Long Term Fellowship in Pediatric Ophthalmology

The Jasti V Ramayamma Children's Eye Centre is dedicated to children's eye health, including service, education and research. Established in 1997, the Centre covers all aspects of a visually challenged child's eye health such as prevention, treatment, and rehabilitation. In addition, the Centre conducts clinical, epidemiological and basic investigations focusing on the outcome, prevalence, genetics, congenital anomalies, infection, cataract, glaucoma, ROP, and retinoblastoma.

Pediatric Ophthalmology (Long-term program)

This program aims to train eye care professionals in early intervention treatment strategies to address the critical issue of childhood blindness. In addition, other aspects of childhood blindness are covered.

Session commences: January and July each year

Places available: One per session.

Qualifications: MS / MD / DNB (Ophthalmology)

Selection: Through a written test and interview in November and May.

Application procedure: Applications must be accompanied by a curriculum vitae and testimonials from two referees.

Program Audience: Ophthalmologists who have completed their residency training in ophthalmology

Training Methodology: The fellows will spend an equal amount of time in clinical diagnostics and surgery. Their areas of exposure and work schedules are:

 

Clinical Training

The fellows will be involved in all aspects of clinical diagnosis and will become familiar with the following procedures under supervision:

• Slit lamp biomicroscopy
• Applanation tonometry
• Gonioscopy direct and indirect
• Pachometry
• Keratometry
• Indirect and direct ophthalmoscopy
• Biomicroscopic indirect ophthalmoloscopy
• Perimetry, including automated perimetry
• Use of Argon and Nd YAG lasers
• Ultrasonograpy (A scan and B scan)
• Slit lamp photography
• Evaluation of children with strabismus, cataract, glaucoma, oculoplasty, tumor related problems and vitreo-retinal disorders

Surgical Training

Basic Cataract surgical skills (one month)

This period of the fellowship is meant to ensure that the fellow can competently perform standard extracapsular cataract extraction and posterior chamber intraocular lens implantation. The second two weeks will give the fellow an opportunity to perform standard ECCE and PC IOL implantation procedures independently.

The fellows will also use the wet lab facility to enhance their skills in using the microscope. They will assist the faculty in:

• Surgery of congenital cataract
• Intraocular lens implantation
• Pediatric IOL power calculation
• Primary posterior capsulotomy and anterior vitrectomy
• Postoperative management
• Amblyopia therapy

Anterior segment, including cornea and cataract surgeries

During this posting, fellows will work in rotation with two cornea and anterior segment surgeons to learn the finer aspects of cataract surgery. Fellows will be assisted by the faculty in performing cataract surgery on children. Eventually, they will be expected to perform cataract surgery independently.

Strabismus surgery

During this posting, fellows will learn basic clinical diagnostic and surgical techniques for the management of strabismus. They will initially assist during surgery and then move on to independent surgeries, based on their level of competence.

Pediatric glaucoma

During this posting, fellows will acquire an understanding of the basic examination techniques for adult glaucoma as well as pediatric glaucoma, and assist in the clinic and the operating room. Initially, they will work with consultants while performing surgery on adult patients, during which time they should also acquire the skills needed to perform glaucoma surgery on pediatric patients. At the end of the fellowship, they should be able to perform a minimum of three surgeries for congenital glaucoma under the consultant's supervision.

• Trabeculectomy with or without antimetabolites
• Combined trabeculotomy
• Cyclodestructive procedures like TSCPC and cyclocryotherapy
• Combined cataract and glaucoma surgery

Ophthalmic plastic surgery

During this one-month posting, the fellow will work with the consultant and learn basic examination and management techniques for common pediatric oculoplasty problems as well as management of pediatric tumors. The fellows are expected to learn about syringing and probing of nasal lacrimal ducts, surgical management of ptosis, entropian, ectropian, etc.

Retina

During this posting with the consultant, the fellow can improve his skills in indirect ophthalmoscopy and basic work-up of vitreo-retinal diseases in children, including familial disorders, genetic retinal diseases, congenital eye anomalies and retinopathy of prematurity. The fellow will be assisted during the evaluation and management of babies who are treated or screened for retinopathy of prematurity and also be trained in the following areas:

• Surgery with lasers related to vitreo-retinal procedures in children
• Diagnosis of pediatric retinal disorders, especially retinal degeneration
• Retinopathy of prematurity and genetic disorders affecting the retina
• Performing laser treatment for premature retinal degeneration
• Simple surgeries for retinal diseases (optimal)

Repeat posting for cornea and anterior segment (1 month)

In this posting the fellows will learn to perform pediatric cataract surgeries independently and should be able to develop the finer skills required for pediatric surgery.

Expectations

• Evaluation of new patients and follow-up examinations
• Good record-keeping
• Thorough investigations
• Timely consultation reports
• Care and consideration of all patients

Evaluation

Each fellow will be given a training module for keeping a record of each case that he assists in or whenever he performs surgery on his own. The concerned faculty will evaluate the fellow's performance at the end of the posting.

For further details contact
Education Centre,
L V Prasad Eye Institute,
L V Prasad Marg, Banjara Hills,
Hyderabad - 500 034
Telephone: +91-40-3061 2445 / 46
Fax: +91-40-2354 8271
Email: education@lvpei.org