For his AI work, he was won many international
prestigious awards, including the Macula Society
Evangelos Gragoudas Award (2019), Asia-Pacific
A c a d e m y o f O p h t h a l m o l o g y ( A PA O ) Yo u n g
Ophthalmologist’s Award (2018), the Asia-Pacific Tele-
Ophthalmology Society (APTOS) Young Innovator Award
(2017), SingHealth Distinguished Young Researcher
Award (2018), and Singapore General Hospital Young
Investigator Award (2017). He has been a regular invited
speaker, abstract reviewer, chair and course organizer for
AI Ophthalmology in ARVO, APTOS, APVRS and APAO.
He is also the executive committee member at the AAO
AI task force committee.

NEW FRONTIERS
PRECISION MEDICINE & CRISPR

GENOMIC EDITING IN RETINA
-DR. MAYANK BANSAL
With the recent Food and Drug Administration (FDA) approval of the first gene
therapy, Voretigene, for RPE65 gene in Leber’s Congenital Amaurosis (LCA), there
has been an advent of new wave of gene therapies in retina. The role of molecular
biology is bigger and gene therapies closer than ever before. This makes a deeper
understanding of genomics, with relation to retinal disorders very relevant. As
young retina specialists delve into this fascinating field of retina, this article
would cover questions like, what is Precision Medicine, what is CRISPR, and
how do they apply in Retinal disorders. As well as guide the way for those
wishing to pursue this field more definitively.
Precision Medicine, refers to tailoring therapy to patients. Our genetic makeup,

often dictates our health profile, in addition to other factors. When it comes to
specifically inherited retinal dystrophies (IRD), ‘one size fits all’ or ‘cookie cutter
technique’ is most often not the answer
to therapy. As a part of precision
medicine approach, what is important
to design therapy based on patients’
genetic make-up. Broadly, we do a
genomic sequencing to detect
mutations, and then develop targeted
therapy against them.
Clustered Regularly InterSpersed Palindromic Repeats or CRISPR, is a cutting

edge genomic editing tool, which has taken the scientific community
by storm. While a detailed description would be out of bounds of this
article, in brief, this powerful tool, acts as a molecular scissors. The
Cas9 enzyme, cuts DNA, at particularly designed sites, which
includes the mutation to be treated. These mutation sites can be
replaced by the correct copy of DNA sequence. While potential
limitations include off-target effects, newer modifications in this
technique, like CRISPR base editors, act as an eraser-pencil,
YO TiMES I AUG 2019

changing point mutations without causing double stranded breaks (DSB) in the
DNA.
Now, where is all this information relevant to us as a retina specialist?
While most retinal gene therapies are in clinical trials, mostly phase I/II, the time is
not long before the new wave of CRISPR genomic editing based therapies are in
clinical trials. All of this makes this field of research most dynamic and exciting.
Further, the possibility of a career as a clinician scientist is an exciting prospect to
explore. It provides the opportunity to see patients, as well as perform basic biology
research. For some, this may mean spending time at a molecular biology lab, while
for others, to take it more conclusively, this may mean taking up a PhD in molecular
biology, leading the way in translational research. Working at a molecular biology
lab, would involve doing basic sciences experiments, including pipetting,
electrophoresis, Polymerase Chain Reaction (PCR), cell culture experiments, as
well as animal experiments. While this area may be very different from the current
set of retina skill you may possess, it can be a very rewarding experience to answer
a critical research question and strategizing ways to develop therapies.
Whichever path you choose, when it comes to genomics experiments, the

idea will always be to deliver the very best to the patient, and to do
meaningful research, developing effective therapies..
Dr. Mayank Bansal, MD, MRCSEd, FICO, FAICO, FRCS (Glasg) is a vitreo-retinal surgeon, who
completed his post-graduation and senior residency from the All India Institute of Medical Sciences
(AIIMS), New Delhi. The International Council of Ophthalmology (ICO) awarded him fellowship in
vitreo-retinal surgery at Stein Eye Institute, University of California Los Angeles (UCLA), USA. He
has been recipient of the Dalai Lama award and Prem Prakash Trophy at RPC, AIIMS. As well as
research grants from the Indian Council of Medical Research (ICMR). In addition to clinical, surgical
work, he is pursuing genomics research at Council of Scientific and Industrial Research (CSIR)
laboratory in collaboration with multiple labs including Stanford University.
https://mahajanlab.stanford.edu/people/mayank-bansal
He can be reached at [email protected], +91 9315668691
YO TiMES I AUG 2019

101
NEW FRONTIERS
ROLE OF SIMULATORS IN SURGICAL

TRAINING
-DR. VEDANG SHAH
Simulation is defined as “a technique to replace or amplify real experiences with

guided experiences, often immersive in nature, that evoke or replicate substantial
aspects of the real world in a fully interactive manner.”1 Simulation was first
described when leaf and clay models were used to simulate the very first recorded
operation, a forehead flap nasal reconstruction in ancient India in 600 BC.2
The paradigm of surgical training has evolved from laboratory practice to operating
on cadaveric tissues and, more recently on synthetic eye models3. The importance
of surgical simulation is now widely recognised for surgeons. It is becoming a
popular way to train both novice and skilled doctors. While traditional didactic
teaching and textbooks remain of utmost importance, it has been shown that the
current generation of trainees is more amenable to technology and alternative
teaching methods. Interactive, hands-on experiences with the opportunity to learn
through trial and error are considered more enjoyable and effective.
The virtual reality training system for intraocular surgery has the potential to
revolutionize medical training. The Ophthalmic Surgical Simulator is unique, as it
provides a realistic and appropriate platform to acquire psychomotor skills and
develop micro-surgical spatial awareness, which can be applied to real-life
vitreoretinal surgery.4 The simulator enhances the process of preparing a surgical
resident for his first surgical experience by providing more skills and confidence.
Repetitive practice of a well-defined task and feedback allow for an
accelerated and safer learning curve.
Ophthalmic surgical trainees must acquire, within a limited time,

sufficient experience and proficiency in Vitreo-Retina surgery
before they can embark on their journeys as consultants. At the
beginning, it is mainly the hand-eye coordination that is difficult to
learn. Because eye surgeries are performed using a
stereomicroscope, hand movement is decoupled from natural vision,
and the coordination is different from the accustomed way. In the
YO TiMES I AUG 2019

limited space of the surgical field, tiny hand movements can have fatal
consequences. Hand-eye coordination can be well-learned using virtual reality.
The virtual training bridges the gap between textbook surgery and real-life theatre
experience, and allows one to contextualize the precise nature of intraocular
surgery. It also provides tactile feedback, an appreciation of depth perception, and
safe instrument-handling. This set-up allows the surgeon to understand the
ergonomic dimensions and challenges that operating presents and to develop
muscle memory for intraocular surgery. Residents learn the foot controls in a no-
stress environment and they can work on posture and hand position. They also
learn to work while looking through a microscope. The simulator allows focussed
practice if a resident is struggling with a particular step of surgery. It also enforces
the habit of learning incrementally even if the mentor is not present. The simulator
has a built-in curriculum that a resident must work through to unlock the next step.
The benefits of simulation are far reaching. It also has the ability to grade an
individual on his surgical skills, such as time to complete a procedure and the
accuracy of manoeuvres. The virtual image is displayed on the screen, so the
teachers can observe and guide the resident well. It is like a video game where
medical training is conducted in the surgical subspecialty with no risk to the patient.
There are several simulators developed for Vitreo-Retinal training like the Eyesi®
and the VR magic. Some simulators have even undergone validation studies with
regard to developing skills necessary to perform surgeries.
The Eyesi® Surgical, a high-end virtual reality simulator for intraocular surgery training.
Image source : https://www.vrmagic.com/simulators/simulators/eyesir-surgical/

There are a few centres in India which offer VR training on simulators. Aravind Eye
Hospital, Coimbatore & Madurai conduct a 2 week paid Vitrectomy Course. The
Eyesi® Simulator is used for training and the candidate should have completed a
VR Fellowship. Please check the website for more details.
The National Ophthalmic Surgical Skills Centre, at R.P. Centre, All India
Institute of Medical Sciences (AIIMS), New Delhi, is equipped with eye surgical
simulator, with a retinal module. With due permissions, it can be accessed by
residents from all over India.
However, the expense of a virtual eye surgical simulator is a barrier to its use in
some programs and may represent the main obstacle to its integration as a
mandatory component of ophthalmic surgical training.
In summary, computer-based surgical simulation is a useful arrow in the quiver of

the trainee surgeon, which acts to supplement – but not replace – surgical
textbooks, videos and wet-lab experience.
References
1. Gaba DM. The future vision of simulation in health care. Qual Saf Health Care. 2004;13(suppl 1):i2–i10
2. Limberg AA. The Planning of Local Plastic Operations on the Body Surface: Theory and Practice.
Lexington, MA: DC Health and Company; 1984
3. Henderson BA, Grimes KJ, Fintelmann RE, Oetting TA. Stepwise approach to establishing an
ophthalmology wet laboratory. J Cataract Refract Surg 2009; 35(6): 1,121–1,128.
4. Saleh GM, Lamparter J, Sullivan PM et al. The international forum of ophthalmic simulation: developing
a virtual reality training curriculum for ophthalmology. Br J Ophthalmol 2013; 97(6): 789– 792.  
DR. VEDANG SHAH, MBBS, MS, DNB, FVRS has completed his Post Graduation and Vitreo-
Retina fellowship from the prestigious Aravind Eye Hospitals. His special interests include Diabetic
Retinopathy and Retinopathy of Prematurity. He is currently working at Shree Netra Eye
Foundation, Kolkata.

P A G E
 
FELLOWSHIP PEARLS
19. What’s behind a proper Vitreoretina training ?

Dr. Rodolfo Mastropasqua
105
20.Try! Try! Try! Till you succeed
Dr. Pritam Bawankar
106
21. Step by Step Vitreoretina Surgical Training
Dr Mayank Bansal & Dr Vinod Kumar
109
22.Ergonomics in our ophthalmic World
Dr R Krishnaprasad
113
23.How to study as a Young Vitreoretina Student ?
116
24.Online Resources for a Vitreoretina Trainee
Dr Jay Sheth
122
25.FAICO Examinations : All you need to know!
Dr. Mahima Jhingan
129
26.Tips for FAICO preparation and wider reading
during a VR Fellowship.
133
Dr. Apoorva Ayachit
P A G E
FELLOWSHIP PEARLS
27. Nuances of Retinal Imaging : A case based

discussion
140
Dr. Mohit Dogra
28.Conferences and Travel Grants

Dr Diva Kant Misra
147
29.Retina Conferences : 2019 - 2020
Dr Tanya Jain
150
30.Establishing an Independent Retina Practice
Dr Bikramjit P Pal
155
31. Best Comebacks to things people say to women in
vitreoretina: A comprehensive manual
163
Dr. Apoorva Ayachit
32.Differential Wars
Dr Mahima Jhingan,
167
Dr Jay Chabblani
Dr Komal Agarwal
Fellowship Pearls
WHAT’S BEHIND A PROPER VITREORETINAL

TRAINING ?
-DR RODOLFO MASTROPASQUA
Becoming a specialist in Vitreo-Retinal surgery means being able to deal with

both straightforward and complicated cases. These include the surgical
treatment of retinal detachment, macular hole, epiretinal membrane, ocular trauma,
complicated diabetic eye disease, complications of cataract surgery and
endophthalmitis.
After completion of residency in Ophthalmology, a subspecialty training of at least 2

years should be performed to acquire the necessary skills to face competently and
independently the above conditions.
The first step of learning Vitreo-Retinal surgery is about gaining clinical skills: a
proper retinal examination is critically important in addressing an adequate
treatment. An expert must be able to examine the patient with both the slit lamp and
the indirect ophthalmoscope. Failing in this will almost surely guarantee a surprise
on the table which will lead to an avoidable “last second” change of plan. Speaking
to the patient is equally important: a large percentage of VR diseases have a
guarded prognosis and in surgery, complications can happen. It is always advisable
to spend time discussing the disease and explaining the risks and benefits of
surgery comprehensively.
Once in theatre, the most important point for a trainee is to respect his learning
process. It is essential to take the time necessary to understand each surgical step
and make it reproducible. At the beginning it’s not important to raise numbers, what
really counts is to make a technique personal and unique. There is no point to take
unnecessary risks and try a manoeuvre never done before: ask for supervision as
much as you need. 
RODOLFO MASTROPASQUA MD FEBO, completed his training in general

Ophthalmology at the University of Verona, Italy. Thereafter he moved to the
United Kingdom, where he completed an 18 months research scholarship at the
Vitreo-Retinal Department of Moorfields Eye Hospital, London. He completed a
cataract fellowship at the Moorfields Eye Hospital and a vitreoretinal fellowship
at the Whipps Cross University Hospital, London, UK. He is currently employed
as a vitreoretinal fellow at the Bristol Eye Hospital, University of Bristol, UK. He
is author of 89 publications and has an H index of 21.

Fellowship Pearls
FELLOWSHIP ENTRANCE TESTS

TRY! TRY! TILL YOU SUCCEED
-Dr Pritam Bawankar
Medical education is the ultimate test of patience, perseverance and passion.

Getting into your dream branch after 5 and a half years of slogging not only
requires intelligence to crack entrance exams but fate also play a very important
role. After 3 years of slogging and endless working hours, a postgraduate doctor
comes out into the real world. It doesn't end here, rather it has just begun and the
lingering question of ‘WHAT NEXT?’ remains.
Ophthalmology comprises of various sub-specialities. Most of the government

medical colleges and the DNB training institutes are unable to provide a
comprehensive and holistic approach which involves medical and surgical training
in various sub-specialities like Refractive, Vitreo-Retina, Oculoplasty, Neuro-
Ophthalmology ,Squint and Glaucoma. Hence the need for a fellowship arises, if
one intends to practice subspecialty in the field of Ophthalmology.
The process of getting into a fellowship is indeed a tedious one. There are a few
tertiary eye care hospitals which offer fellowship programs in each region and have
2-3 spots for each sub-specialty every 6 months or 1 year. The selection criteria of
a candidate at each institute is very different and unknown to the young
ophthalmologists. It usually comprises of a written exam and an interview. Doing
well in the written exam and interview does’t guarantee a selection. Several add on
f a c t o r s like publications, reputation of residency training institute and
recommendations come into play.
In India, the residency training scenario varies considerably

from one institute to another. An environment of research
and publication is lacking in majority of the institutes. Lack of
mentorship, paucity of dedicated time for research and long
working hours create an environment which is not conducive
for research.

In my personal experience, despite having keen interest in clinical research I was
unable to achieve publications due to various factors. I did well in my post graduate
exams and fellowship entrance tests/interview, but they were not enough to get me
a Vitreoretina fellowship. Absence of publications in my resume was one of the
biggest hindrances. I didn’t give-up and kept appearing for interviews and
eventually found my dream institute. During the interview process they overlooked
my shortcoming of not having the add ons and were able to identify my zeal for
research. At the end of the interview they made me promise that I will convert my
aspirations into reality. With my mentors support, excellent infrastructure and
adequate patient exposure, I learned the nuances of research and I was able to
publish in various peer reviewed indexed journals during the course of my
fellowship.
Refinement of the selection criteria or a common and uniform fellowship exam

might be helpful for the young ophthalmologists and is indeed the need of the hour.
Is doing a fellowship mandatory ? Is it beneficial ? Yes ! Undoubtedly, it helps one

gain knowledge but it also changes the way one thinks. The clinical and methodical
approach when treating a patient gives you an edge over the others. During a
fellowship, you get an opportunity to work and excel as a clinician and an
academician. All in all, acquiring a “Specialist” tag in the end is surely worth it !
My Tips for Fellowship Entrance Tests :
1. Start early : The day you decide that you want to pursue a fellowship, start
working towards it. Even if you are in the first year of residency!
2. Be Focussed : Try to focus some of your energy towards your choice of sub-
specialty. That may involve simple things like reading the subject more and
trying to concentrate your research towards that area. But you should not
overlook the fact that we have to become comprehensive ophthalmologists first
and specialists later.
3. Be Aware : Keep your self updated about all the fellowship programs in the
country and abroad. You don’t want to miss an application deadline!

4. Seek Mentorship : Seek mentorship from all possible sources. A mentor can be
any body and from anywhere. Be an eklavya! Know all the possible mentors
form your choice of specialty, follow their work and talk to them when you see
them in conferences. You never know, they might be taking your interview one
day!
5. Talk to people : Talk to your seniors, Fellows & Residents from your dream
institute. They might be able to give you some very important insight and help
you with the process. You will find all relevant contact details in this issue of YO
Times itself.
6. Publish! : Publications look good on your resume! If your institute appreciates

and encourages research then you are in good hands and just follow the
guidance. But if you don’t find the environment conducive, you can seek
guidance from outside. YOSI Research Cell can help you in this endeavour.
7. Know your Subject : Last but definitely not the least, know your ophthalmology
well. You will eventually find your way if know your subject well!
In the end, you have to understand that we have to try and try till we succeed.
Nothing in life comes easy, you have to work hard! Everybody has faced failures
and we have to try again without giving up hope!
I wish you all the best! 
DR PRITAM M BAWANKAR MBBS, MS, DNB, FICO (UK), FVRS is currently working as a Vitreoretina
Consultant at Madhav Nethralaya, Nagpur. He has been a Senior Resident in the
Department of Vitreoretina Surgery at Grant Medical College & Sir J.J. Group of Hospitals,
Mumbai. He has completed his fellowship in Vitreoretina Surgery from Sri Sankaradeva
Nethralaya, Guwahati. He has done MBBS from IGGMC, Nagpur and MS from Grant
Medical College. He is an awardee of “Keshmahinder Singh Award” (APVRS, 2017) and
“International Ophthalmic Heroes of India” (AIOS, 2018). He has presented many papers
and posters and has several publications to his credit
YO TiMES acknowledges the contribution of Dr Aditi Tripathi in developing this article,

Fellowship Pearls
STEP BY STEP VITREORETINA SURGICAL

TRAINING
DR MAYANK
- DR BANSAL
MAYANK BANSAL
DR VINOD DR
KUMAR
VINODAGGARWAL
AGARWAL
One of the most dynamic fields of ophthalmology and perhaps medicine, Vitreo-
Retinal surgery has swiftly become the top choice of recent ophthalmology post-
graduates, wishing to pursue sub-specialty training. The surgical expertise needed,
the challenges involved, and fast changing practice patterns, all add up to make it a
sought-after area of work.
As you embark, or decide to pursue this fascinating speciality, this article in short
will cover some simple nuances to make the most of this field.
GAINING THE ARMAMENTARIUM
Perhaps the most useful skill - and maybe among the neglected ones, is reading.
You may ask, whether reading is really important in a surgical training program.
Much like the ophthalmology training, reading paves the way for better
understanding of the actual subject, and surgeries. Surgical retina involves both
extra ocular and intra ocular maneuvers, and a good knowledge of anatomy to
identify surgical landmarks goes a long way. For example, while passing an
encircling silicon band, the location would be different for myopic and emmetropic
eyes. Identifying the vortex veins and passing the band accordingly (2 mm anterior
to it) is most desired.
Very often when you read up, you will come across the solutions to your common
problems. Learning from other’s experience, and mistakes, knowing common
pitfalls, and how to handle complications is must for making of a good VR surgeon.
Vitreo-Retinal Surgical Techniques by Gholam Peyman, and Retina by
Stephen Ryan are among the top texts available this area. Other excellent online
resources include retinalphysician.com and eyetube.net.
Knowing your equipment - is extremely important in Vitreo-Retinal surgeries as it is

in any other surgery or even in general life. Depending on the vitrectomy machine
YO TiMES I AUG 2019

109
used, foot pedal controls, vitrectomy parameters, and availability of features are
something the surgeon must understand. A minor feature of the vitrectomy
machine/foot switch manuover may sail you through toughest of surgical scenarios
(e.g. reflux is the easiest way of inadvertently caught retina in the cutter). This also
includes troubleshooting features, and compressed air requirements. A knowledge
of all of these will come in handy while operating. It’s best to hope for the best,
however when it comes to the equipment, being prepared for the worst is always a
good idea. Vitrectomy machine error messages, inadvertent shut-down, etc. during
a surgery, especially during a critical step, can significantly tip the operating theatre
environment into a state of panic. Being in control at such times certainly helps.
LEARNING TO OPERATE
When it actually comes to operating, understanding tissue handling is among the

key features to learn surgical skills. Respecting the integrity of tissue goes a long
way in improving the surgical outcomes. My mentor used to say that “every
intraocular movement should be purposeful”. When available, practicing prior on
animal eyes, or eye simulators are a great first step. On a relevant note, the
National Ophthalmic Surgical Skills Centre, at R.P. Centre, All India Institute of
Medical Sciences (AIIMS), New Delhi, is equipped with eye surgical simulator,
with a retinal module. With due permissions, it can be accessed by residents
from all over India. Another pertinent point is being ambidextrous. As an initial step
using both hands for daily activities (e.g. brushing with your non-dominant hand),
does give better control on the non-dominant hand.
A structured introduction into the steps of surgery by a mentor would be an ideal

way. The value of assisting a senior surgeon and if possible assisting multiple
surgeons, cannot be emphasised enough. With every surgeon having some tips to
share, it is also a good practice to observe, assist multiple surgeons when possible,
and adapt to your own technique accordingly. Good assistance involves both
observing the nuances of surgical steps, and asking relevant questions. It always
helps to come prepared in advance, by reading relevant literature before a patient
is scheduled for Vitreo-Retinal surgery. When appropriate, the surgical mentor, can
gradually introduce the retina fellow in training, to steps of the surgery.
When it comes to the extra-ocular steps, techniques of peritomy, hooking muscles,

passing scleral sutures, and so on are best introduced gradually. For Vitreo-Retinal
surgery, making ports, placing infusion cannula, posterior vitreous detachment
induction, macular peeling, eye pressure control, endo-illuminator control, fluid air
exchange and many such other steps have their nuances, again best performed in
YO TiMES I AUG 2019

110
a graded fashion. Also worth noting is that while most of anterior segment surgery
involves operating in a horizontal plane, Vitreo-Retinal surgery is largely in the
vertical plane, which may take some adaptation, especially when coming straight
out of post-graduation.
OTHER AREAS OF RETINA WHICH GO IN TANDEM
Solid clinical skills, indirect ophthalmoscopy (IDO), and 90D skills help in effective
diagnosis, and management. Indenting without causing pain, and visualising
extreme periphery with 90D, are examples of techniques which get better with
practice. Retinal lasers and cryotherapy are aided with good IDO skills.
A good understanding and practice of retinal imaging is integral part of Vitreo-

Retina training. Imaging characteristics learned by doing the retinal imaging on your
own are far superior than reviewing images taken by the optometrist. For example,
as a retinal physician, when it comes to optical coherence tomography (OCT), you
would know which segmentation to apply, how to compare registered images on
follow up, and using appropriate type of OCT protocol for relevant retinal condition.
Lastly, there is always concerns amongst residents about numbers of surgery.

While numbers do matter, equally or perhaps more important is to learn the right
technique. Structured and planned training always has a shorter learning curve.
COMMON MISCONCEPTIONS
This section is relevant for those who are contemplating whether to choose Vitreo-
Retinal surgery, (or those who have chosen it, and are still debating their choice).
There are some common perceptions which often lead to incompletely informed
choices. One of the most common is that ‘all retina patients have poor vision
outcome’. While patients with retinal disorders are among the most challenging in
ophthalmology, prognosis is not always poor, for example patients with fresh retinal
detachment, or vitreous haemorrhage with good underlying macular function.
Moreover, even for those with poor prognosis, there is always vision worth striving
for.
Another common perception is that Vitreo-Retinal surgery cannot be practiced out

of tertiary care hospital setting. With advancing surgical equipment and
instrumentation, most eye institutes, centres are providing Vitreo-Retinal services

now. After cataract surgery, retinal procedures including intravitreal injections are
among the most commonly performed eye procedures.
Last but not the least, attending conferences and retinal meetings forms a very
integral part of retina training, where in you get abreast with the latest in the field.
Presenting your work helps gain insights and critical review of your research.
To conclude, learning is a continuous process, a journey without one

destination. It is great to set targets, and work on constant improvement of
oneself. This field of Vitreo-Retinal surgery, is ever evolving making it
exciting, addictive and most of all satisfying. Wish you all the best in this
journey, please feel free to contact on the details below for any questions. 
Dr. Mayank Bansal, MD, MRCSEd, FICO, FAICO, FRCS (Glasg) is a vitreo-retinal surgeon,
who completed his post-graduation and senior residency from the All India Institute of
Medical Sciences (AIIMS), New Delhi. The International Council of Ophthalmology (ICO)
awarded him fellowship in vitreo-retinal surgery at Stein Eye Institute, University of California
Los Angeles (UCLA), USA. He has been recipient of the Dalai Lama award and Prem
Prakash Trophy at RPC, AIIMS. As well as research grants from the Indian Council of
Medical Research (ICMR). In addition to clinical, surgical work, he is pursuing genomics
research at Council of Scientific and Industrial Research (CSIR) laboratory in collaboration
with multiple labs including Stanford University.
https://mahajanlab.stanford.edu/people/mayank-bansal. He can be reached at

[email protected], +91 9315668691
DR. VINOD
DR. VINOD KUMAR
KUMAR AGGARWAL MS DNB
MS DNB MNAMS MNAMS
FRCS FRCSis(Glasgow) is
(Glasgow)
Currently working as assistant professor at vitreo-retina services at Dr RP Centre for Ophthalmic
Sciences, AIIMS, New Delhi. He has previously worked as registrar at Wrexham Maelor Hospital,
Wrexham, Wales in 2009-2010. ICO fellow Vitreo-retina at Gunma university, Japan (2014). He has
Keen interest in academics with over 140 publications in various journals (120 indexed peer reviewed
publications). Presented over 50 papers at various state level, national and international conferences.
Co-author of “Handbook of clinical trials in ophthalmology.” Jaypee brothers medical publishers (P)
Ltd. 2013

Fellowship Pearls
ERGONOMICS IN OUR OPHTHALMIC WORLD

-DR KRISHNA PRASAD
We learn about Ergonomics in our community medicine text books of our medical
school and then comes a long amnestic interval! Most often as professional
hazards we only start talking about it when our Back and Neck problems prompt us
to do so! Fortunately we are hearing more about Ergonomics in recent times with
more and more ophthalmologists being aware of this silent pandemic.
On an evolutionary perspective, our bodies are not meant to be sitting for long
periods. Our skeletal system is designed for running, walking and standing, not for
sitting! As Ophthalmologists, we sit in our out patient consultation rooms and our
operating rooms. But we just don’t sit! We perform very intricate maneuvers like slit
lamp examination or intraocular surgery where our attention is at its peak and we
momentarily forget how we position our spine. If you consider slit lamp
biomicroscopy, many clinicians cannot even reach out to the eyepieces of the slit
lamp easily. If they are short statured, they have to extent their neck or they have to
cantilever their neck down to reach the oculars, if they are taller! Both positions of
the neck create repetitive stress injury to the bony and soft tissue components of
our neck. It is well known that our neck carries the entire weight of our head and
the effective weight of the head increases, linearly with progressive flexion of the
neck. The persons performing indirect ophthalmoscopy for Retinal Evaluation have
to keep their necks flexed for long periods and also weight of the Indirect
Ophthalmoscope adds to the misery! Similar situations can be seen in our
operating rooms where people perform prolonged surgeries
keeping their neck in awkward postures. The lower end
microscopes which lack tiltable eyepieces makes it mandatory
for a surgeon to flex his neck for performing surgery.
The second mobile segment of our spine is the Lumbar vertebral

column which bears the brunt of this occupational peril. The
healthy sitting posture is one in which lumbar spine
maintains the lordosis and feet firmly on the ground or
any other support which transfers the weight of the
body to the ground. In view of bad design of our
OT Chairs and also the disparity in the
microscope eyepieces levels, the surgeon

slumps down, obliterating the lumbar lordosis which cause prolonged stress on
anterior position of intervertebral discs causing them to degenerate, encouraging
disc herniation.
It is not out of place to recall some of the orthopedics we learnt in medical school.
Spinal column is at its best when the normal curvatures are maintained like lordosis
of lumbar region and slight extension of cervical region. Thoracic and sacral
segments are immobile and hence are not of significance here. Flexion of cervical
spine and loss of lumbar lordosis puts extra strain on the anterior part of
intervertebral discs which can predispose to posterior herniation causing
compression on neural structures. Repetitive stress injury also contributes to
damage. Weak para spinal muscles aggravate the situation and can herald a
dangerous situation. Bad chairs in OR and outpatient areas, poor postures, lack of
regular physical exercise and ignorance about the musculoskeletal disorders
increase the risk.
HOW TO MANAGE THIS PANDEMIC?
Musculoskeletal disorders arising out of occupation as an ophthalmologist are best

prevented. Three strategies can be employed to curb this menace.
Changing the things around us.

Start with chairs on which you sit. Specially designed chairs which maintain
the lumbar lordosis while operating or sitting in OPD can help. Most people
who spend lakhs on microscopes and other machines do not spend some
thousands on good, ergonomically designed chairs. Tiltable eye pieces are
pricey in a microscope but can go a long way in the wellbeing of your cervical
spine. Adjust heights of chairs in such a way that the feet are on the floor
transferring the body weight to the ground directly.
Adopting healthier habits:

Get up every time you complete a consultation in OPD and walk the patient
to the door. You are not only respecting the patient but also respecting your
back. Sitting for prolonged periods in the chair has to be avoided. Remember
that standing is the best posture for spine. You can also perform certain
simple stretching exercise in OR & OPD every 30 minutes. Do not bend
abruptly down with your knees extended as it can precipitate a disc
herniation.
YO TiMES I AUG 2019

114
Fitness, Fitness & Fitness.
A Sound body solves it all. A regular physical exercise regimen can tone up
your muscles, strengthen the bone, can make your joints supple and lastly
can supply regular dose of ‘Endorphins’! Weight training of specific muscles
around the neck and shoulders, crunches, back lifts can be of help.
Swimming is a great aerobic exercise which can strengthen your back and
neck muscles. An Athletic toned up body can be a great asset for a marathon
surgeon. Being aware of this professional hazard can make us wiser and
allow us to have a healthier and happier ophthalmic career.
Wrong Posture
Dr. R. Krishnaprasad is the head of Paediatric

Ophthalmology and Glaucoma services in M. M. Joshi Eye
Institute, a premier superspeciality Institute of Southern
India. Being the Best outgoing University student with 8
Gold Medals in Medical Graduation, he has completed his
M. D. (Ophthalmology) from prestigious All India Institute of
Medical Sciences, New Delhi with honours. He is the
Director of Post Graduate Training and Fellowship
programmes at M. M. Joshi Eye Institute, a niche area very
Oh My Back! close to his heart. He is the Deputy Director of Community
services and has been working tirelessly on pediatric
community ophthalmology projects.
Dr. Krishnaprasad has undergone a fellowship training in

pediatric ophthalmology at Storm Eye Institute, Medical
University of South Carolina USA. He has three
International publications and Eight National publications in
peer renewed journals.
He is the member of South Zone in Academic and Research

Committee of All India Ophthalmic Society for South India.
Correct Posture Post-graduation Education has been the passion of Dr.

Krishnaprasad. He has been a Post Graduate Teacher for
last 23 years. His flagship PG program – ‘Eye to Eye with
Examinations’ has been highly successful in orienting the
exam going post graduates for the ordeal of PG exams. He
has been a member of National Post Graduate Education
Committee in the past and has been a regular Guest Faculty
in all the National Level and State level post graduate
orientation programs. He has been awarded “Distinguished
NBE Teachers” from ANBAI. He has more than 200
scientific presentations as lectures and panel discussions in
various National & State conferences.

Fellowship Pearls
HOW TO STUDY AS A YOUNG VITREO-RETINA

STUDENT  
-DR AWANEESH UPADHYAY
A) Medical Retina Training

•Autofluorescence of RPE
1) Clinical Skills
•Optical Coherence
•Indirect Ophthalmoscopy Tomography
•Scleral Depression •Maps & Line Scans
•Fundus Contact Lenses 78D •Standard and enhanced

and 90D depth
•Biomicrosopy Slit Lamp • ERG - Full field & Multifocal

Examination
•Electro-oculography (EOG)
•Fluorescein Angioscopy
•Dark Adaptometry
•Ophthalmodynomometry
•Microperimetry
•Color vision analysis

2. Diagnostic Tools
•Angiography - Digital
3. Diabetic Retinopathy &
Fluorescein and ICG
macular edema
•Wide field and standard
•Classification and
•Ultrasonography management
•Dynamic B-Scan •Role of Anti-VEGF therapy

Ultrasound
•Role of Steroid therapy
•Exposure to 3D
•Role of Laser therapy
Ultrasound
•Management of rubeosis and
•High Frequency
NV
Ultrasound

4. Various laser techniques 7. Peripheral Retina Disease
•Standard slit lamp focal and Classification and management

PRP
Diagnostic Skills
•Pascal pattern laser
- Indirect Ophthalmoscopy with
•Laser indirect Scleral Depression
ophthalmoscope
- Contact Lens Evaluation of
Peripheral Retina
5. Age Related Macular 1. Goldmann 3 Mirror Lens
Degeneration
2. Super Quad 160 Wide Lens
3. 78D and 90D biomicroscopy
management
Retinal Breaks
•Role of Anti-VEGF therapy
- Recognition
•Role of Steroid therapy
- Therapy with cryopexy/laser
Peripheral neovascularization
•Pneumatic blood
displacement - Recognition & Differential
- Therapy with cryopexy/laser

6. Retinal Vascular Occlusive
Disease
8. Uveitis
Classification and management
management
Diagnostic blood test work-up
•Role of Anti-VEGF therapy
•Role of Steroid therapy Specialty history assessment Role

of PCR testing
Immune suppression management
•Management of rubeosis and
NV
9. Paediatric Retina
•Retinopathy of Prematurity
•Screening Programs

•Classification B) Surgical Retina Training
•Management with laser 1. Retinal Detachment
•Management with Anti-VEGF •Classification: Exudative versus
•Toxocariasis Tractional versus Rhegmatogenous
•Persistent Fetal Vasculature •Rhegmatogenous RD
•FEVR •Localization of Retinal Breaks
•Norrie’s Disease •Drawing of Configuration
•Juvenile Retinoschisis •Surgical Decision Making
•Pneumatic Retinopexy
10. Ocular Oncology •Scleral Buckle
•Recognition and classification •Vitrectomy
•Role of imaging and ultrasound 2. Surgical Skills
•Therapy with I125 plaque •Pneumatic Retinopexy
•Therapy with thermotherapy •Intraocular Gases ~

Kinetics ~ Complications
•Therapy with enucleation
•Retinopexy ~ Cryopexy ~
•Role of Laser therapy Indirect Laser
•Role of fine needle biopsy •Scleral Buckle
•Understanding systemic workup •Options for Elements
•Encircling versus Radial

11. Hereditary Diseases •Drainage vs Non-
Drainage
•Recognition and classification
•Cryopexy
•History taking & Pedigree
•Complications
•Role of electrophysiology
Management & Low Vision Aids

•Vitrectomy •Diabetic Tractional RD
• 3 Port Pars Plana •Dissection techniques

Vitrectomy
•Role of anti-VEGF and
• Vitreous Base Dissection laser
• Scleral Depressed •Giant Retinal Tear -

Peripheral Vitreous
•Role of gas v/s silicone
Shaving
•Role of buckle
• Air Fluid Exchange
•Management of fellow
• Endolaser
eye
Photocoagulation
• Scleral Depressed
Endolaser 3. Macular Surgery
photocoagulation
•Macular Hole Surgery
•ILM peeling techniques
3. Complicated Retinal
•Stains
Detachment
•Gas tamponades
•Proliferative
Vitreoretinopathy •Epiretinal Membrane & VMT
•Membrane Dissection •Peeling techniques
•Illumination & Wide •Stains
Field Viewing
•Use of PFO
4. Endophthalmitis
•Silicone Oil
•OPD based management
•Gas
•Role of vitrectomy
•Role of retinotomy and
buckle

5. Management of Lens • Choroidal Disorders - Jay
Complications Chhablani, Jorge Ruiz-
Medrano
• Retained Lens Fragments
• Retinal Pharmacotherapeutics-
• Dislocated & Subluxated IOL Nguyen, Q.D
• Retinal Pigment Epithelial
Detachment: Differential
Diagnosis and Therapy:, Maria-
6. Vitrectomy Fluidics &
Andreea Gamulescu
Techniques
•23 G
Surgical retina
•25G+
• Vitreoretinal Surgical
•27G and Techniques- G.A. Peyman,
S.A. Meffert, M.D
•high-speed cutters
• Surgical Techniques In
•Chandelier Lights Ophthalmology Series:
Abdhish Bhavsar
• Retinal Detachment Surgery
BOOKS and Proliferative
Vitreoretinopathy – Zoran
Medical retina
Tomic, Diego Ruiz-Casas
• Principles and Practice of • Practical Handbook for Small-
Ophthalmology - Albert
Gauge Vitrectomy - Spandau,
Jakobiec’s
Ulrich, Heimann, Heinrich
• Basic and Clinical Science • Vitreous Micro surgery –
Course. American Academy of
Ophthalmology Steve Charles
• Retinal Prosthesis - A Clinical
• Ryan's Retina - Andrew
Schachat Guide to Successful
Implementation - Humayun,
• The Retinal Atlas - K. Bailey Mark, Olmos de Koo, Lisa
Freund
Imaging
• Gass' Atlas Of Macular Disease
- Anita Agarwal • Handbook Of Retinal OCT:
Optical Coherence - Jay S.
• Macular Edema: A Practical
Duker
Approach - Gabriel Coscas
• Retinal and Choroidal Imaging
in Systemic Diseases – Jay
Chhablani

• Optical Coherence Tomography • https://vrsi.in/vrsi-newsletter/
Angiography Atlas: A Case • http://
Study Approach -Julie eophthalmologyreview.org/
A Rodman newsletters.html
• Ryan's Retinal Imaging and
Diagnostics - Stephen Ryan
PODCASTS
Ultrasound
• http://www.retinapodcast.com/
• Ophthalmic Ultrasound- Sandra
Byrne and Ronald Green
• The Sankara Nethralaya Atlas
OPHTHALMOLOGY BLOGS
of Ophthalmic Ultrasound –
Muna Bhende • https://blog.feedspot.com/
ophthalmology_blogs/
Websites
• https://www.asrs.org/sections/
fellows-in-training/fellows-
reading-list
• https://eyetube.net/retina/
• https://www.aao.org/guidelines-
browse?subspecialty=retina-
vitreous
• https://esaso.org/education/
course-textbooks
Dr. AWANEESH UPADHYAY
• http://www.octnews.org/ DNB, FVRS is working as a
category/1/ophthalmology/ Vitreoretina consultant at Sri
Sankaradeva Nethralaya,
Guwahati. He has completed his
RETINA NEWSLETTER postgraduate and vitreoretina
t r a i n i n g f ro m L i t t l e F l o w e r
Hospital & Research Centre,
• https:// Angamaly.
www.retinalphysician.com/
He can be reached at
newsletter
[email protected]
• https://
www.reviewofophthalmology.c
om/newsletter/retinaonline

Fellowship Pearls
ONLINE RESOURCES FOR A

VITREO-RETINA TRAINEE
-DR. JAY SHETH
Ophthalmology has evolved in a way that subspecializing is almost essential for

career development. A fellowship represents the only official way for obtaining a
subspecialization in ophthalmology, and training in vitreo-retina continues as one of
the most highly sought-after branches.
A fellowship’s duration is limited and therefore the fellow should be prepared to

work hard in order to make the most of it. Of course, the final expectations are
primarily surgical and clinical proficiency at the end of the fellowship. It is imperative
to remember that the fellowship will guide you towards your future professional
development and it is important to be productive and have a keenness and aptitude
for learning. Also, it is advisable to be involved in research and produce scientific
results.
Majority of the residency programs are well-structured in the form of didactic

lectures, clinics and reading schedules. In contrast, a fellowship program is usually
quite flexible and self-directed, and overwhelming to a great extent. These facts are
hard to appreciate unless you are in the thick of it, and once you are in it, the
experience is surprising, exciting and challenging at the same time. The initial part
of the training passes very quickly, due to the sheer volume of work that we face.
Always remember to be like a sponge, take it in as much as you can.
Being up to date with current body of literature is indispensable for a successful
fellowship and a fruitful career. During our routine clinics and operating rooms (OR),
much of what we learn as fellows is what our attendings say,
based on their experience and their opinions about certain
things, which occasionally may be different from what we read
about. Knowledge about the latest happenings in the field of
retina through online resources will help us gain a different
perspective and improve our decision-making capabilities.
Here is a list of online resources which can be a potential
source of knowledge and information for a vitreo-retina
trainee.

