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Sankara Nethralaya
Sankara Nethralaya
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Specialities

Glaucoma

Brief History

Glaucoma is a potentially blinding disease that affects 66 million persons worldwide. It is the second leading cause of blindness worldwide. The disease is characterized by typical changes in the optic nerve (the nerve that connects the eye to the brain) with associated visual field defects (the area seen by the eye). Since the outer portion of the visual field is the first to be affected and most types of glaucoma are asymptomatic the disease is often diagnosed once significant vision/field has been lost. Therefore, early diagnosis is essential so that treatment to halt/slow progression can be instituted.The Jadhavbhai Nathamal Singhvi Glaucoma Department at Sankara Nethralaya main campus, Chennai has 12 Consultants and 4 Consultants at Kolkatta. The Glaucoma Department examines about 22,000 patients every year. Our Glaucoma Department is involved in many research projects related to genetics, epidemiology and treatment of glaucoma. The Department has state of art treatment facilities including laser and surgical procedures for glaucoma in adults, children and infants. The Department also trains Ophthalmologists in the field of glaucoma.

Ophthalmic issues the dept. addresses

Normal eye pressure is maintained by a fine balance between inflow and outflow of fluid in the eye (aqueous). Raised eye pressure is one of the important risk factors for Glaucoma. It is commonly caused by obstruction to the drainage channels of the eye. Although infants and children can rarely be affected, glaucoma is more common in the adult population. The raised pressure can cause irrecoverable damage to the optic nerve and can result in permanent loss of vision. In chronic cases, it is the side vision that is affected initially and the disease slowly and subsequently damages the normal vision before the patient becomes aware of the problem.

Facilities

Glaucoma Diagnosis

Glaucoma is a disease where there is a raise in the intra-ocular pressure, optic disc changes and an associated visual field loss.

Intra - ocular pressure measurement
 
 
Applanation Tonometry
Non Contact Tonometry
Pascal DCT
Tonopen
Perkins tonometer
Proview
Reichert Ocular response analyzer
Rebound tonometer
 
Anterior segment Imaging ; Visante AS-OCT (Zeiss)
Optic nerve evaluation by
Digital Fundus photography (Zeiss)
GDx VCC nerve analyzer (Zeiss)
HD Optical Coherence Tomography (Zeiss)
Heidelberg retinal tomogram
Ultrasound Biomicroscopy
Swept source OCT
Visual field testing by
 
 
 
Humphrey Visual field analyzer
Frequency Doubling Perimetry
Blue on yellow perimetry
Differential light sensitivity
 
Based on the above tests the type of glaucoma is diagnosed.
Lasers available:
ND YAG laser (Zeiss)
Argon Laser (Zeiss)
Diode Laser(Iridex)
Lumenis SLT/YAG integrated combo Laser (Selecta Duet)
Endoscopic Cyclophotocoaglation

Remember

Glaucoma is the second most blinding disease in the World. It is known as the "Silent thief of sight" as most of the types of glaucoma are asymptomatic

Training and courses offered

Smt. Jadhavbai Nathmal Singhvee Glaucoma Services, Sankara Nethralaya

Smt. Jadhavbai Nathmal Singhvee Glaucoma Services, is a specialty department of Sankara Nethralaya and is equipped with all necessary instrumentation for diagnosis and management of glaucoma.
Available Instruments in the Department:
Apart from routine instruments for evaluation (Applanation tonometer, 3 and 4 mirror gonioscopes, 90 D), other specialized equipments available include;
Tonopen
Perkins tonometer
Dynamic Contour Tonometer (DCT)
Ocular Response Analyzer
Proview tonometer
Ultrasound pachymeter
Koeppe direct gonioscopes (for pediatric angle assessment)
Humphrey visual field analyzer (i series)
Frequency Doubling Perimeter (FDP)
Heidelberg Retinal tomography (HRT III)
Optical coherence tomography (OCT)-Retinal Nerve Fibre Layer (RNFL), Ganglion Cell Complex (GCC)
Anterior segment Swept Source OCT
Anterior Segment OCT (ASOCT)
Ultrasound Biomicroscopy (UBM)
Zeiss fundus photography unit (for stereoscopic disc photography)
Outpatient activities:

Routine comprehensive evaluation for glaucoma patients and glaucoma suspects include: Applanation tonometry, indentation gonioscopy, optic disc and fundus evaluations. This is followed by further testing as deemed necessary which may include-Visual field analysis (Humphrey), Disc photography or Imaging (HRT, OCT, Swept source OCT, anterior segment OCT, Ultrasound biomicroscopy)

Management of pediatric glaucomas

Cross consultations for glaucoma from other departments in the institute and referrals from outside which may include complicated glaucomas and post surgical glaucomas (such as post penetrating keratoplasty, post vitreo-retinal surgeries, post uveitic, post traumatic).

