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Dr. Meenakshi S
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Cornea & Anterior Segment Fellowship Program

Prepared by: Dr. N Radhika
Reviewed by: Dr. Prema Padmanabhan
Date: 10/02/2017

Prepared by: Dr.N Radhika Reviewed by : Dr. Prema Padmanabhan Date : 10/02/2017

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

Faculty
Head of the Department : Dr Prema Padmanabhan
Consultants in Chennai (SN Main) Dr. Rama Rajagopal
Dr. N Radhika
Dr. R R Sudhir
Dr. Iyer Geetha Krishnan
Dr. Bhaskar Srinivasan
Dr. Niveditha Narayanan
Dr. Shweta S Agarwa
Dr. Meena Lakshmipathy
Dr. Mamta Agarwal
Consultant in Kolkatta (SNK) Dr. Mona Bhargava
Dr. Ravi Daulat Barbhaya
Dr. John Sarkar


Facilities & Resources

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

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

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

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

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

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


Fellowship Program

The fellowship program is for duration of two years.

The initial three months will be spent in allied specialties like glaucoma, oculoplasty in rotation.

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

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

Role & Responsibilities of Fellow

Research
The fellow will be actively involved in the research work. He/she will complete at least one project of publishable quality in cornea, external diseases or refractive surgery and also assist in other ongoing projects. He/she is expected to present the research work in state/ national conferences.

Clinical Responsibilities

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

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


Surgery
The fellow will have opportunity to assist and perform various surgical procedures like penetrating keratoplasty (optical & therapeutic), lamellar keratoplasty including deep anterior lamellar keratoplasty and deep lamellar endothelial keratoplasty, tectonic procedures like cyanoacrylate glue application, ocular surface reconstruction procedures like symblepharon release, amniotic membrane transplantation, and limbal autografts and allografts, anterior chamber reconstruction, additional procedures in association with keratoplasty like cataract extraction, intraocular lens implantation, intraocular lens explantation/exchange, and vitrectomy, pterygium excision with conjunctival autograft etc. It is anticipated that the fellow will perform about 15 keratoplasties during his training period. He/she will also perform about 10 pterygium surgeries and 40 to 50 cataract surgeries.

Educational Responsibilities

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

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


Eligibility

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

Clinical cornea fellowship program
Duration: 2 Years

Research cum cornea fellowship program
Duration: 2 ½ Years

Please click here to download Application Form