American Academy of Ophthalmology – Ophthalmic News & Education
Network or the ONE Network:
The AAO ONE network provides access to probably the

world’s largest compilation of educational material in
Ophthalmology at https://www.aao.org/clinical-
education. It gives full access to journals such as
Ophthalmology, American Journal of Ophthalmology, Survey of Ophthalmology,
International Journal of Retina and Vitreous and so on. The ONE homepage can be
personalized to see the latest news in just your vitreo-retina subspecialty, from the
month's top journal studies to a rundown of the week's top medical stories
appearing in the popular media. It is the O.N.E. source to access tools for life-long
learning such as diagnostic challenges, image collections, focal points, podcasts,
masterclass videos and free courses. Additionally, it provides multiple self-
assessment tools. There is an Editors’ choice section that provides expert
summaries of recent clinical studies, which gets updated every week. It is the
O.N.E. source to review standards of care with the Academy's library of practice
guidelines at https://www.aao.org/guidelines-browse?subspecialty=retina-vitreous.
One biggest advantage is that the ONE Network can be accessed for free if you are
an AIOS member through the AIOS website www.aios.org . It can be accessed
through the ONE network link in the Member zone section of the website.
All India Ophthalmological Society (AIOS):
Apart from access to the AAO ONE Network, the AIOS website,
www.aios.org provides additional academic materials in the form
of webinars and AIOS YouTube channel. The webinars cover
diverse range of topics in Retina and other subspecialties. These
is also a subsection on surginars which are surgical educational
programs for the trainees. Additionally, member can access the
Indian journal of Ophthalmology (IJO) journal through the website.
American Society of Retina Specialists (ASRS):
As the world's largest retina society, the ASRS offers an

unparalleled global network of leading retina specialists, world-
class meetings and resources to help members stay at the

forefront of developments in the field and delivery of highest quality care. Online
access to academic material is restricted to members only at https://www.asrs.org/.
Nonetheless, the members have exclusive access to an array of products, services
and publications such as webinars, journal clubs, Vitreoretinal Fellowship Reading
List, Wills Eye Hospital Conference Series, spotlight cases, retina image bank and
annual meeting archives. Series of educational videos offers fellows and those new
to practice with a bird's-eye view and expert instruction on some of today's most
common retina procedures through their ‘Surgical Retina Video Learning Library’
and the ‘Innovative Retina Surgical Video Series’. The ‘Best Clinical Retina
Practices’ section is a growing collection of statements offering definitive guidance
on what the Society deems to be the current gold standard for clinical retina
practice. We can also access the annual Preferences and Trends Survey (PAT)
which measures member preferences on a wide range of medical, surgical and
socioeconomic topics and the Global Trends in Retina Survey examining retina
practice trends worldwide. Additionally, free access is provided to the Journal of
VitreoRetinal Diseases (JVRD) and Retina Times.
International Council of Ophthalmology (ICO):
The ICO has got an e-learning module on their website www.

http://www.icoph.org/ . It includes The Ophthalmology Webinar
Network which shares live and archived lectures from training
programs around the world, Online Courses and the Atlas of
Ophthalmology. They also have a subspecialty section to
provide international guidelines for management of vitreoretinal
diseases. It also gives access to the World Ophthalmology Conference resources
through the website www.woc.conference2web.com . This covers free access to
more than 1000 talks and webinars of the past WOC meetings.
Healio Ophthalmology:
The Healio is an educational website which covers all

branches of modern medicine at https://www.healio.com/.
In ophthalmology, the Education lab is available at https://
www.healio.com/ophthalmology/education-lab that
features the industry’s best news reporting, dynamic multimedia, question-and-
answer columns, CME and other educational activities in a variety of formats, quick
reference content, blogs, peer-reviewed journals and a full line of popular book
titles. The website provides free access to most of the contents, including the

journal Ophthalmic Surgery, Lasers and Imaging Retina. Retina CME is part of this
website that provides specific access to educational materials such as articles,
clinical cases, expert videos, surgical videos, lectures and self-assessment tools at
https://cme.healio.com/retinacme.
Medscape:
Medscape is a leading online educational website offering the latest

medical news and expert perspectives; essential point-of-care drug
and disease information; and relevant professional education and
CME at https://www.medscape.com/ophthalmology. It provides free
access to educational materials such as CME, videos, detailed
description of all retinal diseases, procedures, cases, slideshow collections, details
of drugs and latest clinical guidelines.
The Royal College of Ophthalmologists:
The Royal College of Ophthalmologists is a paid professional

membership body for medically qualified ophthalmologist (https://
www.rcophth.ac.uk/). Through the website, we can gain access to
the journal Eye, Focus articles which provide succinct topical
information around important issues for clinical practice and
updated clinical guidelines to identify the best medical evidence,
set standards of patient care and ensure patient safety, providing a benchmark for
outcomes within which high quality Ophthalmology can be practiced (https://
www.rcophth.ac.uk/standards-publications-research/).
EyeWiki:
EyeWiki is the Eye Encyclopedia written by Eye Physicians &

Surgeons (https://eyewiki.org/Main_Page). It has got excellent
subspecialty articles which gets updated at regular intervals (https://
eyewiki.org/Category%3ARetina/Vitreous). The website also has an
option for individual members to revise the content from time to time
as new evidence gets added in the literature.
YO TiMES I AUG 2019

125
Eyetube:
Eyetube is ophthalmology’s leading source for high-quality,

full-narrated ophthalmic surgical videos (https://
eyetube.net/retina/). Eyetube’s video library is highly
organized to help you find the surgical technique or product demonstration that you
want to watch. It also has archived content from the latest webcasts, symposia, and
roundtables focusing on ocular health and practice management.
YouTube:
Similar to Eyetube, YouTube has vast amount of videos available ranging from
surgical, educational, archives of conferences, and so on (www.youtube.com).
Straight from the Cutter’s Mouth:
It is a Retina Podcast in an informal space where host Jayanth

Sridhar, MD, from Bascom Palmer Eye Institute in Miami
invites retina specialists to discuss the latest in vitreoretinal
therapies. It is a weekly broadcast at the website is http://www.retinapodcast.com/ .
Vit-Buckle Academy:
Vit-Buckle Academy, is a web-based educational portal designed for

vitreoretinal surgeons and trainees. The curriculum is comprised of
educational along with high quality videos and figures. It is amongst
Vit-Buckle Academy is amongst the first step-by-step video-based
curriculum of how to perform vitreoretinal surgery. The portal also
includes resources such as retinal detachment case discussions; a surgical video
library; an instrument gallery; a surgical reading list; and more. (https://
vitbucklesociety.org/vit-buckle-academy

The Retina Channel Podcast:
The podcast is a journal club to review recent journal articles in the field of retina.
The target audience are retina specialists and other healthcare professionals who
want to stay up to date with the latest publications in the field of retina. It can be
accessed at http://theretinachannel.libsyn.com/.
eOphtha:
This is an Indian based portal which is very helpful for trainees (http://
www.eophtha.com/index.html). The highlights of eophtha are e-journal
section, ophthalmology powerpoint section, interesting reads about
retinal diseases, landmark studies and trails, learning about fundus
drawing including colour coding, and blogs by experts in the field.
Online Retinal Publications:
There are numerous online retinal publications that can be accessed for free. Most
notable of these include the Retinal Physician (https://www.retinalphysician.com/)
and Retina Today (http://retinatoday.com/). These publications provide in-depth
coverage of the latest advances in medical retina, retinal surgery, vitreous,
diabetes, retinal imaging, pediatric retina, posterior segment oncology, and ocular
trauma. They put into perspective what the scientific developments mean to
today’s practice and discusses ramifications of new studies, treatments and patient
management strategies.
Young Ophthalmologists society of India (YOSI):
The YOSI is created by young ophthalmologists belonging to India as a platform to

share ideas and knowledge in all specialties of ophthalmology (http://www.yosi.in/
home.html). For the young trainee, it offers numerous educational tools such as the
YOSI flash notes, YO Times that contains articles that pertain to requirements of
the young ophthalmologists in the modern era, YoTube which is the official you tube
channel of YOSI that aims to serve as a preferred medium of education for Young
O p h t h a l m o l o g i s t s g l o b a l l y ( h t t p s : / / w w w. y o u t u b e . c o m / c h a n n e l /
UC7c0oitsACPG0ug2gMi_StQ), and Yo Central that consists of eBooks, CME

series, landmarks articles, powerpoint presentations, AAO syllabus and AAO
preferred practice patterns.
Mobile Apps:
In today’s era of smartphone, no list of online resources inis complete without a

mention of mobile apps. They are very handy and can be utilized on the go in the
busy retina clinic or the OR. I would recommend all trainees to get the apps of the
aforementioned online resources such as ASRS, AIOS, Medscape, Healio,
Eyetube, and so on. Few additional apps that can be especially handy for a
vitreoretina trainee would include PubMed, eye emergency manual, Ophthalmic
practice app (OCT imaging), Ullman Indirect (Smartphone fundoscopy app for
capturing fundus photographs) and Amsler Grid app.
The above was a list of few online resources which I feel may help to supplement
the learning during your vitreo-retinal fellowship. Attaining comprehensive
knowledge is paramount for successful completion of vitreo-retinal training. My
advice would be to avoid looking at things through tubular vision and approach your
fellowship like an open slate: Work hard, mould yourself and develop into
something great.
Remember the words of James Lendall Basford “Fill thy mind with useful
knowledge and thou shalt avoid empty words.” All the best!
Dr. Jay Sheth has completed his DNB (Ophthalmology) from the National Board in 2014. Following
which, he pursued International Council of Ophthalmology (ICO) fellowship in Uveitis from San
Raffaele Hospital, Italy(2014). Subsequently, he finished his Surgical Vitreo-Retina fellowship at
Giridhar Eye Institute, Kerala, India (2015-16) and then underwent further training (Observership) in
Vitreo-Retina at the prestigious Moorfields Eye Hospital, London in 2016. He is currently working as
a VR Consultant at Surya Eye Institute and Research Center, Mumbai, India. He is a young
vitreretinal surgeon with multiple international publications in reputed peer reviewed journals. He has
several papers, posters and videos presentations at diverse national and international conferences,
to go with multiple gold medals at AIOS conferences. He serves as a peer reviewer in numerous
indexed journals. His special research interest is in the Pachychoroid Disease Spectrum and he has
played an instrumental role in formulating the first Indian guidelines for management of PCV for
which he has received the AIOS-IJO Gold award for best publication 2017-18.

Fellowship Pearls
FAICO EXAMINATIONS :
ALL YOU NEED TO KNOW!
-Dr Mahima Jhingan
The Fellowship of All India Collegium of Ophthalmology (FAICO) Examinations, are

conducted by the All India Ophthalmological Society once a year. They were
instituted in the year 2010 as a way to urge individuals to ascertain their merit in
their subspecialties of choice and to gain an additional degree which would
recognise their competence in the same. To do a general background on the
examination, it is to test yourself on your own knowledge on the
subspecialties in Ophthalmology following your post-graduation and though in no
ways mandatory, does help validate one’s efforts in pursuing a certain subspecialty.
A lot of us following our post-graduation are often in a quandary as to whether we

should consider pursuing fellowships in certain subjects to hone our skills in them,
but not everyone gets the opportunity to pursue one or their ophthalmology post-
graduation program has been so comprehensive for their particular subject that
perhaps they feel they don’t need to go through another grueling course to be
qualified as that particular specialist.
So, if you have an interest in a particular subspecialty and haven’t had the
opportunity or inclination to go in for a full time fellowship, or if you have completed
a fellowship and are looking to get your skills tested, you can consider giving this
exam to test your mettle with a group of individuals who are leaders in their fields
and serve as examiners for this group of exams.
The exam is conducted once a year in the following subspecialties:
• Glaucoma
• Retina & Vitreous
• Cornea
• Comprehensive Ophthalmoloagy
• Refractive Surgery
• Uvea
• Cataract/Phaco
YO TiMES IAUG 2019

• Pediatric Ophthalmology & Strabismus
• Oculoplastic Surgery
As a candidate you may apply for only one examination at a time, and a total of two
examinations in your life time to be considered as specialists in those fields.
Eligibility criteria includes:
• Must be an AIOS member

• Basic post graduate qualification in ophthalmology recognized by
Govt. of India (DO/ DNB/MD/ MS/ any recognized foreign
qualification)
• Minimum one year experience after post graduation
• Should have at least one year practical experience in the specialities
The forms are available on the website www.aios.org, and the last date for
application is generally in August that year.
The exam pattern consists of three stages:
• Stage I: One hour theory online exam - 60 MCQ Questions, Pass marks:
70%. The questions for this stage are prepared by the International Council
of Ophthalmology to help uphold a certain standard for questions.
• Stage II: OSCE - Cut off 50%
• Stage III: Viva voce
The Stage I exam is an online exam which is conducted in September or October

every year at pre decided centers for which you can give a preference. It is difficult
to guide how to study for this exactly, but my recommendation from personal
experience would be to brush up on all the basics of your subject, things like
percentages for the binding of fluorescein with protein in FFA and indocyanine
green with protein in ICGA. Things which are very basic and which tend to slip your
mind. There may be questions on clinical applications of imaging, and possible
diagnosis, questions on trials which may be long forgotten. All aspects of a
particular subject are covered e.g. in retina imaging, diagnostics, dystrophies to
retinal vascular diseases. My recommendation would be to approach it like you did
your practical exam for your post-graduation. For subjects other than retina my
guidance would be similar, since 50% of the questions in the exam are easy, and
we need just 10% more from the moderate to hard questions.

The OSCE and Viva voce generally takes place at AIIMS, New Delhi with faculty
from the institute and other prestigious members of AIOS serving as examiners. Ten
fairly straight forward and standard questions ranging from pictures and their
management to electrodes of electrophysiology, which are timed and that you have
to write down.
Based on your written answers, you will be called in for a viva voce at two tables
and maybe asked to elaborate on those answers, or you may be asked some
related questions as an addendum.
So if you are good with your subject, have a good grasp of how to manage patients
and have a basic good comprehensive understanding you may come out with flying
colours.
The online MCQ examination, requires a pass percentage of 60% and has no
negative marking, but 25% of the questions are hard and from what I have seen
around me, has been a hurdle which most individuals have found difficult. I cannot
stress enough on the importance of reading for this before going, because
sometimes the difference between a pass and a fail maybe one mark. For a quick
refresher before you enter your hall, spending just one day looking at your notes
from your post-graduation exam concerning that subject should be fine. No
extensive literature reviews or searches needed but a quick revision of facts is a
must. For retina, when a colleague and I were going over all the questions that we
remembered, we figured out that some questions were very similar in their options
and how just a quick review of just the retina aspect of the textbook on clinical
ophthalmology by Kanski, might have been adequate. If you haven’t read it and
have focused on other texts, maybe FAQ’s in ophthalmology by the Aravind group
might be adequate. Any text book that you have focused on for your post graduate
examination should be adequate. I do not want to specify which to read, as
everyone will have a different way of going about things. Do go over numbers,
because often they might be where we miss out and that can be the difference
between a pass and fail.
At the end of this discussion you might be of the opinion, why do I need to give
another exam anyways?
It always feels good to be appreciated by one’s peers in the field, all the more
so when they come with such an illustrious background.

Often when we have been working as senior residents or fellows, we take our
knowledge in the subject for granted as we don’t have structured examinations at
the end of those. Taking an exam to gauge one’s own ability is always good,
because at the end of the day you are responsible for you own knowledge and the
way you apply it in your day to day practice in terms of your patients.
Holding yourself accountable to your practice in terms of taking an exam though not
exactly necessary, would be perhaps good form and a validation of your beliefs.
With that information in mind, I wish you good luck, whether you give the exam or
not, keep learning!
Dr. MAHIMA JHINGAN, MS, DNB, DOMS, FCPS, FICO, FAICO, F-LVPEI (Retina) is currently a
research fellow at Shiley Eye Institute, University of California, San Diego. She has been
previously a Consultant at Aravind Eye Hospital Madurai

Fellowship Pearls
TIPS FOR FAICO PREPARATION AND WIDER READING

DURING A VR FELLOWSHIP
- DR APOORVA AYACHIT
Getting straight to the point – FAICO written test is the major hurdle to passing
the whole exam. The FAICO VR practical is a breeze for most people because it
mostly is about answering 10 OSCEs and elaborating about the same with the
examiner.
So how do we prepare for a FAICO written test. We know that it has 60 questions
and requires 70% marks to acquire a pass. The questions range from simple,
moderate to difficult.
There is only so much reading that can be done FOR the exam itself. The questions
can be majorly answered by being alert during your daily work as a fellow and
reading the latest in literature. We had MCQ questions on combined hamartoma
of retina and RPE, bilateral diffuse uveal melanocytic proliferation, macular
telangiectasia type 1, FEVR. These cases are not uncommon in a high-volume
vitreoretinal setup and can be answered if you have seen these cases during
fellowship. Since you cannot really prepare for such questions, because we spend
our time reading about common disorders like diabetic retinopathy, choroidal
disorders and vascular disorders; it is important that during fellowship you
actively seek out interesting cases of the day by talking to your colleagues
and seniors. At the end of the day, make it a point to jot down in a small notebook
all the interesting cases of the day and read about them. For example- CRAO may
have had an Amalric sign, a case of colonic cancer may have been seen with
pigmented ocular fundus lesions (POFLs), reticular pseudodrusen may have been
noted in a routine dry AMD. It is your job to be totally updated about all that you see
in the clinic and make note atleast mentally! It really helps if you have a couple of
like - minded colleagues who are enthusiastic in discussing concepts and imaging
features of everyday cases and newer disease terminologies too. Acute
macular neuroretinopathy (AMN), paramacular acute middle
maculopathy (PAMM) were the hot new terminologies in 2017 and sure
enough we had two questions, one each on AMN and PAMM. It was
possible to answer those questions mainly because I had seen those
cases and looked at the OCTs closely.
Know the landmark trials and studies like the back of your hand.
Know all the trials that established practice patterns. DRCR
protocols- especially the very latest ones and the older landmark
YO TiMES I AUG 2019

ones, trials establishing efficacy of various anti VEGFs in DME, RVOs and wet AMD
must be read again and again and committed to memory because these trials
changed the way we manage these common disorders. Reading only the abstracts,
seeing the figures and tables at the last minute will jog your memory and serve as
good revision tools.
It is also important to have a bit of practice with answering MCQs. The best sources
for MCQs are
SELF - ASSESSMENT ONE NETWORK :
It is good to have an AAO ONE network account. There are about 150-200
questions on retina and vitreous which cover all the important topics. There is also
a section called ‘’Diagnose this’’ on the website that showcases some interesting
and rare cases with relevant MCQs.
It is a great source of MCQs and gives good

practice because it gives you your score at
the end of the test and recommended
additional reading material at the bottom of
questions you got wrong. So basically, your
weak areas are strengthened.

DIGITAL JOURNAL OF OPHTHALMOLOGY - DJO HARVARD :
This has a section called grand

rounds, which is a huge repository
of questions arranged according to
specialty. The questions are all
case based. Typical cases like
VKH, PDR and CRVOs have
multiple MCQs to each and make
up for any lacunae you may have.
MRCOPHTH.COM/CHUA:
This website is the mecca of

sorts for all exams. There are
questions for practice for FRCS,
MRCOphth and many others.
There are picture galleries, trivia
questions, questions on trials and
studies, common ancillary
investigations, surgical
instruments and so much more.
Get on the website and scoop
out all the retina questions.

BOOKS:
AAO BSCS BOOKS – At the end of the vitreoretina

and Uvea volumes there are a few questions that
can help assess yourself. They cover a wide range
of clinical topics.
Another great book with 150 questions in

vitreoretinal - makes for good practice. An especially
good book because each of the options are a source
of information. The explanations include why an
option is correct/ most appropriate with sound
reasoning.
Massachusetts manual is a slightly tougher book to

sift through if you have less time on your hands
before the exam. The questions and options are a
slightly differently framed. Each option must be
answered as true/ false. So, reading through this
manual is a tad tedious.

A lot of people in this YO times issue have recommended that you read Ryan,
Gholam Peyman, Michels, Steve Charles and other comprehensive textbooks in
their entirety. Although I agree that it is ideal to do so and these books are beautiful,
I myself haven’t read these books cover to cover. I tried reading some chapters and
found that although wonderfully compiled and written, they are not exhaustive
sources of information and outdated by the time they are printed sometimes.
REVIEW ARTICLES :
A simpler hack to go through life is to discover review articles on each topic instead.
Review articles are these little

beauties ranging from 25- 45
pages long, that cover the
historical aspects to the latest
in the treatment for a disease-
entity. Most topics in retina
have excellent review articles
that one can read, to grasp the
essence and be updated
about a topic.
Apart from review articles,

important articles defining
certain clinical characteristics,
classifications can be sought
out from a good literature
search.
Make a folder for all these articles and read them regularly to revise about common
conditions that you see in your clinic. Maybe your consultant suddenly talks about
CRORA and iRORA and they may not have the time to explain fully. There are
many articles you will find online that you can devour in your free time. If you spend
YO TiMES I AUG 2019

137
about an hour reading what you saw in the clinic, theoretical aspects about the
technicalities of a surgical step or something novel in the OR, you are bound to
have a very solid foundation by the end of fellowship.
Writing case reports, photo essays and review articles during fellowship is a great
way to delve deeper into retinal diseases.
WHAT ABOUT THE FAICO PRACTICALS?
Like I said previously, the practicals are simple. Our OSCEs were an image of
APROP, small vein occlusion with macular edema (OCT and colour photo), a
chandelier, OCTA of a case of Macular telangiectasia, ICGA image of a case of
PCV, wide field angiography of PDR, FFA of a case of vasculitis, HP slide showing
Flexner wintersteiner rosettes, an image of an exudative RD in melanoma and a
panfundoscopic lens. The images were accompanied by 2- 3 questions pertaining
to the spotter/ instrument. The questions were also simple.
It is important to give a standardized exam at the end of your fellowship. In

Karnataka, there is a university (RGUHS) exam that must be passed in order to
obtain the fellowship degree. These are just theory papers and a simple practical
exam. However, FAICO exams have set the bar high and are a very good test of
your knowledge. It validates your fellowship and experience in the subspecialty. It is
highly recommended that you give this exam as you’ll know where you stand at
least in terms of knowledge, after completing your fellowship.
DR APOORVA AYACHIT MS, DNB, FICO, FVRS, FAICO is a vitreoretinal consultant at M M Joshi
Eye Institute, Hubballi. She finished her residency at Maulana Azad Medical college, Delhi and
obtained medical and surgical vitreoretina training at M M Joshi Eye Institute, Hubballi. She has
multiple publications in the field of vitreoretina. Her areas of interest include- retinal imaging and VR
surgery. She is the assistant editor of the Medical retina section in the Indian journal of ophthalmology.
She has been closely associated with YOSI and YO times since 2014. In her spare time, she likes to
read and write about varied topics.
She can be reached [email protected]
YO TiMES I AUG 2019

138
Click here for the official guidelines : https://aios.org/article-66-about-faico.php
Click here to download the form : https://www.aios.org/pdf/FAICO-Form.pdf
Fellowship Pearls
NUANCES OF RETINAL IMAGING:

A C A S E B A S E D D I S C U S S I O N
- Dr MOHIT DOGRA
CASE 1
Fig. 1
A 37 year old female presented with gradual painless vision loss in her right eye
since 3 months. She was diagnosed to have choroiditis elsewhere and was treated
with tapering doses of oral steroids for 2 months. However, her vision deteriorated
and she developed exudative retinal detachment (RD). The left eye was essentially
normal. At this time her visual acuity was counting fingers at 1metre along with
absence of anterior segment and vitreous cells. Fundus photograph (FP),

autofluorescence (AF), swept source optical coherence tomography (SS-OCT) line
scan and fundus fluorescein angiography (FFA) are shown in Figure 1(A,B,C,D).
FP shows multiple discrete hypopigmented (blue arrows) and hyperpigmented (red

arrow) lesions over the posterior pole with inferior exudative RD (Figure 1A and
inset). AF and FFA images highlight the “leopard skin appearance” of these
lesions- alternating hypo and hyper lesions (Figure 1B and D). SS-OCT scan shows
grossly thickened choroid with loss of choroidal architecture, “lumpy-bumpy
appearance” of the surface of the choroid, presence of subretinal fluid and multiple
areas of retinal pigment epithelium (RPE) loss (red arrow) and RPE hyperplasia
(blue arrow, Figure 1C).
A clinical diagnosis of unilateral diffuse uveal melanocytic proliferaion (DUMP) was

made. Radiological imaging of the chest revealed a mass lesion in the upper lobe
of the right lung, which turned out to be adenocarcinoma on FNAC.
Nugget: Leopard-skin appearance on AF or FFA is seen in:
1) Hypertensive choroidopathy
2) Uveal effusion syndrome
3) Primary/secondary vitreo-retinal lymphoma
4) Bilateral/unilateral diffuse uveal melanocytic proliferation
CASE 2
A 7year old girl presented with sudden decrease in vision of her left eye since 4
days. Best corrected visual acuity (BCVA) was 6/12 and 6/24 in the right and left
eye, respectively. Pupillary reactions and anterior segment examination was
unremarkable in both eyes. Fundus examination revealed multiple yellowish
deposits in the macular and extramacular area in both eyes (blue arrows) along
with subretinal hemorrhage in the left eye (yellow arrow, Figure 2 A and D).
AF imaging showed these yellow deposits to be hyperAF while the subretinal

hemorrhage was hypoAF (red arrow, Figure 2 B and E). SS-OCT line scan passing
through the fovea revealed hyperreflective structure in the subfoveal area of the
right eye, corresponding to the yellow deposit on FP (green arrow, Figure 2C). The
left eye OCT revealed elongated and shaggy photoreceptors (blue arrows) while
both the eyes had hyporeflectivity of the subretinal space (red arrows, Figure 2F).

Fig. 2
A clinical diagnosis of bestrophinopathy with left choroidal neovascular membrane

(CNVM) was made. Electro-oculogram (EOG) revealed Arden’s ratio of 0.4 in the
right and 0.5 in the left eye, thus confirming the diagnosis.
Nugget: Vitelliform subretinal deposits are diagnostically hyperAF in the following

conditions:
1) Best’s disease
2) Autosomal recessive bestrophinopathy
3) Adult-onset vitelliform macular dystrophy

CASE 3
A 33 year old doctor presented with complaints of juxtafoveal scotoma in her left
eye since 10 hours. She was diagnosed to have dengue fever (IgM positive) 8 days
earlier and was afebrile since 2 days. BCVA was 6/6 in both eyes and the right eye
was essentially normal. Anterior segment of the left eye was normal and the fundus
was also unremarkable (Figure 3A). SS-OCT line scan passing through the fovea
showed a normal foveal contour with linear hyperreflectivity involving the inner and
middle retina, just nasal to the fovea (red arrow, Figure 3B).
A diagnosis of paracentral acute middle maculopathy (PAMM) secondary to dengue

was made. Optical coherence tomography angiography (OCTA) of the left eye
revealed flow void areas in the superficial capillary plexus (SCP) and deep capillary
plexus (DCP), nasal to the foveal avascular zone (blue arrows, Figure 3C),
confirming the diagnosis. 2 weeks of oral steroids led to restoration of flow in the
SCP and DCP on OCTA and disappearance of scotoma (green arrows, Figure 3D).
Fig. 3

Nugget: Hypo lesions on OCTA are seen in:
1) True absence of flow
2) Slow/sluggish flow
3) Blockage of light- RPE/ fibrosis/ blood/ tumors
CASE 4
Fig. 4
38 year male presented with sudden painless decrease in vision of her right eye of
4 day duration. His visual acuity (VA) was counting fingers at 2metres and he had
2+ anterior chamber reaction in the right eye. Fundus of the right eye showed
vitreous cells with a creamy yellow retinitis lesion inner to the inferior arcade with
subretinal fluid at the fovea (Figure 4A). Left eye was normal. SS-OCT passing
through the fovea and the retinitis showed hyperreflective cells in the posterior
vitreous, disorganization of the retinal architecture with increase in retinal thickness
(blue arrow) and subretinal fluid at the fovea (red arrow, Figure 4B).

Fig. 4
A clinical diagnosis of toxoplasma retino-choroiditis was made and the patient was
treated with two injections of intravitreal clindamycin (1mg/0.1ml) and
dexamethasone (0.4mg/0.1ml). At 10 days follow-up, his VA improved to 6/36 with
decrease in size of the retinitis lesion on FP and restoration of foveal anatomy on
OCT (Figure 4 C,D). At 15 days although the retinitis further decreased in size,
there was presence of subretinal hemorrhage surrounding it (green arrow). The SS-
OCT scan passing through the bleed did not show subretinal hemorrhage or fluid.
Development of inflammatory CNVM was suspected and OCTA showed presence
of a hyperreflective membrane in the DCP with normal outer retina and
choriocapillaris slabs (Figure 4J). On closer inspection of the SS-OCT, the inner
retinal layers were seen to be dragged towards the RPE, most likely due to
perilesional fibrosis of the healing retinitis (blue box, Figure 4E). Hence, the
increased network of flow seen in the DCP on OCTA was considered to be an
artifact due to inferiorly pulled vasculature of the SCP and the subretinal
hemaorrhage was presumed to be secondary to contraction of the fibrosed retinitis
lesion. The patient was observed and over a period of 3 months the retinitis healed,
subretinal hemorrhage resolved (Figure 4G,H,I) and the OCTA showed no change
in size of the hyperreflective membrane in the DCP (Figure 4K).
Nugget: Hyper lesions on OCTA are seen in:
1) Telengiectatic
Telangiectatic or new vessels

2) CNVM
3) Unmasking of the choroidal vessels due to loss of overlying RPE
4) Artifacts- projection of vessels from overlying structures
DR MOHIT DOGRA MS is an Assistant Professor in Ophthalmology

at PGI Chandigarh. He has 52 publications in indexed, peer reviewed
journals and is the author of 16 chapters in various Ophthalmology
books/e-books. He has several papers presentations and invited talks
to his credit. He is an associate editor of Indian Journal of
Ophthalmology and reviewer for several others. He is the
Co-founder of “COS Youth Forum” in 2014, under the aegis of

Chandigarh Ophthalmological Society. He has several academic
awards to his credit including Best Video award at Asia Pacific
Vitreoetina Society Annual Conference held at Seoul, South Korea
2018, 2nd runner up in the Young Ophthalmologst Symposium held
during the Asia Pacific Vitreoetina Society Annual Conference held at
Seoul, South Korea in December 2018, International Heroes of
Ophthalmology Award at AIOS annual conference held at Indore, 2019
and Best of IJO Award at AIOS annual conference held at Indore, M.P.
YO TiMES IAUG 2019

Fellowship Pearls
CONFERENCES & TRAVEL GRANTS

- DR. DIVA KANT MISRA
There has been a tsunami of ophthalmic conferences & CMEs in India & in
locations all over the world encompassing the whole spectrum of ophthalmology.
While great conferences provide attendees with the opportunity to connect with like-
minded individuals, learn the best tips & latest ophthalmic innovations from the
professionals & boost their clinical & surgical acumen. The wrong ones can be a
sheer waste of precious time.
Ophthalmologists in training & early in their careers have limited time & resources
and they should be very careful in choosing the conferences they attend. The
expectations from a conference at this stage should be realistic, but if planned
appropriately the right conference can be a real boost to ones carrier.
SO, HOW DO YOU A CHOOSE CONFERENCE TO ATTEND ?
Get Enlightened : If this is your first attempt at attending conference you need to
get enlightened. There are various resources on the internet where you can find a
list of International & National events planned for the calendar year (ICO : http://
www.icoph.org/events.html AIOS: https://www.aios.org/aios-events1.php ). There
you will also find the links to the websites of these conference, which you can visit
to get detailed information about the event. You should acquaint your self with the
various deadlines and other important details of these events. This will help you to
align your interests with the main focus area of the various conferences or vice-
versa.
Make an informed decision : When you are aware of all the

details of conferences that are happening around you then you
are in a position to take an informed decision. For example, If
you working on a specific project or thesis then you can chose
a conference of that sub-speciality. It will help you
tremendously in enhancing your knowledge base and you will
find an appropriate platform to present your research as well.
YO TiMES I AUG 2019

International v/s National Conferences : Indian conferences are being conducted
in a very professional manner and are no way inferior to their international
counterparts. But, there is always something extra, something different you will find
when you attend an International meet. You get to meet with international experts
and innovators, you get to network at an international level, which becomes very
valuable when you are looking for collaborations and opportunities abroad. All the
pain that you take to attend an international meet is a reflection of your commitment
towards academics and looks good on your resume as well.
Sub-specilaty v/s General Conferences : While in residency, it might make more

sense to attend general conferences ( AIOC, APAO, AAO, State Conferences etc)
which cover all specialities. A resident can attend talks on basic topics of different
specialities, present paper of any speciality and interact with peers and seniors of
all sub-specialities. But, while you are in fellowship or have finished one it might be
more prudent to go for sub speciality conferences ( ASRS, EURETINA, APVRS,
VRSI etc). You have better chances of your paper being accepted, its a wonderful
opportunity to interact with people of your speciality and there is a lot of focused
learning.
Beware of Predatory Conferences : Predatory Conferences are are not

organized by scholarly societies. Instead, they are conferences organized by
revenue-seeking companies that want to exploit researchers' need to build their
vitas with conference presentations. They have a science-free, zero peer review
process. You can find a list of predatory conferences at https://
beallslist.weebly.com. The original website has been brought down due to legal
issue but this blog maintains a cached version of the website and is still useful. You
should always carefully see the website and see who is organising the conference.
It should be an internationally recognised society or body. When ever in doubt
consult your colleagues and seniors, training period is a very valuable time and
should not be wasted on bogus meetings.
Presenting to attend or Attending to present? : Your own presentation at the

conference is of utmost importance and should be the focus of your efforts. Having
said that, one should completely avoid presenting fake data & research just to be a
part of the event. Nothing beats presenting your genuine hard work and getting a
constructive feedback form peers and seniors.
Early in the carrier one of the biggest barriers that you might face in attending a
national or international conference are the finances. But, thankfully there are ways
of financing your trips.

SO, HOW DO YOU ATTEND A CONFERENCE FOR FREE ?
The answer is travel Grants. Here is a list of various travel grants available for
ophthalmologists you can avail.
State best Papers : All winners of state best papers are awarded a travel grant of
upto 10,000/- and waiver in registration fees for the next AIOC.
AIOS ARC Young Researchers Thesis Award : The winner of the best thesis
competition held every year during AIOC is given a grant of 1,00,000/- towards
attending an international conference.
AIOS YOSI Writing Competition : The winners of AIOS YOSI writing competition
are awarded travel grant of upto 10,000/- and waiver in registration fees for the next
AIOC. http://www.yosi.in/aios---yosi-writing-competition-2019.html
APAO Prof Yasuo Tano Travel Grant : The APAO in memory of Prof Yasuo Tano
awards 10 travel grants of 1000$ for attending APAO Congress. http://
www.apaophth.org/travel-grant-awardees/
APVRS Tano Travel Grant : The APVRS in memory of Prof Yasuo Tano awards 5
travel grants of 500$ for attending APVRS Congress. http://2018.apvrs.org/travel-
grant/
Association of Research & Vision in Ophthalmology (ARVO) : ARVO provides a

variety of travel grants for high scoring abstracts. https://www.arvo.org/awards-
grants-and-fellowships/arvo-travel-grants/
Indian Council of Medical Research (ICMR) : ICMR has an international travel

support scheme : https://www.icmr.nic.in/content/international-travel-non-icmr-
scientists
Science & Engineering Research Board (SERB): SERB offers international travel
support for deserving candidates. http://www.serbonline.in/SERB/HomePage 
DR. DIVA KANT MISRA, DO, DNB, MNAMS is working as a Vitreo-Retina Surgery fellow at Sri Sankaradeva
DR. DIVA KANT MISRA, DO, DNB, MNAMS is working as a Vitreo-Retina Surgery fellow at Sri Sankaradeva
Nethralaya. He holds the post of General Secretary, Young Ophthalmologists Society of India & Chief
Nethralaya. He holds the post of General Secretary, Young Ophthalmologists Society of India & Chief Editor,
Editor, Young Ophthalmologists Times. He is the recipient of various Ophthalmic awards like,APAO
Young Ophthalmologists Times. He is the recipient of various Ophthalmic awards like, Best of IJO Award
Achievement Award, Bangkok 2019, Best of IJO Award 2017-18, Ophthalmic Hero of India 2017 & 2018,
2017-18, Ophthalmic Hero of India 2017 & 2018, KOS International Travel Grant 2019, Busan, The Yasuo
KOS International Travel Grant 2019, Busan, The Yasuo Tano Award from Asia Pacific Academy of
Tano Award from Asia Pacific Academy of Ophthalmology, Singapore in 2017 and The APVRS Tano Award
Ophthalmology, Singapore in 2017 and The APVRS Tano Award 2018, Malysia Singapore and other
2018, Malysia Singapore and other national & state level awards. He has published extensively (26
national & state level awards. He has published extensively (26 publications (Indexed & Non Indexed) and
publications (Indexed & Non Indexed) and book chapters) and has presented in conferences held at various
book chapters) and has presented in conferences held at various international and national forums. He
international and national forums. He can be reached at [email protected]
can be reached at [email protected]

Fellowship Pearls
RETINA CONFERENCES : 2019-2020
• 20TH ANNUAL ADVANCED VITREORETINAL

TECHNIQUES AND TECHNOLOGY SYMPOSIUM
Aug 23 - 25 | Chicago, Illinois
• 19TH EUROPEAN SOCIETY OF RETINA SPECIALISTS

Sep 05 - 08 | Paris, Ile-de-France
• THE RETINA SOCIETY 2019 ANNUAL MEETING

Sep 11 - 15 | London, England
• UVEITIS SOCIETY OF INDIA

Sep 22-23 | Bangaluru, India
• INTERNATIONAL SYMPOSIUM ON OCULAR

PHARMACOLOGY AND THERAPEUTICS CLINICAL,
RETINA CHAPTER
November 7-9 | Valencia, Spain
• INHERITED RETINAL DISEASES - BENCH, BESIDE

AND BEYOND
Dec 04 | London, England
• VITREO-RETINAL SOCIETY OF INDIA

DEC 5-8 | Lucknow, India
CLICK ON TITLE FOR CONFERENCE WEBSITE

RETINA CONFERENCES : 2019-2020
• OPHTHALMIC IMAGING: OPTICAL COHERENCE
TOMOGRAPHY (OCT) TECHNOLOGIES COURSE
Dec 07, 2019 | Palm Beach, Florida
• 24TH ANNUAL AMERICAN UVEITIS SOCIETY WINTER

SYMPOSIUM
Jan 18 - 20, 2020 | Park City, Utah
• 20TH ANNUAL RETINA FELLOWS FORUM

Jan 24 - 25, 2020 | Chicago, Illinois
• ANGIOGENESIS, EXUDATION, AND DEGENERATION

Feb 08, 2020 | Miami, Florida
• 43RD ANNUAL MACULA SOCIETY MEETING

Feb 19 - 22, 2020 | San Diego, California
• 48TH ANNUAL ASPEN RETINAL DETACHMENT SOCIETY

MEETING
Feb 29 - Mar 04, 2020 | Snowmass, Colorado
• 8TH ANNUAL VIT-BUCKLE SOCIETY MEETING

Mar 26 - 28, 2020 | Miami Beach, Florida
• WORLD ROP CONFERENCE

2020 | DUBAI
CLICK ON TITLE FOR CONFERENCE WEBSITE

http://2019.vrsi.in/delegate-registration/
152
Fellowship Pearls
ESTABLISHING AN INDEPENDENT RETINA PRACTICE:

IF THE CHALLENGE EXISTS, SO MUST THE SOLUTION!
- DR BIKRAMJIT P PAL
Congratulations my dear colleague and welcome to the club. Finally; years of your
formal medical education, a rigorous post - graduation and a hard earned Vitreo-
Retina fellowship has finally come to an end. Now that you are ready and eager to
showcase your talent and also hungry to be financially independent, multiple ideas
come to mind as to ‘how’. There are very few who are absolutely clear in their
planning and execution for establishing an independent retina practice. Many, like
me are confused and take few years to finally realise their dream.
This article takes on the challenge of opening your own retina practice
‘heads-on’ by looking into the finer details and its logistical issues. Hopefully this
article will attract many non-believers of private practice to change their sides.
WHERE DO YOU WANT TO START YOUR PRACTICE: METRO CITY V/S TIER 2
OR 3 CITY ?
The most crucial point before you jump into private practice is to decide your area
of work. Although a bigger metro has its own advantages, getting early recognition
is not easy and it takes years in what could have been a lesser time if started
somewhere else. The financial burden in a metro is also higher when compared to
a smaller city. So for those planning to have their own set up in a bigger city are
advised to initially get attached to few bigger hospitals, ophthalmic setups, work for
2 years and then open your own. Even after having your own setup, its advisable to
continue being attached to few of the previous commitments: this will not only help
to weather the initial financial burden but also be socially and politically right.
Remember, Vitreoretinal practice depends a lot on referral, hence a healthy

amicable relationship is a necessary evil. Starting a practice in a tier 2 or 3 city has
lesser financial pressures, recognition and personal growth is also faster. Tier 2/3
cities having less VR surgeons is a thing of the past. But, the most
important thing to realize is that there are enough patients for all, so
no mater how many VR surgeons keep coming in the area you
practice, you will have work provided you continue an ethical
practice. Apart from your work, family will also play an important
part when deciding the place. Choose a city which will provide an
ample balance between your work and a pleasure of being closer
to your dear ones.
YO TiMES I AUG 2019

PROS OF OPENING IN TIER 2 OR 3 CITY
a) Faster and Early work recognition
b) Better revenue generation
c) Larger patient referral
CONS OF OPENING IN TIER 2 OR 3 CITY

a) Less opportunity to attend local CME( weekly / monthly CME more common
in metros)
b) More time to get recognized at a national level
c) Quality of life( individual perception) is less when compared to metros
DO YOU GO SOLO OR JOIN A GROUP PRACTICE?

Each has its own merits and demerits and its upto an individual to decide whats
best for him. While being in a solo practice means you are your own boss, it also
means taxing yourself with multiple non clinical work. Group practice helps in
dividing the duties and is less of a hassle. Although a group practice is better in the
current scenario, finding the right group is the challenge. Just being buddies
DOES NOT mean you can have a good and successful practice. An ideal group
should comprise of doctors with a common goal, common purpose, excellent
understanding but different subspecialties. Having said that; group of same
subspecialties working under the same roof can work wonders too, but it’s much
rarer specially in India. When joining an already established group(as a VR surgeon
as is common)make sure that your duties are well defined. As long as your role
helps you to LEARN, accept it. No matter how many surgeries you might have
done in your fellowship, VR takes time to master and is an ever learning process,
so BE HUMBLE, BUT NOT A FOOL. Never join a group where the next generation
of the owners are being groomed to take your place. Most important talk to VR
surgeons of the group or those who have left, that might give you an insight as to
what you may expect. When new into practice, CHOOSE a GROUP WITH MORE
WORK rather than more MONEY.
Solo practice avoids all the above hassles but is more advisable when a certain
section of the society where you want to practice knows you. Before you are ready
to begin with your own clinic be sure of the following

a) That you have an existing patient base
b) That local ophthalmologists, at least few know about your work

c) That you are mentally prepared to have less patients in the initial period
d) That you are financially sound to weather off the first year.
Now that you are have finalized the city and have decided to go solo, its time to
select a place to practice
DO YOU RENT OR BUY YOUR OWN PLACE?
Buying your own place is always advisable. Although renting may be less
economically taxing , in the long run its not profitable. Clinic of any size will need
considerable interior designing which in a rented place will seem a waste of money.
If your own house has a small space, that too can be utilized. Although there are no
fixed measurement for owning a place, 900-1200 square feet is an ideal space to
begin with. Cities like Mumbai have independent clinics even smaller . Remember
it’s all about starting, doesn’t matter how big or small it is. You can always shift to a
larger space as and when you develop your practice.
FOLLOWING ARE THE MINIMAL REQUIREMENTS FOR SETTING UP A

VITREO-RETINAL CLINIC:
1) Reception area: will need a table to accommodate a computer and

peripherals. The same space needs area to house multiple cabinets.
2) Patient waiting area: The space should allow at least 10-15 chairs. The
waiting area can be square or rectangular depending on the space.
3) Optometrist work up area
4) Doctor’s chamber
5) Investigation area
6) Washroom
7) Operating Room
DO I INVEST IN OT NOW OR LATER?

The most foxing question! To begin with and specially if new to an area i’ll suggest
just to invest in a medical retina set up. You can take your patients elsewhere for

surgery where depending on mutual understanding a specific day can be fixed for
your surgeries. Before investing in any machine: surgical or medical look into the
following aspects.
a) After sales service: This is the most important aspect before buying any
machinery. The best machine with excellent images but with poor after sales
service is NOT AN OPTION. Remember after sales service varies from
region to region, so enquire in your regional area about the company’s
services.
b) Talk to your colleagues in the area who have a similar machine. Enquire
the price at what your colleague got the machine. You may be surprised at
what he may add
c) Always take a demo before buying
d) Avoid refurbished machines. Company people may offer you or lure you to
buy a machine at a very low price and hide its refurbished nature. If in any
doubt CHECK THE SERIAL NUMBER ON THE MACHINE.
e) Negotiate and Negotiate. Prices quoted by companies may be different,
depending on how well your negotiation skills are. For example when buying
a vitrectomy machine negotiate on the number of free cassettes, when
buying laser negotiate on providing free lenses( focal or PRP lens). BE
RUTHLESS WHEN NEGOTIATING.
f) Be clear about AMC (annual maintenance charge). Some companies just

charge horrendous AMC, avoid them.
g) You need not buy top of the end machines. Look for alternatives, enquire
about them and then purchase
h) When ordering any machines, ask whether a new variant of the existing
machine is in the pipeline. If yes, then whether the existing ones are
upgradable. Company representative may hide the fact of a new variant.
i) Enquire about payment options. Many companies may offer deferred

payment options. Stretch to maximum possible limit of deferred payment.
This of course is not applicable when you are super rich.
j) If possible, buy instruments at conferences where you get the best deals.
k) Finally, document all deals in writing. All verbal deals become useless
once you pay the money

LET’S LOOK INTO THE BASIC EQUIPMENT’S NECESSARY TO START A
BASIC VITREO-RETINA CLINIC
MEDICAL RETINA SET UP
(The author has no financial interest)
1) SLIT LAMP : Minimal 1 for yourself. Slit lamp for optometrist although is
desirable, can be updated later. A way around saving money on a separate
slit lamp is to use the slit lamp of the laser. You don’t need a ‘5’ step , a
simple ‘3 step’ is sufficient. Choose between Top-Con or Appasamy
Associates although many other are also available
2) Refraction Unit( Minimal 2) with Eye chart : The most common available
units are from Plantech ( provided by Top Con) and Appasamy Associates
3) Indirect Ophthalmoscope(minimum 2): Heine or Keeler are amazing, but
friend what you see with them can also be beautifully seen through
Appasamy wireless indirect. The newer models are at a fraction of the cost of
its expensive companions
4) Lenses: 78D, 90D, 20D. One of each
5) Laser (532 green): When buying laser you will be spoilt for choices. Buy the
one following the above guidelines. I personally use the newer Appasamy
Green single spot green laser. Buy the one which can be moved around( to
OT or ROP screening). It is advisable to buy both the slit lamp and LIO
attachments.
6) Lenses for laser: Focal and PRP lens. If you are a good negotiator , both
these are be obtained free when buying the laser. Insist on the company to
provide the same. This will save a minimal of 1,00,000 INR
7) Optical Coherence tomography(OCT). Just like while buying laser, buying
OCT can be tricky. My advise will be to invest in one which also has inbuilt
fundus photo. This will save money on procuring a separate Fundus photo
machine. Current machines which have the same are from Nidek and
Topcon.
8) Autorefractor with Keratometer: 1 that can be placed in the optometrist
room

9) Goldman Applanation tonometer: Again, if you are a good negotiator, you
may get it free with your slit lamps. Avoid NCT( if not planning to see 100
patients a day) and save money
10) Miscellaneous : Trial frames( minimal 2: one for you and one for the
optometrist), Trial set box, Ishihara Chart etc
SURGICAL SET UP
1) Operating microscope: Options are between Top-Con, Zeiss, Leica,

Appasamy. Go for the one which best suits your pocket
2) Vitrectomy machine: Now all of us want a Ferrari, but Maruti will still take
you to your destination. Although in my personal opinion Constellation( Alcon
Technologies) is one of the best , its way outside reach for most of us. It is
ideally suited in practices where there are multiple surgeries with a rapid turn-
over. Hence, look out for other options where the running costs are low,
cassette are reusable and if possible can be run on compressed air rather
than nitrogen. Retikare Vitrectomy ( Icon Medicare) with its newer machine is
a workhorse. Not only is it available at a fraction of the cost of others, its
running costs are low too. Appasamy too has great reviews and if believed
are coming out with a system with inbuilt laser (similar to constellation) later
this year. Again it is my own opinion and readers are encouraged to buy what
suits them the best.
3) Viewing system: This depends entirely on how you were trained in your
fellowship. Some may opt for contact whereas others may opt for non contact
system( BIOM, Resight, EIBOS etc). Choose which delivers the best results
in your hands
STERILIZATION SYSTEM
When running a OR, its advisable to have both ETO( Ethylene oxide) and steam
sterilization. If cost is a prohibitive factor, a formalin chamber can be used for
cassettes and other instruments, although it’s not the preferred method. Whatever
method employed, it SHOULD NOT COMPROMISE the quality of eye care.
Autoclaving silicone oil/ PFCL are some of the practices that should be absolutely
discouraged.