Minor OPD procedures:
Nd: YAG peripheral Iridotomy
Argon Laser Trabeculoplasty (ALT)
Selective laser Trabeculoplasty (SLT)
Argon Laser Iridoplasty
Argon Laser Suturelysis
Postoperative 5-Flurouracil injections
Inpatient procedures:
Major
External trabeculotomy and/or trabeculectomy for congenital glaucomas
Combined cataract (Phacoemulsification) and glaucoma filtering surgery (Trabeculectomy)
Trabeculectomy with/without use of antimetabolites
Combined Filtering surgeries with vitreoretinal surgeries
Combined Filtering surgeries with corneal/ocular surface surgeries
Aqueous drainage implants (valved or non-valved)
AC reformation + choroidal drainage
Needling of blebs
Revision of blebs
Endoscopic cyclophotocoagulation
Management of overfiltering and leaking blebs (Autologous blood injections or conjunctival patch grafts)
Cataract surgery (ECCE or Phacoemulsification) in post filter situations
Minor
Evaluation under anaesthesia for pediatric glaucomas
Diode cyclophotocoagulation
Research activities:

Drug trials

Basic and clinical research-availabilty of large retrospective data and avenues for conducting prospective studies are widely available.

Fellowship program:

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

Training period: 18 months

Research fellowship includes 6 months of research based activities including data collection, statistical analysis and if possible publication of articles.

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

Break up of training period:

First 3 months: The fellow is oriented to the routine practices of the institute in the first month. Subsequently he/she is posted in the Neuro-Ophthalmology department and Glaucoma Diagnostics for 15 days each. In the third month, the fellow has an option to choose any 2 postings of their choice (of 15 days duration each) either in the Vitreo-Retina, Cornea, Uvea or Emergency departments. This period serves to prepare the fellow for the forthcoming glaucoma training.

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

Next 8 months: The fellow will have rotation postings with glaucoma consultants. The fellow will be trained in basic OPD evaluation, visual field evaluation, postoperative care and follow up of patients along with observation of minor OPD and OT procedures and major OT procedures. The fellow will actively assist in OT procedures. The fellow will also be responsible for inpatients of the consultant under whom he/she is posted. The fellow will be allowed to perform OPD and OT procedures as mentioned above under the consultants' supervision.

Besides a once weekly posting throughout the fellowship, an exclusive one month period in the community ophthalmology department to further train for cataract and glaucoma surgeries.

The fellow should start on the research schedule he/she has prepared under the guidance of one of the senior glaucoma consultants. The fellow is encouraged to do combined cataract and glaucoma procedures and trabeculectomies under supervision on selected patients. The fellow has ample opportunity and is encouraged to use with all instruments and diagnostics under supervision during this period.

Last 7 months: In the 12th Month of the fellowship program, the fellow will see day to day glaucoma cross consultations under the supervision of glaucoma consultant to prepare for an independent role. In the last 6 months, the fellow sees independent consultations in the outpatient department. They will continue to perform surgeries and are also encouraged to supervise their junior colleagues. During this time he/she will have a weekly diagnostic posting to continue training in use of imaging modalities and perimetry.

The fellow has additional posting of one month in this period exclusively in the community ophthalmology department for cataract and glaucoma surgeries.

The fellows are encouraged to present their research work in a scientific meetings, [National, State and City meetings] and publish it in peer reviewed journals during this period.

Summary of clinical training:

Level 1
Basic evaluation of glaucoma patient (Tonometry, Gonioscopy, Disc evaluation)
Hands on with Humphrey visual field analyzer,Frequency Doubling Perimetry
Imaging in glaucoma (HRT, OCT, Disc photographs)
Ultrasound Biomicroscopy, Anterior Segment OCT

Level 2
Nd-YAG peripheral iridotomy
Cyclodestructive procedures
Postoperative wound modulation in glaucoma surgeries
Evaluation under general anesthesia for pediatric glaucomas
Trabeculectomy with / without antimetabolites
Combined cataract and glaucoma procedures

Level 3
Basic research methodology and publication

Apart from clinical and surgical training, active participation in journal clubs and clinical presentations in weekly department meetings, case presentations, journal clubs, quiz and academic sessions within and outside the institute is encouraged. They are encouraged to present their research at National meetings.