ROUGH COST FOR SETTING UP A VITREORETINAL SET UP :
The following table provides a rough estimate for setting up a Retina practice
Medical Retina Equipments Cost( INR): Minimal

1 Refraction Chair unit 1,15,000
2 Slit lamp 1,15,000
3 Applanation Tonometer 42,000
4 Indirect Ophthalmoscope 44,000
5 78D lens 22,000
6 90 D lens 22,000
7 Green Laser 13,50,000
8 Focal lens( Volk/ Ocular) 45,000
9 PRP lens( Volk/ Ocular) 45,000
10 OCT machine with peripherals 21,00,000
11 Autoref/ Keratometer 3,00,000
Total 42,00,000( Forty two lacs)
Surgical Retina equipment Cost( INR): Minimal

1 Operating Microscope 18,00,000
2 Viewing system( non contact, BIOM) with 10,00,000
inverter
3 Vitrectomy Machine 15,00,000
4 Sterilization: Steam with ETO 5,00,000
Total 48,00,000( Forty eight lacs)
The above table is just a rough estimate. Cost can be upgraded or downgraded
as per requirement. For example surgeons may prefer a contact viewing system
whereby the cost reduces by almost 7-8 lacs. Similarly a BIOM from different
companies have different cost which can alter the final cost.
FINANCE :
Majority will need a loan to help start your dream. While looking for a loan look for
those with minimal interest. Choosing between private/ nationalized/ local corporate
banks will depend on various factors

a) Obtaining loan from nationalised banks can be extremely tedious and
frustrating
b) When choosing amongst private banks, look for the minimal interest and
period of moratorium (period during which you need not pay the EMI)
c) Local corporate banks, which varies with regions can be an excellent place
to take loans. They have a generous moratorium period sometimes extending
to an year
d) When taking loan, be realistic. Don’t take exorbitant loans which may affect
you mentally and physically. The excessive loan with excessive EMI may
force you to do unethical work, so take what’s necessary to begin with. You
can always invest later as and when your practice starts flowing.
Apart from above mentioned points, you will need to hire few people to run your
clinic. A optometrist, a receptionist are the minimal requirements. Pay well to
attract the best and encourage multitasking at least initially. Investing in an
electronic medical records cannot be over emphasised. Similarly, don’t forget to
have your own website. Digital PR skills are an absolute necessity.
Setting up an independent Retina clinic may appear strenuous and frightening, but
let me assure you that the struggle is just in the initial few years. In the long
run, sky is the limit with excellent recognition and financial returns.
Don’t compare with other colleagues, don’t invest in unethical work and most
important DON’T be slaves to the Pharma companies. Be Affable, Be
Approachable, Be Available and most important Be Affordable and let the world
take care of you! 
DR BIKRAMJIT P PAL DNB,DO,FMRF,FECF,FICO completed his basic post graduation( D.O) from the oldest
eye centre in India and the second oldest eye centre in the world: Regional Institute of Ophthalmology
Egmore, Madras Medical College. After completing his D.O he then did his DNB Ophthalmology from
Aravind Eye Care Tirunelveli.
It was in Sankara Nethralaya Chennai where he received his formal training in Vitreoretina. With a training in
retina, he further received his Eye Cancer ( Ocular Oncology ) training after getting selected through Eye
Cancer Network: New York. He spend seven months learning about eye cancer from the premier eye cancer
centre of Europe situated in Helsinki under guidance of Professor Tero Kivela
After returning to India, Dr Pal set up the eye cancer centre at Sankara Nethralaya, Kolkata where he was a
consultant looking into cases of both Retina and various eye cancers.
After leaving Nethralaya Kolkata, he has been actively associated with development of department of Retina
and eye cancer at HM Diwan Eye Foundation Kolkata where he is still actively associated. Dr Bikramjit has
recently opened his Retina and Eye cancer unit at Ranchi, called as Pals Retina Care

Fellowship Pearls
BEST COMEBACKS TO THINGS PEOPLE SAY TO WOMEN IN

VITREORETINA: A COMPREHENSIVE MANUAL
- DR APOORVA AYACHIT
Since school, girls have been told to choose painting, singing and crafts over
karate, soccer and tabla lessons. There are a million stereotypes we fight since we
are kids and the challenges only seem to increase as we grow older. In medicine,
we were told to choose ophthalmology, skin and anaesthesia and not surgery or
orthopaedics. We entered ophthalmology and to our utter shock, here too, Vitreo-
Retinal surgery apparently is not very suited for women. The reasons given for
propagating these stereotypes range from being illogical to downright ridiculous.
The following scenarios and random comments are to bring these thought
processes to the forefront. These ‘’Comebacks’’ as I call them will probably help us
all give calm, mature responses to questions and comments.
SCENARIO 1
At fellowship interviews-
Random comment (RC) 1- Why Vitreo-Retinal surgery? It’s not feasible for
women. The surgeries take long and are back breaking. How will you
manage?
Answer- During residency, the HOD/ senior consultant was a woman. Even for
complex VR surgery, she took an hour and a half maximum. I also saw many
amazing surgical videos and presentations by women in national and international
conferences. These women inspired me to get into VR surgery.
RC 2- What if you move to a place with your husband after

fellowship where there is no setup for VR?
Answer- We’ll work it out somehow. I am sure my husband will
consider a place that allows my career growth too. It’s between
us.
YO TiMES I AUG 2019

SCENARIO 2
Men talking about women VR surgeons in groups/ social gatherings-
RC 1- She’s good in medical retina. Just many publications. I’ve heard she is
not a surgeon.
Answer- I think whether someone is good in surgery depends on the type of cases
he/ she takes up. Retinal surgeries are complex, and recurrences are common
even with male surgeons operating. Not right to comment on anyone’s skills without
witnessing first- hand. All second- hand information is just hearsay and subjective.
RC 2- She’s a taskmaster and expects everyone to complete assignments in

no time. Gives everyone grief for incomplete work. Doesn’t get along with
anyone. Everyone hates her in the department.
Answer- Oh well I think any man in her place would be described ‘’no-nonsense’’,
‘’strict’’, ‘’focused’’ and ‘’extremely professional’’. Unfortunately, smart, confident and
ambitious women must bear other adjectives.
RC 3- Why doesn’t she have a child and focus on her family also? Career is
optional for women. Families suffer because of such women who spend all
their time immersed in VR.
Answer- How thoughtful of you to care so much about her family! Maybe if you
cared this much about your own wife and kids, your life would be more pleasant
and free from negativity.
RC 4- Yeah before marriage and kids, she used to be good and prominent in
every conference. Now she is on a break for family. Doesn’t come for any
conferences or anything. She is not very focused or ambitious now.
Answer- Yeah lucky for your male privilege that you are getting to go to
conferences because the women chose to have family. Now finally you can call
yourself accomplished because the women made sacrifices and opted out of the
workforce.

RC 5- Yeah Dr. female surgeon ma’am told me its PCV and not CSC and told
me to inject anti- VEGF. But I just asked Dr. ‘’same- age- same- experience’’
Sir also just to be doubly sure. Patient also wanted opinion of a
‘’doctor’’ (*snigger*).
Answer- So wise of you to get sir to ‘’mansplain’’ for the patient. Very cool of you
to propagate the notion of women not being ‘’doctor- enough’’ for patients. I don’t
know if you are updated on your reading, Dr. Female surgeon published about PCV
masquerading as CSC years ago. She is an authority on choroidal disorders.
RC 6- I don’t know why she goes on and on about minute things in imaging
that don’t even matter. In real world practice, it just matters if there is swelling
or not. Inject or don’t. Simple. Why obsess about details that don’t even
matter! Annoying!
Answer- Weren’t you praising the VR guy’s deep knowledge yesterday because he
knew what outer retinal tubulations were? Well, VR girl told us about ORTs in 2017.
RC 7- She just has the ‘’female-factor’’ working for her. People invite her for
conferences because she is pretty and adds charm.
Answer- Oh please forgive her for being smart AND good-looking. How dare she
right!
RC 8- I will include Dr. XY for my instruction course (knowing he is a terrible

surgeon and has no concepts of surgery), not Dr. XX because well usually
women are not good VR surgeons.
Answer- Pity your fellowship full of women mentors taught you nothing about the
level of competence women surgeons possess. I in fact think women surgeons
have an edge over male surgeons.
Although it is politically correct to say ‘’ Any resemblance to actual persons, living or

dead, is entirely coincidental’’, my venture is to call out sexism in the Vitreo-Retinal
world. Women in VR are increasing in number and are the smartest, brightest and
the most talented in India and the world. The objective of this write- up is to
emphasize that it is not ok to let these comments slide. It is to encourage more

women to do Vitreo-Retina and flourish and not listen to regressive narratives about
women in VR surgery.
Both men and women have said at least one of these things to a woman in VR. I
hope it will make us question our thought processes and reflect on the biases
against women.
DR APOORVA AYACHIT MS, DNB, FICO, FVRS, FAICO is a vitreoretinal consultant at M M Joshi
Eye Institute, Hubballi. She finished her residency at Maulana Azad Medical college, Delhi and
obtained medical and surgical vitreoretina training at M M Joshi Eye Institute, Hubballi. She has
multiple publications in the field of vitreoretina. Her areas of interest include- retinal imaging and VR
surgery. She is the assistant editor of the Medical retina section in the Indian journal of ophthalmology.
She has been closely associated with YOSI and YO times since 2014. In her spare time, she likes to
read and write about varied topics.
She can be reached [email protected]

 
S I
O
YDIFFERENTIAL WARS
-DR MAHIMA JHINGAN
As young ophthalmology students, fledgling fellows and

sometimes even as established practitioners, we all tend to
struggle with differential diagnoses of two similar disorders
which may have entirely different treatment paradigms. The idea
of this section is to place two closely related differentials in the
same ring and pit them against each other, with an in depth
analysis as to how we can differentiate the two based on
imaging and clinical acumen.
Wars are often waged with the concept of creating peace, much
the same as DD wars hopes to quell some of our lingering
doubts and give us some much needed clarity. For those
without doubts, it is about time we create some.
“Dubium sapientiae initium” (Doubt is the origin of wisdom)

- René Descartes
A picture speaks louder than words, and here we hope we can

use both these outlets of expression to their optimal capacity
for a learning experience that is superlative. A pearl of wisdom
encouraged by one of the finest mentors as a fledgling fellow
that I have had the chance to learn from, “Never stop learning”.
As always, Happy learning!
167
S I
O
YDIFFERENTIAL WARS 1.01
• 65/F
• Asymptomatic
• No systemic disorder
• Under review for ocular disorder for

the past thirty years
NAEVUS OR MELANOMA?
Images courtesy
 
Dr William R Freeman and Dr Michael Goldbaum
Shiley Eye Institute
University of California
San DIego
Complied By: Moderated by:
Dr.Mahima Jhingan Dr Jay Chhablani 
168
NAEVUS MELANOMA
May be symptomatic due

to SRF encroaching the
HISTORY Asymptomatic fovea, or another
associated neoplasm,
photopsias
Large dome shaped lesion

Pigmented lesion shows with orange pigment
CLINICAl presence of surface pigment, associated
drusen, insignificant exudative RD, margins
EXAMINATION orange pigment, Halo near disc, and absence of
present surrounding halo
Fig1a Fig1b
Echodense, minimally A-scan - medium to low internal
echoes with smooth
vascular, shallow solid attenuation. Vascular
regular lesion, high pulsations within the tumor
reflectivity. can also be seen by this mode.
Angle kappa prominent.
USG B-scan - three classic features
of choroidal melanoma are: An
acoustically silent zone within
the melanoma, choroidal
excavation and
Fig2a shadowing in the orbit Fig2b
Mixed hyper and hypo- Dual circulation, profuse
fluorescence leakage, hot spots at the
level of the RPE
FFA
Fig3a Fig3b
Better defined dark Dark better defined
lesions on ICGA, no lesions with intrinsic
intrinsic vessels vascularity
ICGA
Fig3c
Photoreceptor loss (50% Serous retinal
of cases), absolute detachment, debris on
scotoma, retinal atrophy back of retina, retina of
OCT and thinning, and pigment normal thickness, and
epithelial detachment intact photoreceptors
(15% of cases) Fig4a Fig4b
No significant patterns Hyperautofluorescence in
the region of the orange
pigment
FAF
Fig5a Fig5b
1. Singh P, Singh A. Choroidal melanoma. Oman Journal of Ophthalmology. 2012;5(1):3-9
2. Shields CL, Furuta M, Berman EL, Zahler JD, Hoberman DM, Dinh DH, Mashayekhi A, Shields JA. Choroidal nevus transformation into melanoma: analysis of 2514
consecutive cases. Arch Ophthalmol. 2009 Aug;127(8):981-7.
1a 1b
2a 2a
3c
3a 3b
4a 4b
5a 5b
S I
O
Y DIFFERENTIAL WARS 1.02
Dr.KOMAL AGARWAL
LV PRASAD EYE INSTITUTE
HYDERABAD
STAGED ROP V/S APROP
STAGED ROP AP ROP

ZONE I OR
PERIPHERAL LOCATION POSTERIOR ZONE
II
Dichotomously PATTERN OF
Loops and shunts
branching VESSELS
Develop at Flat new
junction of vessels, on the
vascular and surface of
Pattern of
avascular neovascularization retina and can
retina, grow be found
vertically into anywhere in Zone
the vitreous I or Zone II
Not well defined
Well defined and Junction of
and not easily
easy made out on vascular and made out on
clinical avascular
clinical
examination retina
examination
Treatment
Responds well to failures might
laser REPONSE TO
TREATMENT occur despite
adequate
treatment

P A G E
INTERNATIONALTraining
33. The ICO Three Month/One Year Fellowship Program
Prof. Dr. Berthold Seitz & Cordula Gabel-Obermaier

172
34. FICO exams & ICO fellowships: My experience
Dr Chintan Dedhia
178
35. Vitreoretina Fellowship in Korea
Dr Jeeyun Ahn
183
36. US Fellowship experience
Dr Aniruddha Agarwal
188
37. International Fellowship Programme in Hong Kong
Dr Lawrence Pui-Leung IU
194
38. Fellowship Experience in Hong Kong
Dr Ahmed Al Satrawi
196
39. Vitreoretina Training & Working in Germany : An Overview
Dr Aditya Sudhalkar
199
40. International fellowship program, Singapore National Eye Centre
Dr. Thiyagarajan Jayabaskar
204
41. SNEC-AIOS-ARC-Fellowship Interview Experience
Dr Sahil Bhandari
210
42. EURETINA—Young Retina Specialists
Dr. Fischer M. Dominik
215
43. ESASO
Dr Sahil Bhandari
216
44. GOAP Fellowship Award: My Experience
Dr Prerna Shah
221
INTERNATIONAL TRAINING
THE ICO THREE MONTH/ONE YEAR

FELLOWSHIP PROGRAM
-Prof.
Dr. Berthold Seitz
-Cordula Gabel-Obermaier
The International Council of Ophthalmology (ICO) is building a World Alliance for

Sight, working with ophthalmologic societies and others to enhance ophthalmic
education and improve access to the highest quality eye care in order to preserve
and restore vision for the people of the world.
About the ICO
The history of the ICO goes back to 1857, when 150 ophthalmologists from 24
countries met in Brussels, Belgium, for the first International Congress of
Ophthalmology, which is nowadays known as the World Ophthalmology Congress
(WOC).
Since the early days the ICO is committed to
• Enhancing ophthalmic education, particularly training of ophthalmologists
and other eye care personnel to meet public needs in developing countries
• Stimulating and supporting communication and collaboration among
ophthalmologic societies and ophthalmologists globally and their involvement
in initiatives to preserve vision
• Defining and disseminating standards and guidelines in order to enhance
eye care
• Stimulating research to eradicate preventable blindness
• Raising awareness worldwide of the economic, social and personal impact
of vision loss and advocating for increased funding and other support for
preservation and restoration of vision.

In order to reach these challenging aims the ICO offers the following programs
• The World Ophthalmology Congress (WOC), which is held every two years
in a different region of the world.
• ICO Exams (initiated in 1996)
• ICO Three Month/One Year Fellowships (initiated in 2001)
• ICO International Clinical Guidelines
• International Standards For Vision, Eye Care and Ophthalmology
• Research Agenda for Global Blindness Prevention
• Various ophthalmic educational initiatives
About the ICO Fellowships Program
In 2001 the International Council of Ophthalmology (ICO) Fellowships Program

was organized by Prof. Balder Gloor from Zurich, Switzerland, to help promising
young ophthalmologists from low-resources countries improve their practical skills
and broaden their perspectives of ophthalmology. ICO Fellows are expected to
bring the acquired knowledge and skills back to their home countries and take part
in programs to preserve vision and prevent blindness.
YO TiMES I AUG 2019

173
The ICO offers training (mainly classified as observerships) in more than 20
subspecialties at more than 130 ICO Training Centers in 34 countries. Since 2001
more than 1200 ICO Three Months Fellowships were granted.
Favorite subspecialties are Vitreoretina, Cornea and External Diseases, Pediatric
Ophthalmology and Cataract Surgery.
Clinical opportunities with three months and one year duration are available.
Please find out more on http://www.icoph.org/refocusing_education/
fellowships.html
• ICO Three-Month Fellowships (among these opportunities offered in

collaboration with subspecialty societies as The World Glaucoma
Association, The Retina Society or the International Uveitis Study Group)
• ICO-Children's Eye Cancer Foundation (KAKS Germany) Three-Month

Retinoblastoma Fellowship
• ICO-Eye Cancer Foundation (ECF) Six-Month Fellowships for Diagnosis and

Therapy of Retinoblastoma
• ICO-Retina Research Foundation One-Year Helmerich Fellowships
• ICO-Fred Hollows Foundation One-Year Subspecialty Fellowships

Eligible candidates have passed their Specialist in Ophthalmology degree, have
completed their residency training and look back on a considerable amount of
experience in their subspecialty. Ideally they come from a public services and/or a
teaching position. Successful candidates are highly motivated and their training
has a high impact to their home institute.
Women are strongly encouraged to apply for an ICO Fellowship award.
ICO Exams are recommended and considered in the assessment for an ICO
Three Month / One Year Fellowship. Please find out more on www.icoph.org/
exams.
During the application process ICO candidates explain to and discuss with their
hosts their motivation, their expectation and the impacts they wish to gain from
their training. This allows an individual addressing of the candidate’s recurring
questions and challenges they face in their daily work.
The most favorite subspecialties are Vitreoretina (23%), Pediatric Ophthalmology

and Strabismus (15 %), Cornea and External Diseases (12%), Glaucoma (9%),
Medical Retina (9%), Oculoplastic (9%) and Cataract Surgery (8%).
The ICO offers training in Retina (Vitreoretina and or Medical Retina) at more than
75 collaborating host institutes around the world, almost all of these are university
institutes or national referral centers.

Evaluation
Since December 2016 the ICO does a survey on the impacts of the ICO Three
Month / One Year Program for the individual Ophthalmologist. More than 93 % of
the respondees said that they learned new techniques in diagnosis, treatment and
surgery. 95 % would recommend their colleagues to apply for one of the ICO
Fellowship opportunities. About 75 % of the former ICO Fellows have installed
regular teaching events in their home institutes as they have seen them in the host
centers. With training on individual level the program meets individual needs of the
ICO Fellows, it does not offer curricula that should be completed. The program
proved to be sustainable through training teachers so there is strong benefit from
the multiplier effect. The program is highly efficient and attractive for hosts and
fellows because of intercultural and professional exchange.
Another result from our evaluation was that three months proved to be a
reasonable, long enough, time for an observership. This duration allows ICO Three
Months Fellows to easily take leave from home institute and families, on the other
hand it is enough time to integrate well in the medical team at the host institute.  
More results will be published later this year.
Sponsorship
ICO Three Months Fellowships go with a grant of US$6000 to support the ICO
Fellow’s expenses for return travel and student-style living expenses. One Year
awards go with a grant amount of US$ 24000 resp. US$ 25000. Grants can be
spent as needed.
The ICO gratefully recognizes grants, gifts, and pledges to the ICO Fellowships
Program. Support ICO Fellowships by contributing to the ICO, ICO Foundation, or
the International Ophthalmological Fellowship Foundation (IOFF), which was
formed in Germany to support the ICO Three Months Fellowships.
Funds come from Industry, from NGO’s like the Fred Hollows Foundation or CBM,
from Subspecialty Societies like the World Glaucoma Association or the
International Uveitis Study Group, from Private Donors and National
Ophthalmological Societies like the German Ophthalmological Society, the
Taiwanese Ophthalmological Society or the Chinese Ophthalmological Society.  
The ICO invites industry, Ophthalmological Societies and NGO‘s to collaborate in
order to support the ICO Three Months / One Year Fellowships Program.

The ICO-Allergan Advanced Research Fellowship
The ICO-Allergan Advanced Research Fellowship allows one young

ophthalmologist to continue basic or clinical research at a chosen university,
preferably in a foreign country to where they live. Applications will be accepted for
research work in the following subspecialties: Glaucoma, Neuro-Ophthalmology,
Pediatric Ophthalmology, Retina, Tumors, Uveitis, Dry Eye, and Cornea.
 
Please find out more about this opportunity on http://www.icoph.org/
refocusing_education/fellowships/fellowships_more_information.html#ICO-
Allergan.
Cordula Gabel-Obermaier from Prof. Dr. Berthold Seitz from

Munich, Germany is Executive in Germany served a one year
charge of the ICO Fellowships Research-Fellow in Cornea and
Program. Since her start 10 years Refractive Surgery at the Doheny
ago she has arranged about 900 Eye Institute, University of Southern
ICO Three Months Fellowships and California School of Medicine, Los
more than 30 one year fellowships. Angeles/USA (Peter J. McDonnell,
She is actively involved in MD) in 1995 before he became full
developing new opportunities and professor and chairman of the
new collaborations. Contact the Dept. of Ophthalmology at
ICO Fellowships office Saarland University in Homburg/
at [email protected]. Saar, Germany in 2006. Since 2011
he is Member of the German
Academy of Sciences
Leopoldina. He is member of the
ICO Exams Committee and Head of
the ICO Fellowships Program.

FICO EXAMS & ICO FELLOWSHIPS:

MY EXPERIENCE
- DR CHINTAN J DEDHIA
The International council of Ophthalmology (ICO) represents and serves

professional associations of ophthalmologists throughout the world.
ICO offers Standard examinations (Visual sciences, Optics & Refraction
and Instruments and Clinical Ophthalmology) and Advanced examination.
Recently, ICO has also started Foundation assessment and subspecialty
examinations.
I took my first step of Basic sciences and Optics & Refraction (usually
clubbed together) in second year of residency (April 2013), second step of
clinical sciences in third year (April 2014) and final step of ICO Advanced in
October 2014 immediately after my residency. (Group discount of 40-50
percent in exam fees can be availed if there is a group of 3 or more
candidates from a local ICO exam co-ordinator)
WHY TO APPEAR FOR ICO EXAMS?

Taking the ICO exams during our residency helps in the preparation for our
post-graduation examinations. The probability of getting the grant
(scholarship award) for ICO fellowships increases if one has cleared the
ICO exams (Though few colleagues of mine with very impressive CV have
got the grant even without giving a single ICO exam). After clearing ICO
Advanced exam, we can use postnominal acronym FICO as an
international degree.
WHY TO APPLY FOR ICO FELLOWSHIP?

ICO offers eight different types of fellowships: the most popular
one is ICO Three-months fellowships (Grant of 6000 USD) (more
details on www.icoph.org/refocusing_education/fellowships.html)
ICO fellowships offer us the opportunity to work in prestigious eye
institutes globally, with access to latest management protocols,
techniques, research, and renowned experts in their respective
fields to broaden one`s horizons. An alternative approach need
YO TiMES I AUG 2019

not always be better, but it definitely adds to our armamentarium. We get to
learn a lot of surgical pearls and refine our surgical techniques just by
observing these pioneers in their operating rooms. We have read their
scientific accomplishments and have always heard them in conferences or
on webinars, but interacting with them on a one to one basis is a different
experience altogether. The amount of chair time they give and the way they
explain the disease pathophysiology and counsel about the treatment
options and prognosis, really has a positive impact on doctor-patient
relationship. Also, there is extensive research carried out at these institutes
and one has an opportunity to get innovative ideas from it and even actively
take part in it. Apart from Ophthalmology, it helps in grooming our
personality as well.
WHEN TO APPLY?
Though we are eligible to apply for the ICO funded fellowship anytime, the
chances of acceptance and award of grant are greatest after clearing all
FICO exams. It would be ideal to do this fellowship after acquiring your
basic medical/surgical skills of your subspecialty in our home country, like
just after completion of our fellowship so that we can refine ourselves and
inculcate minute
modifications in
our algorithms.
The whole
procedure takes
a long time, so
timely advance
planning is
i m p o r t a n t
(Deadlines being
31 st March for
the slots from
next September
to next March
and 3 0th
September for
the slots from
DR DAVID SARRAF & DR CHINTAN DHEDIA

next April to next September).I had applied a year before in March 2018 for
the slot of January- March 2019. You may get an ICO award/grant of 6000
US dollars to cover your travelling and student style living expenses.
WHERE TO APPLY?
The application process is online, and straightforward. There is a long list of
institutions in different parts of the world (most of them are in Europe or in
United states); the whole application process is explained in detail on the
official ICO website www.icoph.org. Most of your queries will be addressed
in the FAQ section, but if you still have queries, you can mail them to
[email protected]; Ms. Cordula Gabel-Obermaier (ICO fellowships co-
ordinator) will revert back immediately with a satisfactory response.I had
short-listed 3 choices to apply for medical retina:
1. Dr David Sarraf (UCLA, USA)

2. Dr Frank Holz (Bonn, Germany)
3. Dr Giovanni Staurenghi (Milan, Italy)
MY ICO FELLOWSHIP EXPERIENCE!

I had applied and luckily got the opportunity to do Three-month ICO
fellowship in Medical Retina at one of the most highly regarded
Ophthalmology centers in
the world, Jules Stein Eye
Institute (JSEI), University
of California, Los Angeles
(UCLA) under the
supervision of Dr David
Sarraf, who is a world-
renowned medical retina
physician. It was a state of
the art learning experience
to work in close association
with him.
During my tenure, I used to

shadow the attendee
(terminology for “consultant

faculty”) - Dr. David Sarraf,
Dr. Michael Gorin
a n d D r. C o l i n
McCannel in their
medical retina
clinics days. I had
the opportunity to
attend Fluorescein
conferences
(medical retina
grand rounds)
moderated by Dr.
David Sarraf every
T u e s d a y ,
Ophthalmology
grand rounds every Wednesday, Surgical retina grands rounds moderated
by Dr Allan Kreiger and Dr Jean-Pierre Hubschman every Friday. I also got
a chance to attend retina journal clubs and local retina CMEs, and
operating rooms whenever feasible. I was really lucky to get an opportunity
to attend 2 prestigious international meetings: Pacific retina club 2019 and
International Retina Imaging Symposium (IntRIS) 2019 conducted at UCLA
(March 2019).
Currently, I am working on a paper with Dr Colin Mccannel, which hopefully

will be published soon. I also got an opportunity to shadow Dr Narsing A.
Rao, Co-Director, Roski eye institute, USC (University of southern
California) in his Uveitis clinic for a day. During my stay, I got an insight of
their preferred practice patterns as well as alternative approaches of patient
management. This fellowship gave me an indepth understanding of the
subject and also helped me in refining my diagnostic and imaging skills
especially in the interpretation of advanced retinal imaging including
spectral domain OCT (both cross sectional and enface OCT), OCT
angiography, fundus autofluorescence and dye-based angiography. I learnt,
updated and upgraded myself to a great extent in many aspects. We were
5 international fellows with Dr Sarraf (all from diverse backgrounds and
from different parts of the world), so I had a chance to interact with them
and learn about their practice of Ophthalmology. I found the overall work

environment very friendly and approachable. They follow evidence-based
approach in treating patients.
BEYOND OPHTHALMOLOGY AND ACADEMICS:
I had gone with my wife who also got an Observership for the same
duration in the department of Dermatopathology at UCLA. As an additional
bonus, we planned every weekend to tour different destinations in
California such as San Diego, San Francisco, Yosemite national park,
Santa Catalina island, etc. Los Angeles is truly known as La La land
because of its crazy nightlife, fine-dining restaurants, variety of Art
museums, numerous beaches and tourist attractions such as Universal
studios, Disneyland theme park, etc. We also visited Las vegas, Grand
Canyons national park.
In nutshell, It was a great memorable and an all-round enriching lifetime
experience. As we all are lucky enough to have this opportunity, I strongly
recommend this fellowship for young ophthalmologists (eligible to apply
below 40 years age).
DR. CHINTAN JETHALAL DEDHIA completed his MBBS (2005- 2011) from Seth GSMC and KEM
hospital, Mumbai followed by MS Ophthalmology (2011-2014) from GMC, Bhavnagar. Subsequently, he did
his senior residency at TNMC (Nair Hospital), Mumbai and GSMC, Mumbai (2014-2015). During this period,
he cleared 3 grades of ICO Examinations including the Advanced exam (2014) and also passed DNB
Ophthalmology examinations (2015). He then went ahead to do long term clinical fellowship in Vitreo-
retina from LVPEI, Hyderabad (2015-2017) and also Cataract and Community Ophthalmology fellowship
from Sankara Nethralaya, Chennai (2017). Thereafter, he served as a Consultant Vitreo-retinal surgeon at
Sadguru Netra Chikitsalaya, Anandpur, M.P. (2018). He then went ahead to do ICO three-month fellowship
in Medical Retina at Jules Stein eye institute, UCLA (Jan-March 2019). Currently, he is working as a
Consultant Ophthalmologist and V-R surgeon at Shree Ramkrishna Netralaya, Thane. He has to his credit
various paper and poster presentations at the national and state level and various peer reviewed
publications in indexed journals. He also has co-authored a chapter on " Instruments in Vitreo-retinal
surgeries" in the book " Ophthalmic surgical instruments" (Jaypee). His special areas of interest are
macular disorders and diabetic retinopathy. He keeps himself updated by regularly attending various CMEs,
scientific meetings, conferences, etc. Apart from Ophthalmology, he has special interest in music and
indoor sports. 

VITREO-RETINA FELLOWSHIP IN
KOREA
-DR. JEEYUN AHN
It is a great honor for me to have a chance to write about my experience as a

Vitreo-Retinal fellow in Korea and I would like to thank the Young
Ophthalmologist Society of India and Dr. Diva Kant Misra for giving me the
opportunity. It has been about 9 years since I trained as a fellow and in truth, I
never had much of a chance to reflect on those times since it was always about
looking ahead, busy with my clinic, writing research grants as well as papers. I have
a lot of good memories and I learned a great deal, and without YOSI I wouldn’t
have had a chance to give thought to those years. So, thank you once again!
Before I start, I should orient the readers on the medical school and resident
training system in Korea. Unlike the US, we enter medical school directly after
graduating from high school. Medical school is comprised of 2 years of pre-med
and 4 years of medical school. During pre-med, we have a chance to take course s
that are not necessarily associated with medicine, such as liberal arts, foreign
languages, economics, etc. When we transition into medical school, the first 2
years are usually spent learning basic anatomy and science such as biochemistry,
histology and pathology. The last 2 years are spent out in the field observing on first
hand outpatient clinics, surgeries and patient rounds, also getting a taste of
conferences and learning how to write up patient charts and reading medical
images.
Next up is 1 year of internship at the end of which, you choose

which field you want to major in and apply for residency.
After that, you receive 4 years of training and then, you’re
ready to become a fellow! So, in total, it would take 11
years before you start working as a vitreoretinal fellow in
Korea. In Korea, men are required to complete
compulsory military service of 2 years which people
usually get out of the way before residency, so for men it
can take 13 years.
YO TiMES I AUG 2019

I received my Vitreo-Retinal fellow training under professor Kyu Hyung Park in
2010 at Seoul National University Bundang Hospital (SNUBH) one of the 3
branch hospitals of Seoul National University. In 2010, there were 2 Retina
Professors in total, Professor Park and Professor Se Joon Woo. I was professor
Park’s first fellow and although the specific rules for training had not yet been laid at
that time, professor Park allowed me to get a very balanced taste of both clinical
and research work and enabled me to get the necessary training needed to embark
on my journey ahead as a retina specialist.
Fig 1. Group photo of the retina team taken in November 2010. Front row, from left to right, professor
Se Joon Woo, professor Kyu Hyung Park, and I.
In Korea, the retina specialty is not divided into medical or surgical retina. A retina
specialist is required to do both and hence an important part of fellow training is
learning to do surgery. Coming out from 4 years of residency, I had about 20
cataract surgery experiences under my belt and although I had much experience
having assisted vitrectomies and buckles surgeries, I hadn’t had any experience
doing retinal surgeries by myself. That is usually the case for many Korean
residents, so in the beginning, we start out with buckle surgeries. SNUBH is
notorious for the large number of emergency rhegmatogenous retinal detachment

(RRD) surgeries. It might be related to its geographic location, being in the southern
part of Bundang, a satellite city located about 40 minutes out from Seoul.
Nonetheless, I was able to dive into buckle surgery within a few weeks from starting
my fellowship. Also, one of the advantages I had was being the only fellow.
Currently, professor Park has 3-4 fellows and SNUBH has 4 retina professors, so
the retina specialty itself has multiplied in size over the years. Being the only fellow
meant that I was the go-to person for residents to call for emergency RRDs and I
was able to experience diverse types of RRD and realise that there are limitless
ways in which scleral buckling can be done. You can be very imaginative! As for
vitrectomy training, it was done more in a step-by-step manner. I started out doing
core vitrectomy for professor Park and Woo’s surgeries, after that doing endolaser,
filling in the area that professor Park would outline for me to do. Then, learning to
use forceps, grasping epiretinal membrane flaps professor Park had lifted up for me
to hold and also using the Ocutome to segment and delaminate traction
membranes. Having the chance to observe and learn from 2 surgeons was also a
major plus since professor Park and Woo both had very different styles and
approach to surgery. Over time, I was able to integrate both professor’s styles, add
some of my style to finally make it my own.
Fig 2. A group photo of the retina team at SNUBH and alumni taken in February 2019.
There are currently 4 retina professors at SNUBH and after my fellowship in 2010, there
have been 13 more clinical Vitreo-Retinal fellows trained under professor Park.

As for medical retina training, I had my own outpatient clinic twice a week and
about once or twice a week, I would observe either professor Park or Woo’s clinic.
As a resident, I already had experience of both professor’s clinics, but during that
time, I had more or less acted as a passive typist writing down patient’s findings,
putting in orders in the electronic medical charts, having little understanding of the
complex medical decisions being made around me. As a fellow, I was able to see
directly how each professor approached different diseases, how treatment
decisions were made and also ask questions about cases that puzzled me. Surgery
itself was very dynamic, but the outpatient clinic was also an excellent learning
ground for a beginning retina specialist.
Research was also a large part of my fellow experience. Both professor Park and
Woo are very active in research, in both clinical and basic areas. During residency, I
had some exposure to clinical research since residents are usually expected to
publish 1-2 SCI papers, usually retrospective case reviews, so I had a basic idea of
how clinical research and paper writing is done. During my fellow years, I also had
numerous clinical research topics and managed to publish a few. I think the most
exciting and invigorating part of my fellow years was learning the basic steps of
doing translational research. I started out by writing research grants about 2-3
weeks of my first day and putting into words the whys and hows of the related
research. This was something very new, hard at first, but very educational, since
grant funding is an essential part of doing research. Professor Park and Woo also
collaborated with numerous researchers and I was able to get involved in genetics,
drug delivery, OCT imaging, proteomic research projects, all very interesting and
hot topics in retina, even today.
After one and a half year of fellowship, I was lucky enough to be offered a position
as an assistant professor at one of the other branch hospitals of Seoul National
University, SMG-SNU Boramae Medical Center, and started working there from
September 2011. Looking back at my fellow years, I realise how balanced my
training was, from learning the ABCs of surgical techniques, to seeing patients in
the outpatient clinic, setting the groundwork for new translational research and
setting ideas in motion, reaching out to researchers for collaborative work and
seeing the fruits of research in forms of patents and papers. Both professor Park
and Woo were always supportive and dedicated to seeing me grow and I am and
always will be deeply thankful to them for giving me such both an educational and
fun experience.

As for anyone who is interested in doing a Vitreo-Retinal fellowship in Korea,
I think the best way is to directly contact the professor you would like to work
with. There have been international fellows in other subspecialties at Seoul
National University hospital who have spent 1-2 years in Korea and I believe the
specific training systems varies from hospital to hospital. I am not clear on what
level the international fellows can be involved clinically but seeing or performing
surgeries would be technically difficult due to the language barrier, but I am sure
observing in the outpatient clinic and the operating room are basically available
options. As for research, there would be no boundaries and it would be up to the
professor to decide up to what length he/she would involve the international fellow.
If you have any questions, please feel free to email me at [email protected] or
[email protected] .
DR. JEEYUN AHN, MD, PhD is an Associate Professor in the Department of

Ophthalmology at the Seoul National University, College of Medicine SMG-SNU
Boramae Medical Center.
 

US FELLOWSHIP EXPERIENCE
- DR. ANIRUDDHA AGARWAL
When I completed my residency in Ophthalmology at Post Graduate Institute of

Medical Education and Research (PGIMER), Chandigarh, India, I had felt a
calling to visit foreign shores and learn something new and exciting. Like most of
us, I was satisfied with my residency training program which had the usual ups and
downs. I could have continued with my super-specialty training in India at that point.
I reckoned that I would be the happiest and most satisfied in the specialty of Vitreo-
Retina and uveitis. In India, luckily for us, we have several excellent retina training
programs spread throughout the country, including my alma mater, PGIMER.
Therefore, deciding between staying back and learning from the masters in India
versus going to a different country and starting afresh was very difficult.
At a young age, during residency or just fresh out of a post-graduate program, we

all yearn for a mentorship that can give us the early push in our careers. Prof.
Amod Gupta, and Prof. Vishali Gupta at PGIMER provided me that mentorship
support early during my residency, and encouraged me to explore and see the
outside world. Overall, I would rate my international experience a life-changing one
in a very positive way. In 2014, when I stepped out to spend the next three years of
my life with Dr. Quan Nguyen and Dr. Diana Do, I had no clue how things would
fall in place. The path seemed long and tiring, and full of obstacles related to visas,
licensing, USMLE, family, and finally, settling down.
When a junior colleague asks me how to go about an

international experience, I ask them the following questions –
How interested are you (half-hearted or fully motivated)? Are
you interested in a long-term career abroad? What are you
looking to gain from the stint outside? Do you have
family/someone special also traveling with you? These
questions may not have easy answers. My experience may
help you answer some of these questions.
YO TiMES I AUG 2019

188
How does one apply to a foreign fellowship?
Broadly, if you are thinking of applying to the US, be prepared for a long-term
commitment. With increasing number of applicants and competition among peers,
Professors in US universities are looking for candidates who can spend a minimum
2 year period with them in research positions, before moving on to a clinical
position (residency or a fellowship). A big caveat - these positions may not be paid
initially (though eventually your mentor may be able to obtain funds for you).
Our team at University of Nebraska Medical Center during the International Ocular Inflammation Society (IOIS)
Conference in 2015 with Dr. Quan Dong Nguyen and Dr. Diana V. Do
To begin applications, it is best to contact the individual ophthalmologists you

are looking to spend time with. Contacting administrative staff and coordinators may
be mandated by certain faculty, who do not wish to receive emails from prospective
students. Either way, it is best to establish contact and demonstrate willingness to
work in the field of interest of your prospective mentor. It is always best to apply to
as many places as possible. With over 100 Universities and programs, searching
and networking may be a daunting task, so it is better to start early. It is a big help if
your mentor in India has a strong professional relationship with US faculty. This will
help the US faculty to assess the candidate better, and be sure of his/her future
plans. So if you are not fully motivated, and not prepared to spend a few months

without salary, it is unlikely that a mentor will accept your candidature. It is not
difficult to distinguish a motivated worker from a “window shopper”. My advice
would be to apply broadly and widely.
Candidates fear that their lack of publications may be an important factor for getting
rejections. I shared a similar fear since I did not have more than 2 published
manuscripts at the time of my application. During my interviews, I realized that the
mentors were looking for a candidate with a mindset to publish, rather than
an established author. From my mentor, I realized the importance of the term,
Clinician scientist. An aptitude of asking questions, reasoning out, hypothesizing
and doing an in-depth patient-related analysis will make you a winner in any
interview. Also, during the interviews, a candidate who has chalked out a career
plan taking into consideration his/her passion and calling will definitely fare well. My
sincere advice to all potential applicants: it is best to plan your life well in advance
as these applications begin early and the process of contacting Professors and the
subsequent paperwork may take a year or more.
Presenting at the American Academy of Ophthalmology (AAO) Instruction Course in 2017 with my mentors, Dr.
Quan Dong Nguyen, Dr. Vishali Gupta (PGIMER) and Dr. Rupesh Agrawal (Tan Tock Seng Eye Hospital,
Personally, I feel that spending more than 2 years in a foreign institution has
several advantages. In my experience, the initial few months fly past quickly while
you adjust to the corridors of the hospital, new apartment, cooking food (it was my
first time!), and the local culture. Your mentor will also trust you with larger projects

and impactful manuscripts once you have demonstrated competence will smaller
tasks such as case reports and book chapters. With increasing number of
researchers world over, submission and manuscript review takes many months,
and it may not be until a year (or more) before you finally see your manuscript
proofs. When I completed my first six months into the fellowship, I realised that I
could not publish a single manuscript, though I had contributed pieces in several
ongoing projects. However, after 18 gruelling months, I was finally working on
several proofs and accepted manuscripts, much to my satisfaction. All of us go
through this initial lag phase, which should not dishearten us.
These manuscripts and papers will win you lecture invitations, faculty
invitations, and bring you recognition in your field.
A memorable picture with my mentors in PGIMER (Prof. Amod Gupta and Prof. Jagat Ram) and USA (Dr. Quan
Dong Nguyen) at the Superannuation Ceremony of Prof. Amod Gupta in 2015.
We all like to gain clinical experience in a foreign country. If you are looking for a
proper US clinical experience, I would highly recommend USMLE (yes, all three
steps). There are international fellowships in certain parts of US and Canada that
do not mandate USMLE, but the amount of clinical exposure they provide is
questionable. These fellowships are usually unregulated, and to my mind do not
count more than a “hands-on Observership”. As a candidate, it is best to search
and browse these online by visiting University websites.

The current fellows and past students of the university will always help if you shoot
them an email. USMLE scores and medical education credentialing can get you a
paid clinical fellowship through “the match”. If you plan a long-term stay, you could
directly apply for a
residency spot and apply for Board certification. I would recommend visiting
www.sfmatch.org for more details, as these programs and requirements are
regularly updated.
What did I gain from my US experience?
In terms of clinical skills, I gained immense knowledge regarding retinal imaging,

especially because of my association with the Image Reading Center and Lab. I
learnt “which drug when”; this is often not evidence-based but driven by logistic
issues and personal opinions in India (due to various factors such as patient
affordability, or marketing/packaging issues). I learnt all the know-hows of running a
clinical trial, right up to applying for US FDA approvals. I learnt the art of effectively
communicating with the patients and answering their questions. I was fortunate to
work in a busy clinical environment in US, which taught me nuances of slit-lamp
examination, ultrasonography, setting up a electrophysiology laboratory, and
meticulous record keeping. For a prospective applicant, if you choose a mentor/
fellowship program which lays emphasis on clinics and surgeries, there would be
no dearth of clinical material. Gradually, as you demonstrate your competence, your
mentors will be very happy to hand over independent charge and patient care. In
my experience, I found the hospital staff and patients very forthcoming and friendly
in the US, despite my foreign background and medical school training in India. I
was happy to learn that world over, Indian doctors are greatly respected!
My journey in the US was fruitful for me in all aspects – clinical, research and
education. The three years I spent have given me adequate training and recognition
in the field. I could interact with US residents and fellows, teach them and learn
from them. My fellowship gave me the opportunities to apply for prestigious NIH
grants, International Research Projects, learn collaborative research, winning
awards, talk directly to machine makers (the big companies!), present papers in
various forums, travel the world and see different continents, meet people from
different cultural backgrounds, and find my soulmate. I have made a number of
friends in different countries, and strong ties with my mentors who are now like my
family members.

I would strongly recommend my colleagues to enrich their knowledge by
thinking out-of-the-box, try new adventures, and take the path less traveled.
Ultimately, I believe that one can always choose where one wants to settle
down in life. Your time is NOW, you only need to go and get it! 
Dr. Aniruddha Agarwal MS, FRCS is currently working as a Clinical Vitreo-Retina and Uveitis
Fellow in the Department of Ophthalmology, Postgraduate Institute of Medical Education and
Research (PGIMER), Chandigarh, India. He has completed his Clinical Research Fellowship (sub-
specialty of Vitreo-Retina and uveitis) in the Stanley M. Truhlsen Eye Institute, Omaha, Nebraska,
USA (2014 to 2016). He did his ophthalmology residency at the PGIMER, Chandigarh, India. He is
the recipient of prestigious awards such as the Bayer Global Ophthalmology Association Project
(GOAP) Fellowship at Royal College of Surgeons UK, Carl Camras Best Researcher Award, J.M
Pahwa Award by Vitreo-Retina Society of India (VRSI), Narsing Rao Award by Uveitis Society of
India (USI), and the Carl Herbort Award by the USI. In 2015, he was felicitated by the Hon. Prime
Minister of India (Kataria Gold Medal Award). He has authored more than 150 publications and 36
book chapters. His areas of interest include uveitis, as well as medical and surgical diseases of the
retina. He is an expert in ocular imaging, and has numerous international presentations and
collaborations for the same. He can be reached at [email protected]

CUHK-HKEH-PWH INTERNATIONAL
OPHTHALMOLOGY FELLOWSHIP
PROGRAMME IN HONG KONG
- DR. LAWRENCE PUI-LEUNG IU
It is my great pleasure to introduce the retina fellowship programme in Hong Kong.

Thank you very much YOSI for the kind invitation. The Chinese University of Hong
Kong (CUHK) offers an International Ophthalmology Fellowship Programme for
overseas ophthalmologists in various subspecialties. Two of them are related to
retina: (1) Surgical Retina Fellowship and (2) Medical Retina & Uveitis Fellowship.
Fellows will be involved in clinical services and research projects in Hong Kong Eye
Hospital (HKEH), Prince of Wales Hospital (PWH) of Hong Kong and the teaching
hospital of the CUHK. The fellowship is intended be 1 year in duration, but duration
other than 1 year can be arranged. Normally only 1 to 2 fellows are accepted in
each period.
The Surgical Retina Fellowship Programme Director is Dr. TSANG Chi Wai,
Consultant of HKEH. Surgical Retina Fellows will have up to 4 surgical retina
clinics, at least 1 surgical retina operating list and 1 surgical retina imaging session
every week. Fellows will be given opportunities to lead surgical retina research
projects and they are expected to be Principal Investigator of at least 1 project
during the fellowship. The Medical Retina and Uveitis Programme
Director is Dr. Marten BRELEN, Clinical Assistant Professor of
CUHK. Medical Retina and Uveitis Fellow will have 3
outpatient clinics including Medical Retina Clinic, Uveitis
Clinic and Diabetic Macular Edema Clinic and 1 session of
electrophysiology every week.
The fellowship programmes accept only applicants who are

under the age of 45 and have completed residency in
general ophthalmology. Preferences are given to those who
have completed full subspecialty fellowship, with good
references from supervisors and with strong track record in
research and publications. Fluency in written and spoken
YO TiMES IAUG 2019

English is a prerequisite. The selection process includes an online interview.
Dr. Ahmed Al Satrawi from the Kingdom of Bahrain is our present Medical Retina
& Uveitis Fellow. You will find his fellowship experience in the next article. If you are
interested, you can find details of the programme and the application procedure in
the website of Department of Ophthalmology and Visual Sciences of CUHK at:
https://www.ovs.cuhk.edu.hk/training-and-education/cuhk-hkeh-pwh-
international-ophthalmology-fellowship-programme.
Dr. Lawrence Pui-Leung IU is an Associate Consultant in the Department of

Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong and an honorary Clinical
Assistant Professor at the Chinese University of Hong Kong. Additionally he is a
Council Member of the Hong Kong Ophthalmological Society and
member of the Hong Kong Young Ophthalmologists group.
 
195
FELLOWSHIP EXPERIENCE
IN HONG KONG
-DR. AHMED AL SATRAWI
In general, the application process was similar to many other international

fellowship programs except for one major advantage. The CUHK-HKEH-PWH
International Ophthalmology Fellowship Program application process is open during
the whole year and applicant can submit his/her papers anytime. This was very
helpful in my case because I had a very long delay in processing my fellowship and
sponsorship papers back home and this logistical delay is common for many
fellows. To be honest, some of my sponsorship papers are still pending.
During any application and submission, it is very crucial to have a direct and
continuous communication with the program director and luckily the CUHK-HKEH-
PWH International Ophthalmology Fellowship Program had it in its best. I can say
with no hesitancy that one of the important reasons why I am here today in Hong
Kong training at this high international standard fellowship despite many obstacles I
faced back home was the outstanding and supportive communication with the
program directors and their high level of understanding.
The program directors and supervisors showed a high degree of flexibility when I
requested to delay the starting date of my fellowship training for a few months,
because at that time I had some personal and financial issues that made starting
the fellowship almost impossible. It is well known to many new ophthalmologists
and fellows that most fellowship programs are rigid especially for
something related to dates and calendar.
Honestly, I do not know much about the details of selection process

or the exact qualities that favored my selection. However, I can
assure all future applicants that it was professional and it depends
mainly on the record of your academic and clinical work provided in
your CV, good references from your home supervisors, dedication
and
YO TiMES I AUG 2019

commitment in your cover letter and the interview. In my case was very convenient
because it was done through internet (skype).
It is worthwhile to mention here that the only difficulty I faced was getting the
training visa and the limited medical registration and it was purely related to the
process of collecting the required documents and certificates and notarizing them
with the exact standards needed by both authorities in Hong Kong. However, to be
fair, I had no difficulty the visa process and the medical registration, and it was only
a matter of 6 to 8 weeks to receive them both. I am mentioning this because , 5
years back I had the pleasure to do a clinical attachment at ICARE Eye Hospital in
Noida, India for around 1 month, and the visa process and permission to see
patients and perform surgeries was much simpler compared to Hong Kong.
It has been now 4 months since I have started the one-year fellowship in the field of
medical retina and uveitis. In the past few months, I was thrilled with the amount of
clinical exposure available in the Hong Kong healthcare system. The beauty of this
fellowship is in its richness, fellows will be exposed to a wide variety of patients and
cases. They will attend and manage cases in both the public and private sectors
which helps to understand how the healthcare system operates and how each
sector has its own advantages and limitations.
Having a well-established fellowship program supervised by a recognized university

differs 180 degrees from a simple clinical attachment in a hospital. In both
scenarios, fellows will have a good hand-on clinical experience; however, in the
former the academic and research yield is so great that you would feel you are only
a service doctor in the latter.
197
In general, the medical retina and uveitis fellowship program includes seeing,
evaluating, diagnosing and managing patients in the subspecialty clinic. Having
hand-on laser and intravitreal sessions, exposure to the most common and
advanced imaging and diagnostic procedures available in ophthalmology e.g. OCT,
OCTA, ERG, EOG, VF, microperimetry, FFA, ICG, B-scans etc. If a fellow has
special interest in surgical retina like me, sessions to the operating theatres might
be arranged. I feel myself lucky because my direct supervisor Dr. Marten Brelen is
a VR surgeon so he adds a touch of surgical retina to my fellowship. This is
important for me because I have been working in the past 3 years as a medical and
surgical retina specialist in the Kingdom of Bahrain but because of the urgent need
of my country for a uveitis and medical retina specialist I had applied and joined this
amazing fellowship.
Fellows will be involved in researches and clinical trials at the CUHK Ophthalmic
Research Center and they will have assigned sessions to work on these. There is
also continuous medical education in the form of weekly grand rounds, wet lab
courses, external speakers and experts, Eyesi surgical simulator (available at the
CUHK Center) and plenty of other opportunities for education and keeping the
knowledge up to date.
There were two obstacles I had face when I started my fellowship in Hong Kong.
One was language problem because only few patients in Hong Kong could speak
English. Fortunately, all the colleague doctors and staffs were more than helpful to
help me overcome this obstacle. After a couple of weeks, I started to feel that
language is no longer a problem. The second was the cost of living in Hong Kong,
mainly the accommodation. Hong Kong has a very high rental rates. Some online
reviews classify it as the highest in the world. Other costs of living such as food,
transportation, entertainment etc. were reasonable and similar to that in Bahrain or
even cheaper.
Overall, during the past 4 months, I think I have started to gain subspecialty training
with clinical enhancement of high international standards and this is the major
objective of my fellowship.
DR. AHMED AL SATRAWI hails from the Kingdom of Bahrain and is a Medical
Retina and Uveitis Fellow enrolled in the CUHK-HKEH-PWH International
Ophthalmology Fellowship Programme 

VITREO-RETINA TRAINING & WORKING IN

GERMANY : AN OVERVIEW
-DR. ADITYA SUDHALKAR
The Federal Republic of Germany has a universal health care system comprising of
statutory(Gesetzliche Krankenversicherung) and private health insurance(Private
Krankenversicherung). The insurance system in Germany Is patient-oriented and largely
very easy to access, with little if any restrictions in place.
Insofar as health-care is concerned, the German Government allows direct access to
specialists without having to subject oneself to the rigmarole of visiting a general
practitioner first(as mandated by the NHS in the United Kingdom). This considerably
reduces treatment times and ensures targeted delivery of therapy.
Notwithstanding, it is certain that Germany will face a shortage of health care professionals
in the next two decades. The German Government, has, in anticipation of a breakdown in
the system eased the rules for studying and practicing medicine in Germany. Given that
the esteemed readership of this publication comprises mainly of ophthalmologists or
ophthalmologists-in-training, this article shall focus primarily on Ophthalmology in
Germany, and how fruitful can training and working in Germany be.
Observerships through the International Council of Ophthalmology(ICO) are readily

available and are a great way to familiarize oneself with the German health care system,
vastly different that it is from the Indian way of practice. The most popular destinations are
Regensburg, Münich, Hamburg and Berlin among others.
Thanks to a universal insurance system, practicing in Germany is based strictly on

scienfitic guidelines and the rules laid out by the Kassenärztliche Vereinigung(Association
of Physicians and Insurance Firms). This makes day to day practice straightforward, given
that money has been taken out of the equation. One must add that physicians are very
well compensated for the years they spend in training and for their skills. This a far-throw
from places like India, where money is central to health care and a
physician’s popularity and OPD numbers are often determined by the
number of ‘packages’ and ‘incentives’ that he or she has on offer.
The current state of affairs in India is testimony to the apathy
demonstrated by successive governments, who prefer to erect
understaffed and underequipped civil hospitals and focus on
delivering(or claiming to deliver) ‘free’ health care to patients without ever
attempting to liberalize and modernize the health-care system by allowing
poor patients access to the latest technology and techniques. Whereas
there are several regional centres of excellence throughout India,
competent healthcare in India is largely the privilege of the urban
YO TiMES IAUG 2019

population(with notable exceptions).
Training in Germany can begin at the undergraduate or postgraduate level. It must be

borne in mind that German universities have a very high standard of training and
certification, regardless of specialty, and fewer than 60% of students successfully complete
their tenure at the university. On the whole, it is advisable to apply for post-graduation in
Germany rather than undergraduate studies or fellowships. It must also be made clear at
the outset that good to excellent command over German (Deutsche Sprachkenntnis) is a
prerequisite. Doctors are expected to present, upon arrival, a certificate that demonstrates
sufficient knowledge of German (the B2 level certificate at the very least; preferably C1).
Our Second Praxis
This corresponds to the fourth level of competence (Beherrschung) out of the six levels of
knowledge of language as laid out in the Europäische Referenzrahmen(European
Framework for Language Competency). The different grades of knowledge range from
A1(beginner) to C2(expert). The certificate must be obtained either from the Goethe
Institute (the only available option for Indians in India) or the Volksschule in
Germany(popularly known as Telc). It is not necessary to attend the training courses
offered by these institutes; one can directly take part in the examination held on
predetermined dates as an external candidate. Most universities in India seem to have a

German department, and there are several private coaching centres in most Tier 1 and 2
cities across India that offer very good training.
The second vital step towards practicing in Germany is obtaining Approbation. This is the
German equivalent of M.B.B.S. and can be achieved in two ways: a) taking the
Gleichwertigkeitsprüfung ‘equivalence exam’ or b) having a Gutachter(appraiser) evaluate
your medical curriculum and declare ‘equivalence of education’.
The equivalence examination is generally an oral test and identical to the final M.B.B.S
Viva voce that every Indian medical student goes through; the candidate will be presented
with a patient(medical or surgical) and he or she will be asked to document the
Anamnese(history) and examine him in much the same way that one would do during a
With the Director of the Praxis, in the primary consultation room
final MBBS surgical/medical practical examination(in German selbstverstädnlich!). The

viva voce will then proceed accordingly. Fallbuch Innere Medizin and Fallbuch Chirurgie
are popular books for preparation for the examination. The examination will take place
6-12 months from the date you apply for the examination(schriftliche Beantragung) at the
Senatorium (Medical Council); there is a long queue!

Having the curriculum appraised is easier but more expensive; the average cost of
translation can vary between 4000 and 6000 euros. Additionally, one has to make several
rounds of the clerk’s office at one’s medical college to first obtain in writing a detailed
report of how many hours one spent in learning each subject(Such as Anatomy or
Forensic Medicine) and what sub-topics were covered under the curriculum. Additionally,
the appraiser will charge you a fee for the appraisal process. Rarely, the appraiser can
judge you to have inadequate knowledge of a particular subject(Surgery, for instance) and
ask you to appear for the equivalence exam.
Germany also requires you to pass a Fachsprachenprüfung or professional linguistics

examination wherein one needs to demonstrate adequate knowledge of German medical
terminology (which is based entirely on Latin terms) and of the vernacular terms for
various organs and their afflictions. The candidate then must know both the Pankreas and
Bauchspeicheldrüse(the German layman’s term for the pancreas). The primary focus is on
your comfort with the German language and the secondary objective is to test your
knowledge of medicine. The Fachsprachenprüfung must be taken by all candidates
regardless of whether they get the medical curriculum approved or choose to take the
equivalence examination.
Students with an MBBS degree become eligible at this point in time to pursue residency in
Germany; the process is somewhat similar to the
USA, wherein you may be required to apply to
several universitites before receiving an affirmation.
Many private clinics are authorized to train residents
as well and there is only one postgraduate degree
that one can obtain: The Masters’ Degree. This
process can be considerably shortened by enlisting
the services of one of several agencies who help
medical students find a Stelle (residency) in a
teaching hospital or private clinic.
For doctors who wish to immigrate to Germany after
completion of post-graduate studies, the situation
becomes a little more complex. They will still be
expected to take the equivalence and professional
linguistic examinations and attend a residential
programme for at least a year before they can
become eligible for the Ophthalmology examination. One of the Consultation rooms
An exception is people who have a diploma in Ophthalmology(DNB is generally
considered to be equivalent to a diploma) may be expected to complete 5 years of
residency in Ophthalmology much the same way as an MBBS graduate.
Fellowships in Germany are generally not worth their while because German postgraduate
students themselves must wait several years after completion of residency before they

can start off with surgeries. Ironically, surgeries are not a part of the curriculum in any
surgical discipline in Germany; this is a ruse to stifle competition. A retinal surgeon in
Germany is the first among all doctors in terms of remuneration; the financial benefits are
enormous. Logically, then, fellowships in Germany can rarely offer students the surgical
training and insights into a particular ophthalmic subspeciality that one gains through
fellowships in India. Obtaining surgical privileges in Germany is the domain of a select few
and one can be granted entry into the ‘big circle’ based on something as frivolous as the
student being the professor’s future son-in-law! Our personal equation with the head of
department has a bearing on our success as a doctor in Germany. Conversely, residency
in medicine or allied branches can be immensely fruitful as it eliminates dependence of
surgery as a source of income. Additionally, a konservativ doctor(without operative
privileges or training) can generally earn much more than an employed(and salaried)
retinal surgeon in India; the minimum estimate would put the financial worth of the German
medical ophthalmologist at three times that of the Indian retinal surgeon.
Overall, the process of qualification is considerably shorter than what one might have to
undergo in the USA or the UK. The German thought process supersedes the English or
the American one and is far more liberal and accepting. Learning German might seem at
first sight to be the biggest stumbling block in our path but is far easier than negotiating
commissions and kickbacks with errant and voracious colleagues. One can look forward to
a life untouched by caste and religion. With reservations in universities closing in on 100%
of available seats, future generations can look to free schooling and university education in
a country which has been continuously the home of influential and successful scientists,
inventors and entrepreneurs.
Dr. ADITYA SUDHALKAR obtained his Masters’ Degree in Ophthalmology from the M & J Western Regional Institute of
Ophthalmology in Ahmedabad and followed it up with a fellowship in Vitreoretinal surgery at the LV Prasad Eye Institute,
Hyderabad. He furthered his training with short term fellowships with Dr Carl Claes in Antwerp, Belgium(for complex
rhegmatogenous retinal detachments) and Priv. Doz. Dr Thorsten Böker in Dortmund, Germany(for radial buckling
surgery). He divides his time currently between his family clinic in Baroda, Gujarat, India and a private clinic in Bremen,
Germany(Land: Bremen). He has a keen interest in research and has 32 publications in peer-reviewed journals to his
credit. He has presented various papers at several national and international conferences. He has received the
prestigious Kreissig Travel Grant for EURETINA(Nice 2015) and the Keshmahinder Singh Travel Grant for APVRS(Kuala
Lumpur 2017). He has sat on advisory boards for Bayer and Allergan. His areas of interest are diabetic tractional retinal
detachments and endophthalmitis. When not at work, he enjoys traveling, swimming and reading the history of the world.
He can be reached at [email protected] 

INTERNATIONAL FELLOWSHIP
MEDICAL AND SURGICAL RETINA

INTERNATIONAL FELLOWSHIP PROGRAM
IN SINGAPORE NATIONAL EYE CENTRE
Singapore National Eye Centre (SNEC)

is the designated national eye centre
within the public sector healthcare
network in Singapore. SNEC spearheads
and coordinates the provision of
specialised ophthalmological services
with emphasis on quality education and
research, with a faculty of close to 80
ophthalmologists. SNEC is part of the
Singapore Health Services (SingHealth)
academic cluster of four hospitals, five
national specialty centres, eight primary
healthcare polyclinics and three
community hospitals. Since its opening in
1990, 11 subspecialties have been
established to provide a full range of eye
treatment from primary to tertiary levels
for the entire spectrum of eye conditions.
Clinical Service
SNEC offers 11 major subspecialties, a
range surpassed by few centres in the
world. It provides specialist eye care to
more than 50 per cent of patients in the
public sector and is ranked among first-in-
class for its clinical excellence, the
enduring legacy of founding Medical
Director, the late Professor Arthur Lim.
SNEC is one of the few institutions in the
world that records every single major
operation for teaching and monitoring of
surgery to ensure high standards and
outcomes. The impact has been
tremendous. At SNEC, the success rate
of cataract surgeries is about 99% (visual
outcome of 6/12 or better).
DR. THIYAGARAJAN JAYABASKAR

Objective Of The Surgical And Medical Retina Fellowships
1. The Surgical Retina Fellowship aims to produce mature, experienced,
knowledgeable, Vitreo-retinal surgeons who are capable of advanced level
competency in the diagnosis and management of patients with retinal and
vitreous diseases. The Medical Retina fellowship training will focus on the
diagnosis and treatment of non-surgical retinal diseases and the candidates will
participate in medical retina clinics, diabetic retinopathy clinics and laser clinics.
2. As such the training program exposes and involves the clinical fellows in all
aspects of the patient care with retinal diseases. Our aim is to train competent
ophthalmologists in the respective surgical and medical retinal expertise. We
also provide exposure to ongoing clinical research in retina area in SNEC and
Singapore Eye Research institute.
Minimum Entry Requirements:

o MMed (Ophthalmology), FRCS or its equivalent and would have completed 2
years of advance training rotations in general ophthalmology.
o Must be experienced in most aspects of clinical ophthalmology.
o A demonstrated familiarity with principles of clinical research studies
o Leadership qualities to work independently and to multi-task
o A good command of English

Surgical Retina Training components:
Clinical Exposure
• Exposure in clinical teaching which includes patient care, examination,
investigation, treatment, and discussion of a broad variety of retinal and
vitreous disorders
• Rotate through clinics and operating theatres of all surgical retina faculty
members
• Opportunity to diagnose and manage diseases, e.g. retinal tears, lattice
degeneration, retinal detachment (simple and complex, e.g. GRT),
proliferative vitreoretinopathy, proliferative diabetic retinopathy, etc
• Understand the principles of fluorescein angiography, including supervised
independent interpretation of angiograms
• Hands-on experience with FFA as well as ICG Angiography with state-of-
the-art equipment
• Perform electrophysiology testing, CT scan and MRI interpretations
• Training in both vitreous and retinal surgery
• All fellows will be placed on an on-call roster
Surgical Exposure

• Fellows will be able to perform procedures, e.g. Intravitreal injection, air-
fluid exchange, laser (direct and indirect), cryopexy, scleral buckle, pars
plana vitrectomy with intraoperative and postoperative tamponade as
appropriate under supervision.
Medical Retina Training components

• A broad variety of retinal and vitreous disorders including macular
diseases, retinal vascular disease, oncology, degenerative
hereditary disease and infectious retinal diseases.
• The principles, interpretation and hands-on experience with

fluorescein and indocyanine green angiography and optical
coherence tomography using state-of-the-art equipment.
• The principles, interpretation and hands-on experience in

electrophysiology such as age-related macular degeneration (AMD),
diabetic retinopathy, various types of uveitis.
• The fellow will gain an in-depth exposure to both diagnostic and

therapeutic approaches to all types of medical retinal problems
including retinal vascular disorders, macular degeneration, posterior
uveitis, intraocular tumours, and inherited retinal degenerations.

This will include the comprehensive evaluation of patients as well
a s t h e r e v i e w o f a n c i l l a r y t e s t s , s u c h a s a n g i o g r a p h y,
ultrasonography and electrophysiology.
• Competency in the use and interpretation of fluorescein and ICG

a n g i o g r a p h y, o p t i c a l c o h e r e n c e t o m o g r a p h y ( O C T ) ,
ultrasonography, and visual function tests will be achieved during
this training. In addition to evaluation and management of patients
in the clinic, the fellow will gain expertise in intraocular injection
therapy, retinal lasers, ultrasonography, and retinal imaging. The
fellowship is structured to provide the fellow with maximal
responsibility in the performance of clinical and medical retina
procedures, depending on the skill level of the fellow.
On Call: During the fellow’s attachment at retina clinics, diabetic

retinopathy clinics and laser clinics in SNEC, he/she will be on a rotating
call schedule with the other Vitreo-Retinal fellows.
Number of fellows per year:

One to two fellowship trainees will be offered in both Surgical and medical retina
fellowship per year.
Funding Support:
Selected candidates would receive stipend for the duration of the training and the
funding will be determined after the confirmation of the selection and it will depend
on the educational and years of practice in Ophthalmology, previous subspecialty
fellowship and MRCOph etc.
SNEC-AIOS-ARC-Fellowship (SAAF) program
This is a fellowship exchange program we have collaborated with

All India Ophthalmological Society (AIOS) and we will be launching
a yearly fellowship application under this scheme to invite suitable
young ophthalmologists to apply to our fellowships. More information
will be announced once we launch the new one year SAAF
program. Those interested could write to us separately if they wish
to get more information on this scheme or how to apply to our
fellowships directly.
YO TiMES IAUG 2019

208
For SNEC Fellowship related inquiry, Please contact:
Ms Esther Teo
Executive, Educational Development Unit 
Training & Education (Fellowship) 
Singapore National Eye Centre 
Email: [email protected]
DR T JAYABASKAR (MBBS, MSc(Public Health), MSc(Healthcare Industries Management)).

Since he joined Singapore National Eye Centre (SNEC) in 2012, he has been working to improve
the educational and training programs at the fellowships, nursing and allied health portfolios. Apart
from other achievements, Dr T Jayabaskar has worked with the AIOS and SNEC leadership to
develop a bilateral fellowship exchange between the two entities and established a new pathway
for developing ophthalmic speciality excellence between the 2 countries.  
YO TiMES I AUG 2019

209
SNEC-AIOS-ARC-FELLOWSHIP
INTERVIEW EXPERIENCE
- DR SAHIL BHANDARI
Fellowship in an eye care centre of international repute is a dream of every

Ophthalmologist. ARC (Academic and Research) wing of All India
Ophthalmologist Society, the second largest Ophthalmic society across the
globe, has for the first time started a fellowship exchange program with Singapore
National Eye Center. For the information of YO’s (Young Ophthalmologists) who
are in the beginning of their career, ARC wing of AIOS actively conducts many
different educational activities. ARC wing is chaired by DR. PARTHA BISWAS &
under his guidance ARC has reached its zenith and is continuously engaged in
some remarkable activities. The basket of ARC is filled with educational support like
CME series, fellowships grants, young researcher award; leadership programs like
LDP, teachers in Ophthalmology and many others substantially impressive
programs.
SNEC-AIOS-ARC fellowship is a once in lifetime opportunity for Young

Ophthalmologists and everyone who completes their fellowship in India should aim
for SNEC-AIOS-ARC Fellowship program to polish their skills and advance the
depth of their knowledge. The program has been started in three sub-specialties
Uvea, Neuro-Ophthalmology and Medical Retina. I was fortunate that AIOS-ARC
selected me for Uvea fellowship. I would like to share my experience of the
interview which was conducted in Kolkata on 2nd December 2018.
The application for the AIOS-SNEC fellowship has to be

submitted online. In order to get shortlisted, you need to
make sure that your resume is worth the spot. This will
begin from your residency days and probably reach a
plateau by the end of your fellowship. So better make the
best use of the time and make your profile strong both
clinically and academically. The application submission
is straight forward and answers to few questions should
be well thought in advance. I suggest that well written
answers in the application will give an extra edge. Once
shortlisted, you will receive a mail which will provide

you the date of interview. Further details about the interview venue will be
communicated to you a little later.
Since the program is a fresh start, interview pattern and details were not very well
known to any of the candidate. Keeping this into mind, I have jolted down the
details of the interview. The panel comprised of office bearers of AIOS, zonal ARC
members, Uvea specialist and Retina specialist. Interview comprised of questions
ranging from subject specific to general ones. The list of questions has been
mentioned below. Subject specific questions were like:
a. A 40 year old male with right eye pain and headache with FFA showing pin
point hyperfluorescent leak. What will be the differential diagnosis?
b. A neurological disease which can cause vitritis also?
c. A drug that can cause keratitis?
d. Typical Features of viral uveitis?
e. A case of ARN – how to treat and evaluate. Where will we take the sample
for serology from? (ans: aqueous > vitreous)
f. Etiologies for scleritis?
g. Other name for Wegener granulomatosis?
Although interview comprised of subject specific questions, but it started with

questions related to previous experience and exposure in Uveitis. This was followed
by queries related to future plans and commitments. The questions were as follows:
a. How much uvea exposure I have had previously?
b. Why did I leave AIIMS, Jodhpur?
c. What are my plans / outlook for next 5 years?
d. How will I establish VR and uvea setup in the charitable organization

which I have joined?
e. How will I contribute to research?
f. How will I contribute to academics?

g. What will I give back to AIOS after coming back?
h. What level of commitment can I give to ARC?
i. What all ARC activities I know of?
j. Have I been a part of any ARC activity previously?
k. Importance of my alma mater (RIO-GOH)?
Answers to these questions are variable as per the candidate’s present and past
scenario. I am sure that clinical questions will not be difficult for a uvea person but
proper well thought answers to the general questions are equally important and
more difficult than subject specific questions. Imagine yourself answering the
question “What are your plans for next 5 years”. If you start stuttering or blabber
that I will do this or that then nothing will make sense, rather it will backfire. Either
you say clearly that you will join an institute, start your own, join private chain,
prefer government setup or start group practice. Anything you answer should be
clear. I personally prefer that you can tell that you have not planned anything yet.
Knowledge of the organization i.e. AIOS and the wing i.e. ARC is also important. It
is important to know what the AIOS-ARC wing has been doing in the field of
academics and research. If you have organized or participated in any ARC event
then certification of the same will give you an extra edge. In contrast, if you have
previously in some ARC event like LDP (Leadership development program) or any
academic activity and you have not pursued it further with zest and zeal then that
will reflect negatively. Remember, if ARC is giving you opportunity to excel or
upgrade yourself, then you have to make sure that you will be able to fulfill their
commitments in future.
Apart from the questions, the way you answer or present yourself is also a key
factor. Be crystal clear in your answers and also make sure that you are audible to
other judges also, not just the one person who is asking you questions.
Now comes the big thing: My limitation! Before answering this I will give a brief of
my professional situation at the time of interview. When I applied for the fellowship I
was working as a Senior Resident in AIIMS Jodhpur and at the time of interview, I
had recently left AIIMS and joined a trust organization. From academic point of
view, shifting from an academic institute of national repute and joining a secondary
eye care center is little on the negative side of the graph. Therefore, answering to
questions like how will I contribute to academics etc was dilemmatic for me. What I
preferred was answering the questions which I had some clarity to, rest I mentioned
that I can remain and fulfill the commitment required by AIOC-ARC and give priority
to such academic and research activities.

In conclusion, it is important to understand that interview of such sort can
have all type of questions and you need to be prepared to answer them boldly
and clearly. The competition for such fellowships will always increase only and you
need to stand out with your resume and answers. Resume needs to be improved
from the residency days. Your resume is first thing that will get you shortlisted. So
it’s time to expand your reach in both academic and research. It’s time to start
looking farther and plan your career course well in advance. All the best and stand
out from the rest.
DR SAHIL BHANDARI, a Senior Consultant and Vitreo Retinal surgeon at Guru Hasti
Chikitsalya, Pipar City (Jodhpur) is an eminent academician cum clinician. He did his under
graduation from Stanley Medical College & completed his Diploma in Ophthalmology from
Regional Institute of Ophthalmology ,Chennai, & Diplomate of National Board from Aravind Eye
Hospital. After completing his DNB, Dr Sahil did his VR fellowship from the same Institute and then
joined All India Institute of Medical Sciences (AIIMS) Jodhpur. During his training he published 12
papers in peer reviewed journals, bagged first prize at AIOS-SUN PHARMA Quiz, stood second at
ERUDIO quiz, received IIRSI-APACRS travel grant, gave 25+ presentation at various state and
national level conferences. Presently he is a part of Executive committee of YOSI and has been an
invited Faculty at AIOC 2019 and AIOS-YOSI session. In addition to his academic interest ,he has
also shown his administrative skills in organising AIIMS AKSHICON, an annual conference of
AIIMS Jodhpur. 

GLIMPSES OF SNEC-AIOS-ARC-FELLOWSHIP INTERVIEW
 
214
EURETINA - YOUNG RETINA SPECIALISTS
-Dr. Fischer M. Dominik

Since its foundation in 2000, the annual EURETINA congress has provided a forum
for discussion and dissemination for retinal specialists. Approximately 5000
delegates participate every year and EURETINA welcomes individuals with different
backgrounds and clinical experience who share enthusiasm for retinal research.
The purpose of Young Retina Specialists (YOURS) is to provide a platform for

young (< 40 years) members of EURETINA to ensure that issues and focus points
of interest to this demographic are voiced. As part of this initiative, young
ophthalmologists can apply for a free YOURS membership. As an added
benefit, YOURS membership comes with a free EURETINA membership for
three years.
During each annual EURETINA congress, exciting YOURS program sessions are of
special interest to young retina specialists as it offers content and form that are
unique from the rest of the congress. Examples include mystery cases, in-depth
discussions on breaking news in research and future treatment options, and a
Science Slam for early career scientists to explain their research projects in an
unorthodox and exciting fashion. Every year, the Ophthalmologica Lecture is given
by a prominent young clinician or scientist who has made significant or highly
promising contributions to retinal research.
However, our platform is more than just the annual program session during the
EURETINA congress. The YOURS initiative also features a fun reception, open to
all, which allows us to meet other young ophthalmologists and get social! At our
social event, you are among fellow young and aspiring retinal specialists from all
over the world and can share thoughts about building your experience and career
as a retinal specialist. Many enduring friendships have been formed at the YOURS
Social. We look forward to seeing you future EURETINA/ YOURS conferences.
For further information, please visit http://www.euretina.org/about-us/yours.asp
FISCHER M. DOMINIK, MD PhD, is a professor of Ophthalmology and Attending

Ophthalmic Surgeon at the University Eye Hospital Tuebingen since 2015. He leads a
research group concerned with translational research on the retina at the Institute for
Ophthalmic Research (http://www.eye-tuebingen.de/fischerlab/). He completed his training
in general Ophthalmology at the University of Verona, Italy. Thereafter he moved to the
United Kingdom, where he completed an 18 months research scholarship at the Vitreo-
Retinal Department of Moorfields Eye Hospital, London. He completed a cataract fellowship
at the Moorfields Eye Hospital and a vitreoretinal fellowship at the Whipps Cross University
Hospital, London, UK. He is currently employed as a vitreoretinal fellow at the Bristol Eye
Hospital, University of Bristol, UK. He is author of 89 publications and has an H index of
21.
YO TiMES I AUG 2019

EUROPEAN SCHOOL OF ADVANCED

STUDIES IN OPHTHALMOLOGY
-DR MARIO TORO
General ophthalmology is a well-recognised medical specialisation in all over the

world, but Master’s degree programmes to provide further training and education
are not yet fully developed. More often ophthalmology graduates wishing to
specialise, need to find an institution or hospital that can offer them facilities for
research or on-the-job training. Others may want to pursue a fellowship
programme, but these are usually only available to US graduates.
ESASO was founded in 2008 to address both this challenge and the specific further
education needs of training and practising clinicians, drawing on the skills of
colleagues worldwide and the support of various universities. It seeks to facilitate
the dissemination of new and effective ophthalmological learning and expertise
through a dynamic combination of in-depth exposition of topics and direct face-to-
face training, where experts show students how to deal with practical situations and
problems, according to the most recent Evidence Based Medicine, and help them
to achieve their careers inside an international panorama.
ESASO’s mission is to provide post-graduate education and disseminate new and
effective learning and expertise to improve the clinical and surgical practice of
specialists in ophthalmology.
The School is based within the ESASO Training Centre (ETC), Lugano Campus,
Switzerland. Due to the difficulties for Asian doctors to reach the European
headquarters of ESASO, in 2010 was decided to open an Asian
Campus, located in Singapore, in order to meet the various
needs of Asian ophthalmologists.
ESASO aims at improving the clinical and surgical

practice of specialists in ophthalmology by helping them
develop and enhance their professional skills. Through
the promotion of training courses, fellowship
opportunities, MODULES and other courses ESASO
improves scientific knowledge within the ophthalmic
YO TiMES I AUG 2019

216
community, hence improving outcomes for all patients with eye conditions
worldwide.
ESASO offers theory classes as well as practical training, where constant

interaction between internationally renowned faculty members (which includes
approximately 260 experts from over 35 countries) and participants is enhanced by
debates, and concepts are always illustrated with clinical cases to make the
sessions very dynamic.
The School’s activities cover all subspecialties such as medical and surgical retina,
cornea and refractive, cataract, glaucoma, uveitis, oculoplastics, pediatric
ophthalmology and strabismus.
ESASO’S EDUCATIONAL PROGRAMME OFFERS:

 
1. Modules: Full ophthalmologists only 
2. 3D & Simulator training: Residents, full ophthalmologists or other professionals 
3. Wet lab Residents: full ophthalmologists or other professionals 
4. Preceptorships: Residents, full ophthalmologists or other professionals 
5. Executive Training Courses: Residents, full ophthalmologists or other
professionals 
6. Congresses: Residents, full ophthalmologists or other professionals 
7. Retina forum: Residents, full ophthalmologists or other professional 
8. ESASO days and forums: Residents, full ophthalmologists or other professionals
Recently a great success is coming from all activities concerning the medical
and surgical modules on retina.
The modules generally have a duration of five days,The Medical Retina, is a purely
theoretical module, offers every day different topics, with illustrations of clinical
cases and how to approach them with a session on surgical techniques. The
Surgical retina, on the other hand, is structured on two levels, basic and advanced.
In addition to the theory, it offers two days divided between wetlab and drylab with
the possibility of practicing on a 3D simulator.
The laboratories are equipped with the most advanced equipment and are
supervised by specialised trainers.
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217
THEIR GOALS ARE:
1. To provide the method for the correct application of the guidelines for the
diagnosis and treatment of retinal diseases, and the unique opportunity to take
advantage of the extensive clinical experience made available by leading
experts in the field.
2. To identify the surgical indications and to train the participant to face the surgical
pathologies of simple or high complexity in a correct and rational manner.
A particular module aiming to help the surgeon to highlight the essential elements
to read the specific characteristics of a surgical pathology, to choose the most
suitable surgical approach, to foresee and face possible difficulties and
complications and to manage the response to treatment.
PROGRAMME ACTIVITIES OFFER:
A different topic each day with clinical cases illustrating the disease in all its clinical
variables: how to provide a prognosis, how to choose the most suitable therapeutic
approach, how to identify all types of response to treatment and its possible
complications
• A session on para surgical techniques (Laser, Intravitreal Injection Therapy, etc.)

to present the treatment of retinal diseases
• Imaging courses with technical explanation of clinical engineers about the correct
use and potential of the most up-to- date instrumentation
• Practical instruction carried out in laboratories on wet lab stations fully equipped
with the most up-to- date equipment
• Technical improvement carried out in virtual reality on dry-lab stations that allow
the perfect reproduction of surgical techniques in the anterior chamber and
vitreous-retinal space
• Clinical engineers explaining the operation and optimal use of machinery and
surgical instruments
• Execution of different surgery techniques on pig eyes.
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In 10 years ESASO has contributed to the education of about 4000
ophthalmologists from all over the world.
Furthermore, ESASO will continue to dynamically optimize and adapt to the

changing educational needs of its students and partners.
It looks forward to fruitful collaborations and partnerships to reach the next level of
excellence in post-graduate ophthalmology training.
As part of the educational programme structure, ESASO started publishing the full
teaching syllabus in the ESASO Course Series volumes in order to make part of the
modules’ content available to a wider public.
Last but not least, the new specific courses for companies have extended the
ESASO learning experience to industry professionals future managers.
New research projects are on going for the best practice in ophthalmology.
ESASO Events 2019
ESASO Module: Cornea and corneal refractive surgery May 13-17 Vinnytsia, Ukraine
ESASO Module: Intermediate & Advanced Surgical Retina June 3 - 7 Lugano, Switzerland
ESASO Module: Intermediate & Advanced Surgical Retina July 3 - 7 Bangkok, Thailand
ESASO Module: Cornea and corneal refractive surgery September 23 - 27 Lugano, Switzerland
Milan Drives Europe: Pediatric Ophthalmology Updates September 20-21 Milan, Italy
Special Programme Lublino September 30 - October 4 Lublino, Poland
ESASO Module: Glaucoma October 14 - 18 Lugano, Switzerland
ESASO OCTA Course October 24-26 Lugano, Switzerland
ESASO Module: Basic Cataract and intraocular refractive surgery November 11 - 15 Lugano, Switzerland
Retina Academy November 14-16 Varsavia, Poland
ESASO Module: Intermediate & Advanced Cataract and intraocular refractive
December 2 - 6 Lugano, Switzerland
surgery
s
ESASO Module: Orbital, Lacrimal & ophthalmic plastic surgery January 27-31 Lugano, Switzerland
ESASO Module: Intermediate & Advanced Surgical Retina February 10-14 Lugano, Switzerland
ESASO Module: Medical Retina March 9-13 Rome, Italy
ESASO Module: Basic Surgical Retina March 30 - April 3 Lugano, Switzerland
ESASO Module: Orbital, Lacrimal & ophthalmic plastic surgery April 27 - May 1st Lugano, Switzerland
ESASO Module: Medical Retina May 11-15 Lugano, Switzerland
ESASO Module: Intermediate & Advanced Surgical Retina June 15-19 Lugano, Switzerland
ESASO Module: Cornea and Corneal refractive surgery September 21-25 Lugano, Switzerland
ESASO Module: Glaucoma October 19-23 Lugano, Switzerland
ESASO Module: Basic Cataract and Intraocular refractive surgery November 16-20 Lugano, Switzerland
ESASO Module: Intermediate & Advanced Cataract and Intraocular Refractive
December 14-18 Lugano, Switzerland
surgery
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SIMULATOR TRAINING - ETC LUGANO
Training courses with ophthalmic surgical simulators enhance technical skills of

participants and hands-on experience in vitreoretinal and cataract surgery through
the use of dry lab equipment, instruments, and technologies. Thanks to simulators’
software and sensors, every phase of surgery is reproduced in an extremely
realistic way, allowing participants to improve their surgical ability.
3D & SIMULATOR TRAINING - ETC LUGANO
Training courses with ophthalmic surgical simulators and 3D visualisation system

enhance technical skills of participants and hands-on experience in
vitreoretinal surgery through the use of dry lab equipment, instruments, and
technologies. Thanks to simulators’ software and sensors, every phase of surgery
is reproduced in an extremely realistic way, allowing participants to improve their
surgical ability. Training courses with 3D visualisation system give participants the
opportunity to try a new way of working.
For more information please see www.esaso.org
DR MARIO TORO DiSSO, FEBO is an honorary lecturer and a senior clinical researcher at the
General Department of Ophthalmology with paediatric service of SPSK1 hospital in Lublin (PL),
directed by Professor Robert Rejdak.
His Department is now regarded as the most known and with higher standards of ophthalmological
cares in Poland, and one of the European Referential Centres for the treatment and diagnosis of rare
ocular diseases (EYE-ERN).
His main interestes are the vitreoretinal and cataract surgeries.
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GOAP FELLOWSHIP AWARD :

MY EXPERIENCE
- DR PRERNA SHAH
WHAT IS GOAP AWARD?
Global Ophthalmology Award Program From Bayer is a mentored award program
that allows you to pursue research in the field of retina by providing the necessary
platform to do the same. Their aim is to encourage ophthalmologists to develop
skills and to support future thought leaders and to improve treatment outcomes and
patient quality of life through management of retinal diseases.
A GOAP grant could enable a recipient to make significant contributions to
research in ophthalmology by furthering experiments, contribute to tangible benefits
for patients with retinal disorders, improve patient access to high-quality eye care
and also increase disease understanding and dissemination of scientific knowledge
through publications.
There are two types of award, either a Fellowship Award or Research Award.
Applicants applying for the Fellowship Award should demonstrate commitment to
becoming a retinal specialist. The Research Award is an award supporting clinical
and/or basic research projects. The duration of the award is for 1 year and the grant
is upto 50,000USD.
The research focus changes every year. The year 2019 being biomarkersaandn d
phenotyping for retinal disease progression, 2018 about retinal
dystrophies, 2017 as biomarkers for wet ARMD etc.
APPLICATION PROCESS
An application process is vetted by a group of eminent healthcare
professionals from the field of ophthalmology ( Grant review and
Award Committee ) with an aim to encourage young
ophthalmologists and aspiring clinical scientists to pursue
careers as retinal specialists. The awards program is
helping to ensure that the next generation of patients has
access to high-quality eye care by funding cutting-edge
research that may lead to new therapies.
YO TiMES IAUG 2019

The application is a step wise process that begins at the beginning of the year. It
starts with submission of Letter-of-Intent which is then reviewed by the GRAC. The
selected applicants are then informed and requested to submit a Full Proposal
according to preset proforma. From these submissions the final awardees are
selected and funding is provided.
PROJECT
The fellowship award I applied for was titled - Ensuring healthy eyes in
premature infants using tele-screening for Retinopathy Of Prematurity in
community with an aim to set up a customised tele screening protocol using a
portable 3nethra Forus NeoCamera to screen preterm babies in their hospital, to
provide diagnosis by connecting to a Vitreo-Retinal specialist through tele
ophthalmology and to decide for urgent treatment or deferred referral.
This project for ROP screening has been planned for the district of Madurai, Tamil
Nadu , India and additional districts of Sivagangai and , or Virudhnagar , both
districts in the state of Tamil Nadu , India. An existing project by Arvind Eye Hospital
with the NICUs in Madurai entails sending trained ophthalmologists from the Vitreo-
Retinal Services for screening.
Under the programme being
proposed, one year will be
divided as follows – the
preparation period, the
training period, and the
screening period. The one
month allocated to
preparation includes
obtaining oral permission/
approval written letters from
NICUs, making screening
protocol, and preparing ,
distributing IEC material and
for acquiring equipment,
software on a laptop,
updating the ADRES
software to the base
hospital
RECEIVING THE AWARD FROM PROF. BANDELLO
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222
Within the second month, I will be trained by my mentor to screen babies at risk
with 3Nethra Forus Neocamera during which images will be collected, assessed by
my mentor but not run through software. In months three and four, all screened
babies will have their fundus photographed by me and images sent to base hospital
by telecommunication.They will be assessed by my mentor, and referral or
management may be advised. The months five and six would be utilized in training
technicians by me with the use of the 3nethra Forus Neo Camera for capturing
images with the use of mannequin, uploading images to be evaluated by base
hospital and communicating to the NICU, the need for referral and management
strategies offered by base hospital for each baby .
The next six months will be spent screening babies from the NICUs using
photographs taken by technician and uploaded ,to be analyzed by me at base
hospital. Once analyzed by me and also with the modified ADRES software, need
for treatment either in form of laser or intravitreal injection, referral either to base
hospital, or review with NICU will be conveyed to the respective parents. The last
month of the project will be used for data analysis and report writing
BENEFITS
This project may be important in decreasing the attrition of the babies reaching
ophthalmologist after they have been advised screening and, giving a chance to all
those babies whose systemic condition does not allow their check up at distant
hospitals.
By screening babies with the camera at their own NICU, there are multiple benefits.
The babies remain in the healthy environment of the NICU, their systemic condition
is well monitored, travelling is prevented, thereby reducing risk
of exposure to infection. The neonatologist/ paediatrician is
involved in the whole process, allowing them to modulate
treatment processes. Also, photographs taken by the camera
area available for comparison, decreasing the measure of error
Our current reach for diagnosis and treatment for retinopathy
of prematurity is as low as 30% of the desired outcome, which
means that there is an urgent need to address the growing
issue of ROP associated blindness. This programme will give
an additional benefit of alleviating the necessity of trained ROP
specialist’s visit to the NICU, thereby increasing the utility and
productivity of the services at the hospital and screening at
NICUs without time hindrance.
THE GOAP AWARD