Evaluation of performance of fellows will be done by regular internal assessment tests. Fellows have to maintain a log-book for the period of their fellowship duration which is assessed every month end by their mentors.

Please click here to download Application Form

Research activities

The Chennai Glaucoma study & Molecular Genetics of Glaucoma in the South Indian Population

(June 2001 – February 2004)

The Chennai Glaucoma Follow-up study

(February 2004 to February 2007)

The Chennai Eye Disease Incidence study

(CEDIS: February 2007- February 2010)

Funded by: The Chennai Willingdon Corporate Foundation

Glaucoma is a potentially blinding disease that affects 66 million persons worldwide. It is the second leading cause of blindness worldwide. The disease is characterized by typical changes in the optic nerve (the nerve that connects the eye to the brain) with associated visual field defects (the area seen by the eye). Since the outer portion of the visual field is the first to be affected and most types of glaucoma are asymptomatic the disease is often diagnosed once significant vision/field has been lost. Therefore, early diagnosis is essential so that treatment to halt/slow progression can be instituted.

Public health planning to develop strategies for early diagnosis and treatment of this disease in the population requires data on the prevalence, distribution and pattern of the disease. Existing data from India suggest that Indians have a different pattern of disease. Recent genetic studies from the West indicate that glaucoma has a hereditary component with specific genes identified from the affected persons. There is a paucity of such data from India . If such data were available it would be possible to identify persons at risk of developing the disease.

The Chennai Glaucoma study is a population-based study, designed with a view to gather information on the prevalence of glaucoma in rural and urban South India . The study, funded by Chennai Willingdon Corporate Foundation, commenced on 2 nd Nov 2000. Clinical work on the rural component started on 15 th June 2001. 7785 persons, above 40 years of age, from rural Tamil Nadu and Chennai city were examined at a special facility created at Sankara Nethralaya. 3924 subjects representing the rural south Indian population participated from 27 contiguous villages of Thiruvallur and Kancheepuram districts of Tamil Nadu. 3850 Urban subjects participated from 5 randomly chosen divisions from Chennai city.

Every patient underwent a detailed ophthalmic evaluation. Ophthalmic examination consisted of the following components/ tests:

(a) Ocular and medical history,

(b) Lensometry (Appasamy LM14 telescopic lensmeter, Chennai , India ) if necessary,

(c) Refraction and recording of best-corrected visual acuity using the Modified ETDRS chart (Light House Low Vision Products, New York , NY , USA ),

(d) Scanning Laser Polarimetry using the NFA GDx (GDx Version 1.0.16, Laser Diagnostic Technologies, San Diego , CA , USA )

(e) Frequency doubling perimetry using the Frequency Doubling Perimeter (Zeiss Humphrey Systems, Dublin , CA , USA )

(f) Corneal pachymetry using the DGH 550 Ultrasonic pachymeter (DGH Technology Inc., Exton , PA , USA )

(g) Slit lamp biomicroscopy, (Zeiss SL 130-Carl Zeiss, Jena , Germany )

(h) Applanation tonometry (Zeiss AT 030 Applanation Tonometer, Carl Zeiss, Jena , Germany )

(i) Gonioscopy, (Sussmann-type 4 mirror hand held gonioscope -Volk Optical Inc, Mentor, Ohio, USA)

(j) Ocular biometry (Alcon ultrasonic biometer - Ocuscan, Alcon laboratories Inc, Fort Worth , TX , USA ).

(k) Grading of lens opacities, (The Lens Opacities Classification System (LOCS II)

(l) Fundus examination, (Indirect ophthalmoscope - Appasamy Associates, Chennai , India )

(m) Optic disc and fundus photography ( Zeiss FF450-plus fundus camera with VISUPAC digital image archiving system - Carl Zeiss, Jena, Germany)

(n) Visual field – White on white ((Zeiss Humphrey Systems, Dublin , CA , USA )

All the abnormal features will be recorded using standard international classifications. Data collection also included assessment of socio-economic status, systemic and ocular history, and ophthalmic examination. In addition a detailed pedigree is taken from those identified to have glaucoma and family members are screened for the disease. Genetic analysis to identify risk factors for glaucoma is also being performed. The project was successfully completed by February 2004. The study has generated 27 peer reviewed publications.

The important findings of the study are:

1) Prevalence of primary open angle glaucoma in the rural population was 1.62%. The prevalence increased with increasing age and 98.5% were unaware that they had the disease.