TIPS AND SUGGESTIONS
Have a clear idea of what you want. Define the
problem statement so that there are no
uncertainty. Put forward plausible definitions.
Have an easy and achievable success criteria
and adhere strictly to deadlines. Identify your
benefits on how you can maximize on the grant
by expanding the research question. And always
ask for help. When I wrote the full proposal, apart
from my mentor Dr. Renu Rajan and co-author
Dr.Sanjana Naik, the inputs for the proposal
came from our Chief medical Officer, Dr Kim
Ramasamy and Chief of Paediatric
Ophthalmology, Dr. P. Vijayalakshmi. It is with
the wisdom of many, and hard work of few that I
have had the privilege to be awarded with the
GOAP award
DR. PRERENA SHAH, MBBS, DNB FICO FVRS, is a medical officer at Aravind Eye
Hospital ,Madurai, TamilNadu. She has presented at various conferences at state , national
and international level. She is one of the 12 clinicians who received a grant of $50,000 as part
of Bayer India’s Global Ophthalmology Awards Program - an initiative by Bayer India to
promote research and development in Ophthalmology for the year 2018.
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P A G E
INSTITUTE WATCH
SENIOR RESIDENCY
45. GNEC, New Delhi 225
46. PGI, Chandigarh 229
47. McH Vitreoretina, PGI, Chandigarh 231
48. RP Centre, AIIMS, Delhi 233
FELLOWSHIPS
49. Aditya Jyot Eye Hospital, Mumbai 235
50. Aravind Eye Hospital, Madurai 238
51. Centre for Sight Eye Institute, New Delhi 242
52. Chaithanya Eye Hospital And Research Institute, 247
Thiruvananthapuram
53. C.H. Nagri Eye Hospital, Ahmedabad 251

54. C.L. Gupta Eye Institute, Moradabad 254
55. Dr. Shroff Charity Eye Hospital, New Delhi 258
56. Eye Foundation, Coimbatore 261
57. Giridhar Eye Institute, Kochi 265
58. Haji Bachooali Charitable Ophthalmic & ENT
269
Hospital, Mumbai
59. HV Desai Eye Institute, Pune 271

60. Indra Gandhi Eye Hospital, Lucknow 275
61. LV Prasad Eye Institute 277
P A G E
INSTITUTE WATCH
62. ROP Training, LVPEI, Hyderabad 281
63. MGM Eye Institute, Raipur 284
64. Minto Eye Hospital, Bangaluru 287
65. MM Joshi Eye Hospital, Hubbali 290
66. Nandadeep Eye Hospital, Sangli 294
67. Narayana Nethralaya, Bangaluru 297
68. National Institute of Ophthalmology, Pune 300
69. Nethradhama Super Speciality Eye Hospital, 303
Bangaluru
70. Prakash Netra Kendra, Lucknow 306

71. Raj Eye Hospital, Gorakhpur 309
72. Retina Foundation, Ahmedabad 311
73. Retina Hospital, Rajkot, Gujarat 315
74. Retina Institute of Karnataka, Bangaluru 318
75. Sadguru Netra Chikitsalaya, Chitrakoot 321
76. Sankara Eye Hospital 324
77. Sankara Nethralaya, Chennai 328
78. Shanti Saroj Netralay, Miraj 331
79. Shri Ganapati Netralaya, Jalna 333
80. Sri Sankaradeva Nethralaya, Guwahati 337
81. Susrut Eye Foundation & Research Centre, Kolkata 341
INSTITUTE WATCH
SENIOR RESIDENCY IN VITREORETINA AT

GURU NANAK EYE CENTRE, NEW DELHI
-DR. ANIKA GUPTA
Super specialty training in ophthalmology in India is synonymous with fellowship

programmes. Although, the ideal Vitreo-Retina training may be a long-term
fellowship course, however the quality and training module varies from one institute
to the other. At the same time, Senior Residency in Vitreo-Retina at Guru Nanak
Eye Centre, Maulana Azad Medical College, New Delhi, which is one of the premier
medical colleges of the country equipped with the latest technology is also a great
platform to pursue super specialty training in retina.
Guru Nanak Eye Centre (GNEC), New Delhi is the largest Delhi Government
operated hospital offering medical and surgical Vitreo-Retinal services to patients
across north India free of cost. GNEC offers senior residency posts to candidates
with a recognized ophthalmology degree (MS, DNB, Diploma) for a duration of 3
years. The retina unit is incharge of the Vitreo-Retina services at GNEC and usually
consists of three senior residents, one for each year of residency. The senior
resident posts for the institute are advertised on a yearly basis in the second
quarter (July- August) of the year at www.health.delhigovt.nic.in. The numbersofof
seats depend on the number of third year senior residents completing their course,
which usually would consist of one vacancy in the retina unit. The selection process
is a two-step process which includes a written comprehensive ophthalmology
entrance test, which is common for all candidates followed by an interview for the
candidates who score more than 50% in the written test. A strong curriculum vitae
with academic work and participation at national and international platforms, along
with a good knowledge of ophthalmology gives a candidate an edge
over the others. The final list of selected candidates is for the
institute rather than a particular specialty; however, the
candidates may mention their preferred specialty, which is
usually taken into consideration at the time of allotment of
units. The date of joining may vary anywhere between
August – March depending on the completion date of the
outgoing senior resident.
YO TiMES I AUG 2019

The Retina clinic at GNEC offers medical retina services including investigative
procedures and therapeutic retinal lasers. It is well equipped with Fundus
photography (Zeiss Visucam, Germany), Fundus Fluorescein Angiography (Zeiss
Visucam, Germany), Indocyanine green angiography (Zeiss Visucam, Germany)
and Spectral domain Optical Coherence Tomography (OCT) with Enhanced Depth
Imaging (EDI) mode and OCT Angiography (Nidek RS3000 Advance 2, Japan).
Both slit lamp delivery and laser indirect ophthalmoscopy are available for single
spot Nd-Yag laser (Zeiss Visulas, Germany), along with a multi spot Nd-Yag laser
system (Lumenis, Israel) and Yellow micropulse laser (Iridex IQ 577, Germany).
With the available imaging devices, one gets trained to perform diagnostics for
various vitreo-retinal pathologies, including uvea. GNEC is also the ROP referral
center for Delhi and Central Government hospitals. ROP screening as well as laser
treatment is routinely done at the retina clinic, however, surgical treatment facility
for ROP is not available. During residency, one can expect to perform over 100
ROP lasers and well above 1000 retinal lasers.
The surgical vitreo-retina armamentarium at GNEC consists of Zeiss OPMI Lumera

T surgical microscope with Zeiss Resight 500 viewing system. The hand-held Volk
wide angle viewing system and irrigating contact lens are also available. Among
vitrectomy systems, the Stellaris PC (Bausch and Lomb, USA) and megaTRON S4

HPS microsurgical system (Geuder, Germany) are available with 23-gauge
equipment. All vitreoretinal forceps and scissors are available in 23-gauge,
chandelier illumination system is however, not yet available. Scleral buckling
equipment with cryotherapy is available, along with anesthesia backup for pediatric
vitreoretinal surgeries. During residency, one gets to perform scleral buckling
procedures and vitrectomies for various retinal disorders, including macular
surgeries and complex vitrectomies both supervised and independently. There is a
great deal of hand-on retinal surgical exposure during residency training, with an
average number of over 200 surgeries at the end of 3 years. Intravitreal injections
are also routinely given.
Being an academic and tertiary care research institute, emphasis is always on

various academic activities at the institute and as a senior resident research
publications and active conference participation is always motivated and
encouraged by the institute. The senior residency tenure does not include any
rotation in the other units or any peripheral centres and there are no compulsory
commitments with the institute after completion. Post senior residency, one may
consider one of the international fellowships to enhance their skills and get a global
perspective, which I personally feel is an asset in one’s super specialty training.
Apart from the training aspect, a lot of other factors are important in the practical
world, especially when considering a long-term course after post-graduation. During
senior residency, the salary provided by the Delhi government varies from 1.1 lakhs
to 1.3 lakhs per month depending on the year of residency. One is also entitled to
about 30 leaves per year, excluding the various national holidays in a year. As a
professional at a government institute, one is also eligible for the academic grants
provided by the government research authorities for their academic activities. Apart
from training in a specific specialty, during senior residency there is also exposure
to comprehensive ophthalmology and one also performs cataract surgeries on a
regular basis, which is almost indispensable for an ophthalmologist in the practical
world. At the completion of senior residency, a teaching certificate is provided by the
institute, which is a prerequisite for anyone considering a teaching job at a
government medical college in future.
As a GNEC alumnus, I owe my professional knowledge and skills to my alma

mater. Exposure to a large number and variety of clinical cases, helped me
enhance my clinical skills under the guidance of my consultants. Vitreoretinal
surgeries are very demanding and can be very unpredictable with some potentially
devastating complications, even with the most experienced surgeons. The

importance of a good hands-on surgical exposure during our vitreo-retinal training
cannot be undermined. It helped me nurture my microsurgical skills and be a
confident retinal surgeon capable of managing my cases and complications
independently.
I hope with this article, the aspiring vitreo-retina young ophthalmologists have an
understanding of the training module and experience during senior residency at
GNEC and it helps them in opting for their preferred training institute. If anyone has
any questions and queries regarding this, they can contact the following present/
past senior residents from GNEC.
Dr. Bhumika Sharma : [email protected]

Dr. Kirti Jai Singh : [email protected]
Dr. Ketaki Rajurkar : [email protected]
The academic department for any queries at Guru Nanak Eye Centre can be
reached at [email protected] or 011-23230033. 
DR. ANIKA GUPTA is a Vitreoretina and Cataract surgeon, currently working at Centre for Sight,
New Delhi as Vitreoretina consultant. She is an alumnus of the prestigious Maulana Azad Medical
College, New Delhi where she pursued her MBBS, MS and Senior residency training in Vitreoretina
(GNEC).

INSTITUTE WATCH
SENIOR RESIDENCY IN VITREO-RETINA

AT PGI, CHANDIGARH
-Dr. SAMENDRA KARKHUR
Senior Residency (SR-ship) at PGI is one of the most sought-after training

programs in ophthalmology in the country. More so, if it is in the department of
Vitreo-Retina and Uveitis. The department is not strictly compartmentalized into
separate Medical Retina, Surgical Retina & Uvea and follows a unit system. The SR
is usually assigned to a particular consultant in one of the several units. Most
faculty in the department of VR practice all aspects of the specialty like, medical/
surgical retina, uvea, ROP and paediatric retina. Rotation among different
consultants may be possible.
There no fixed number of seats but roughly speaking 3 to 5 seats may be filled
every year. Exact details need to be looked at the PGIMER website for vacancies,
written test and interview dates. Please also look at the qualification criteria for SR-
ship at PGI on the website and MCI guidelines, especially if you are a DNB in
Ophthalmology. The duration is 3 years. Completion makes you eligible for
recruitment in any state/central institution for faculty position.
Exposure to research is tremendous and if one shows inclination and interest; you
can complete the program with a good number of publications in reputed journals
with unrestricted ‘first authorship’ depending on your contribution. Number of
surgeries, lasers and injections are adequate for becoming a confident and well
trained surgeon. Stipend is as per the central government guidelines. There is
however no compulsory bond or compulsory commitment after the program.
Entire training program is completed at PGIMER, Chandigarh and there is no

peripheral or satellite centre rotation as of now. Advanced Eye Centre, PGI has
recently started Mch. Program in VR, which is an MCI recognized 3 years
super-specialty degree parallel to SRship with compulsory thesis
program. Details of Mch program can be looked at the website of one is
interested in facing another competitive exam and 3 years of exhaustive
grilling ☺
YO TiMES I AUG 2019

PGIMER is a highly rated and prestigious central government institution with
exhaustive work-hours, tremendous patient load and infinite opportunities for
learning by doing. It a personal limit that decides how much one can absorb from
the high quality training, up for grabs.
All the best!
Dr. SAMENDRA KARKHUR MS, DNB, FICO, FAICO (UVEA), MNAMS, is presently appointed as an
Assistant Professor in Ophthalmology, AIIMS Bhopal, Madhya Pradesh. He has completed his
training in Vitreo-Retina, ROP & Uvea from PGI, Chandigarh. He is a visiting instructor at Byers Eye
Institute, Stanfor University School of Medicine, Palo, Alto, CA, USA.

INSTITUTE WATCH
MCH - VITREO-RETINA & UVEITIS,

PGI CHANDIGARH
-DR. ATUL ARORA
Recently a super speciality course M.Ch. Vireo-retina has been started in

PGIMER, Chandigarh, an established Central government institute. The course
consists of 3 years duration with rotational postings in Medical retina, Surgical
retina and Uveitis.
Being a tertiary care institute, there is significant footfall of patients and also referral
of diagnostically and surgically challenging cases thereby providing ample
opportunity to master clinical skills and surgical experience.
There is a passing exam after 2 1/2 yrs and one also needs to submit a thesis at
the end of second year of residency.
Application and selection process
To be eligible, a candidate should have:
a) Passed the required MD/MS, or its equivalent qualification, recognised by the

Medical Council of India (MCI).
b) Must be registered with Central /State Medical Registration Council.
c) Must be within the prescribed age limit as on/before 31st December for January
and 30th June for July session respectively as detailed below:
- For general category candidates: 35 years
- For OBC candidates: 38 years
- For SC/ST candidates, Ex-Servicemen and Commissioned Officers: 40
years
- For Deputed/Sponsored candidates: No age limit
Entrance examination:
Selection of candidate for D.M./M.Ch. courses is based on

Theory examination consisting of a paper with two parts (Part
YO TiMES I AUG 2019

1 – General, and Part 2 – Specialty), each with 40 marks. Part 1 will consist of 40
multiple choice questions, each with four options and a single most appropriate
response. The questions will be from the subject corresponding to the candidate’s
postgraduate qualification. Part 2 of the paper will consist of 40 multiple choice
questions related to the specialty for which the candidate has applied, each with
five options and single/multiple correct response(s). Total duration of the theory
examination is 90 minutes.
The exam is held twice a year for January and July session.
Chandigarh experience:
Located at the foothills of Shivalik mountains, Chandigarh (The City Beautiful)

provides a peaceful abode to study, work and enjoy. A morning stroll at the Sukhna
Lake or an evening hang out at the Elante with friends provides rejuvenation from
hectic work schedule. The people are homely and helpful.
Stay: One can choose hostel facility provided by the institute in lieu of house rent
allowance or take paying guest accomodation from numerous options available
nearby.
DR. ATUL ARORA MS, is pursuing his Mch in Vitreo-Retina from PGI chandigarh. He can be
reached at [email protected]

INSTITUTE WATCH
RAJENDRA PRASAD CENTRE FOR

OPHTHALMIC SCIENCES, AIIMS,
NEW DELHI  
1. Number of seats of various long and 4. Probable number of surgeries,
short term Retina training lasers and injections one might
programs ? expect ?
Variable, 1 to 5 biannual A good number of surgeries are made

available during the course of senior
residency. The initial 6 months or so
2. Duration of fellowship/training ? are mainly focused on learning about
the diseases and surgical training by
3 years assistance.Thereafter an average of
around 3 retina surgeries are made
available each OT day.
3. Exposure to research and
expectations by the institute in Laser procedures of the retina are
research ? taught and performed under
supervision for about a month or so
Excellent opportunities for research. then independently for the rest of the
Centre is equipped with ultra modern course. 
instruments, state of the art diagnostic
and therapeutic modalities and above A significant number of intravitreal
all has immense patient load all Injection are administered on days
conducive for research. allotted, the procedure is taught under
supervision for initial months then
performed independently.

5. Names & positions of Medical retina ROP lasers under supervision. In
and VR Faculties ? addition there is also a fair exposure to
Ocular oncology. 
• Available on Website
10. Brief overview of VR equipments

6. Selection procedure in brief available in the Institute.
including probable dates (Interview
& Joining) ? All latest surgical and diagnostic
equipments are available
Selection procedure comprises of two
steps. First being 80 multiple choice
11. Any post fellowship International
question which is followed by a round exposure?
of interview of the eligible candidates. 
Exam is conducted every 6 months. There is no provision for post
Probably in the months of June and fellowship International exposure. But
December  attending International conferences is
encouraged. 
7. Most important points that you

consider in a CV ? 12. Any bonds or compulsory
• Number of surgeries performed commitments with the institution
• Experience after completion?
• Academic research/ publications
No bonds or mandatory commitments
after completion.
8. Stipend
Salary is as per the government norms. It 13. Any peripheral centres for
is more than sufficient to cover for compulsory rotation and duration of
expenses.  the same ?
Rotational duties are put up for

9. Exposure to other areas like ROP, peripheral centres like Jhajjar and
Ocular Oncology, Uvea etc Ballabhgarh for maximum of 45 days.
Apart for medical and surgical retina, the

course also offers a vast exposure to
Uvea and ROP. Residents are trained in
  DR NITESH SALUNKHE
MD(AIIMS , NEW DELHI), DNB
EX SENIOR RESIDENT, DR R.P CENTRE, AIIMS
CURRENTLY WORKING AS CONSULTANT VITREO-RETINA, UVEA, ROP AT
ASG EYE HOSPITAL, PUNE, MAHARASHTRA

INSTITUTE WATCH
ADITYA JYOT EYE HOSPITAL,

MUMBAI
Aditya Jyot Eye Hospital has more than two decades of services with more than
100 years of combined experienced hands in eye care. Aditya Jyot offers medical
retina as well as surgical retina fellowship courses. We are proud to have
successfully trained over 60 doctors under the guidance of Prof. Dr. S Natarajan
and team of well known retina surgeons. We are one of the very few hospitals
with all the specialities of eye care under one roof making cross consultation
easy and seamless. All eye disorders including the most complicated ones are
treated here with utmost precision and compassionate care.
Fellows can get exposure to a variety of retinal disorders like diabetic
retinopathy, retinal vein occlusions, macular degeneration, hereditary retinal
dystrophies, ROP, etc. They are encouraged to participate in conferences and
CMEs, and take part in research activities. Additionally, also organise and take
part in community eye care camps in conduction with our Aditya Jyot Foundation
for Twinkling Little Eyes (AJFTLE).
Aditya Jyot Eye Hospital also have DNB seats and is the first NABH Accredited
eye hospital in Mumbai.
YO TiMESI AUG 2019

235
YO TiMES I MAY 2019
1. Number of seats of various long and 7. Most important points that you
short term Retina training consider in a CV ?
programs ?
• Surgical exposure
Long term retina fellowship - 4 • Publications
• Recommendations
Short term retina fellowship - 2 
8. Stipend
2. Duration of fellowship ?
30,000/-
Long term - 18 months
9. Exposure to other areas like ROP,
Short term (Medical Retina) - 12 Ocular Oncology, Uvea etc
months
Average
expectations by the institute in 10. Brief overview of VR equipments
research ? available in the Institute.
There are a lot of research Zeiss Cirrus SD 500 OCT machine

opportunities. Various collaborations
with researchers from all over the Zeiss FF450 Plus Fundus camera,
world.  FFA, ICGA
4. Probable number of surgeries, Compact Touch B Scan machine

lasers and injections one might
expect ? Zeiss Visulas 532 laser machine
Lasers and injections - > 100 in a Appasamy JERICHO 532 laser

duration of 18 months. machine
Surgeries - variable. Alcon Constellation vitrectomy machine
5. Names & positions of Medical retina Resight & Oculus Viewing system
and VR Faculties ?
Various retinal instruments including
• Dr. S. Natarajan - Chairman advanced instrumentation for the
and Managing Director management of IOFB - pellet.
• Dr. Jaydeep Walinjkar - Vitreo 11. Number of permitted leaves

Retina Consultant (To Join
From 15th June 2019) 23 casual leaves in a span of 18
months.
• Dr. Amit Jain - Vitreo Retina
Consultant Academic leaves - yes, depending on
academic presentations, posters,
• Dr. Ritu Shah - Adjunct Vitreo papers, research, etc.
Retina Consultant
6. Selection procedure in brief exposure?
& Joining) ? Encouraged to apply for international
fellowships like APAO fellowship, etc.
Send in your CV to the fellowship
director ([email protected]). You
will be asked to fill in a fellowship
application form and an interview will
be scheduled. No fixed date of
interview or joining. 

13. Any bonds or compulsory 15. Contact details ( Phone & Email) of
commitments with the institution the academic department.
after completion?
Mr. Joseph Thomas - 9819997978 -
No compulsory bonds / commitments  [email protected],
[email protected]
14. Any peripheral centres for
compulsory rotation and duration of 16. Names and Contact details of 3
the same ? past(within 2 years) or present
fellows.
Yes. On rotation basis at various
centres. Various camps conducted by Dr. Sonali Verma - 9755778322
Aditya Jyot Foundation for Twinkling [email protected]
Little Eyes(AJFTLE) - in Mumbai and
also outside Mumbai. Dr. Chaitali Bhavsar - 9850061323
[email protected]
Dr. Mohd. Anash Pathan - 9799710786

[email protected]
Young Ophthalmologists Times is highly indebted to Dr S. Natarajan for providing us the above
information.
YO TiMESI AUG 2019

237
INSTITUTE WATCH
ARAVIND EYE HOSPITAL,

MADURAI
Aravind Eye Hospital was founded in 1976, by Dr. G. Venkataswamy, a man

known to most of us simply as Dr. V. In an eleven bed hospital manned by 4
medical officers, he saw the potential for what is today, one of the largest
facilities in the world for eye care. Over the years, this organization has
evolved into a sophisticated system dedicated to compassionate service for
sight. The Aravind Eye Care System now serves as a model, for India, and
the rest of the world.
 
YO TiMESI AUG 2019 238

1. Number of seats of various long and 5. Names & positions of Medical retina
short term Retina training and VR Faculties ?
programs ?
Please look at our website.
The Retina department at Aravind eye
hospital offers a 2-year long term
surgical fellowship in vitreous and 6. Selection procedure in brief
retina (4 candidates every 6 months) including probable dates (Interview
and a 1-year long fellowship in medical & Joining) ?
retina (1 candidates every 6 months).
The department also offers a 1 month The selection of long term fellows
long short-term training in retinopathy happens twice a year (January and
of prematurity (one candidate every July). Interested candidates can apply
month) and a 2 month long short-term through the online portal of Aravind eye
training in lasers for diabetic hospital. Selection will be based on a
retinopathy (2 candidates every written test(MCQ) followed by an
month). interview.
Mentioned Above consider in a CV ?
3. Exposure to research and Candidates’ knowledge and passion in

expectations by the institute in the subject, previous academic
research ? achievements ( publications , Awards ,
thesis , number of conference papers)
The department provides ample and surgical exposure will also be
opportunity and resources for research taken into account
in the both the fields of surgical and
medical retina. Every candidate 8. Stipend
undergoing the long-term fellowship is
expected to be actively involved in Selected candidates are eligible for a
research based on his / her own stipend of Rs.20,000 during the first
original ideas and scientific questions. year and Rs.27,000 during the second
Such activities are periodically year.
monitored and feedback and expert
advice are provided. Average retina 9. Exposure to other areas like ROP,
OPD at Aravind eye hospital ,madurai Ocular Oncology, Uvea etc
is more than 600 per day which
provides a very good exposure to the The candidates are posted in the uvea
candidates . department for one entire month where
they are exposed to an extensive range
of uveitis and related conditions and
4. Probable number of surgeries, their management modalities. The
lasers and injections one might candidates are also posted on ROP and
expect ? retinoblastoma posting where they
receive hands on training in the
Every candidate undergoing the long- examination, diagnosis and
term fellowship has one operation management of these conditions.
theatre day every week throughout the
entire course of the fellowship and they 10. Brief overview of VR equipments
are trained systematically and stepwise available in the Institute.
in surgical procedures by the medical
officers in the department. Similarly, The department is well equipped with
every fellow has one day posting in advanced and extensive state of art
lasers every week where they get to do instruments in both lasers and surgical
an average of 20 lasers per day. operating systems including pattern
yellow and green lasers like PASCAL,
3D operating system (NGENUITY) and
high-end vitrectomy systems.The

hospital wetlab also has a simulator to
train for VR surgery (Eyesi) . 14. Contact details ( Phone & Email) of
the academic department.
11. Number of permitted leaves Central Office

Email :
15 days per calendar year [email protected]
Phone : 0452 4356500
12. Any post fellowship International Retina department:
exposure? Aravind Eye Hospital
1, Anna Nagar
Nil Madurai
Phone: 0452 4356100
13. Any bonds or compulsory Fax: 0452 2530984
commitments with the institution Email: [email protected]
after completion?
Nil
Young Ophthalmologists Times is highly indebted to Dr Naresh Babu for providing us the above
information.

VITREO-RETINA FELLOWSHIP INTERVIEW EXPERIENCE AT
ARAVIND EYE HOSPITAL, MADURAI
- DR. TANYA JAIN 
I am a Primary DNB candidate, and during my residency I was convinced that I wanted to pursue a
career in Vitreo-Retina. Coming from a high volume center (Sadguru Netra Chikitsalaya, Chirakoot)
during DNB most of my options included Institutions with a high volume setup and good
academics.
Everyone and anyone even sparsely related to Ophthalmology has heard about the Prestigious
Aravind Eye Hospital. Hence, I applied for a Vitreo-Retina fellowhip there through their website.
Even though my practical result had not come out, eventually I did have my result before the
interview. I received a confirmation e-mail by Mrs. Uma and I went for the interview at Madurai in
May 2019.
They had invited applications for 2 seats in Madurai and 1 each for the centers at Pondicherry and
Tirunelveli. The application form is exhaustive and one is required to upload all the documents
before hand, including MBBS marks card, degree certificate and registration among others.
Upon reaching the center, the interview was exclusively for Retina fellowship at the Retina
department. There was an MCQ exam, which included 15 image based one-word answer type
questions and 35 MCQ. All images and most questions were retina and uvea based. This was for
about 1 and a half hours. After that, they invited all the participants for the interview. It was
conducted by Dr. R. Kim (Chief Medical Officer) and Dr. K. Naresh Babu (Head of Department).
They were extremely warm and welcoming. They asked me a range of question varying from my
personal choices in life to my involvement in various research activities at our Institute. They also
judged me based on the amount of work I had in my residency. I was asked about some basics of
laser and few vitreo-retinal procedures. They also asked me about my future aspirations and if I
would be able to live in Madurai. My interview went on for about 45 minutes. At the end they told
me that they would inform me 1 week later.
I received an email about 4 days later, informing me about my selection at Madurai and I was given
about a month’s time to decide and send my confirmation.
It was pretty smooth and simple. They are basically judging your passion and your hard work
throughout the 3 years of your post graduation. It would be advisable to brush up on your research
work and a few publications and real interest in the subjects really helps.
All the Best!! 
DR. TANYA JAIN, MBBS, DNB, FICO is a Vitreo-Retina fellow at Sadaguru Netra
Chikitsalaya, Chitrakoot. He can be contacted at [email protected]

INSTITUTE WATCH
CENTRE FOR SIGHT EYE

INSTITUTE, NEW DELHI
Centre for Sight Eye Institute (CFSEI), Dwarka, Delhi is a premier eye care facility
where the most well-known names in Ophthalmology engage in teaching, research and
patient care.
• The institute offers you an exposure and training into the ever-expanding world of
retina both as a 4 month short term medical retina fellowship and as 2 year long
term Vitreo-Retina fellowship.
• The aim is to mature a suitably knowledgeable and experienced Vitreo - Retina

surgeon who possess advanced level competency in the diagnosis and management
of varied Vitreo-Retinal diseases or through the short term program provide a broad
and extensive exposure to medical retina as a basis for pursuing a subsequent career
as a comprehensive ophthalmologist.
• The program provides an opportunity to obtain both clinical and evidence-based

experiences. Clinical training will focus on retinal diseases such as Diabetic
retinopathy, Age related macular degeneration (AMD), Retinal vascular diseases,
ROP, Various types of uveitis and diagnostic approaches to genetic
retinopathies and maculopathies etc.
• The use of retinal imaging for clinical diagnosis and

as follow up tools will be emphasised upon
during the program. Long term fellows will
get an opportunity to train in varied
procedures eg. Intravitreal injections,
Laser (direct and indirect), cryopexy,
scleral buckling, pars plana
vitrectomy (both simple and
complex) as appropriate under
supervision.
• The program will also try and

stimulate the minds towards
epidemiological research (both
retrospective and prospective)
and toward publications in
academic journals
242
1. Number of seats of various • at least 500 intravitreal injections.
long and short term Retina
training programs 5. Names & positions of VR
Faculties
• One seat for long term fellowship
every six months (April and 1. Dr. Lalit Verma
October) 2. Dr. Dinesh Talwar
• One seat for Short term 3. Dr. Avrindra Gupta
fellowship Every 4 months April, 4. Dr. Ritesh Narula
August, December 5. Dr. Arindam Chakravarty
6. Dr. Saurabh Arora
2. Duration of fellowship 7. Dr. Chitralekha De
• Long term fellowship – 2 Years 6. Selection procedure in brief

• Short term fellowship – 4 Months including probable dates
(3 months medical retina + 1 (Interview & Joining)
month surgical retina
Observership) • The selection will be based on a
two-step process involving a
3. Exposure to research and MCQ paper followed by an
expectations by the institute in interview with the Board of
research Consultants.The written test,
generally conducted in (March
CFSEI, Dwarka, being optimally and September) and will
equipped and staffed, is the home- constitute of 50 multiple choice
ground for multiple ongoing questions, each question having
international and national clinical four choices to choose from.
trials. In an effort to train the fellows Each correct answer will fetch the
in research protocols and candidate one mark and each
methodology, fellows are actively wrong answer will have a
engaged in these trials and have to Negative marking of one mark.
complete one research project during
their tenure. All projects are ethically • A merit list consisting of Five
approved by the Centre for Sight times the number of seats in the
Institutional Ethics Committee (CFS- concerned specialty will be
IMEC). prepared and displayed at the
examination centre. These
4. Probable number of surgeries, candidates will be eligible to
lasers and injections one might appear for the interview.
expect
• The interview board will
Though a lot of these numbers unanimously prepare a merit list
depend on the initial skills and the consisting of double the number
grasping speed of the fellow, but as a of candidates as the vacancies.
thumb rule we expect the fellows to Call letters will be sent to the
perform around successful candidates and wait
listed candidates, instructing them
• 150 VR surgeries,
to deposit the fee/security deposit
• 150 retinal lasers
and confirm acceptance of

admission at least 10 days before 10. Brief overview of VR
the start of the course, so that in equipments available in the
case of a vacancy, the next wait Institute.
listed candidate can be called.
• The admission to short term a) Zeiss Lumera I with Resight
fellowship will be on “First come, b) Constellation Vitrectomy System
First Served” basis. A list to this d) Endolaser
effect will be maintained and all e) Heidelberg Spectralis FFA,ICG &
candidates opting for that OCT
particular specialty will be asked g) Optivue Avante with OCT
for their willingness to join and the Angiography
receipt of acceptance and course h) Appasamy USG-B Scan and
fee will confirm the admission. UBM
7. 3 most important points that 11. Number of permitted leaves

you consider in a CV
• One and a half days Privilege
a) Academic Excellence leave per month, which cannot be
b) Capacity to put in long hours used in the first and last months
unhindered by personal of the fellowship.
commitments and • More than 6 days leave will not
responsibilities be sanctioned at a time.
c) Background in Research & • 7 days of Academic leave to
Publications attend conferences at their own
expense (only for oral paper.)
8. Stipend
• Long Term fellowship :- Rs 12. Any post fellowship
30,000/- p.m. First year; Rs International exposure ?
40,000/- Second year. (All NA
inclusive , 10% TDS will be
deducted) 13. Any bonds or compulsory
• Short term fellowship – Fee commitments with the institution
based, a fee of Rs 50,000/- per after completion?
course (Subject to change without
notice) No bond or compulsory commitment
post completion.
9. Exposure to other areas like
ROP, Ocular Oncology, Uvea etc 14. Any peripheral centres for
compulsory rotation and duration
The Occuloplasty department, of the same
headed by Dr Vikas Menon has all
facilities to provide exposure to the Can be posted to other centres of
latest diagnostic and treatment Centre for Sight as independent
modalities for the same. consultants and for surgical
procedures.

15. Contact details ( Phone &
Email) of the academic 16. Names and Contact details of 3
department. past (within 2 years) or present
fellows.
CFS Training, Cell Centre for Sight
Eye Institute a) Dr Mithun Thulasidas :
[email protected]
Plot No 9, Sector 9, Opp. R D Rajpal
School,Dwarka, New Delhi- 110075 b) Shraddha R Pawar :
Tel- +91 9958956838, 1800 120 [email protected]
0477, +91 11 40022955 c) Rupin Dang :
E-mail [email protected] [email protected] 
www.centreforsight.net
 
Young Ophthalmologists Times is highly indebted to Dr Tarun Choudhury for providing us the
above information.
YO TiMES IAUG 2019

VR FELLOWSHIP INTERVIEW EXPERIENCE AT CFS
-DR SHRADDHA PAWAR
After completion of MS, I was serving my 1 year compulsory PG bond as

speciality medical officer . During the last few months there was a big
question….what next?? I Started searching for various fellowship programs in
various institutes. And came to know that Centre For Sight, New Delhi has
decided to start the Fellowship teaching programme. I immediately sent my CV to
Dr. Tarun Chaudhary, co-ordinator of fellowship training programme and very
soon got the reply from him. We were asked to fill the form with basic
information.
The candidates were called at CFS Eye Institute, Dwarka , New Delhi for
the further process. Our documents were verified. Selection process comprised
of 2 parts. In the first part all candidates were asked to give MCQs examination
which contained 50 questions to be solved in 1 hour. After 1 hour results were
declared and amongst all candidates only few were declared as qualified for the
second part of selection process i.e interview. I was one of those selected
candidates. Felt very joyous and proud after hearing my name in those selected
candidates.
The interview was conducted in the board room. The panel members were
Dr. Mahipal Singh Sachdev, MD and Chairman of CFS, Dr. Harsh Kumar, Dr.
Ritesh Narula, Dr. Ritika Sachdev and Dr. Keya Barman.
I was made very comfortable as soon as I entered the board room. It was
the first time when I personally talked to the legend himself DR. Mahipal sir. He
was very humble and kind towards all the candidates. The questions asked in the
interview started with general ophthalmology, and then mainly related to VR. I
was also asked about my family and my future plans and settlement. Once the
interview was over , on the same day at the end the selected candidates were
called again in the board room and were told about the selection. We were given
time of few days to decide and were asked to send the conformation letter by
email. After conformation we were given time of 1 month to join the institute.The
day spent in CFS was very memorable. Especially, the whole process of
selection was conducted very well and all the candidates were treated very nicely
by the staff of CFS.
Before giving any fellowship interview it is very important to be clear about the
sub-speciality you are more interested in and also about the future plans.
I am very thankful to DR Mahipal Sachdev Sir and team CFS for making me
part of such a great institute.
DR. SHRADDHA PAWAR, MBBS, MS is a Vitreo-Retina fellow at CSFEI, New
Delhi. She can be contacted at [email protected]

INSTITUTE WATCH
CHAITHANYA EYE HOSPITAL AND

RESEARCH INSTITUTE,
THIRUVANANTHAPURAM
CHAITHANYA EYE HOSPITAL AND RESEARCH INSTITUTE – Vitreo-Retinal services
Chaithanya Eye Hospital and Research Institute is a reputed NABH certified tertiary care
eye hospital at Thiruvananthapuram, Kerala. This institute is the parent organization which
now has sister concerns in 5 districts in Kerala.
Recognizing that advancement in eye care can proceed only with a multifaceted
approach, the Institute started the Chaithanya Vitreo-Retinal service unit in 1997 as an
exclusive speciality centre. This unit serves as a major referral centre for the diagnosis
and treatment of Vitreoretinal diseases for the adjacent 5 districts. It is the first fully
established and functioning speciality unit in this region. It is a fully integrated and
independent unit equipped with all diagnostic and therapeutic modalities related to
management of all retinal diseases. The hospital has an exclusive Diabetic Retinopathy
screening program, AMD Clinic & Macula clinic. The clinics are involved in medical and
surgical management, clinical research and serves as a reading centre for retinal imaging
in patients with various retinal and choroidal diseases. Our surgical retina team manages
all vitreoretinal surgical conditions and is equipped with one of the best surgical units in
the state.
The hospital besides being a training institute for DNB residents, runs a strong academic
program awarding fellowships in many specialities. Over 23 medical and surgical trainees
have benefitted from the academic program run by the Vitreo-Retinal services and are
successfully in practice in various parts of the country and abroad. Regular classes, web
lectures, debates, video sessions and journal clubs are part of the Retina fellowship
training programme. The hospital has an independent ethics committee and has been
part of many multi-centric drug trials and clinical research. The clinical research at the
Vitreo-Retinal services has won appreciation in the form of various awards at state and
national meetings. 
247
YO TiMES I MAY 2019
1. Number of seats of various long and from the applications for the interview.
short term Retina training Opening for fellowship is open in April
programs ? each year for surgical fellows. Medical
retina fellowship recruitment happens
Medical retina fellows; 4/year, during April (2 candidates) and
Surgical retina fellows; 2/year  September (2 candidates) each year.
Interview will be held at Trivandrum
2. Duration of fellowship ? within the hospital premises. A basic
assessment on the aptitude,
Medical retina fellowship; 1year, knowledge and skill of the candidates
Surgical retina fellowship; 1.5 years will be assessed. 
3. Exposure to research and 7. Most important points that you

expectations by the institute in consider in a CV ?
research ?
• References from faculty where
Fellows have to present papers/posters last studied/ worked
at the state and national meeting • Academic awards and citations
compulsorily.Fellows are required to be • Research background/
part of the clinic based research trials Publications
and studies. 
8. Stipend
4. Probable number of surgeries,
lasers and injections one might Medical retina fellow- 35000 Rs
expect ? Surgical retina fellow- 35000 Rs
Surgeries- 20 independent procedures, 9. Exposure to other areas like ROP,

30 assisted procedures Ocular Oncology, Uvea etc
Lasers- atleast 100 procedures
Injections- atleast 100 procedures  The clinic runs a robust ROP
telescreening programme spread
over 4 districts in Kerala with NICU
5. Names & positions of Medical retina based visits on a regular basis. Also
and VR Faculties ? OPD based ROP consultation does
happen. Candidates will have an
• Dr Unni Nair- Medical Director opportunity to participate in this
and Senior Vitreoretinal program and will be involved in
Consultant treatment including laser and
• Dr Manoj S- Coordinator intravitreal anti VEGF injections.
Fellowship Program and Senior The clinic is also involved in
Vitreoretinal Consultant management of Retinoblastoma with
• Dr Srilekha- Consultant Retcam based documentation and
Medical Retina works in close consultation with
• Dr Rejina Mohan- Consultant Regional cancer institute for
Vitreoretinal Surgeon chemotherapy and Sree Chitra
• Dr Padmanaban- Consultant Tirunal Institute for Medical Sciences
Medical Retina & Te c h n o l o g y f o r i n t r a a r t e r i a l
• Dr Rahul Menon- Consultant chemotherapy. Candidates will have
Vitreoretinal Surgeon an adequate exposure in this area.
• Dr Sheera- Junior Vitreoretinal Our uvea clinic was started in
Surgeon 2008 to manage the growing number
of patients with uveitis. The uvea
6. Selection procedure in brief faculty presently includes an
including probable dates (Interview internationally trained specialist. The
& Joining) ? clinic coordinates with a well equiped
pathology/Immunology clinic and with
Selection of candidates is based on Sankara Nethralaya Referral
interview. Candidates with MS/ DNB Laboratory specifically to analyze
Ophthalmology and DO with atleast 2 tissue fluids and samples which help
years experience will be shortlisted in arriving at specific aetiological

diagnosis. A new PCR lab is 12. Any post fellowship International
expected to function within the exposure?
premises shortly with an in house
microbiologist. Candidates will NIL
therefore have an adequate exposure
in this area. 
13. Any bonds or compulsory
10. Brief overview of VR equipments commitments with the institution
available in the Institute. after completion?
• Hiedelberg HRA2- FFA, ICG, OCTA, NIL 

Multicolour Imaging, Fundus
Autofluorescence, Infrared imaging,
OCT unit with multiviewing port facility. 14. Any peripheral centres for
• ELLEX Ultrasonogram with UBM compulsory rotation and duration of
facilities the same ?
• Rolland Electrodiagnostics including
ERG, EOG, Pattern VEP, pattern ERG, An opportunity to work at the other
flash ERG, flash VEP. sister concerns of the hospital
• 2 IRIDEX laser systems with Day visits to Diabetic screening
micropulse delivery module, indirect centers, Military hospital service 
laser delivery
• IRIDEX Transpupillary thermotherapy
• Photodynamic therapy with Visudyne 15. Contact details ( Phone & Email) of
• CONSTELLATION vitrectomy unit the academic department.
with endolaser, 23/25/27 gauge
instruments, bimanual surgical Retina Vitreous Services, Chaithanya
instruments, BIOM Eye Hospital & Research Institute,
• Cryotherapy Trivandrum
• Video archiving software 0471 2955500 (ext 6001)
[email protected] 
11. Number of permitted leaves

16. Names and Contact details of 3
1 day leave for every completed month past(within 2 years) or present
of fellowship. fellows.
Compensatory duty off for camp/ Dr Asmita Indurkar 9561592153

Sunday duties. Dr Anshuman Gehlot 9810958562
Dr Sheera Arun 9447315236
 
Young Ophthalmologists Times is highly indebted to Dr Unnikrishna Nair for providing us the
above information.

VR FELLOWSHIP INTERVIEW EXPERIENCE AT CHAITANYA EYE HOSPITAL AND
RESEARCH INSTITUTE, THIRUVANANTHAPURAM
-DR ANSHUMAN GEHLOT
I had been looking for VR fellowship for a couple of months after my post graduation, and
had submitted my CV along with letter of recommendation at this institute a couple of
weeks ago. I got a phone call from the fellowship coordinator and was informed about the
upcoming interview in a humble voice . I was afraid I may not be able to attend the
interview because i was informed only two days in advance. The journey from my
hometown in Rajasthan would take at least 24 hrs if I managed to get the first train and
first flight towards the destination. But I was relieved when I came to know that the
interview will be conducted telephonically. So I picked the time slot of my choice among
the available slots. Now I could brush up my concepts and prepare for the interview with
peace of mind without worrying about the hassles of travelling.
On the day of interview I was comfortably seated in my backyard enjoying the December
Sun. I got a call at an expected time and it was the same person again, she asked me
whether I am ready and I said yes. The next voice was of Dr. Unni Krishnan Nair,
Medical Director of the Institute. He asked me more about my educational background,
probably looking at my CV at the same time as few questions regarding my publications
and presentations followed. He asked me about my previous experience in retina and my
future plans. The talk went on for 15-20 minutes. He was very friendly and made me
comfortable whenever I was not able to answer a question he had asked. I was told that
the results will be announced in a couple of days.
Surprisingly, the next day I received a call from Prof. Dr. Y Chingsui who had been my
guide and mentor during my post graduation and had written the letter of recommendation
for me. He said he had received a call from Kerala from Dr. Nair. That’s when I knew I was
being seriously considered for the fellowship.
The next day, I had fingers crossed when I was informed about my selection and given a
date to join. I was very happy and thanked Mrs. Shalini, the lady with a humble voice.
DR ANSHUMAN GEHLOT, MBBS, MS is a Vitreo-Retina fellow at Chaitanya Eye

Hospital and Research Institute, Thiruvananthapuram. He can be contacted at
[email protected]

INSTITUTE WATCH
C.H. NAGRI EYE HOSPITAL,

AHMEDABAD
C. H. Nagri Eye Hospital is an exclusive eye hospital, research and training centre
located in the heart of the Ahmedabad city. Its mission is to provide excellent and
equitable eye care services to all the sections of people of Ahmedabad city and
Gujarat since more than 40 years by now.This eye hospital is affiliated to Smt.
N.H.L. Municipal Medical College and Sheth K,M. School of post graduate Medicine
and Research, V.S. General Hospital and recognized by Gujarat University for
undergraduate and post graduate teaching. C.H. Nagri eye hospital has been
working continuously for prevention of blindness and treatment of eye diseases
since 1963. Approximately 200 patients daily in the O.P.D. and 5000 surgeries are
carried out annually.
. 
YO TiMESI AUG 2019

251
1. Number of seats of various long and • Dedication towards the institution,
short term Retina training • No. of publication and research
programs ?
8. Stipend
2 seats per year of long term VR
fellowship 15,000/ per month
2. Duration of fellowship ? 9. Exposure to other areas like ROP,

Ocular Oncology, Uvea etc
1 year
Splendid experience in diagnosis and
3. Exposure to research and management of uveitis.
expectations by the institute in
research ? ROP services not available at present
1 compulsory study topic which has to 10. Brief overview of VR equipments

be published and presented at the end available in the Institute.
of the year. Candidate can present
papers and posters wherever and OCT ,FFA, USG,LIO, SLE Mounted
whenever he /she wants laser machine, Constellation machines
for V.R surgeries
lasers and injections one might 11. Number of permitted leaves
expect ?
15 leaves
2 surgeries per OT day during the last
6 months. Prpc ,grid laser, laser 12. Any post fellowship International
barrage from 2nd 3rd month of the exposure?
fellowship. Intravitreal injections in
patients of endophthalmitis from the Nil
very beginning of the fellowship
5. Names & positions of Medical retina commitments with the institution
and VR Faculties ? after completion?
• Dr. Tejas Desai Nil

(Superintendent And HOD -
C.H. Nagri Eye Hospital) 14. Any peripheral centres for
• Dr. Shaileen Parikh (Retina compulsory rotation and duration of
Consultant) the same ?
• Dr. Usha Vyas (Honorary
Retina Consultant) Nil
6. Selection procedure in brief 15. Contact details ( Phone & Email) of

including probable dates (Interview the academic department.
& Joining) ?
Dr. Tejas Desai(Program Head),
Entrance examination (McQ test) 9327004888,
followed by interview on the same day . [email protected]
Examination held around 2nd or 3rd
week of August. Date of joining 21st 16. Names and Contact details of 3
August. 21st August to 31st August - past(within 2 years) or present
observership. 1st September onwards - fellows.
commencement of the fellowship.
Dr. Prakriti Khetan - +91 9131139695
Dr. Dhaval Patel - +91 7002202613
7. Most important points that you Dr. Unnati Shukla - +91 7874889197
consider in a CV ? Dr. Ashka Shah - +91 9904003711
• Performance at the entrance
exam and interview,

VITREORETINA FELLOWSHIP INTERVIEW EXPERIENCE AT
CH NAGRI EYE HOSPITAL, AHMEDABAD
DR. UNNATI SHUKLA 
After completing my M.S. Ophthalmology examination in the year 2017, I started

searching for options for pursuing fellowship in Vitreoretinal Surgery . I applied at all
the possible places for july session examination and interviews.
The examination for VR fellowship at Shankar netralaya Chennai and C.H. Nagri
Eye hospital Ahmedabad was held on the same day. I was in a Dilemma as
whether to appear for S.N. examination or NERF(Nagri eye research foundation)
examination. Since Nagri hospital was in my hometown, fellowship was of one year
duration and interview was held only once a year, I opted to appear for NERF
examination.
The examination was held in the 3rd week of august at Nagar School of Optometry
Campus. There was M.C.Q examination of 40 marks followed by interview. After
completion of the interview , the candidates were made to sit in the waiting lounge.
Within half an hour ,shortlisted candidates were called in for the interview. There
was a panel of 3 consultants. They asked very basic questions regarding retina and
assessed candidate’s inclination towards the field of retina.
By evening 5:00 pm I received an Email from NERF foundation that I was selected
for the VR Fellowship at NERF.
They asked me to join as an observer from 21st August to 31st August .The
fellowship is of one year starting from 1st august every year.
 
DR. UNNATI SHUKLA MS ,is a senior resident in the department of Vitreo-
Retina at Sri CH Nagri Eye Hospital, Ahmedabad. She can be contacted at
[email protected]

INSTITUTE WATCH
CL GUPTA EYE INSTITUTE,

MORADABAD
At times post graduation in Ophthalmology does not address the need and the
precision required in the sub specialties and an ophthalmologist who is passionate
to pursue the dream usually finds oneself in two minds on the decision of further
education and experience.
With a limited number of institutes offering the fellowship courses there are many
aspiring candidates who kill their dream of pursuing further experience and settle in
their lives. Long wait period of fellowships also play a role in this.
We are affiliated to L V Prasad Eye Institute, Hyderabad and aim to provide quality
care to the patients and try to maintain same thing in our fellowship programmes
also. C L Gupta Eye Institute (CLGEI) provides a blend of academics and clinical
exposure so that the candidate on completing the fellowship can look forward in the
right and desired direction.
Apart from having a Vitreo-Retina fellowship CLGEI also offer paid short term
observership in medical retina. 
YO TiMESI AUG 2019

254
programs ? • Candidate should be hard-
working and sincere.
Variable • Candidate should have keen
interest to learn.
2. Duration of fellowship ? • Tissue handling should not be an
issue for the candidate.
The fellowship is of 24 months duration
with rotational posting with different
consultants in retina department. Last 6 8. Stipend
months of fellowship, candidate will
have independent OPD & OR. We also Total emoluments of Rs. 30000 per
expect them to share institutional month in the starting 18 month
responsibilities like OPD & OR and 40,000 in the last 6 month
coverage for other consultants
3. Exposure to research and Ocular Oncology, Uvea etc
research ? Candidate will have exposure in ROP
(screening and laser), Uveitis and its
A candidate has to work on research management. No exposure in ocular
projects, analyse data and write papers oncology.
for publication and presentation. The
institute expects each candidate to 10. Brief overview of VR equipments
complete at least one original study available in the Institute.
during the fellowship tenure.
Zeiss laser, Visucam 450 (Fundus
camera), Constellation vitrectomy
4. Probable number of surgeries, system, Accurus vitrectomy system,
lasers and injections one might Reticare VR, Purepoint laser for OT,
expect ? Zeiss Lumera operating microscope
with BIOM 4.
Depends upon the efficiency of the
candidate, we start giving surgeries in
steps initially and when the candidates 11. Number of permitted leaves
are confident enough, they are given a
free hand. The candidate is permitted for 24 days
leave during your fellowship
5. Names & positions of Medical retina 12. Any post fellowship International
and VR Faculties ? exposure?
• Dr. Abhishek Varshney, Nil

Consultant Vitreo-Retina.
• Dr. Rohini G Agrawal, 13. Any bonds or compulsory
Consultant Vitreo-Retina. commitments with the institution
• Dr. Upma Awasthi, Consultant after completion?
Vitreo-Retina.
The candidate is required to submit
6. Selection procedure in brief your original documents at the time of
including probable dates (Interview starting fellowship and these will be
& Joining) ? retained by the institute till the time
period of two years, for the purpose of
Interview based selection. Probable security.
dates are December and June for
interviews and January and July for
joining.

14. Any peripheral centres for 16. Names and Contact details of 3
compulsory rotation and duration of past(within 2 years) or present
the same ? fellows.
No Dr Priyanka Chaudhary, Consultant

Vitreo-Retina, Maharaja Agrasen
15. Contact details ( Phone & Email) of Medical college, Agroha, Haryana
the academic department. Pin 125047.
Email : [email protected]
Dr Abhishek Varshney
[email protected], Dr Upma Awasthi, Consultant Vitreo-
[email protected], Retina, C L Gupta Eye Institute, Ram
[email protected] Ganga Vihar Phase 2 (Ext.),
Phone Numbers : +91 9873364157, Moradabad, Uttar Pradesh
+91 7599270961 PIN 244001.
Young Ophthalmologists Times is highly indebted to Dr Abhishek Varshney for providing us the
above information.
 

CL GUPTA EYE INSTITUTE
-DR UPMA AWASTHI
Before starting with my learning experience in CL Gupta eye institute, I need to tell
that I have worked under one eminent vitreo-retina surgeon for approximately 2
years. Thereafter I worked as independent vitreo-retina surgeon in Delhi-NCR and
there I did lasers and handful of vitreo-retina cases in 1 and 1⁄2 years. When my
family started thinking of shifting to Moradabad in 2018, it was the time when I
started searching options and I found C L Gupta Eye Institute as the best option.
I got the appointment with the director Dr Pradeep Agarwal and there he discussed
about my vitreoretina exposure in the past. Then I met the HOD of retina
department Dr Abhishek Varshney and he asked me about the practical questions
related to daily retina practice and what I have not done till date. Keeping all my
background in mind, I was offered 1 year fellowship. This was commendable as no
other institute consider your past experiences.
In this one year, I had lot of exposure in OPD with daily free discussion with
consultants. I did variety of surgeries ranging from uncomplicated RhegRD, glued
IOL/SFIOL, traumatic RD, endophthalmitis with or without IOFB as well as macular
holes. These surgeries I have not done in my private practice. Last few months of
my fellowship, I had my independent OPDs and OTs also, which have boosted my
confidence level.
I would say that my experience is little different from others. There was no formal
interview but they considered my background and customized my fellowship
program. And I can say for sure that any person joining this institute in any
department will learn a lot and can start his or her own practice independently after
fellowship.
DR UPMA AWASTHI is a consultant Vitreo-Retina Surgeon at C L Gupta Eye

Institute she can be reached at [email protected]
 

INSTITUTE WATCH
DR. SHROFF CHARITY EYE

HOSPITAL, NEW DELHI
DR. SHROFF CHARITY EYE HOSPITAL Daryaganj, New Delhi provides a 6 months
clinical research fellowship followed by long term Vitreo-Retina fellowship for 2
years during which the fellows work independently in the last six months, when
they perform independent clinics and Vitreo- Retinal surgeries. They perform
laser photocoagulation, Fundus Fluorescein Angiography, ICG, B- SCAN, UBM,
Optical Coherence Tomography,OCT-A, FAF and intravitreal injections.
They are posted in clinics where they see a variety of medical and surgical retina
patients. 
258
1. Number of seats of various long and 8. Stipend
short term Retina training
programs ? 19,000/ per month (which increases
every year)
2 seats per year of long term VR
fellowship 9. Exposure to other areas like ROP,
Exposure to ROP - regular screening of
2½ years (clinical research + VR) babies in NICU+ laser & intravitreal
injections are performed
Exposure to uveitis in the uvea clinic
expectations by the institute in 10. Brief overview of VR equipments
research ? available in the Institute.
One prospective study to be completed OCT (Cirrus), OCT-A (Angioplex), ICG

during fellowship and expected to have (Zeiss), FFA (Topcon), UBM
5 peer reviewed publications during the (Appasamy), B SCAN (Appasamy),
fellowship. FAF (Zeiss), Constellation Vitrectomy
Machine, Zeiss Microscope,
BIOM,Iridex and Zeiss laser machines.
lasers and injections one might 11. Number of permitted leaves
expect ?
24 leaves in 2 years
50 vitreoretinal surgeries(independent
but supervised, more than a 100 lasers 12. Any post fellowship International
and intravitreal injections) exposure?
5. Names & positions of Medical retina Nil

and VR Faculties ?
• Dr. Manisha Agarwal - Head commitments with the institution
of Vitreoretina Services after completion?
• Dr. Shalini Singh - Senior
Consultant Nil
• Dr. Rahul Mayor - Senior
Consultant 14. Any peripheral centres for
• Dr. Lagan Paul - Consultant compulsory rotation and duration of
• Dr. Ankita Shrivastav - the same ?
Consultant
Yes
6. Selection procedure in brief
including probable dates (Interview 15. Contact details ( Phone & Email) of
& Joining) ? the academic department.
Written test and interview, May and Ms. Kalpana Gupta,

November [email protected], 011-43528888
7. Most important points that you 16. Names and Contact details of 3
consider in a CV ? past(within 2 years) or present
• Exposure to retina during post fellows.
graduation
• Post VR fellowship planning to Dr. Deepa Sharma-9968050005
serve an area where VR- services Dr. Ankita Shrivastav- 9560073529
are not available Dr. Prachi Gaurav- 8800642841
• Interest in Research
Young Ophthalmologists Times is highly indebted to Dr Manisha Agarwal for providing us the
above information.

SHROFF CHARITY EYE HOSPITAL, DARYAGANJ, NEW DELHI
DR. ANKIT GARG 
After considering many options throughout the country and even beyond, and having
applied to many respected institutions, i was lucky to get selected for a Vitreo-Retina
fellowship at Shroff Charity Eye Hospital, Daryaganj New Delhi.
The website may not be routinely updated so calling the HR is a better option to stay in
touch regarding the dates for session intakes. They usually take fellows every 6 months,
the duration of the fellowship is 2.5 years with initial few months focussed on research
orientation.
They conduct an MCQ exam followed by an interview on the same day itself. I found the
pattern of MCQs similar to those of other institutions such as LVPEI and SNC Chitrakoot. I
found reading MCQ oriented books very helpful, almost all the questions were image
based. The interview for fellowship exams tends to be very unconventional at times and
there is no set standard and pattern for it.
My interview started with questions on common pathologies such as DR, CRVO and then
they focussed on my thesis topic. It was followed by a few questions regarding my
experience in retina so far and also a few questions regarding my current job profile. They
also asked why i chose this institute among so many others and what are my expectations
from this fellowship.
I think its important to be honest here, at the same time u need to focus on why you are
joining for the right reasons and would be a valuable addition to the institute. the
examiners usually try to get an idea about the attitude of the candidate and want to make
sure that the fellow would demonstrate a strong work ethic and be willing to attach with the
institute for a long productive duration. The institute lays special focus on research and
shows preference towards candidates who are more inclined towards it. i was asked about
my previous experience in research, however the lack of it did not seem to be an issue.
There is no bond required to be served after finishing the tenure although they might ask if
you would be willing to join one of their secondary centres after finishing the
fellowship.They announce the results within 2 weeks or less. And generally joining is within
1-2 weeks.
The work atmosphere at the institute is healthy, however punctuality and sincerity is
something that is not compromised on. regular academic activities are conducted and
fellows get ample time for research and academic discussions.
 
DR. ANKIT GARG, MBBS, DO, DNB is a Vitreo-Retina fellow at SHROFF EYE
HOSPITAL, NEW DELHI. He can be contacted at [email protected]

INSTITUTE WATCH
THE EYE FOUNDATION, COIMBATORE

The Eye Foundation, Coimbatore is an ultra-modern eye care
facility, founded by Dr. D. Ramamurthy. The eye hospital has a track
record of nearly three decades, treating more than a million patients
located in the districts of Coimbatore, Tirupur, Nilgiris and nearby
areas.
Always at the cutting edge of technology the institution has to its

credit several firsts in the field of Ophthalmology in the country. It is
situated at the heart of the city and conducts a robust academic
program, 
261
1. Number of seats of various long and RETINA AND UVEA
short term Retina training SERVICES
programs ?
6. S e l e c t i o n p r o c e d u r e i n b r i e f
• Medical retina: 2 seats per year including probable dates (Interview
(January and July session) & Joining) ?
• Surgical Vitreo-Retina fellowship: 2
seats per year (January and July Last date for submission of application
session) form -12 June 2019
Entrance examination – 16 June 2019
2. Duration of fellowship ? (MCQ based written entrance test
followed by Interview of selected
• Medical retina: 6 months candidates)
• Surgical Vitreo-Retina fellowship : 24 Deceleration of results- 23 June 2019
months (18 months + 6 months as Date of joining – 01 July 2019
Vitreoretina adjunct faculty)
Dates for subsequent sessions will be
3. E x p o s u r e t o r e s e a r c h a n d available on the website
expectations by the institute in www.theeyefoundation.com two
research ? months prior to the entrance
examination.
• The Eye Foundation, Coimbatore has
a robust and enthusiastic research 7. Most important points that you
environment and has its own in consider in a CV ?
house DCGI approved Ethics
Committee . Our institute has been • Interest and passion for the
part of many global multi-centric trials subject
and has been an active contributor in • Attitude
the field of research at a global level. • Basic skills and knowledge
4. Probable number of surgeries, 8. Stipend

expect ? Rs. 35,000 per month.
Free single accommodation
(As per log book of outgoing long term
fellow) 9. Exposure to other areas like ROP,
Intravitreal injections: 630 Ocular Oncology, Uvea etc
PRP Laser: 427
Barrage laser: 350 Our practise involves full range of
Focal laser : 10 management modalities for all cases of
VR surgeries: 38 uveitis and ROP.
Surgical opportunities entirely depends 10. Brief overview of VR equipments

on the capabilities & performance of available in the Institute.
the candidate and discretion of the VR
consultants. OPD-Heidelberg Spectralis –
Autofluorescence , FFA &ICG, Optovue
5. Names & positions of Medical retina wide field SD OCT, Zeiss green laser,
and VR Faculties ? B scan
• D R . J AT I N D E R S I N G H - OR- MIVS -Constellation Vision

S E N I O R C O N S U LTA N T , system, Iridex green laser, Zeiss
VITREORETINA AND UVEA Resight , Sony 4k surgical video
SERVICES recording
• DR. ASHRAYA NAYAKA –
C O N S U L T A N T , 11. Number of permitted leaves
VITREORETINA AND UVEA
SERVICES 15 days, If greater leaves than the
• D R . PA R V E Z B H AT - permitted allowance are availed, the
C O N S U LTA N T, V I T R E O - candidate is required to complete the  

same as an extension 15. Contact details ( Phone & Email) of
exposure? Landline : 0422-4242000
No Email:
[email protected]
13. A n y b o n d s o r c o m p u l s o r y
commitments with the institution Website: www.theeyefoundation.com
after completion?
No past(within 2 years) or present
fellows.
14. A n y p e r i p h e r a l c e n t r e s f o r
compulsory rotation and duration of Dr.Swarnima Saxena (Surgical
the same ? Vitreoretina fellow)- 9677773856
D r. A b h i s h e k D a s ( S u r g i c a l
Compulsory peripheral posting- 2 Vitreoretina fellow) - 7757841988
months Dr. Jayachitra (Medical Retina
fellow)- 9566195021
Young Ophthalmologists Times is highly indebted to Dr Gitansha Sachdeva for providing us the
above information.

EYE FOUNDATION, COIMBATORE 
DR. ABHISHEK DAS 
Like others, I was also at a dilemma for the simple reason being that nowadays
ample of Institutes in India provide vitreo retina fellowships; few with Uvea also. The
Eye Foundation came into limelight through one of my colleague’s father. Then I
scrolled through it’s website and found out that the course was of 18 months and
Dr. Jatinder Singh (HOD, VR dept) and Dr. Jayashree leading the department. The
process was simple. Just I had to download the application form, fill it and send
them back along with CV. They replied promptly and gave dates for the interview.
Then came the interview day, where after reaching the Institute I had to meet the
HR dept, then she took me to the concerned faculty of the respective department.
Then I had to sit for a MCQ test. The questions were focused on vitreo retina only,
few being from uvea also. Other department fellowship interview was also on the
same day. After the test, then individual interview was there where they asked few
questions from the subject and few from non academic part. Finally I had a meeting
with the chairman of the Institute, Dr. Ramamurthy. He was mainly asking about the
future plans and the working pattern of the Institute. And that’s it!!
Finally I like to comment on the current scenario in short. The Vitreo retina course is
of 2 years now; Dr. Jayashree is no longer working there. Dr. Ashraya Nayaka has
replaced her. Dr. Gitansha Sachdev is the academic coordinator. On the interview
day, you will have a MCQ exam mostly of 50 marks which comprise of 50
questions. Then there will be the interview in the board room in the form of OSCEs
and questions related to the subject along with recent trials.
The results will be announced within 1-2 weeks and they will send you in your mail
along with the joining date. What I have learned is that you should have interest in
the subject you are choosing and know the recent things which are happening.
Good luck!! 
DR. ABHISHEK DAS, MBBS, MS, FVRS is a Pediatric Retina and Ocular Oncology fellow at
Aravind Eye Hospital, Coimbatore. He can be contacted at
[email protected]

INSTITUTE WATCH
GIRIDHAR EYE INSTITUTE

The Vitreoretinal Fellowship at Giridhar Eye Institute is a two year program devoted
to clinical training in the evaluation, diagnosis, and medical and surgical
management of vitreoretinal diseases.Training is done with the individual retina
faculty on a schedule that allows the first year fellow to begin all aspects of medical/
surgical procedures, and gives a more intense surgical experience in the second
fellowship year. Our surgical volume is among the highest for academic fellowships,
and our fellows have extensive exposure as primary surgeon to the most
complicated cases. One of our key strengths is the breadth of training and
experience of our faculty, which provides the fellows with a unique opportunity to
learn a variety of surgical techniques and approaches. We support our fellows to
submit their research for presentation to national and international conferences and
our expectation is for the fellows to pursue meaningful research projects and
develop the skills needed to have dynamic careers as leaders in the field of
retina.Fellows are part of the teaching staff and are expected to take an active role
in teaching the residents and medical students who rotate through our service. 
265
YO TiMES I MAY 2019
1. Number of seats of various long and Email detailed CV with a recent

short term Retina training photograph, expressing interest (Email:
programs ? [email protected])
Surgical Retina : 3 every year Interview in July/August and course

Medical Retina : 1 every month commences in September.
( Course fee 40,000) 
2. Duration of fellowship ? 7. Most important points that you

consider in a CV ?
Surgical Retina : 2 years
Medical Retina : 2 months  • Exposure to VR in post
graduation
3. Exposure to research and • Research Experience including
expectations by the institute in any publications
research ? • Practical application of knowledge
There is a tremendous opportunity to 8. Stipend

conduct research at the Institute. We
have a huge patient load with exposure Rs. 40,000/- per month
to variety of cases and latest Imaging.
So it's a great opportunity to initiate Accommodation is provided at Rs.
prospective studies and also perform 5,000 per month (Room with basic
retrospective studies with the existing amenities – food not included).
dataset under able guidance of Dr. A.
Giridhar and Dr. Mahesh G. You will be 9. Exposure to other areas like ROP,
expected to get sufficient number of Ocular Oncology, Uvea etc
publications in peer reviewed journals.
  There is sufficient exposure to ROP
as we are one of the leaders ROP
4. Probable number of surgeries, screening in Kerala and have
lasers and injections one might dedicated staff for the same. We also
expect ? have Dr. Sandhya N, who is our
Uveitis specialist. We do not deal
Expect to take part in at least 450-500 with ocular oncology.
surgeries (Assisting + independent),  
500-700 lasers (Focal, PRP; We have
our own PDT machine too) and around 10. Brief overview of VR equipments
1200-1500 intravitreal injections.  available in the Institute.
We have 2 Heidelberg spectralis

5. Names & positions of Medical retina (OCTA, ICG, DFA, SDOCT, Multicolor),
and VR Faculties ? Zeiss Fundus camera, Iridex laser
(Multispot, Yellow, Micropulse), Green
• Dr. A. Giridhar: Medical laser, Diode laser machine, 2 Alcon
Director Constellation Machines, One Acurus,
• Dr. Mahesh G: Head of One Geuder Vitrectomy machine,
Vitreoretinal Services BIOM viewing system.
• Dr. Anubhav Goyal:
Consultant
• Dr. Indu VP: Consultant 11. Number of permitted leaves
6. Selection procedure in brief 12 annually

& Joining) ? 12. Any post fellowship International
exposure?
Based on the performance in the
entrance examination (theory + Viva) The fellowship provides abundant
followed by personal interview. opportunities to present at national and
international conference with financial

aid. After completion of fellowship, the
fellow can expect to receive adequate 16. Names and Contact details of 3
recommendations if they plan to pursue past(within 2 years) or present
further international studies. fellows.
13. Any bonds or compulsory Dr Jay Sheth

commitments with the institution Email: [email protected],
after completion? Mob: 9961167200
Nil Dr Prashant Jain

14. Any peripheral centres for Mob: 9690502727
compulsory rotation and duration of
the same ? Dr Rutul R Patel
Nil. However the fellow is expected to Mob: 9624722995
go for ROP screening during the
second year of fellowship. Present: Dr Aarti Jain
15. Contact details ( Phone & Email) of Email: [email protected]
the academic department. Mob: 8940570017
Mr. Murukan:
[email protected],
Ph- 8129311899

VR FELLOWSHIP
VR FellowshipINTERVIEW
InterviewEXPERIENCE AT SHANKARA
Experience at GridharEYE
EyeHOSPITAL,
Institute BANGALORE
- DR. AARTI JAIN
Interviews are never easy and especially when they are taken by the stalwarts, adds on to
the anxiety and nervousness. Sharing my interview experience of Vitreo-Retina fellowship
in Giridhar eye hospital may help the budding ophthalmologists to prepare themselves.
The fellowship test comprised of two sessions:
The first session consisted of 60 multiple choice questions which had to be solved in
45mins. The bulk of questions were from retina, a very few from general ophthalmology as
well. Majority of the questions were simple and tested the basic theory knowledge
provided one has read well. But a few questions were tricky. Out of the four options two
could be ruled out easily but the other two were quite close. One should solve the
questions with calm mind and do not spend too much time on a single question which you
are not able to answer in the first go as you have limited time.
The second session consisted of 2 interviews one with Dr. Giridhar, the medical director
of Giridhar eye institute and the other with Dr. Mahesh, head of department, Vitreo-Retina.
The interview mainly focused on the clinical skills of the candidate. Questions consisted of
clinical scenarios and their diagnosis and management. Candidates were also evaluated
on the basis of their experience in various procedures like laser photocoagulation and
intravitreal injections. A common question that was asked to all was why they wanted to
pursue fellowship in Vitreo-Retina. Though it sounds to be a very easy question, many
people fumble while answering it. Your answer should clearly justify your interest and zeal
in the field. Since Giridhar eye hospital holds a special interest in research and
publications, basic statistical knowledge of a few candidates was also ascertained. A
special consideration was given to candidates who had publications, presentations in
conferences and keenness in research.
So, a candidate is assessed in every aspect. A few tips to crack an interview along with
having a sound knowledge are speak with confidence, be clear in what you say, show your
interest in the field and resolution to work hard.
 
DR. AARTI JAIN, MBBS, DNB is a Vitreo-Retina fellow at Giridhar eye hospital.
She can be contacted at [email protected]

INSTITUTE WATCH
HAJI BACHOOALI EYE & ENT

HOSPITAL, MUMBAI
We at Haji Bachooali Eye & ENT hospital offer long-term surgical Vitreoretina
fellowship of 2 years duration, along with a short term Medical retina fellowship of 1
year duration. These courses are designed in such a way to offer a systematic and
a comprehensive approach to managing varied vitreo retinal conditions with
precision . These courses help the fellows to take advantage of the vast array of
clinical cases available at the institute which pose not only a diagnostic challenge
but also management difficulties. We offer comprehensive training in managing
various vitreoretinal conditions including Retinopathy of prematurity and uveitis.
The department is fully equipped with state of the art machines like FFA, ICG , USG
B scan, Green LASER, Yellow LASER, Diode LASER, Micropulse with pattern
scan LASER, Retcam etc..The fellowship offers a hands on approach to using
these instruments and interpreting their results along with their successful
application to patient management. The surgical training includes step by step
methodical approach on one of the best ..Alcon Constellation system with BIOM
optical system. The training involves a 1:1 trainee mentor ratio which not only
offers a personal touch but also helps the trainee to sharpen his surgical acumen
by being under constant observation and guidance of the mentor while he performs
his surgeries. The fellow during his tenure is also encouraged to undertake clinical
research activity and publish papers along with actively participate and present
papers in various CMEs and conferences. 
YO TiMES IAUG 2019

269
YO TiMES I MAY 2019
1. Number of seats of various long and 9. Exposure to other areas like ROP,
short term Retina training Ocular Oncology, Uvea etc
programs ?
Yes
Surgical Retina 1 seat   
2. Duration of fellowship ? 10. Brief overview of VR equipments

available in the Institute.
Surgical Retina : 2 years
  FFA, ICG , USG B scan, Green
LASER, Yellow LASER, Diode LASER,
3. Probable number of surgeries, Micropulse with pattern scan LASER,
lasers and injections one might Retcam , constellation vitrectomy with
expect ? BIOM optical system
50-75 surgeries a year 11. Number of permitted leaves

500 lasers in a year
500 injections a year 12 annually
4. Names & positions of Medical retina 12. Any post fellowship International
and VR Faculties ? exposure?
• Dr Anand Subramanyam No
HOD
• Dr Sarvesh Tiwari 13. Any bonds or compulsory
Consultant commitments with the institution
• Dr Gaurav Shah after completion?
Honorary Consultant
No
including probable dates (Interview 14. Any peripheral centres for
& Joining) ? compulsory rotation and duration of
the same ?
Interviews held every year in JUNE
AND JOINING BY JULY. No
7. Most important points that you 15. Contact details ( Phone & Email) of
consider in a CV ? the academic department.
• MS/DNB trained candidate [email protected]

• Inclination for research
• Positive attitude with an 16. Names and Contact details of 3
eagerness to learn past(within 2 years) or present
fellows.
8. Stipend
Dr Abhishek Heranjal Ph: 9833426774
Rs. 15,000/- per month Dr Prajakta Patil Ph: 7718913117
Dr Mamta Gurav Ph: 9930339917

INSTITUTE WATCH
H V DESAI EYE HOSPITAL, PUNE

H V DESAI EYE HOSPITAL , offers 2 types of full time fellowships (research/
clinical) in Vitreo-Retinal surgery, with the aim of developing clinical and research
skills pertaining to medical and surgical Retina.
• Fellows get to learn from 3 medical retina specialists and 3 Vitreo-Retinal

surgeons and the clinical exposure is wide, ranging from management of
diabetic eye diseases, retinal detachments, posterior segment trauma,
ARMD, macular surgeries, uveitis, retinopathy of prematurity, endophthalmitis
and many rare diseases.
• Fellows participate in all the clinics, handle diagnostics on a rotation basis

and assess and get to discuss and plan their management with the
consultants. In last 6 months of fellowship, they get to handle clinics
independently.
• They are exposed to a wide variety of medical retina related procedures

including lasers and intravitreal injections of all types.
• They also participate in surgery, both as the independent operating surgeon

or the assistant, depending on the complexity of the case.
• H. V. Desai Eye Hospital runs one of Maharashtra’s biggest ROP program.

Here fellows have a unique exposure to ROP through a dedicated team in
screening, management including ROP lasers in which they are trained and
also perform abundant number of individual ROP lasers, antiVEGF
treatments in the tenure. They also get to assist in numerous ROP surgeries.
• Regular classes are also conducted in which fellows present medical and
surgical cases and power point presentations on various retinal disorders.
YO TiMESI AUG 2019

271
programs ?
• Dr SUCHETA KULKARNI DNB,
• 2 year long term VR Research MSc (Public Health for Eye Care)
fellowship- 1 seat per year (Medical retina and ROP)
• 1.5 year long term fellowship – 1 seat
• Dr VIMAL PARMAR MS, FVRS
(Vitreo - Retina)
per year • Dr NIKHIL BEKE MBBS, MS ,
• 1 year medical retina + phaco (Vitreo-Retina & Uvea)
fellowship -1 seat per year • Dr ASHWINI SONAWANE
• 6 months medical retina fellowship – MBBS, DOMS, (Medical retina and
1 seat every 6 months ROP)
• 2 months laser training fellowship 2 • Dr SMRITI MISRA MBBS, MS,
seats per month FVRS (Vitreo - Retina and ROP)
• Dr ATUL HEGDE MBBS, DOMS
2. Duration of fellowship ? (Medical Retina)
• 2 years (VR+ Research fellowship) 6. Selection procedure in brief

• 1.5 years (VR fellowship) including probable dates (Interview
& Joining) ?
expectations by the institute in Candidates are required to appear for
research ? interview at H V DESAI EYE
HOSPITAL where candidates approach
• Fellows are expected to participate in towards case diagnosis and
ongoing research projects during the management and knowledge of retinal
term of their fellowship diseases is tested. They are
• They also get to attend classes to administered a short questionnaire
improve research skills (Preparing a before interview to gauge their
project proposal, ethics in medical experience, clarity of thoughts and
research, skills for literature search, attitude.
basics of biostatistics etc)
4. Probable number of surgeries, 7. Most important points that you

lasers and injections one might consider in a CV ?
expect ?
• Previous academic achievements
• Lasers- > 10 (assisted), >100 • Qualifications
(Independent) • Attitude and motivation which is
• ROP lasers- > 5 (assisted), >15 assessed in written
(independent) questionnaire)
• Intravitreal Inj- >5 (assisted), >50 • We give importance to where
(independent) (Hopital/city/place) the fellow
• VR surgeries- > 150 (assisted), >15 would finally work after the
(independent) fellowship (It gives us insight into
how the fellowship training would
We also expose VR fellows to cataract get utilised ) We give priority to
surgeries (SICS) which helps in those who would be working in
improving their basic surgical skills areas lacking Vitreo retina
(they get to do about 60-70 SICS surgeons .
surgeries during their tenure). • Research aptitude of the
candidate
There are many factors that influence • Conference presentations and
the number of surgeries that a VR publications
fellow would get such as – sincerity
and dedication , pre-existing surgical
skills, leaves taken during the tenure 8. Stipend
etc.
15000 /month (accommodation charges
deducted, if applicable)

9. Exposure to other areas like ROP, 14. Any peripheral centres for
Ocular Oncology, Uvea etc compulsory rotation and duration of
the same ?
They get exposed to Uvea and ROP
quite extensively and in a limited way Nandurbar and Jalgaon satellite
to Retinoblastoma and Ocular centres where fellows may be posted
Oncology. We have a separate for patient care and ROP services if
department of oculoplastics and ocular required.
oncology.
10. Brief overview of VR equipments 15. Contact details ( Phone & Email) of
available in the Institute. the academic department.
We have regular state of the art Mrs Sangeeta Patil(+912026970144)

equipments at our institute. They are
as follows- 16. Names and Contact details of 3
1) 2 laser machines (Multispot past(within 2 years) or present
(Luminous) and iridex) fellows.
2) Fundus camera (Zeiss and Trinethra
classic) (New camera with ICG will be Dr Rohit Mendke (+91 7218281276)
procured by August 2019) Dr. Astha Jain. (+91 9620326500)
3) Ziess OCT Dr. Azar Lodhi (+91 9810716215)  
3) Microperimetry, mfERG
(Electrophysiology)
4) Constellation Vitrectomy machine
with various other surgical instruments
5) Reticare posterior vitrectomy
6) Ultrasound B scan
7) Pediatric digital wide field cameras
(Retcam as well as Forus Neo)
There are 8 fixed leaves during the long

term fellowship. Fellows are
encouraged to be
regular and take minimum leaves
during the period.

exposure?
There is no specific international

exposure linked to the fellowship
program.However we help connect the
fellows to any program they would like
to pursue through our extensive
international network. We encourage
them for international training
programmes by giving strong
recommendation letters as per their
calibre.

commitments with the institution
after completion?
No
Young Ophthalmologists Times is highly indebted to Dr Sucheta Kulkarni for providing us

the above information.

H.V. DESAI EYE HOSPITAL (HVDEH), PUNE.
DR NILESH GIRI
After completion of my M.S. university (MUHS) theory exams I had a month’s time
before practical exams during which interview processes of most of South Indian
institutes were scheduled. I had made up my mind about speciality of choice as
Vitreo-Retina Surgery by then. I began collecting information about institutes which
should be preferred from acquaintances, web domains like RxPG, e-ophtha.
Contrary to popular belief/ recommendation of a South India fellowship, I was
hopeful of getting fellowship in or near-by my home-town, Pune. I e-mailed
application for fellowship to [email protected] and received a reply within a fortnight
scheduling appointment on one of the three allotted days of first or last week of July
as per applicant’s logistics convenience. They also acknowledged vacancy for 1 VR
(18 months) and 1 research cum VRS (24 months) fellowship seats.
The Interview: On first of the 6 allotted days, 4 applicants had reported. All of us
were seated in the library and were given a questionnaire to fill. It had questions
about general information about qualification, journal publications, and future plans
like where do you see yourself in next five years, and the reason for selecting this
fellowship. All non-academic questions. This was followed by a small break during
which the interviewers analysed our forms, following which each candidate was
interviewed individually by Medical Director and head of retina and ROP
department, Dr Sucheta Kulkarni and senior retina consultant Dr Atul Hegde. I
was asked about my mentioned publications, few clinical questions using a case
scenario. Interview lasted for 15 minutes. The questions varied for each applicant,
few academic and few non-academic. All candidates were told at the end of
interview that selected candidates would be notified on the last interview day via e-
mail.
I received an e-mail notifying the selection for research cum VRS fellowship, stating
duration of 2 years and stipend of Rs.15,000 and was given a date within 1 week to
report and get documents verified, failing which the next wait-listed candidate would
be called.
It is undoubtedly one of the best institutes in Maharashtra with a decent medical
and surgical retina exposure and a good ROP exposure, with 1 cataract case per
week to keep brushing your cataract skills. I would suggest revising the speciality
subject, being formal and carrying print-outs of your publications, if any, might help.
A clear thought process about your future plans so that you can commit for a long-
term fellowship is essential. All the best!
DR NILESH GIRI, MBBS, MS is a Research cum Vitreo-Retina fellow at HVDEH,

Pune. He can be contacted at [email protected]

INSTITUTE WATCH
INDRA GANDHI EYE HOSPITAL,

LUCKNOW
Established in 2008, the hospital is housed in a rented building located in the

Qaisar Bagh area of Lucknow. As a top-of-the-line Tertiary care hospital, it can
carry out the entire range of eye care procedures, including refractive error
correction, cataract surgeries, glaucoma, retinopathy, cornea care and paediatric
eye care. It also hosts post-graduate Fellows, provides hands on training to
optometrists and trains Mid Level Ophthalmic Personnel (MLOP). On an average,
the hospital screens over 500 patients daily and conducts over 150 surgeries daily.
Since inception, IGEHRC Lucknow has screened over 1.5 million persons and
carries out nearly 2 lakh sight restoring surgeries. It also is one of the very few
eye hospitals in North India to have a dedicated patient counselling cell.
The Lucknow hospital covers a population of approximately 35 million (Census
2011) across Bahraich, parts of Bara Banki, Basti, Faizabad, Farrukhabad, Gonda,
Hardoi, Lakhimpur Kheri, Lucknow, Sitapur and Unnao where it organizes rural
eye camps. It is also the referral hospital for Amethi. Patients from all over Uttar
Pradesh and beyond come to this hospital for advanced eye care problems. 
YO TiMESI AUG 2019

275
YO TiMES I MAY 2019
1. Number of seats of various long and 9. Brief overview of VR equipments

short term Retina training available in the Institute.
programs ?
The institute has most state-of-the-art
2 seats for long term vireo retina   equipment for medical, imaging and
surgical retinal work
2 years 10. Number of permitted leaves
3. Exposure to research and 15

research ? 11. Any post fellowship International
exposure?
Adequate exposure is given  
None
expect ? 12. Any bonds or compulsory
Depends on the surgical acumen of the after completion?
candidate, but adequate exposure is
provide,  None 
5. Names & positions of Medical retina 13. Any peripheral centres for
and VR Faculties ? compulsory rotation and duration of
the same ?
• Dr Shireen Pandey
• Dr Rajesh Agarwal None 

& Joining) ? 14. Contact details ( Phone & Email) of
Based on oral interview, as per need
basis.   Details can be found on the website
7. Most important points that you http://www.igehrc.org

consider in a CV ?
• Prior exposure to VR procedures,

• Knowledge of retinal conditions
• Publications/presentations.
8. Stipend
Rs. 35,000/- per month
Young Ophthalmologists Times is highly indebted to Dr Rajesh Agarwal for

providing us the above information.

INSTITUTE WATCH
LV PRASAD EYE INSTITUTE

HYDERABAD - BHUBANESWAR - VISAKHAPATNAM
L V Prasad Eye Institute (LVPEI), a World Health Organization Collaborating

Centre for Prevention of Blindness, is a comprehensive eye health facility.
The Institute offers comprehensive patient care, sight enhancement and
rehabilitation services and high-impact rural eye health programs. It also
pursues cutting-edge research and offers training in human resources for all
levels of ophthalmic personnel.
L V Prasad Eye Institute aims to make an ophthalmologist competent in

the field of Vitreoretina and Uveitis through their fellowship program. The
institute offers 2 kinds of retina fellowships currently. A Medical retina
and Uvea fellowship and a Surgical retina fellowship. The duration for
both of these fellowships is 2 years.
YO TiMESI AUG 2019

277
1. Number of seats of various long and 2. Multiple choice question round – this
short term Retina training happens for the candidates qualified
programs ? through the online round. This would
be on the same day as the interview
LVPEI offers short term observer ship and qualifiers would go to the final
of 3 months – 6 seats per year round.
Long term retina fellows - 12 per year 3. Panel interview – This is the final
step.
Medical retina and Uvea fellowship – 6
per year The interviews are at the end of 3rd
week in the month of May and
2. Duration of fellowship ? November.
2 years 7. Most important points that you

consider in a CV ?
expectations by the institute in Honesty in details, attitude and
research ? publications.
For research related activities we 8. Stipend

encourage fellows to do guided
research along with the Principle Currently the stipend is 25,000 in first
Investigator. Scope of research ranges 18 months and 30,000 in last 6
from a prospective randomised study months.
to a case report or a photo essay.
Currently, retina fellows 6 months into 9. Exposure to other areas like ROP,
their fellowship are expected to Ocular Oncology, Uvea etc
present one case report every month
and dedicated faculty is available to Yes, complete exposure to ROP and
guide them for the case reports apart Uveitis services.
from other projects.
Ocular oncology is not a part of VR
4. Probable number of surgeries, fellowship in LVPEI currently.
lasers and injections one might .
expect ?
Currently, we do not work on a model available in the Institute.
where ‘x’ number of surgeries, ‘y’
number of lasers or ‘z’ number of Basic VR set up including vitrectomy
injections are allotted. Opportunities machines, OCT, OCTA, FFA, AF,
keep increasing depending on the Lasers are available. Novel
performance of the fellows. equipment’s include guided lasers, 3D
Visualization System. We also have a
5. Names & positions of Medical retina complete electrophysiology lab.
and VR Faculties ?
The information can be found at this
link 19 per year
http://www.lvpei.org/about-us/our-team
6. Selection procedure in brief exposure?
& Joining) ? Nil
The selection procedure includes 3

rounds –
1. Qualifying online exam: This
happens approximately 1 month before
the interviews.

13. Any bonds or compulsory 15. Contact details ( Phone & Email) of
commitments with the institution the academic department.
after completion?
Email: [email protected],
Yes 2 years of service agreement Phone: 04030612167
across network - it would be up to the
discretion of the institute to make an 16. Names and Contact details of 3
offer or not. past(within 2 years) or present
fellows.
compulsory rotation and duration of Past fellows
the same ?
Dr Ketan Saoji - 8369758057
Yes. 2 months of peripheral rotation in Dr Deven Dhurandhar - 9820223760
our secondary centres. Dr Anup Kelgaonkar - 8087540324
Young Ophthalmologists Times is highly indebted to Dr Avinash Pathengay for providing us the
above information.

LVPEI
DR. PRABHJOT KAUR 
Long-term fellowship interviews at LV Prasad Eye Institutes (LVPEI) happen every 6 months-
January session and July session. The location of interviews varies between Hyderabad,
Bhubaneswar, and Vishakhapatnam – the three tertiary centres of LVPEI, that run fellowship
programs in different subspecialties. The seat structure varies depending on the requirement of
fellows in the department across network. All the details are made available at our website
regarding the application process and its deadline. Once the application forms are filled out which
requires attachment of our resume along with the application form and a demand draft (details of
which are available online) and sent via post and e-mail, the candidates are notified regarding the
further process via e-mail.
The selection process is similar more or less every time, and details of which are updated on our
website. It’s a very clear and fair process and has been divided into 3 steps as follows-
Step 1- Online MCQ exam
Details of this test are mailed to every candidate along with user ID and password ahead in time of
an aforementioned date on which the exam is scheduled. It includes 30 MCQs with single best
responses.
After the step-1 is cleared, short-listed candidates are notified about the same and will be eligible
for on-campus written exam
Step 2- Written MCQ test
30 minutes MCQ test which includes questions based on comprehensive ophthalmology. Selected
candidates are further notified for the interview which is conducted on the next day
Step 3- Sub-speciality interview
This is a direct interview by the experts in the desired sub-speciality. The candidate should be
prepared with basic knowledge of the subject along with their expectations from the institute. The
interviewers consider not just the academic knowledge, but also the long-term goals, attitude
towards work and integrity of candidate! An important factor is the candidate’s ability to have
utilised the opportunities that were available during post-graduation.
Overall experience of the fellowship interview process is a great one! And one should be extremely
clear in mind as to what are their expectations in life and from the institute and how can they make
the best use of what this incredible place offers to you! 
DR. PRABHJOT KAUR, MBBS, DNB is a Vitreo-Retina fellow at LVPEI, Bhubhneshwar.