2) Prevalence of primary angle closure disease (PACG + PAC) in the rural population: 1.58%. An additional 7% were at risk of developing angle closure glaucoma. A few important risk factors were shown to be associated with primary angle closure disease

Women were at 3 times greater risk thank men
Increasing age was a significant risk factor
Almost all those with primary angle closure disease were unaware about the disease:
The disease was symptomless and only a comprehensive examination would help in timely diagnosis of the disease

3) Secondary glaucoma also contributes to the burden of blindness in our country. The prevalence of post surgical and pseudoexfoliation glaucoma's have been reported for the rural population.

a. Glaucoma is an important cause of ocular morbidity among those who had underwent cataract surgery (with or without intraocular lens implantation)

22% were blind in either one or both eyes due to glaucoma
b. The prevalence of pseudoexfoliation was 3.8% in the rural population
13% had glaucoma

4) Reporting the reasons & risk factors for blindness in the rural population, the study reported that: cataract was the single most important cause of blindness followed by glaucoma.

a. 36% of the rural population were bilaterally blind

Cataract was responsible in 79%, glaucoma (4.3%), non glaucomatous optic nerve disease (3.42%), cystoid macular edema & corneal scar (2.5% each)

5) The study also reported the prevalence of refractive errors in the rural south Indian population. Around 49% of the subjects had refractive error.

a. Myopia was the commonest refractive error in the rural population

27% had myopia (greater than -0.5 diopter power) & 3.7% had high myopia (greater than -5 diopter power) - There was a positive association between nuclear cataract and myopia

6) Tobacco use was significantly associated with cataract. Use of smokeless tobacco (snuff and/or chewing tobacco) use was strongly associated with cataract.

CHENNAI GLAUCOMA FOLLOW-UP STUDY (Feb 2004 to Feb 2007)

A cohort of normal subjects from the urban subset of the Chennai Glaucoma Study and those who had been diagnosed to have primary glaucoma, ocular hypertension, primary angle closure suspects were followed up for a period of three years at six monthly intervals. All subjects underwent a comprehensive ocular examination during each visit.

THE CHENNAI EYE DISEASE INCIDENCE STUDY (CEDIS: Feb 2007- Feb 2010)

This is a population based Incidence study. All subjects who had participated in the Chennai glaucoma study (2001-2004) from both the rural and urban arm will undergo a repeat history and detailed ophthalmic examination. The incidence of new diseases from the baseline and changes from the first examination will be studied

Papers/Publications for last 10 years

Chennai Glaucoma Study

“01. Optic Disc Dimensions & Cup-Disc Ratios among healthy South Indians, The Chennai Glaucoma Study” in the journal of Ophthalmic Epidemiology: 2011;189-197. Hemamalini Arvind, Ronnie George, PremaRaju, S.Ve.Ramesh, M.Baskaran, PrashanthKannan, Lingam Vijaya( c g s )

02. Can Intraocular Pressure Asymmetry Indicate Undiagnosed Primary Glaucoma? The Chennai Glaucoma Study” in the Journal of Glaucoma 2011 (e-pub). Choudhari NS, George R, Baskaran M, Ve RS, Raju P, Vijaya L. ( c g s)

03. Prevalance and causes of low vision and blindness in an urban population – The Chennai glaucoma study – Indian Journal of Ophthalmology. Vijaya L, George R, Rashima A, Ramesh S. Ve, Lokapavani V ( c g s )

04. Can intraocular pressure asymmetry indicate undiagnosed primary glaucoma? The Chennai Glaucoma study. Choudhari NS, George R, Baskaran M, Ve RS, Raju P, Vijaya L – Journal of Glaucoma 2013;22:31-35 ( c g s )

05. Long-term change in central corneal thickness from a glaucoma perspective. Choudhari NS, George R, Sathyamangalam RV, Raju P, Asokan R, Velumuri L, Vijaya L. Indian J Ophthalmol. 2013 Oct 22. [Epub ahead of print] PubMed PMID: 24145562 ( c g s )

06. Six-Year Incidence of Angle-Closure Disease in a South Indian Population: The Chennai Eye Disease Incidence Study. Vijaya L, Asokan R, Panday M, Choudhari NS, Ramesh SV, Velumuri L, Boddupalli SD, Sunil GT, George R - Am J Ophthalmol. 2013 Sep 25. doi:pii: S0002-9394(13)00532- 1. 10.1016/j.ajo.2013.07.027. [Epub ahead of print] PubMed PMID: 24075428 ( C g s )

07. redictors for incidence of primary open-angle glaucoma in a south Indian population: The Chennai Eye Disease Incidence Study. Vijaya L, Rashima A, Panday M, Choudhari NS, Ramesh SV, Lokapavani V, Boddupalli SD, Sunil GT, George R - The Chennai Eye Disease Incidence Study. Ophthalmology. 2014 Mar 17.pii: S0161-6420(14)00045- 1. doi: 10.1016/j.ophtha.2014.01.014 ( C g s )