She can be contacted at [email protected]
YO TiMES IAUG 2019

280
INSTITUTE WATCH
ROP TRAINING AT LVPEI

- DR. SMRITI MISRA
ROP training at LVPEI is four weeks program where you get a very detailed
supervised exposure to clinical and surgical aspects of ROP.
Application Process:
You can apply for the course online through their website (http://www.lvpei.org/
services/education/training-programs) which provides the details of the training and
course fee. The application request has to be sent to [email protected]. The
tuition fee for Indian doctors is INR 65,000/- . Personal logistics are to be taken
care by the candidate. A twin shared guest house at INR 24,000 per month can be
provided by the institute which is subject to availability. For obvious reasons they
take limited number of candidates every month. So, there is usually along waiting
period (5-6 months). If you are planning on doing this course you should apply
considering these factors.
Selection Criteria:
To my understanding they prefer candidates who are confident in indirect

ophthalmoscopy and can do a good contact/ non contact slit lamp biomicroscopy.
An added advantage would be if you know laser indirect ophthalmoscopy. Lodging
facilities are not provided.
My Experience:
LVPEI being a tertiary eye care centre and a leading name in ROP
treatment gets referral from all over India. So, a wide range of
cases are available for trainees at all times. From day one I saw
paediatric cases and ROP in particular with my mentor
Dr. Subhadra Jalali. It was a wonderful learning experience as
almost all the ROP cases are seen by the trainee first and
findings confirmed by the mentor. They also provide us with a
good collection of reading material on ROP as a soft copy and
library is open 24*7. All consultants are open to discussion. A day
is allotted for diagnostic learning where you can see the B
YO TiMES I AUG 2019

scans and Retcam images of these babies. Outside compound you are taken to
other hospitals (NICU) for screening of admitted babies. Usually a consultant and a
fellow accompanies.
It is an advantage if you have a good hand in LIO. As soon as you are confident in
doing laser in these premature babies you can do the entire case individually.
Initially lasers are fully supervised so that you can understand the mistakes in
focusing laser, burn intensity, spacing and handling the baby. You can also observe
Intravitreal anti VEGF injection administration.
If you are interested you can also do a preoperative workup (along with the fellow
posted with the mentor) of these babies so that you understand what are the
requirements prior to surgery in these babies. Also this gives you a better
understanding of what to do in a particular case than just observing the surgeries in
OT(Scleral Buckle or Vitrectomy +/- Lensectomy). If you are confident in Vitreo-
Retinal surgeries you might get a chance to do few steps in surgeries too. There is
a visual rehabilitation centre specially for rop babies where you can learn the
methods and techniques by the trained staff. Apart from ROP one hour morning

class is also quite educational. Working hours are long, 7 am in the morning to 7
pm in the evening and on days of OT it may extend to midnight as well. It’s a
dedicated team work and the enthusiasm is quite palpable in the mentor. She is
very approachable and always ready to take up queries. She goes out to NICUs
after OPD hours on her way back to home. This dedication is very impressive and
something to learn from specially if you are preparing to take a step towards
treating these fragile beings.
In just one month of training period I got good hands-on laser , a thorough
insight on clinical aspects of ROP and great deal of surgical pearls, which I
will cherish for life.  
Dr. Smriti Misra MS, FVRS is a Vitreo-Retina & ROP consultant at HV Desai Eye Hospital, Pune.
She completed her Vitreo-Retina training from Aravind Eye Hospital Madurai and ROP training fr LV
Prasad Eye Hospital, Hyderabad.

INSTITUTE WATCH
MGM EYE INSTITUTE,

RAIPUR
MGM Eye institute, a tertiary eye care institute was established in Raipur the capital of
Chhattisgarh in November 2004 with a mission to provide high quality comprehensive eye
care services to all including the economically underprivileged in an equitable manner.
Th fellowship consists of training fellow in the surgical and medical management of
retina and vitreous disorder. The program provides an intensive, broadly based clinical
experience in retinal and vitreous disease with the goal of training the fellow to pursue
a career in an academic environment.
In the first year, the fellow is fully integrated into all aspects of medical and surgical
treatment of patients on the Vitreo-Retinal services. The fellow will be rotated among
the retinal consultants every 3 months and accompany them in OPD and OT on scheduled
days. He will also get extensive ROP screening and laser exposure during his tenure. In
last 6 months, there is greater emphasis on surgical proficiency. Apart from this he will
have to present cases, seminars and journal club as per academic schedule. He will also
have to publish 2 research articles in indexed journals. 
YO TiMESI AUG 2019

284
1. Number of seats of various long and • Dr Gitumoni Sharma, DNB
short term Retina training Consultant, Vitreo-Retina
programs ? Services, MGMEI
Long term fellowship: Medial and 6. Selection procedure in brief

Surgical Retina (18 months):1 including probable dates (Interview
candidate / year & Joining) ?
Short term fellowship: Medical Retina We receive applications for VR

(3 months): 2 candidates/ year fellowship in months of October,
November. We plan interview in
Retinopathy of Prematurity (3 months): second week of December.
2 candidate/ year
Fellowship at our institute begins on 1
Fellowship offered through January of every year.
International Council of Ophthalmology
(ICO): Vitreo-retina (3 months): As per 7. Most important points that you
ICO application consider in a CV ?
• Subject knowledge
• Practical experience
2. Duration of fellowship ? • Prior research exposure
Long term: 18 months

8. Stipend
Short term: 3 months
As per institute policy
expectations by the institute in 9. Exposure to other areas like ROP,
research ? Ocular Oncology, Uvea etc
We expect the fellow to publish atleast We have full functional ROP

2 articles in indexed journals apart from programme that is covering 6 district
2 oral presentations at national of Chhattisgarh. On an average we
conference. screen around 100 babies / week and
around 8-10 ROP lasers are
performed. We also have Uveitis
4. Probable number of surgeries, Services where we seen on an
lasers and injections one might average 200-250 new uveitis patients
expect ? each year.
We expect fellow to perform atleast

40-50 independent major retinal 10. Brief overview of VR equipments
surgeries, more than 100 retinal lasers available in the Institute.
and more than 100 intravitreal
injections by the end of his tenure Two Alcon Constellation vitrectomy
machines,
One Accurus 400VS vitrectomy
5. Names & positions of Medical retina machine,
and VR Faculties ? Carl Ziess Operating microscope OPMI
Visu 210 equipped with Sony camera
• Dr Anil Gangwe, MD (AIIMS) and recording system,
Consultant, Vitreo-Retina and Iridex green laser,
Neuro-Ophthalmology Iridex diode laser,
Services, MGMEI Cryo machine.
• Dr Swapnil Parchand, MS Wide range of retinal lenses for
(PGI), FAICO (Retina) visualization during surgery that
Consultant, Vitreo-Retina and includes BIOM, Volk surgical contact
Uvea Services, MGMEI lenses, and irrigating contact lenses.
Diagnostic setup includes

Fundus camera (Carl Ziess FF450
plus), 13. Any bonds or compulsory
HRA 2 (Heidelberg Engeneering), commitments with the institution
Carl Ziess Humphery visual field 7501, after completion?
Ziess cirrus HD OCT,
Carl Ziess Visulas 532 Frequency None
Doubled NdYAG Laser with LIO
attachment 14. Any peripheral centres for
Ocular ultrasound (Sonomed Escalon), compulsory rotation and duration of
VEP, ERG and EOG facility. the same ?
Carl Ziess Slit lamp SL 130 with
Visupac 131 No
Carl Ziess Hand held slit lamp
We have total 9 OPD examination 15. Contact details ( Phone & Email) of
rooms totally dedicated to retina the academic department.
department and they all are well
equipped with Haag Streit Slit lamps Dr Samrat Chatterjee
and indirect ophthalmoscope. Mobile: 9893336785
11. Number of permitted leaves 16. Names and Contact details of 3

past(within 2 years) or present
Total 18 days fellows.
12. Any post fellowship International Dr Tripti Saraogi

exposure? MGMEI, Raipur
Email: [email protected] 
Can be arranged
Young Ophthalmologists Times is highly indebted to Dr Swapnil Parchand
for providing us the above information.
YO TiMES IAUG 2019

286
INSTITUTE WATCH
MINTO OPHTHALMIC HOSPITAL,

BENGALURU
The long term fellowship programme in Vitreo-Retina at Minto Ophthalmic
Hospital, which is the Regional Institute of Ophthalmology for south India, aims at
training Ophthalmologists who have completed residency MD/MS/DOMS, to impart
skills in recent advances, diagnosis & management of VR diseases.The fellowship
programme is affiliated to RGUHS. The duration is for 18 months, session
commences every year during August -September with an intake of 4 fellows /
year. The Course curriculum includes training in Clinical aspects like Indirect
Ophthalmoscopy, Fundus bio-microscopy, Diagnostics like Fundus Photography,
Fluroscein angiography ,ocular Ultrasonography , OCT, Laser for treatment of
retinal disorders;.ROP Screening & Bimonthly diabetic retinopathy Screening
camps; Surgical training for procedures like vitrectomy, Scleral buckling,
Secondary IOL implantation, Intravitreal Injections; Handling Ocular emergency
like trauma ,IOFB, Endophthalmitis, Macular threatening diseases.The academic
aspects includes weekly seminars, case presentations, Journal club; Paper &
Presentations at National & State conferences; authentic research work &
Publications in indexed Journals; The VR department conducts an annual CME
meet for the benefit of the fellows & residents. A 3 monthly retina meet is
conducted cases.
Hence, this fellowship programme provides intensive

training in both clinical as well as academic aspects,
thereby aiming at moulding an Ophthalmologists into
capable, independent Vitreo- Retinal specialists. 
YO TiMESI AUG 2019

287
YO TiMES I MAY 2019
programs ?
• Masters/ DO with 2-3 yrs clinical
  3 experience
• Publications
2. Duration of fellowship ? • Gold medals/Awards
8. Stipend
One and half year (Medical & Surgical
Retina) 30,000/month
3. Exposure to research and 9. Exposure to other areas like ROP,

expectations by the institute in Ocular Oncology, Uvea etc
research ?
ROP- screening done with IDO &
According to RGUHS, 2 papers/ Retcam at Vanivilas Hospital NICU;
publications expected Treatment done with diode laser
4. Probable number of surgeries, Ocular oncology, Uvea- in common with

lasers and injections one might Retina clinic.  
expect ?
No of surgery- 10 to12 /wk available in the Institute.
No of laser- around 60-70/wk
No of injection-10-15/wk  Diagnostic equipments:
-B-scan Ultrasound
5. Names & positions of Medical retina -OCT
and VR Faculties ? -OCTA
-FFA
• Prof Dr.B.N.Kalpana Head of -Retcam
the VR Department FRCS Therapeutic equipments
(Glasgow), FMRF (S.N), WHO Well equipped OT dedicated only for
VR Fellowship (AIIMS) DNB, VR surgery
DOMS -Alcon Constellation
-Two OT tables: Zeiss Lumera,
• Dr.Shilpa YD, Asst.Professor Haag-streit
MS, FVR (RGUHS) -Monitoring facility
-ETO Sterilization
• Dr.Ravi B, Asst.Professor OPD
MD (AIIMS), DNB, FAICO, SR -Yellow and Green laser
At VR Dept (AIIMS) -Red laser for ROP
-ILO
• Dr.Hemalatha B C,
Asst.Professor MS, FMRF
(S.N) 11. Number of permitted leaves
6. Selection procedure in brief 2 leave per month

& Joining) ? 12. Any post fellowship International
exposure?
Yearly intake
Personal
Application notification updated in
RGUHS website (july-sept) 13. Any bonds or compulsory
Joining time, 1 week after selection in after completion?
September
  No.

the same ? fellows.
Community Diabetic Retinopathy Past Fellows

Screening camp Dr. Ramprakash 9972047611
Dr. Sonali 9632377563
15. Contact details ( Phone & Email) of Dr. Sadiq 9986200803
the academic department. Dr. Shylaja 9980205896
Prof. Dr. B N Kalpana Present Fellows

Email id- [email protected] Dr. Shivsagar 7337779878
Mobile no. 9448040627  Dr. Kavitha 9448797062
Dr. Bhavna 9731168677
Young Ophthalmologists Times is highly indebted to Dr. B. N. Kalpana


INSTITUTE WATCH
M. M. JOSHI EYE
INSTITUTE, HUBBALLI
M. M. Joshi Eye Institute is an NABH accredited tertiary eye institute in
north Karnataka. With a large volume of patients and state-of-the-art
infrastructure, the retina services cater to a large population in
Karnataka, Goa, parts of Maharashtra and Andhra Pradesh. The retina
fellowship was initiated in 2005 and has trained students in the field of
vitreoretina from all over the country and abroad.
YO TiMESI AUG 2019

290
programs ?
• Medical Director and Head of
A 6- monthly review is done for the Department- Dr.
fellowship vacancies. Based on the Guruprasad A. S. FVRS.35
need of the institute, one to three Years of Experience in
fellowship positions are filled every 6 Vitreoretina.
months.
• Shrinivas M Joshi- FVRS
(Toronto, Canada)
• Dr. Apoorva Ayachit MS,
24 months DNB, FICO, FVRS, FAICO
• Dr. Suresh Babu N MS, FVRS

expectations by the institute in 6. Selection procedure in brief
research ? including probable dates (Interview
& Joining) ?
Research in MMJEI is mandatory for all
fellows. Each fellow is encouraged to The written test is usually held in the
take up at least one project. They are second or third week of June and
frequently encouraged to submit case December. The test consists of 60
reports, case series of interesting questions spanning all specialties of
clinical cases and assist seniors in data ophthalmology. All students are then
interviewed which carries 40 marks.
acquisition, literature review and
Term starts on July 1st/January 1st.
manuscript writing. Selected fellows are required to report
within one week.
expect ? 7. Most important points that you
consider in a CV ?
All fellows assist in the OT on rotation,
twice a week. 6-8 surgical cases are • Number of cataract surgeries
performed – to assess overall
posted on an average daily, of which
competence in ophthalmic
junior fellows are given surgical steps surgery. Those who have
based on their skill and progress. By 8- performed less surgeries are
12 months into the fellowship, senior encouraged to first learn cataract
fellows start doing vitrectomies, surgeries before starting a full-
scleral buckling and SFIOLs fledged retina fellowship.
independently. In all, the fellows
assist about 300 cases, operates under • Curriculum vitae - Interest in
supervision in about 150 cases (steps research is mandatory. Prior
as well as entire surgeries combined). publications and paper
At the end of the fellowship, fellows presentations are viewed
are competent in medium to complex favourably. Having passed post-
cases include membrane surgeries. MS DNB FICO, FRCS steps are
noted. Extra- curricular activities
Lasers – About 300- 500 lasers and
like music, arts and sports are
more than 1000 intravitreal injections. also looked at.
• Clinical knowledge is assessed

with questions about a few clinical
scenarios.

8. Stipend interest, observerships in Toronto or
Hong Kong can be arranged.
Stipend is 30,000 pre month for 18
months. 40,000 for months 19-21. 13. Any bonds or compulsory
60,000 for months 21- 24. commitments with the institution
after completion?
9. Exposure to other areas like ROP, Nil

Exposure to ROP and uvea is very high. compulsory rotation and duration of
We treat all pediatric retina cases and the same ?
uveitic conditions. Oncology exposure is
limited because of limited preclinical and Once a month visit to OPD and OT in
paraclinical support Goa, VR OPD in Hospet and Bijapur.
Cataract surgeries in camp once in a
month.
available in the Institute. 15. Contact details ( Phone & Email) of
Topcon TRX 50x fundus camera,
Spectralis HRA 2 (Heidelberg)- Dr. Guruprasad A S-
includes SD-OCT, (with EDI), [email protected]
autofluorescence (short and long
wavelength), infrared photography, Dr. Shrinivas Joshi –
multicolour imaging, FFA, ICGA and [email protected]
OCT-A, Retcam- Clarity, Iridex
(577nm- yellow laser) platform for Dr. Apoorva Ayachit-
slit lamp delivery and LIO, PASCAL [email protected]
532 nm, Appa LIO, Lumeira 700 with
Zeiss rescan and integrated Ms. Deepa – Office co-ordinator-
intraoperative OCT, Ngenuity Heads 9739922121, Landline-
up 3D monitor (ALCON) with 08362228431/2/3
integrated video recording, Visu 160
with Zeiss rescan, Constellation LXT
(1) and Constellation TT (1); Sony 16. Names and Contact details of 3
PMW MD10 cameras for recording. past(within 2 years) or present
Roland Consult for fellows.
electrophysiology.
1. Dr. Akshata Pattanshetti-
11. Number of permitted leaves [email protected]
One leave per month. 12- 15 leaves 2. Dr. Nishita Yadav-

per year. [email protected]
12. Any post fellowship International 3. Dr. Mridula Sekar-

exposure? [email protected]
None as of now. If fellows show
Young Ophthalmologists Times is highly indebted to Dr. Apoorva Ayachit


MMJEI, HUBBALLI
- DR. MRIDHULA SEKAR
I was always interested in doing Vitreo-Retina fellowship after my MS

Ophthalmology. I came to know about MM Joshi Eye Institute a few years ago when
I had come to attend Eye2Eye, the intensive 3 day PG refresher course for exam
goers with my senior. Looking at the quality of teaching, I had shortlisted this
institute for my fellowship. I kept periodically checking the website for fellowship
announcement and applied with an online application as soon as it was put up.
Based on the application candidates were called for a written test and an oral
interview. We were a total of 160 candidates that gave the exam. Based on the
preferences for fellowship we had given we were shortlisted. 10 for VR. 10 for
Cornea and a few candidates for the other sub specialities. The written exam was in
MCQ format with a 120 general ophthalmology questions to answer in 1hour. The
questions were based on the MS Ophthalmology syllabus. I did not have to read
any other content other than the MS portions.
The VR interview was conducted by Dr. A.S.Guruprasad , HOD Dept of Vitreo-
Retina. My interview was not much of a subject oriented one. I was asked to
elaborate on my thesis topic which I had done in MS and about surgical exposure
at my previous institute. I was asked about how I developed interest in retina being
from an institute that did not much of a retina set up. I answered these questions to
the best of my ability. Three days after the interview I received the appointment
letter .
In my opinion, the selection exam at MM Joshi Eye Institute is one of good standard
and challenging.
  DR. MRIDULA SEKAR is a Vitreo-Retina fellow at MM Joshi Eye Hospital. She
can be contacted at [email protected]

INSTITUTE WATCH
NANDADEEP EYE HOSPITAL

Nandadeep Eye Hospital is established in 1980 and is a renowned super specialty eye
hospital in western Maharashtra with 7 branches spread in districts of Sangli and
Kolhapur. The educational activities available at Nandadeep include:
1. CPS Post graduation in Ophthalmology
2. Long term Fellowship in Phacoemulsification
3. Short term training programs in Phaco and SICS
4. Long term comprehensive Ophthalmology and Retina Fellowship
5. Optometry Fellowship
Our hospital caters to more than 50000 patients per year and over 6000 surgeries are
done every year. Since year 2011 our hospital started various educational activities as
stated above. We have trained more than 50 ophthalmologists from India and abroad. Dr
Sourabh D Patwardhan FRCS, MD(AIIMS) FICO honouree scholar is head of fellowship
programs. He focuses on personal mentoring. Fellowship programs include training on
clinical skills as well as didactic lectures. Fellows work is supervised and are also given
opportunity to handle independent OPD. Development of required communication skills
is also given importance. Research is encouraged and fellows are given study
projects. 
YO TiMESI AUG 2019

294
YO TiMES I MAY 2019
1. Number of seats of various long and

16. Joining will be from 1st June (1 month
short term Retina training extension will be allowed)
programs ?
There is 1 seat every year for Long consider in a CV ?
term Retina plus Phaco fellowship.
Thid is unique program as the fellow • Institute from which candidate
gets adequate exposure to cataract has graduated
surgery as well. Nandadeep also • Surgical and work experience
provides 18 months advanced phaco • Recommendation from teachers
fellowship and 3 years comprehensive
anterior segment fellowship..   8. Stipend
17.
2. Duration of fellowship ? 0-6 Months 15000 pm
7-18 Months 20000 pm
3 years for combined Phaco plus retina 19-30 Months 40000 pm
fellowship 31-36 Months 60000 pm
18.
research ?
ROP screening and Laser (as per
Research is encouraged. Study availability) will be given, Plenty of
projects are given to fellows. Their exposure to Uvea and trauma
presentations in conferences and CME services.  
is also encouraged.  
19.
4. Probable number of surgeries, available in the Institute.
expect ? Constellation Vitrectomy system
Appasamy Red Laser
Probable numbers retina fellow will get Zeiss Green Laser
is assisted Retinal surgeries more than Valon Multispot Laser
500, Independent Retina surgeries Zeiss FFA/ICG camera
minimum 50, Lasers minimum 50, Eidon widefield camera
injections minimum 50, Phaco Lumera I with Eibos 2 and Contact lens
minimum 200  widefield lenses

20.
5. Names & positions of Medical retina
and VR Faculties ? 1 per month, 1.5 per month in last year
• Dr Sourabh D Patwardhan, 12. Any post fellowship International

FRCS, MD(AIIMS) Surgical exposure?
Retina
Talks going on.
• Dr Madhavi D Patwardhan
MD,DOMS Medical Retina 13. Any bonds or compulsory
• Dr Nidhi S Patwardhan MD, after completion?
DOMS Medical Retina
No compulsory commitment after
6. Selection procedure in brief finishing fellowship.
& Joining) ?
Last date of application 30th April,

Interview will be done in 2 weeks time.

14. Any peripheral centres for 15. Contact details ( Phone & Email) of
compulsory rotation and duration of the academic department.
the same ?
Dr Sourabh D Patwardhan
Yes as per need. But speciality fellows [email protected]
will only go for visits and not for stay for 9404705777  
longer duration.
fellows.
Dr Pankaj Deshmukh (phaco fellow)

9923797376
Dr Gaurav Bhati (phaco fellow)
8830650899
Dr Varun Gupta (phaco fellow)
9458076626
 
Young Ophthalmologists Times is highly indebted to Dr Sourabh D Patwardhan for providing us

INSTITUTE WATCH
NARAYANA NETHRALAYA
Narayana Nethralaya was started in the year 1982 as an eye clinic at
Srirampuram, Bangalore by Dr. K. Bhujang Shetty. Recognizing the need to provide
comprehensive eye care to the ever growing number of patients, while at the
same time offering the best in ophthalmic sub-speciality services, Dr. K. Bhujang
Shetty established the first centre at Rajajinagar in 1993.
Narayana Nethralaya has now expanded to become even bigger and better. The
four centres are spread across the city and offer eye care in various specialties
and departments, which are fully equipped with state of art diagnostic and
therapeutic tools. Ocular health is closely related to many systemic diseases like
diabetes, hypertension, heart disease, systemic infections and cancer. Research,
both basic and clinical science, is a priority and strength. Narayana Nethralaya a
dedicated wing to facilitate this endeavor at our Hosur Road branch. The focus is
on applied research in areas such as stem cells, molecular diagnostics, genetics,
ocular immunology and infectious diseases.
The National Board of examinations, New Delhi has recognised the hospital for
training of candidates for DNB in Ophthalmology with an intake of 6 candidates
per year. Our programme gives vast learning experience in terms of clinical,
surgical and continuing medical education programs. Narayana Nethralaya offers
fellowships, short and long term, in all subspecialties of ophthalmology. The
students are exposed to the best in clinical ophthalmology and research. 
YO TiMESI MAY 2019

297
YO TiMES I MAY 2019
1. Number of seats of various long and • Dr Ramesh Venkatesh

short term Retina training • Dr Vishma Prabhu
programs ? • Dr Arpita Pereira
Three long term fellows at our Paediatric

PaediatricVitreoretina Service
Vitroretina Service
Rajajinagar branch and one long term
fellow for the Hosur Road branch. The • Dr Anand Vinekar
fellows may need to rotate between all
the four centers if need be. Two fellows NN 2 — NARAYAN HEALTH CITY
will be selected per year on merit basis
for the RGUHS certified fellowship, •• Dr Sherine Braganza
Marina
which requires an exit exam at the end • Dr Thirumalesh M B
of the program (theory and practical).
There is no difference in the training NN 3 — ASHOK NAGAR
between the University and NN
fellowships.   • Dr Prathibha Hande
2. Duration of fellowship ? NN 4 — BANERGHATTA ROAD
2 years • Dr Subhashchandra H D
• Dr Aniruddha Tirumalai
research ?
NN has several basic, clinical and including probable dates (Interview
imaging studies ongoing. Fellows are & Joining) ?
encouraged to be a part of the
research activities, present the same at An oral interview is held in late June
meetings and publish the data as well. and late December. The sessions
Our previous fellows have presented at begin in January and July. If there are
national and international meetings and several applicants we have a written
published in several high impact assessment to shortlist for the
indexed journals.   interview.  
4. Probable number of surgeries, 7. Most important points that you

lasers and injections one might consider in a CV ?
expect ?
• Prior exposure to VR procedures,
On an average, there are 10-12 VR • Reasonable knowledge of retinal
surgeries, 15-20 lasers and 20-25 conditions and their management,
injections performed each day. • Publications/presentations.
Depending on the seniority, skill level
and confidence, fellows get to do 8. Stipend
independent procedures.  
Rs. 30000/- per month
5. Names & positions of Medical retina 9. Exposure to other areas like ROP,
and VR Faculties ? Ocular Oncology, Uvea etc
NN 1 — RAJAJI NAGAR Fellows would have rotations in ROP

and Uvea. They can visit the Hosur
•• DrDr Naresh
Naresh K Yadav
K Yadav branch if interested in ocular oncology
•••Dr Naresh
DrDr Priya
Priya BVKBV
Yadav work.  
•••Dr Priya
DrDr BV
Chaitra
Anand Jaydev
S Vinekar
•••Dr Santosh
DrDr Anand
Chaitra Gopi Krishan Gadde
S Vinekar
Jaydev 10. Brief overview of VR equipments
•••Dr Chaitra
DrDr
Santosh Jaydev
Santosh Gopi
Gopi Krishan
Krishan available in the Institute.
•••Dr Navin
DrDr Kumar
Navin
Navin Nayak
Kumar
Kumar Nayak
Nayak
DrDr
•••Dr Poorna Chandra
Poornachandra
Poorna ChandraBB B

The institute has most state-of-the-art 14. Any peripheral centres for
equipment for medical, imaging and compulsory rotation and duration of
surgical retinal work the same ?
As in point 1  
12 15. Contact details ( Phone & Email) of

exposure? Dr. Sriharsha Nagaraj +919632419350
[email protected]  
Not anything linked to our fellowship,
but can be facilitated if needed.
13. Any bonds or compulsory fellows.
after completion? Dr. Shivani
Dr. Deepa Sharma-9968050005
Sinha +91 9453100699
Dr. Sabitabh
Dr. Ankita Shrivastav- 9560073529
Agarwal +917042147501
No. But there is a non-refundable Dr.Ruchi
Dr Prachi Gaurav-
Vala 8800642841
: +919879527285
fellowship course fee of Rs.  
1.25 lakh  
Young Ophthalmologists Times is highly indebted to Dr. Chaitra Jayadev

  for providing us the above information.

INSTITUTE WATCH
NATIONAL INSTITUTE OF OPHTHALMOLOGY,

PUNE
National Institute of Opthalmology (NIO) is a super speciality eye hospital in Pune
committed to delivering high quality eye care, where Dr. Shreekant Kelkar and
Mrs. Aruna Kelkar have worked untiringly to bring together state-of-the-art
technology and trained experienced personnel.
NIO is the first NABH accredited eye hospital in Pune. Established in 1993, NIO has
achieved remarkable growth with the largest pool of highly specialized staff
comprising of over 20 eye specialists, and 70 nursing, paramedical, and
administrative staff. Having consistently maintained high quality standards for
decades, today NIO has become the hospital of choice for patients with eye
problems in & around Pune.
Over the years, NIO has expanded into an ultra-modern facility with a full array of
subspecialty clinics, well integrated diagnostic, imaging and laser systems, state-
of-the-art operation theatres, daycare recovery suites, sophisticated training and
education facilities.
With clinical expertise and sophistication of diagnostic and treatment procedures,
NIO serves the needs of its patients across a wide spectrum of eye disorders
related to Cornea, Retina, Paediatric Ophthalmology, Neuro Ophthalmology and
Oculoplasty. NIO carries out advanced eye procedures like LASER treatments and
Retinal Surgeries. The hospital annually screens about 75,000 out-patients and
performs nearly 6000 surgeries. 
YO TiMESI AUG 2019

300
YO TiMES I MAY 2019
16.
programs ? Rs. 15,000/- per month
VR training program : 2 per year 9. Exposure to other areas like ROP,

Short term retina training at the institute
: Not available  Exposure to ROP : 3 months
observership training at paediatric
17.
2. Duration of fellowship ? hospitals
1 year Ocular oncology : Not much exposure
18.
3. Exposure to research and Uvea: Good exposure 
research ? 10. Brief overview of VR equipments
Good enough to publish one or two
articles in peer reviewed journals.  • Alcon constellation table top version
• Resight 700 viewing system
19.
4. Probable number of surgeries, • Alcon 23 / 25 gauge instruments
lasers and injections one might • OT viewing camera system for
expect ? observation and recording of
surgeries : 3 chip jd camera
Surgery: approximately 50 • Alcon laser machine with LIO
Lasers : approximately 100 attachment
Injections : approximately 50 • Aurolab laser machine with LIO
( Phacoemulsification cataract attachment
surgeries are also given to perform if • IRIDEX laser machine
candidate is already performing it • Triton OCT and OCT angiography
independently)  • Bscan
• Wireless and wired both indirect
ophthalmoscopy viewing systems
5.
5.and VR Faculties ?
• Dr. Aditya Kelkar, Director
NIO 10
6. Selection procedure in brief 12. Any post fellowship International

including probable dates (Interview exposure?
& Joining) ?
None, but can recommend to suitable
Through Maharashtra University of
Health Sciences (MUHS) once a year candidates willing to go self funded
or via interview directly at the institute ,
in December every year. 13. Any bonds or compulsory
7. Most important points that you after completion?
consider in a CV ?
No. 
• Overall performance in Post
Graduation course 14. Any peripheral centres for
• Publications and surgical compulsory rotation and duration of
exposure during post graduation the same ?
and
• Number of memos received if any Nil . 2 main centers with rotation
for indiscipline training, 6 months each

 
15. Contact details ( Phone & Email) of 16. Names and Contact details of 3
the academic department. past(within 2 years) or present
fellows.
Phone number : 8600005523
Dr. Hetal Mehta : +91 9869699374
Dr. Akshay Kothari : +91 9007700296
 
Dr. Swayambhu Ghosh : +91
8582965825
Young Ophthalmologists Times is highly indebted to Dr Aditya Kelkar for providing us the above
information.

INSTITUTE WATCH
NETHRADHAMA SUPER SPECIALITY

EYE HOSPITAL, BANGALORE
Nethradhama Super Speciality Eye Hospital is a world-class facility focused
primarily on quality eye care with cutting edge technology and highly skilled
doctors.
We encourage medical students considering post-graduation and of career in
various sub specialties of Ophthalmology. We also regularly conduct continuing
medical education programmes. We are affiliated with Diplomate of National
Board, New Delhi for post-graduation in Ophthalmology and Rajiv Gandhi
University of Health Sciences for post-doctoral fellowship programs. We have a
very comprehensive curriculum for the training of our students. This is supported
by our dedicated and committed faculty. 
YO TiMESI AUG 2019

303
YO TiMES I MAY 2019
programs ?
• Dr. Mahesh Kumar H M -
Medical retina: 2 seats per year (Walk Senior Consultant , Vitreo-
in Interviews) Retina
• Dr. Kadri Venkatesh - Senior
Surgical Vitreoretina fellowship: 2/4 Consultant, Vitreo-Retina
seats per year (January and July • Dr. Mamatha N – Senior
session) as per Rajiv Gandhi University Consultant, Vitreo-Retina
of Health Sciences regulations   • Dr. Chinmayi H Vyas –
Consultant, Vitreo-Retina
Fellowship Director
Medical retina: 3months & 6 months Dr. Sri Ganesh
(Walk in Interviews) Chairman & Managing Director
Nethradhama Super Speciality
Surgical Vitreoretina fellowship : 18 Eye Hospital
months as per as per Rajiv Gandhi
University of Health Sciences 6. Selection procedure in brief
regulations including probable dates (Interview
& Joining) ?
expectations by the institute in Last date for submission of application
research ? form -10th June 2019
The candidates selection process will
The Nethradhama Super Speciality be on Interview Basis with Subject
Eye Hospital, Bangalore has a robust Experts
and enthusiastic research environment Declaration of results and date of
and has its own in house DCGI joining will be informed on the same
approved Ethics Committee. Our day of the Interview.
institute has been part of many global
multicentric trials and has been an Dates for subsequent sessions will be
active contributor in the field of available on the website
research at a global level.   www.nethradhama.com two months
prior to the Interviews 
lasers and injections one might 7. Most important points that you
expect ? consider in a CV ?
(As per log book of outgoing long term • Interest and passion for the
fellow) subject
• Attitude
Intravitreal injections: 250 • Basic skills and knowledge
PRP Laser: 500
Barrage laser: 250 8. Stipend
Focal laser : 10
VR surgeries: 30 Rs. 40, 000/- per month
Surgical opportunities entirely depends 9. Exposure to other areas like ROP,

on the capabilities & performance of Ocular Oncology, Uvea etc
the candidate and discretion of the VR
consultants.  Fellows would have rotations in ROP
and Uvea. They can visit the Hosur
branch if interested in ocular oncology
work.  

10. Brief overview of VR equipments 14. Any peripheral centres for
available in the Institute. compulsory rotation and duration of
the same ?
OPD-Heidelberg Spectralis –
Autofluorescence , FFA &ICG, SD Compulsory peripheral posting - 2
OCT, Zeiss green laser –(PASCAL), B months
scan, ZEISS Angioview OCT
angiography 15. Contact details ( Phone & Email) of
OR- MIVS - Constellation Vision the academic department.
System, Iridex green laser, Zeiss
Resight , Sony 4k Surgical Video Landline : 080-26088000 / 26633533
recording Email: [email protected] /
[email protected]
Website: www.nethradhama.com 
18 days, If greater leaves than the past(within 2 years) or present
permitted allowance are availed, the fellows.
candidate is required to complete the
same as an extension Dr. Ravichandra G (Surgical
Vitreo-Retina fellow) : +91 8008839084
exposure? Dr. Sivaranjani (Surgical Vitreo-Retina
fellow) : +91 9943759150
No.
Dr. Neha Khanna (Surgical Vitreo-
13. Any bonds or compulsory Retina fellow) : +91 9158926130
after completion?
No. 
 
Young Ophthalmologists Times is highly indebted to Dr. Mahesh Kumar

INSTITUTE WATCH
PRAKASH NETRA KENDRA,

LUCKNOW
Prakash Netra Kendra ( PNK) is one of the oldest tertiary eye care centre at
Lucknow in Northern India. Established in year 1991 by Dr. Shobhit Chawla and Dr.
Rajat Dhesi with a vision to provide comprehensive eye care services to each
segment of society, it is now one of the most reputed eye hospitals in this part of
the country.
 
We have been providing retina services science inception. We started our vitro-
retina ( VR) fellowship in year 2001 under the expert guidance of Dr. Shobhit Chawla
who is one of the founder member and the current president of Vitro-retina Society
of India( VRSI). We have trained many ophthalmologist in VR sub speciality who are
practising in various parts of India.
 
We have a very good retina work load and referral patients from adjoining states
and Nepal. It is our endeavour to acquire, upgrade and utilize the latest technology.
We have state of the art cutting edge diagnostic, therapeutic and surgical
equipment which are maintained by well trained technicians and paramedics.
We have 5 full time VR consultants taking care of Vitreo-Retinal diseases and

various sub specialities like Uveitis, ROP and ocular oncology as well.
YO TiMESI AUG 2019

306
programs ?
We have fellowship trained Uvea/
Two ocular oncology and ROP specialists .
2. Duration of fellowship ? 10. Brief overview of VR equipments

2 years
Heidelberg system for Spectral domain
3. Exposure to research and OCT/FFA/ICG/FAF/OCT ANGIO
expectations by the institute in Retcam for ROP screening
research ? Pascal Laser by Nidek .
Constellation machines for VR Surgery.
We give various VR topics to our DNB
students thesis which is done 11. Number of permitted leaves
methodologically an can be used.
20 leaves in a year
lasers and injections one might 12. Any post fellowship International
expect ? exposure?
Surgery more than 50, lasers and Yes at NEI Singapore

injections as much as they can
perform safely. commitments with the institution
after completion?
No
and VR Faculties ?
Dr. Shobhit Chawla -
HOD,Medical Director
Dr. Mohit Khemchandani- the same ?
Assistant Medical Director
Dr. Saurabh Singh - Sr Consultant No peripheral centres we have one
Dr. Prabhat Ranjan - Sr Consultant
Dr. Dipendra Shukla - Jr Consultant
Retina clinic nearby.
6. Selection procedure in brief 15. Contact details ( Phone & Email) of

including probable dates (Interview the academic department.
& Joining) ?
Dr. Prabhat Ranjan- 9956589746
Interview is conducted in the month of ([email protected])
May each year.After the interview by
Medical Directors candidate is asked to Konpal Shrivastava- 7668511116
join the hospital from June ([email protected])
7. Most important points that you 16. Names and Contact details of 3
consider in a CV ? past(within 2 years) or present
fellows.
• Interest in VR,
• Previous work experience Dr. Tanu Raja- 9839986044
• Academic achievements. Dr. Dipendra Shukla - 9450592002
Dr. Ashish Gupta- 8004966399  
8. Stipend
25,000 /month
Young Ophthalmologists Times is highly indebted to Dr Shobhit Chawla for providing us the
above information.

PRAKASH NETRA KENDRA(PNK), LUCKNOW
- DR MOHIT GUPTA
After finishing my MS I was keen to join fellowship in VR and started my research

regarding all the institutes across the country. With the help of my various seniors
specially Dr. Diva Kant I had spoken to the various current and ex fellows from the
respective institutes to know the ground situation about the VR fellowship . Based
on that I had considered PNK as one of my top priority institutes for VR fellowship.
I checked all the details from official website and sent my CV along with my
application to PNK chief coordinator Mrs Konpal Srivastava. She was very quick in
providing all the necessary information and processing my application .
The interview was a single day process for all the applicants, there was no written
exam or any MCQs exam. It was done by the Medical Directors of PNK
(Dr. Shobhit Chawla and Dr. Rajat Dhesi)
The questions asked were about reasons of joining VR fellowship, academics,
working experience, family background and future plans etc. I think they just check
your very basic knowledge and your commitment level to sustain the 2 years of
fellowship programme
It was very smoothly conducted and confirmation was given by same day. Within 3
days I got the official confirmation email from PNK along with my joining date.
I would say you just have to be thorough with your basics along with clear mindset
about your future plans before going through the interview process.
DR MOHIT HUPTA, MBBS, MS is a Vitreo-Retina fellow at PNK, Lucknow. He

INSTITUTE WATCH
RAJ EYE HOSPITAL,

GORAKHPUR
Raj eye hospital was established in Jan 1990 with the aim to provide modern,
compassionate and quality eye care to all. It is situated in Gorakhpur, 300 KM east
of Lucknow, UP, India.
Large number of people visit the hospital every day for consultation, diagnostic
procedures and surgical procedures for Femto cataract, Femto Lasik, ICL, IOL,
Cataract Surgery [without Stitch, Injection and Bandage], Diabetic Retinopathy,
Vitreous Hemorrhage, Retinal Detachment, Glaucoma, Squint, Amblyopia, Ptosis,
Eye Problem in Children, Corneal Transplant, Eye Injury, Orbital Tumors,
Dacryocystitis, Botox Injection.
Raj eye hospital has department of general ophthalmology, Pediatric

ophthalmology, Retina, Specialty of – Refractive Surgery, Orbit and Oculoplasty,
Cornea, Glaucoma, Cataract. To serve poor people and educate masses we have
department of community ophthalmology. To treat complicated cases we have
latest equipments like femto second laser, red, green and blue laser, highest
quality surgical and diagnostic gadgets in 5 stories building covering around 24000
sq feet area, at a land of 23000 sq feet , modular operation theatres are
equipped with Anaesthesia workstation with ventilator and set for infants, defib,
monitors, operating microscopes , computers on lan for recording the patient
details. 
YO TiMESI AUG 2019

309
YO TiMES I MAY 2019

programs ?
Alcon Constellation & Accurus
1 per year   Vitrectomy System , Iridex Red Laser
with Slit Lamp, LIO & Endo Laser
2. Duration of fellowship ? Delivery Systems, Nidek Green Laser
with Slit Lamp, LIO & Endo laser
2 years delivery systems, Topcon Digital FFA &
ICG , BIOM attachment for Zeiss &
3. Exposure to research and Topcon Operating Microscope,
expectations by the institute in Ultrasound B Scan, Resight Inverter
research ? Zeiss in Lumera
Candidates will be involved in research  11. Number of permitted leaves
4. Probable number of surgeries, 12 medical leave and 6 casual leave

expect ? 12. Any post fellowship International
exposure?
Unlimited as assistant, under
supervision and independent cases will Possible
be 20+10 ( surgeries), 40+30 ( lasers),
10+30 (Injections) 13. Any bonds or compulsory
5. Names & positions of Medical retina after completion?
and VR Faculties ?
No.  
• Dr Shrikant
• Dr Devesh Maurya 14. Any peripheral centres for
6. Selection procedure in brief the same ?
& Joining) ? One in the same city at present for
better exposure
Interview and 3 days observership  
15. Contact details ( Phone & Email) of
7. Most important points that you the academic department.
consider in a CV ?
Dr Anil Srivastava 9935657999,
• Academic records 9415210529 
• Presentations and
• Publications
8. Stipend past(within 2 years) or present
fellows.
85000 per month with increment of
5000 after every 6 months[ completed Till now we have trained only anterior
working days] segment fellows. We will starting VR
fellowship now.
Yes
Young Ophthalmologists Times is highly indebted to Dr. Anil Srivastava & Dr Simmi Chalwa
Sarin for providing us the above information.

INSTITUTE WATCH
RETINA FOUNDATION AND EYE

RESEARCH CENTRE, AHMADABAD
AHMEDABAD
RETINA FOUNDATION, offers a full time 2 year fellowship in Vitreo-Retinal surgery,

with the aim of developing clinical and research skills pertaining to medical and
surgical Retina. There are exposed to three Vitreo-Retinal surgeons and the
clinical exposure is wide, ranging from acute management of retinal detachments
and posterior segment trauma, to macular surgeries. The fellows are also taught
about the management of common uveitis diseases. Fellows participate in all the
clinics, handle diagnostics on a rotation basis and assess and get to discuss and
plan their management with the consultants. They are exposed to a wide variety of
medical retina related procedures including lasers and intravitreal injections of all
types. They also participate in surgery, both as the operating surgeon or the
assistant, depending on the complexity of the case. Regular classes are also
conducted in which fellows present medical and surgical cases and power point
presentations on various retinal and uveal disorders. 
YO TiMESI AUG 2019

311
programs ?
We look at the following points while
4 seats assessing the CV:
2. Duration of fellowship ? • Previous academic achievements
2 years • We give importance to where

(Hopital/city/place) the fellow would
3. Exposure to research and finally work after the fellowship
expectations by the institute in (It gives us insight into how the
research ? fellowship training would get
utilised)
Fellows are expected to participate in
ongoing research projects during the • We give priority to those who would
term of their fellowship be working in areas lacking Vitreo
retina surgeons .
lasers and injections one might • We ask for a five days observership
expect ? to see how the candidate with the
fellow colleagues.
There is no present number for any
procedure for a fellow. These numbers 8. Stipend
would vary on basis of the type of
cases to the competence of the fellow 15000-18000 /month plus
as he/she evolves through the accommodation
fellowship period
and VR Faculties ? They get exposed to Uvea quite
extensively and in a limited way to
• Dr.P.N.Nagpal MS, FACS ROP and Ocular Oncology. We have a
( USA),FDAAD( West Visiting Oculoplasty surgeon who
Germany) handles ocular oncology and exposes
• Dr Manish Nagpal MBBS, MS the fellows to the same
(Ophthalmology),
FRCS( Edinburgh, UK) 10. Brief overview of VR equipments
• Dr Navneet Mehrotra MBBS, available in the Institute.
DNB (Ophthalmology), FRF
We have regular state of the art
6. Selection procedure in brief equipments at our institute. We have
including probable dates (Interview both Indirect and PASCAL lasers,
& Joining) ? fundus camera, Heidelberg OCT and
FA , Microperimetry, OCT angiography,
Candidates are required to do a 5 day and Constellation vitrectomy machines
observership program prior to selection apart from various other tools
for the fellowship. In this period the
consultants get to meet the applicant 11. Number of permitted leaves
and visa versa to get an idea about
their aptitude and interest in the There are no fixed leaves during the
fellowship program fellowship. Fellows are encouraged to
be regular and take minimum leaves
during the period.

12. Any post fellowship International 15. Contact details ( Phone & Email) of
exposure? the academic department.
Ms Meera
There is no specific international [email protected]
exposure linked to the fellowship
program,. However we help connect
the fellows to any program they wouold 16. Names and Contact details of 3
like to pursue through our good offices past(within 2 years) or present
with international colleagues fellows.
13. Any bonds or compulsory Dr.Pranita Chaudary

commitments with the institution [email protected]
after completion? +91 9727765729
No Dr. Jayesh Khandelwal

[email protected]
14. Any peripheral centres for +91 9220545496
the same ? Dr. Gayathri Mohan
[email protected]
Fellows visit a charitable centre two +91 8007185115 
hours away twice a month by rotation
to screen and treat vitreo retinal cases
Young Ophthalmologists Times is highly indebted to Dr Manish Nagpal for providing us the
above information.

DR. NAGPAL’S RETINA FOUNDATION, AHMEDABAD
-DR GAYATRI MOHAN
During my third year of residency I was looking into institutes offering VR fellowship
programs. After my research and enquiry about the same , I got to know about RF
from a professor of mine who was an ex-fellow. Once I narrowed down to RF from
all my options, I got in touch with the institute via Mrs.Meera Zala, the secretary,
through e-mail . She promptly responded telling me that I had to do a 4 day
observership, where i shall observe the working and practice patterns of RF. She
asked me to send in my CV and she got back to me with alloted days for
observership, which was in two months. The institute takes in one observer at a
time.
During the period of observership, I was posted in the OT in the morning and
thereafter in the OPD or investigation room. I was also allowed to attend classes
with the other fellows. Even though I was an observer , the consultants encouraged
active participation in academic discussions . The fellows were very helpful and
they gave me an insight on the working pattern of the institute. During the
observership, I was also allowed to attend OPDs with Dr. P.N.Nagpal sir. During
OPDs with Dr. Navneet Mehrotra, he used to ask clinical questions related to
cases in the OPD. Once the 4 days were over, I had a discussion with Dr. Manish
Nagpal and Dr.Navneet Mehrotra. The topics covered were mainly regarding why I
chose VR fellowship, interest in academics, research and about my future plans.
They then told me that they would decide and revert back to me.
I got an e-mail in a week saying that I got into the program and that I could join after
6 months.i.e after completion of my final MS exams.
The entire process was well co-ordinated and organised. In my opinion, the biggest
advantage of the observership is the applicant gets an insight and first hand
experience to how the fellowship programme is, which is really helpful to the
candidate.
DR GAYATHRI MOHAN , MBBS, MS is a Vitreo-Retina fellow at Dr. Nagpal’s

retina Foundation, Ahmedabad. She can be contacted at
[email protected]

INSTITUTE WATCH
RETINA HOSPITAL, RAJKOT,

GUJARAT
Retina Hospital, Rajkot was established in March 2008 by Dr Mukesh Porwal. The
training program at Retina Hospital involves exposure to all aspects of a VR
practice, right from the initial examination of the patient to seeing old patients
on their follow-ups. Trainees & Fellows get a good hands-on experience not only
in all aspects of Medical Retina including Intravitreal injections but also in
Surgical Retina closely supervised by Dr Mukesh Porwal, who now has 21 years of
experience in the field of Retina. All cases are discussed with the Fellows before,
during and after their management in the OPD as well as in the OR. Not only the
clinical & surgical aspects but the trainees get a good exposure to the counselling
of patients as well as to the monetary and charity aspects of Retina work. The
fellows are given graduated surgical steps, progressing quickly to independent full
depending on their grasping abilities. Scientific, practical & ethical VR practice in
a private set-up is seen first-hand by the trainees without any restrictions. The
aim of the fellowship is to transfer the tough early years of VR experience to the
newcomers in the field, including the nitty-gritties of setting up & upgrading a
Retina practice.
YO TiMESI AUG 2019

315
programs ?
• MS/DNB in Ophthalmology (Not
Two per year, usually one every 6 DOs) with good knowledge  
months
• Interest & a rough road map for
2. Duration of fellowship ? future work in Retina  
2 years for freshly passed out MS or • Any previous Retina work/

DNBs research or publication
 
1.5 years for those who have worked in 8. Stipend
a Retina Unit earlier
Starts with Rs 30000 per month Raised
1 year for those who have done a by Rs 10000 every 6 months  
Retina Fellowship already  

3. Exposure to research and Ocular Oncology, Uvea etc
research ? Regular ROP screening in referred
babies, with some NICU visits.
Being a small institute with a single
solo Retina-only practice, the emphasis Regularly scattered Uveitis cases in the
on research is not much but Fellows OPD on daily basis. Occasional
are encouraged to collect data &
present & publish papers & cases.   Melanoma, Retinblastoma & Lymphoma
cases, not many.  

lasers and injections one might 10. Brief overview of VR equipments
expect ? available in the Institute.
Depends on the skill level and clinical Alcon Constellation Vitrectomy

competence of the candidates.  machine  
On an average: more than 100
surgeries, 250 lasers & 50 injections Leica M822 Operating Microscope  
per year.  
Oculus BIOM IV wide angle viewing
system  
and VR Faculties ? Retina Lasers:  
• Dr. Mukesh Porwal, MS, FRF, a) Nidek Pattern Yellow Retina Laser
FICO Director & Senior VR with Slit Lamp Delivery
Consultant   b) Appasamy Green Laser with
Indirect Ophthalmoscopic delivery  
6. Selection procedure in brief c) Dedicated Green Laser with
including probable dates (Interview Endoprobe delivery for surgery  
& Joining) ?
Zeiss Visucam 524 Fundus camera for
We receive applications through email, FFA, FAF & Fundus photography  
need 2 good references from recent
work Selection done based on CV, Optopol Copernicus Revo NX SD-OCT
references & telephonic interview from with OCT-Angiography  
the applicants  

Ocular Ultrasound machine with 10 time to time.  
MHz probe with Vector A-Scan  
11. Number of permitted leaves the academic department.
Flexible, depends on the genuine Phone: +91-281-2456 500/600,

need of the candidates, not very strict.   Mobile: +91-94262 29442 (Dr. Porwal) 
12. Any post fellowship International with a CC to
exposure? [email protected]  
Have a few friends in US they are free

to visit but no formal arrangement.
13. Any bonds or compulsory past(within 2 years) or present
commitments with the institution fellows.
after completion?
Can be seen on this webpage: http://
Nil www.retina-hospital.in/academics-
training.php  
the same ?
No, only participation in some

outreach/ screening programmes from
Young Ophthalmologists Times is highly indebted to Dr. Mukesh Porwal


INSTITUTE WATCH
RETINA INSTITUTE OF KARNATAKA,

BENGALURU
Vitreo-Retinal surgery fellowship in RIK is a 18 months program devoted to clinical

training in the evaluation, diagnosis and medical and surgical management of
Vitreo-Retinal diseases. The overall goal of the fellowship program is to train
clinicians who will become the next generation of leaders, and our program is
structured with this goal in mind. The depth and breadth of our faculty affords
access to the best in medical and surgical retina training, and our fellows work
side-by-side with pre-eminent leaders in the field. Our fellows are exposed to
the most advanced Vitreo-Retinal surgical techniques.
We also have a medical retinal fellowship of 6 months duration.
Our fellowship program is registered with the Rajiv Gandhi University of Health
Sciences and meets guidelines set by the RGUHS. 
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318
YO TiMES I MAY 2019
programs ?
• Institution background
Surgical retina – 2 candidates per year, • Presentations/publications
Medical retina – as per requirements • Experience in the field of Vitreo-
(3-4 per year) Retina.
  • Motivation to continue in the field
of Retina
8. Stipend
18 months, Medical retina – 6 months
Surgical retina – 25,000/month
3. Exposure to research and Medical retina – 20,000/month
research ? 9. Exposure to other areas like ROP,
We encourage our fellows in doing
retrospective and prospective studies During the training, our fellows are
for many vitreoretinal conditions and exposed to screening for ROP and
treatment. We always support them in diagnosis and management of uveits.  
doing these academic activities and
publications.   10. Brief overview of VR equipments
lasers and injections one might Zeiss fundus camera, Topcon swept
expect ? source OCT (with AF, FFA and OCTA),
HRA for FFA/ICGA, PDT, Zeiss and
During the training, our fellows get PASCAL laser delivery systems with
access to do lot of lasers and volk quadrespheric and Mainster
injections. Surgical training depends on contact lenses. We are equipped with 2
his/her skills and abilities.  constellation vitrectomy systems, Zeiss
Lumara microscope with resight in one
5. Names & positions of Medical retina OT and BIOM 5 in second OT, and
and VR Faculties ? wide angle viewing systems (contact
and non-contact). Both OTs have 3
• Dr N S Muralidhar (President) chip cameras for recording and
• Dr Hemanth Murthy (Medical viewing.
Director)
• Dr B L Sunitha (Medical
Retina and Uvea) 11. Number of permitted leaves
• Dr Kavitha S Rao (Senior VR
Consultant) 1 leave per month
• Dr A M Sumanth Kumar (VR
Consultant) 12. Any post fellowship International
• Dr Manjula ( Junior Consultant exposure?
in Medical Retina and Uvea)
No.
including probable dates (Interview 13. Any bonds or compulsory
& Joining) ? commitments with the institution
after completion?
Surgical retina fellowship selection has
a written test (MCQs) and personal No.
interview. Medical retina fellowship
selection is based only on personal
interview. Courses start in January and
September. 

the same ? fellows.
No.  Dr Sweety from Maharashtra, recently

successfully completed her surgical
retina fellowship (8857990661)
the academic department. Dr Arun Bhatti from Ludhiana, pursuing
his surgical retina fellowship
Contact Number: (080) 22410106, (9646900978)
email: [email protected] 
Dr Sonia Singh completed her medical
retina fellowship (7760772233)
  Young Ophthalmologists Times is highly indebted to Dr. Manjula Shankar


INSTITUTE WATCH
SRI SADGURU NETRA

CHIKITSALAYA, CHITRAKOOT
Vitreo – Retina Fellowship at Sadguru Netra Chikitsalaya, Chitrakoot provides a

good all round medical and surgical exposure to retina. The two courses being 2
year exclusive retina fellowship and the 3 year comprehensive fellowship (with
cataract training). Being a tertiary care referral centre, the clinical exposure is
extensive with a large number of outpatients. Fellows get to perform lasers and
intravitreal injections. Surgically, the fellows perform scleral buckles in the initial
phases with steps of VR surgery. By the end of the tenure, fellows perform
independent surgeries. Uvea exposure is very good with a variety of cases. The OT
has the Constellation vitrectomy system and the latest equipment. Academics are
stressed upon with regular presentations and the fellows are expected to take up
research projects during the course of the fellowship. 
YO TiMESI AUG 2019

321
programs ? 1st year - 25000
2nd year - 35000
Variable: between 1 to 3 3rd year - 45000
2. Duration of fellowship ? 9. Exposure to other areas like ROP,

2 years exclusive retina, 3 years
Basic exposure to Uvea and ROP.
comprehensive retina (with cataract
training; 50:50 breakup of fellowship
duration) 10. Brief overview of VR equipments
expectations by the institute in OCTA
research ? FFA/ICGA
LIO
Research output and multiple & other state of the art surgical
publications expected during the equipments.
course of fellowship training
4. Probable number of surgeries, 20 leaves per year

expect ? 12. Any post fellowship International
exposure?
Scleral buckles in the initial phase,
Nil
steps of VR during the course with
independent VR surgeries by the 13. Any bonds or compulsory
end of the tenure commitments with the institution
after completion?
and VR Faculties ? Variable
• Dr. Alok Sen – HOD 14. Any peripheral centres for

• Dr. Shubhi Tripathi compulsory rotation and duration of
• Dr. Sachin Shetty the same ?
• Dr. Samendra Karkhur
• Dr. Tina Agarwal Exclusive Retina - Yes
Comprehensive Retina - Yes
Interview in July and January with Mr. Kamlesh Shukla - 9165462997

joining in August and February
respectively. Initial MCQ’s followed
by interview
fellows.
consider in a CV ?
1. Dr Pratik Shenoy,
[email protected]
• Academics 2. Dr Aman Khanna
• Surgical exposure [email protected]
• Previous training 3. Dr Rashmi Kashikar
Kashikar [email protected]
Young Ophthalmologists Times is highly indebted to Dr. Samendra Karkhur

SADGURU NETRA CHIKITSALAYA, CHITRAKOOT
DR. AMRUTA MORE 
In the big ocean of opportunities out there, we all seem lost. After post graduation, decision
of choice of faculty is simple, like for me it was Vitreo–retina; but the when, where and how
are difficult questions left unanswered in our stream of ophthalmology. There are the
traditional ways which I followed, calling up fellows who were in their tenure of fellowship
at various places and then took to finding dates of interviews of respective institutes online.
For me the most suited options were the ones which held interviews around June-July.
Sadguru Netra Chikitsalaya was one place I was aware by word of mouth. It is an
ophthalmology dedicated institute at Chitrakoot in Madhya Pradesh. The facts about the
place were all mentioned at their official website. It stated regarding the fellowship
programme & its tenure. It also mentioned the date of interview and the contact details of
the course co-ordinator Mr.Kamlesh Shukla. Application procedure was to mail them my
CV .
I was very well guided by Mr.Shukla about the nearest station and even regarding
transport facilities. At Chitrakoot it is always better to come in a day prior to the interview.
All applicants were provided accommodation on campus. The interview was a day long
procedure starting from 8am with MCQ test. The MCQ test paper had a column right at the
top to be filled regarding your choice of faculty. As the test ended it was followed by
interview. There was a panel which included the Medical Superintendent & HOD of Vitreo-
Retina Dept (Dr. Alok Sen) and HOD’s of the other concerned departments.
They were aware of my details from my CV. The interview began with a picture projected
at the screen related to retina. The academic part of the interview was mostly conducted
by Dr.Sen. The questions were based upon my choice of faculty. While a few questions
regarding choice of VR & future plans were taken up by the other panellist. A part of the
interview also covered recent updates in VR. Other candidates were interviewed in a
similar manner with different slides and different questions pertaining to their choice of
faculty by their respective HOD’s.
I was told that I would be called in again after lunch break and the results would be
declared the same day. I was called upon again and asked about my take at dedicating
time to the institute in future. They declared the results the same day and an appointment
letter was mailed in 7 days woking time. The scheduled start of the session was from 1st
August as per every year.
From my experience at centres I had applied, recent advances and various studies is
something every candidate must be aware in his/her subject.
DR AMRUTA MORE, MBBS, MS is a 2nd year Vitreo-Retina fellow at SNC,

Chitrakoot. She can be contacted at [email protected]
YO TiMES IAUG 2019

323
INSTITUTE WATCH
SANKARA EYE HOSPITAL

BENGALURU - GUNTUR - SHIMOGA
The fellowship would provide well-rounded exposure to both the clinical and
academic sides of medical and surgical retina along with ocular oncology. The
Sankara Eye Foundation India Training Program in retina is a highly regarded VR
fellowship program in India. Its longstanding reputation derives from its
association with state-of-the-art facilities, a full range of clinical and surgical
hands-on experiences, and, most importantly, the sincere commitment of the
faculty towards fellowship training. Fellows are selected amongst those who have
completed their post-graduation in ophthalmology from any of the centres
recognized by the Medical Council of India.
The VR fellowship program in Sankara eye hospital is one of a kind, as they are
trained under great mentors. With a great community health set-up, every fellow
gets a great oppurtunity to serve the under-served. During training, fellows learn
to acquire not only surgical skills but also observational skills, communication
skills, great moral and ethical values, presentation and publication skills. Sankara
Eye Foundation gives a great platform for research and innovational ideas. The
goal of the program is to train highly competent and ethical ophthalmologists
who can contribute to the field and help reduce the burden of curable blindness
in the society. 
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YO TiMES I MAY 2019
1. Number of seats of various long and • Dr Divyansh K Mishra:

short term Retina training Consultant
programs ? Guntur:
Bangalore: 2 long term surgical VR • Dr Madhu Kumar: HOD

fellows every 6 months Surgical Retina
1 medical retina fellow every 6 months • Dr Jayamadhuri: Consultant –
Medical Retina
Guntur: 1 long term surgical VR • Dr Ashok K: Consultant
fellows every 6 months
1 medical retina fellow every 6 months Shimoga:
Shimoga: 1 long term surgical VR • Dr Ravi Shankar: HOD

fellows every 12 months Surgical Retina
1 medical retina fellow every 6 months  • Dr Pradeep Sagar: Consultant
2. Duration of fellowship ? 6. Selection procedure in brief

18 months – medical and surgical & Joining) ?
retina
Twice a year (every 6 months)
expectations by the institute in Notification : Usually April & October
research ?
Exam (MCQ test) and Interview:
Good exposure to several ongoing in- Usually 1st or 2nd week of June &
house and multicentric trials and December
innovations
Joining: January 1st week & July 1st
Great scope for publications during the week 
tenure of fellowship
Mandatory publication for successful consider in a CV ?
completion 
• Letter of reference
4. Probable number of surgeries, • Surgical skills
lasers and injections one might • Managerial skills and soft skills
expect ?
8. Stipend
Surgeries:
Observed: 1000 – 1500 35,000 INR/month
Assisted: 600-800
Individually performed: 80-100 9. Exposure to other areas like ROP,
Lasers: 500-700 Ocular Oncology, Uvea etc
Intavitreal inj: 400-500 
Fellows get to go for ROP
screenings, lasers; Assist ROP
5. Names & positions of Medical retina surgeries
and VR Faculties ?
Tremendous exposure to
Bangalore: intraocular tumors of all kinds:
training in diagnosis, investigations
• Dr Mahesh P Shanmugam: and planning of tumor management;
HOD – Retina and Ocular assisting brachytherapy, PDT and
Oncology TTT for various tumors.
• Dr Minija C K: Consultant -
Medical Retina And Uvea Good exposure to uvea
• Dr Rajesh R: Consultant and ocular immunology. 

10. Brief overview of VR equipments 13. Any bonds or compulsory
available in the Institute. commitments with the institution
after completion?
Diagnostic:
B scan USG, FFA, ICG, No mandatory bonds.
Autofluorescence (Flash based and
SLO based), Swept source OCT, OCT But if you are willing, there is a scope/
angiography oppurtunity in various branches of
Transillumination scope for tumor Sankara across the country. 
diagnosis
ERG, EOG, VEP
Therapeutic: compulsory rotation and duration of
Lasers – Pascal Yellow laser (577 nm) the same ?
Green LIO (532 nm)
Diode laser (810 nm) Nil 
Transpupillary thermotherapy
PDT
Surgical equipment: the academic department.
4 vitrectomy machines
Non-contact wide angle viewing Radhika
systems (BIOM and MERLIN) Mobile: 9666677505
Endolaser Email: [email protected] 
Cryoprobe
Endocryoprobe
All essential VR surgical instruments 16. Names and Contact details of 3
fellows.
Dr Pradeep Sagar:
1 day leave per month [email protected]
Dr Sriram:
12. Any post fellowship International [email protected]
exposure?
Dr Payal Shah:
NIL [email protected]
Young Ophthalmologists Times is highly indebted to Dr Mahesh P Shanmugam for providing us


VR FELLOWSHIP INTERVIEW EXPERIENCE AT SHANKARA EYE HOSPITAL,
BANGALORE
-DR. DEVASHISH DUBEY
The time just after completion of post-graduation is complex in any graduate’s life and I was no
different. With clarity as to which branch I wanted, but not knowing where I wanted it. I had a clear
thought about what I was looking for in the institute where I wanted to pursue my fellowship. The
most important thing I was looking for was guidance and mentorship apart from an academic
environment and surgical exposure. After speaking to my seniors and the people who I look up to, I
decided to try for Shankara. I specifically wanted the Bangalore campus because of Dr. Mahesh
Shanmugam sir, who apart from being a clinician and surgeon par excellence is also the best
teacher one can come across.
Bangalore being a metropolitan city, is well connected to every part of the country, so reaching
here wasn’t a problem. The examination process here was divided into two parts, the first is the
multiple choice question and the second being an interview with the faculty. On the day of the
exams all of the candidates were asked to sit in a hall room where we were given an introduction to
the Shankara academy of vision, its history and its mission. We also had an interactive session
with few of the faculty members which was really helpful in easing our nerves. This was followed
by the MCQ examination which comprised of questions from all subspecialties, these question
were not straight forward one liners but thought provoking case scenarios. After the MCQ
examination got over we were asked to join the faculty for some tea and snacks where we could
directly interact with them whereas they could get to know us and our expectations from the
fellowship program.
This was followed by the one on one interview where all of us were divided up into groups
depending on the subspecialty we applied for. The interview was in the academic board room by a
panel consisting of Dr. Mahesh Shanmugam, Dr. Ravi Shankar, Dr. Rajesh R and Dr. Divyansh
Mishra. The interview wasn’t only restricted to academic and subject based questioning but they
were also keen on knowing more about us, our interests and overall personalities. The questions
covered both surgical and medical aspect of Vitreo-retina. We were also asked about our
aspirations, our future plans and our expectations from the fellowship program.
The exam was conducted in an extremely transparent and fair manner and the results were put up
on the notice board after lunch. The individual candidates were ranked according to different
subspecialties they applied for and were called rank wise to make a choice between the different
centres of Shankara Academy across the country. We were given our joining letters on the same
day and asked to stay back for the two-day induction program. The accommodation and food was
taken care of by the institute. The induction program was extremely useful as it apart from helping
us understand the pattern of work also helped all the candidates to get introduced to each other
before joining into different subspecialties. It was important for us to attain clarity about the
institute, its way of functioning, what it had to offer us and what its expectations were from us.
In conclusion, personally I would say I was completely satisfied and content with the process that
Shankara follows for recruiting its fellows and am still in awe of its way of functioning and its
mission.
DR. DEVASHISH DUBEY, MBBS, MD is a Vitreo-Retina & Ocular Oncology
fellow at Sankara Eye Hospital, Bangalore. He can be contacted at
[email protected]

INSTITUTE WATCH
SANKARA NETHRALAYA,
CHENNAI
VR training program is
one of the most successful
retina training programs in
the country.
We take immense pride in

mentioning that 80% of
practising VR surgeons in
India have ben trained by
us.
O u r p ro g r a m i s v e r y
comprehensive and
includes exposure to all
aspects of retina- imaging,
diagnostics, surgery etc.
YO TiMESI AUG 2019 328

programs ?
Any previous record of publication
VR Clinical 6 seats (2 years) helps
Medical Retina 2 seats (1 year) 8. Stipend
Uvea + Medical Retina 1 seat (1.5 25,000/ per month

years),
Research + clinical VR 2 seats (2.5 Ocular Oncology, Uvea etc
years)
Yes. Fellows get 1 month of Uvea
The intake is every 6 months. posting and 3 months of Intraocular
tumor posting.
Mentioned Above available in the Institute.
3. Exposure to research and We have almost everything that is

expectations by the institute in available for clinical use.
research ?
All fellows are involved in Clinical 11. Number of permitted leaves

research and are expected to present
in meetings and also publish 14 days per calendar year
4. Probable number of surgeries, 12. Any post fellowship International

lasers and injections one might exposure?
expect ?
Nil
It varies but the number is large. None
of our VR fellows have had to struggle 13. Any bonds or compulsory
after leaving SN. At the end of the commitments with the institution
fellowship they are able to handle after completion?
Routine VR cases with relative ease.
Nil
and VR Faculties ? 14. Any peripheral centres for
Please look at our website. We are 19 the same ?
consultants in Chennai.
No
Available at our website. Usually N Sivakumar

involves a theory exam and interview. [email protected]
1st April and 1st Oct
Young Ophthalmologists Times is highly indebted to Dr Vikas Khetan for providing us the above
information.
YO TiMES IAUG 2019

329
SANKARA NETHRALAYA, CHENNAI
DR. DHAIVAT SHAH 
During the torment of MS Ophthalmology, my interest in the subject of Vitreo-Retina slowly grew its
own wings. Hence, post MS result, I applied at Sankara Nethralaya Chennai, the place where the
finest in the country today have been trained. The application process was quiet lucid, which
comprised of posting CV along with the online fellowship form to the institute. A week later, I had a
mail in my inbox, stating the date, time and location for the exam and interview.
When I stood outside an institute that is considered as the “Temple of Eye” in India, alongside the
greatest minds in the country, a whirlpool of thoughts ran through my cranium. I followed the one
and only advice my senior had given to me, to sleep well the previous night, have a scrumptious
Idli-Dosa breakfast in the morning and maintain absolute composure.
The process of entrance for the fellowship commenced with a written MCQ test followed by an
interview. The question format was not to test how farfetched ones knowledge was, but how well
was ones understanding of the subject. The papers were evaluated by lunch time and forty out of
the ninety students were called for interview in the noon. The interview to be followed was in three
sets, which I thought was very well structured.
The first room interview was conducted by Dr Pramod Bhende (Director, SNC). I was asked
regarding my core purpose of joining a VR fellowship, my family background, aspirations post
fellowship, and what if this didn’t get though here. I expressed my sole purpose of taking this
course was my absolute love for the subject, and nothing else mattered otherwise.
The second one was conducted by Dr Muna Bhende (Deputy Director, SNC). Her questions were
oriented towards knowing how well one has done residency. Basics of managing ophthalmic
emergencies, routine practices in the operating theatre and keenness regarding research work
were some of the topics that were discussed.
The final one was conducted by Dr Parveen Sen (Senior Consultant, SNC), and this one was
directed towards retina. Her room was full of Fundus photos, OCTs, FFAs and ERGs. Her idea was
not to ask high end stuff regarding the same, but a basic diagnosis and plan of treatment.
After this exploratory expedition, I got a mail a week later that I have cracked the fellowship, and
they had attached a joining letter, expecting a reply within a week. Retrospectively, I realized that
this “highly talked about” mammoth institute is really about simplicity and conceptual transparency.
It doesn’t matter if you have no research work in your hands, or you haven’t gain paramount
surgical skills during your residency, or you don’t have a cavernous background. What really
matters is the way you converse, how confident your outlook is, and clarity and honesty of your
thoughts. I am privileged today to be a part of this foundation, to receive training under true
legends, and I believe this is one of the foremost training institutions in the country today.  
DR. DHAIVAT SHAH, MBBS, MS, DNB is a Vitreo-Retina fellow at Sankara

Nethralaya, Chennai. He can be contacted at [email protected]

INSTITUTE WATCH
SHANTI SAROJ NETRALAY,

MIRAJ
Shanti Saroj Netralay established in 2003 is a ISO 9002:2015 certified and NABH
accredited eye hospital situated at Miraj, Maharashtra. It is a forerunner in Retina
Vitreous services in the surrounding geographical region with an average volume
of 2000 surgical retinal cases every year .
The 2 year retina fellowship is MUHS ( Maharashtra Universiy of Health

sciences ) accredited and provides practical skills for the aspiring retina fellow to
face the world confidently at the completion of the fellowship . The hospital is fully
equipped with the latest armamentarium in medical and surgical retina including
HRA, OCT ,FFA, ICG & OCT angiography, ocular electrophysiology , Ultrasound ,
UBM along with micropulse , pattern and traditional laser systems , Alcon
constellation vitrectomy and wide angle viewing systems Stipend and rent free
accommodation is provided to all fellows .
The retina fellows are trained under the personal supervision of Dr Sharad Bhomaj
who has the experience of 18 years of high volume Vitreo-Retinal surgical
expertise .He has 14 publications in peer reviewed journals and has won many
awards for his paper presentations in the field of Vitreo-Retinal surgery .  
YO TiMESI AUG 2019

331
YO TiMES I MAY 2019
programs ?
Yes 
1 position every 6 months
  10. Brief overview of VR equipments
5 Laser machines, 2 fully equipped VR
2 Years OT tables with constellation vitrectomy
machine and non contact wide angle
3. Exposure to research and viewing system , Spectralis HRA,OCT,
expectations by the institute in OCTA , Micropulse , pattern and TTT
research ? facilities available
We encourage fellows to undertake a 11. Number of permitted leaves

research project and present or publish
the same . 12 / year
 
4. Probable number of surgeries, exposure?
expect ? Yes , if candidates are willing . But
most candidates arent keen to go
Surgeries around 100 or more , lasers abroad as no surgical hands on is
and injections : countless available at such places

5. Names & positions of Medical retina commitments with the institution
and VR Faculties ? after completion?
• Dr Sharad Bhomaj , Retina NIL

Consultant
6. Selection procedure in brief the same ?
& Joining) ? Monthly visit to peripheral centres for
OPD and laser work
Submission of CV by email and
selection based on personal interveiw 15. Contact details ( Phone & Email) of
at the hospital the academic department.
7. Most important points that you Shanti Saroj Netralay , A N Gaikwad

consider in a CV ? road , Miraj 416410, Maharashtra
• Preferably MS / DNB , though DO 16. Names and Contact details of 3

candidates aren't universally past(within 2 years) or present
refused. fellows.
• Candidates sponsored by
hospitals with existing VR setups Dr Pathik Baravaliya 9016766304
may be given preference Dr Pratik Gandhi 9028851061
Dr Sagar Petkar 9960073626
8. Stipend
25000 with increment of 5000 every 6

months . Rent free accommodation
given opposite hospital .
Young Ophthalmologists Times is highly indebted to Dr Sharad Bhomaj for providing us the
above information.
YO TiMES IAUG 2019

332
INSTITUTE WATCH
SHRI GANAPATI
NETRALAYA, JALNA
Shri Ganapati Netralaya is 95 bedded tertiary eye care hospital located in central
Maharashtra, which has state of art Vitreoretina department with all latest
equipments ( eg Angio OCT, FFA, ICG, Micropulse diode laser, Constellation and
Reticare vitrectomy unit etc) , so fellows get good overall exposure of all vitreo-
retinal pathologies. The hospital is empanelled with all government schemes and a
percentage of surgeries are performed free for underprivileged section of society.
Approximately VR dept performs more than 5000 retina surgeries annually due to
which retina fellows get a good exposure under supervision initially followed by
independent hands on experience making them confident enough to practise
independently once they finish fellowship programme. 
YO TiMESI AUG 2019

333
programs ? 20,000/ per month
3 per year ( 2 in June session and 1 in Dec 9. Exposure to other areas like ROP,
session) Ocular Oncology, Uvea etc
2. Duration of fellowship ? i)Diagnostic oncology as management

part is taken care by Oculoplasty.
2 years
ii)Diagnosis and management of
3. Exposure to research and various cases of uveitis and ocular
expectations by the institute in inflammation with the help of various
research ? diagnostic modalities eg FFA, ICG,
fundus autofluoroscence etc
For fellows it is mandatory to publish
and present at least 1 project in peer iii)ROP – being only tertiary eye care
reviewed journal and national hospital in region we get lot of
conferences during their tenure. referrals of ROP babies and also we
have MOU with local government
hospital , paediatric hospitals for
4. Probable number of surgeries, ROP screening and management.
expect ? 10. Brief overview of VR equipments
No. of Lasers - 2000 approx
No. of Injections - 1000 approx Topcon OCT ANGIO, ZEISS FFA, ICG
No. of Surgeries - 200 approx and autofluoroscence, Topcon & Iridex
laser delivery systems, Constellation
independently following supervision for Vitrectomy Unit, Oculus BIOM , Zeiss
initial cases. Number varies based on Lumera and Topcon microscopes,
candidate’s capabilities and surgical Sony HD video recording system in OT.
skills.

and VR Faculties ? 12 leaves in a year
• Dr Rushikesh Naigaonkar, MD 12. Any post fellowship International
SGN and HOD VR Dept exposure?
• Dr Abhishek Desai Senior VR
Consultant Nil
• Dr Reetika Saxena Senior VR
Consultant 13. Any bonds or compulsory
6. Selection procedure in brief after completion?
& Joining) ? Nil
Through interview which includes MCQ 14. Any peripheral centres for
test followed by viva compulsory rotation and duration of
the same ?
consider in a CV ? Yes, for 2 months.
• Candidate should be a degree
holder ( MD/MS/DNB)
• Number of presentations
• Number of Publications

fellows.
Interested candidates may apply
through email by sending CV and Dr Rashi Taori +91 9765572272
letter of interest, details of which are VR consultant, Gomabai Netralaya,
as follow: [email protected], Nimach.
[email protected]
Dr Vaibhav Autade, +91 7588797539
Contact Person: VR consultant Dr Agarwals eye hospital
Dr Abhishek Desai, Consultant VR Pune.
department , Shri Ganapati Netralaya.
Email : [email protected] Dr Shubham Malpani ( Current Fellow)
Phone 02482-239001,2,3. +91 9518710598
Young Ophthalmologists Times is highly indebted to Dr Abhishek Desai for providing us the
above information.

SHRI GANAPATI NETRALAYA, JALNA
-DR KOMAL KHETWANI
Hello friends, I am writing this to share my retina interview experience at Shri

Ganapati Netralaya, Jalna. The whole interview process was quite interesting and
challenging. There were 2 rounds, the first round comprised of 50 MCQs questions
(both case based and one liners). After clearing that we had main interview where
a panel of 5 members Dr Rushikesh Naigaonkar (Medical director and Head of
Dept Retina,SGN), Dr Abhishek Desai (Assistant consultant Retina and Academic
incharge ,SGN) and 3 board members and trustee of the institute sat across the
table. They were calling our names in order of merit in the theory exam.
In interview, they were asking different kind of questions like they asked me pictorial
questions to diagnose various retinal conditions along with ultrasound, OCT images
and case scenario based questions to check my approach in diagnosis and
management of patients and some non academic questions like why I wanted
retina, will I do institutional practice or private startup after completion of fellowship,
number of cataracts I did during my PG and some were asked about their thesis as
well.
For me some things really helped me a lot in cracking the interview like I did
multiple MCQs from Provision series and questions of one network AAO site and
for interview ,they check your approach and command towards subject, your
confidence level so I would suggest you all to do hard work, have a good
knowledge thorough about retina ,do as many MCQs and quiz questions.
Never ever go to any interview without preparation and last but not the least you
should know each and every word of your resume.
DR KOMAL KHETWANI, MBBS, MS is a Vitreo-Retina fellow at SGN, Jalna. She


INSTITUTE WATCH
SRI SANKARADEVA
NETHRALAYA, GUWAHATI
Sri Sankaradeva Nethralaya has emerged as a premier centre for ophthalmic

education in ophthalmology. Postgraduate Course in Ophthalmology - DNB
(Diplomate of National Board) with affiliation of National Board of Examinations,
New Delhi under the Ministry of Health & Family Welfare of Govt. of India, is
conducted by the Institute every year. It also offers Fellowships in various
subspecialties to Postgraduate students. The Institute got its DNB accreditation in
the year 2000 and since then its alumni awarded with DNB have been engaged in
the respective departments of the institution as well as in other institutions in
India and abroad. The institution is equipped will latest state of the art
equipments to manage various ocular conditions and for training purposes. 
337
YO TiMES I MAY 2019
programs ?
• Prior exposure to Vitreo - Retina
Surgical Retina : 2  • Knowledge of retinal conditions
Medical Retina & Uvea : 1 • Publications & presentations.
2. Duration of fellowship ? 8. Stipend
1.5 years Rs. 30,000/- per month

research ?
SSN has an active ROP clinic and
Fellows are required to complete at several screening sessions and camps
least one research project during their are held along with further
fellowship period. They are encouraged management of ROP babies
to publish and time and facilities are
provided for the same SSN caters to the Retinoblastoma
  patients of the North East and beyond
and ample exposure is provided.
lasers and injections one might SSN has a dedicated Uvea clinic.
expect ? Though Uvea postings are not part of
the VR fellowship program, exposure
• Lasers >1,000 can be given if the candidate desires.
• Intravitreal Inj > 1,000  
• VR surgeries : Though ample amount
is given, numbers may vary 10. Brief overview of VR equipments
according to candidate’s acumen. available in the Institute.
 
The institute has most state-of-the-art
5. Names & positions of Medical retina equipment for medical, imaging and
and VR Faculties ? surgical retinal work
• Dr Harsh Bhattacharjee 11. Number of permitted leaves

( Medical Director)
• Dr Manabjyoti Barman 21 leaves in 1.5 years
( HOD & Senior Consultant )
• Dr Hemlata Deka 12. Any post fellowship International
( Senior Consultant ) exposure?
• Dr Ronel Soibam
( Senior Consultant ) Not anything linked to our fellowship,
• Dr Debajit Deka but can be facilitated if needed.
( Medical Officer)
• Dr Awaneesh Upadhyay 13. Any bonds or compulsory
( Junior Consultant) commitments with the institution
after completion?
including probable dates (Interview None 
& Joining) ?
An oral interview & written test is held compulsory rotation and duration of
in July. The sessions begin in August. the same ?
None
 

fellows.
Dr. Sumita Sharma Borthakur
Academic Officer Dr. Chintan Desai : +91 9326431464
Sri Sankaradeva Nethralaya Dr. Jitender Kumar : +91 8017210615
+919632419350 Dr. Diva Kant Misra : +91 9670964875
  Dr. Pushkar Dhir : +91 8510009983
Young Ophthalmologists Times is highly indebted to Dr Manabjyoti Barman for providing us


SRI SANKARADEVA NETHRALAYA, GUWAHATI
DR CHINTAN DESAI
I was looking at various options to pursue a Vitreo-retina fellowship post the completion of
my DNB. I came to know about SSN from various acquaintances, and also spoke to
previous and current VR fellows from the institute regarding the same. Based on my
research, I had listed SSN as one of my top three choices for the fellowship. Once the
decision was made, I checked the official website for the interview dates and application
process, and also got in touch with the academic co-ordinator Dr Sumita Sarma. She was
prompt with her replies, and the application process was fairly simple wherein I just had
send a mail with my CV and letter of recommendation attached.
The interview was a single day process. No written exam/MCQ’s. All speciality interviews
were held on the same day and were conducted one speciality at a time. A bunch of us
were seated in the resting area and were made to feel comfortable till our turns arrived.
The interview area was the boarding room, where a panel of 5-6 members sit across the
table; and comprises of Dr Harsha Bhattacharjee (Medical Director, SSN), Dr Kasturi
Bhattacharjee (Academic Director,SSN), HOD of the concerned Department (Dr Manab
Jyoti Barman for VR), the academic co-ordinator Dr Sumita Sarma, and also board
members and trustee of the institute.
The questions asked in the interview varied from academic and subject based questions to
various non academic issues. They also varied from one candidate to the other. Whereas I
was mainly asked academic VR related questions for the major part, my colleague was
asked to elaborate on his army background and future plans with very few ophthalmology
questions. Although already mentioned in the CV, I was not questioned about my research
and publications, or the lack of it either. There was emphasis on future plans, my
background, and the reason for my interest in pursuing a fellowship in VR. Once the
interview was over, we were told that we would be informed about the result via email in
2-3 working days. I received the email with a list candidates selected and also the
waitlisted candidates. We were given 10 days to join the programme after receiving the
mail.
I would say, the interview process was fairly smooth. It would be wise to brush up on the
subject before coming for the interview. At the same time, it is also important to have a
clear mind about the future plans and whether we can commit to work for the hospital post
the completion of the programme. From 2019, a written test will also be conducted along
with interview.
  DR CHINTAN DESAI, MBBS, DO, DNB, FICO is a Vitreo-Retina fellow at SSN

GUWAHATI. He can be contacted at [email protected]

INSTITUTE WATCH
SUSRUT EYE FOUNDATION & RESEARCH

CENTER, KOLKATA
In the year 1998, Dr. Sunil Chandra Bagchi and Dr. Ratish Chandra Paul
founded Susrut Eye Foundation & Research Centre with a vision to eradicate
blindness and make this world a beautiful place to those who are still in
darkness. They realized the necessity of a team, an organization to overcome
the insurmountable load of blindness in our country. Today, we are a leading
non-profit organization dedicated to providing eyecare and rehabilitate people
of all ages suffering from ophthalmic problems. In this journey, Susrut Eye
Foundation has proved itself as one of the best tertiary eye care institutes in
Eastern India and a leader in ophthalmic education. 
YO TiMESI AUG 2019

341
programs ? -
• Fellowship in surgical & medical 11. Number of permitted leaves
retina at Susrut eye foundation and
research centre 15 days in year
2. Duration of fellowship ? 12. Any post fellowship International

exposure?
• 2 years
No
expectations by the institute in 13. Any bonds or compulsory
research ? commitments with the institution
- after completion?
lasers and injections one might 2 years mandatory post-fellowship
expect ? consultancy bond with attractive salary
Depends on the skill level of the

candidate. Adequate opportunity for 14. Any peripheral centres for
hands on training compulsory rotation and duration of
the same ?
and VR Faculties ? Compulsory peripheral posting- 2
months
• DR ANIRUDDHA MAITI
(CHIEF) 15. Contact details ( Phone & Email) of
• DR PROSENJIT MONDAL the academic department.
• DR SANGEETA ROY
• DR UTSAV PAN Miss Munmun Das
• DR SANTOSH KUMAR +91 9874892609
6. Selection procedure in brief 16. Names and Contact details of 3

including probable dates (Interview past(within 2 years) or present
& Joining) ? fellows.
Quarterly in a year(dates available in Dr Santosh Kumar 9402756267

susrut website & on enquiry mail Dr Priyanka Ahuja- 95821 38616
to [email protected])
Present fellow -
Candidate has to send complete CV Dr Soumabha mandal 7501716671
with passport size photograph  

consider in a CV ?
-
Young Ophthalmologists Times is
8. Stipend
highly indebted to Dr Aniruddha Maiti
1st year 40,000 for providing us the above information.
2nd year 60,000

Fellow will get exposure to ROP

patients examination and its laser.

SUSRUT EYE FOUNDATION, KOLKATA
DR SOUMABHA MANDAL 
After completion of my post graduation (DNB) at Susrut Eye Foundation & Research Centre
kolkata, I was bit confused about my future plans. As I was actively practising general
ophthalmology at various small peripheral centres(mainly cataract based) I was in a
dilemma whether to continue this or to upgrade to any subspecialty as recent trend is like
that only. My only choice was vitreo-retina and I had not searched for other institution
fellowship schedules as surgical exposure at my mother institution is great in comparison
with so called premium institutions. And my preference while choosing surgical branch is
always surgical exposure rather than academics as you have to upgrade academics by
yourself.
So, I have mailed my CV to HR person (Ms Munmun Das) and date and time
of interview was replied to me. On the day of interview almost 20-25 candidates for all
specialities came and seated in our seminar room. Lunch was provided on behalf of
institution. Interview was based on academic and non academic questions and consultants
from all subspecialties were present on the day of interview.. As there was strict bond of 2/3
yrs(VR-2 yrs course+2 yrs bond/ others 1 yr course+ 3 yrs bond) everybody was questioned
about their willingness to stay for that much long period or not. Academic questions were
related to general ophthalmology largely and few about particular subspecialty. Successful
and unsuccessful candidates were mailed within 2 weeks. Except 1 or 2 most of successful
candidates joined the institution.
After joining I have asked other candidates about their experiences regarding
interview and the replies were positive. Overall satisfactory interview experience in Susrut
Eye Foundation and Research Centre.
DR SOUMABHA MANDAL is a Vitreo-Retina fellow at Susrut Eye Foundation,

Kolkata. He can be contacted at +91 7501716671
YO TiMES IAUG 2019

343
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OFFICIAL PUBLICATION OF THE YOUNG OPHTHALMOLOGISTS SOCIETY OF INDIA

ISSUE 15, AUG 2019

Dr HARRY W FLYNN Dr S. NATARAJAN

Dr SUBHADRA JALALI Dr JOSEPH MAGUIRE:

MENTORS PANEL ON VITREO-RETINA TRAINING

VITREO-RETINA TRAINING SPECIAL

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allow YOSI members to seek fellowship advise from a panel of experts.

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Young Ophthalmologists Times

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Dr Aniruddha Agarwal Dr Apoorva Ayachit Dr Ashish Ahuja

Dr Awaneesh Upadhyay Dr Bhavik Panchal Dr Chintan Desai

Sri Sankaradeva Nethralaya, Guwahati

Dr Diva Kant Misra Dr Jay Sheth Dr Mayank Bansal

Sri Sankaradeva Nethralaya, Guwahati

Dr Neha Goel Dr Samendra Karkhur Dr Sahil Bhandari

ICARE Eye Hospital & PG Institute, AIIMS, Bhopal

Dr Tanya Jain Dr Vedang Shah

Dr Shroﬀ Charity Eye Hospital, Delhi

Dr Digvijay Singh Dr Sonal Kalia Dr Diva Kant Misra

Director, Noble Eye Care

HOD (Ophthal), Narayana SMS Medical College, Jaipur

Hospital , Gurgaon Guwahati

Dr Karan Bhatia Dr Apoorva Ayachit Dr Indeevar V Mishra

Sri Sankaradeva Nethralaya

Dr Akshay G Nair Dr Aniruddha Agarwal Dr Annu Joon Dr Ashish Ahuja

Dr Bhavik Panchal Dr Biswajit Dey Dr Chintan Desai Dr Jay Sheth

Dr Mayank Bansal Dr Mainak Bhattacharyya Dr Nandini Chandak Dr Neha Goel

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Dr Saurabh Agrawal Dr Sumit Grover Dr Vaitheeswaran L G Dr Vedang Shah

YOUNG OPHTHALMOLOGISTS SOCIETY OF INDIA

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1. Guest Editorial : Role of a Mentor

11. Medical Retina or Surgical

12. How to find the right Fit ? 76

13. Research & fellowship: Can they go hand in hand?

16.My Artificial Intelligence Journey: And How to

17. Precision Medicine & CRISPR Genomic Editing in

18.Role of simulators in surgical training

19. What’s behind a proper Vitreoretina training ?

27. Nuances of Retinal Imaging : A case based

28.Conferences and Travel Grants

Prof. Dr. Berthold Seitz & Cordula Gabel-Obermaier

Dr. Thiyagarajan Jayabaskar

Dr. Fischer M. Dominik

53. C.H. Nagri Eye Hospital, Ahmedabad 251

59. HV Desai Eye Institute, Pune 271

70. Prakash Netra Kendra, Lucknow 306

THE ROLE OF A MENTOR

Learning is a lifelong process. It should be in the life-sustaining flame of every physician. A

Gratitude is the virtue from which all others spring. It is

- Dr. SUBER HUANG

YO TiMES IAUG 2019

Q TELL US A LITTLE BIT ABOUT YOUR RETINA FELLOWSHIP EXPERIENCE?

A Following my residency of the University of Virginia in Charlottesville, VA, I was a

YO TiMES I AUG 2019

Q WHAT ARE THE MOST COMMON MISTAKES FELLOWS MAKE EARLY IN

Q SURGICALLY, WHAT ARE THE MOST IMPORTANT PRINCIPLES TO

A Taking a conservative approach towards surgery is generally the preferred

DR. SRIDHAR is a Vitreo-Retinal surgeon on faculty at the Bascom Palmer Eye

YO TiMES I AUG 2019 4

HARRY W. FLYNN Jr., M.D is the J. Donald M.

MASTERING YOUR MIND

- Dr. SUBER HUANG  

गुरुब्रर्ह्मा ग्रुरुिवर् ष्णुः गुरुदेर्वो महेश्वरः । 