08. Six-year incidence of ocular hypertension in a South Indian population: the Chennai eye disease incidence study. Manish P, Ronnie G, Rashima A, SatyamangalamVe R, Lokapavani V, Nikhil S C, Sachi Devi B, Govindan T Sunil, L Vijaya - Br J Ophthalmol 2014;0:1–5. doi:10.1136/bjophthalmol-2014- 305714 ( c g s )

09. Six-year Incidence and Baseline Risk Factors for Pseudoexfoliation in a South Indian Population:The Chennai Eye Disease Incidence Study in Ophthalmology. Vijaya L – Accepted in Ophthalmology 2015 ( c g s )

10. Is prophylactic laser peripheral iridotomy for primary angle closure suspects a risk factor for cataract progression? The Chennai Eye Disease Incidence Study. Vijaya L, Rashima A, Manish P, Ronnie G - British Journal of Ophthalmology; Aug 2: 2016 ( Cgs )

11. Outcomes of cataract surgery in rural and urban south Indian population VijayaL , George R , Asokan R et al IJO 2010 , may -jun 58 ( 3) , 223-8

12. Baseline risk factors and incidence of blindness in a South Indian Population The Chennai Eye Disease Incidence Study PandayM , George R , Asokan T , Ramesh SV , et al Investigative Ophthalmology and Visual Sciences 2014 , august 7 : 55(9 ) 5545-50

13. Six year Incidence of visually significant age related cataract : The Chennai Eye Disease Incidence Study Lingam Vijaya ,RashimaAsokan , Manish Panday , Nikhil Choudary et al Clinical Experimental ophthalmology 2016 , march 44( 2) , 114-20

14. Central corneal thickness in Adult South Indian population The Chennai Glaucoma Study Lingam Vijaya , Ronnie George , HemamaliniAravind , S Ramesh et al Ophthalmology 2010 : 117 : 700-704

Clinical Studies

01. Lens thickness and angle closure disease. George R, L Vijaya. Clinical and Experimental Ophthalmology. ( clinical )

02. Our experience of fibrin sealant-assisted implantation of Ahmed glaucoma valve. Choudhari NS, Neog A, Sharma A, Iyer GK, Srinivasan B – Indian Journal of Ophthalmology, Jan-Feb 2013;61(1):23-7.

03. The effect of prior trabeculectomy on refractive outcomes of cataract surgery. A Shah J, Vijaya L, Shantha B, George R - m J Ophthalmol 2013 Nov;156(5):1070-1. doi: 10.1016/j.ajo.2013.07.024. PubMed PMID: 24138756 ( clinical )

04. Topiramate-induced secondary angle closure. Rewri R, Rao NC, Vijaya L – Health Spec 204;2:26-7 ( clinical )

05. Prospective evaluation of early visual loss following glaucoma filtering surgery in eyeys with split fixation. Balekudaru S, George R, Panday M, Singh M, Neog A, Vijaya L, - Journal of Glaucoma Feb: 2014;23:211-218. ( clinical )

06. Intra-bleb hematoma and hyphema following digital ocular compression. Bhargava S, Choudhari NS, Vijaya L - Oman J Ophthalmol 2014; 7:22-4 ( clinical )

07. Ahmed Glaucoma Valve in Eyes with Preexisting Episcleral Encircling Element. Choudhari NS, George R, Shantha B, Neog A, Tripathi S, Srinivasan B, Vijaya L - Indian J Ophthalmol 2014;62:570-4 ( clinical )

08. Safety and Efficacy of Single-site Phacotrabeculectomy with Mitomicin C Using Nylon andPolyglactin Suture for Scleral Tunnel Closure. Vijaya L, David RL - J Glaucoma 2014 May 22. [Epub ahead of print] PMID: 24859802 ( clinical )

09. he use of the Ahmed glaucoma valve in the management of pediatric glaucoma. Shantha B, Vadalkar J, George R, Vijaya L - JAAPOS: 2014:18:351-6 ( clinical )

10. Management of Elevated Intraocular Pressure Associated With Subluxated/Dislocated Lenses by Combining TrabeculectomyWith Adjunctive Mitomycin C With Lensectomy, Vitrectomy, and Scleral Fixation of Intraocular Lens. David RL, Balekudaru S, George RJ, Sen P, Lingam V - Journal of Glaucoma. 2015 Nov 6 ( clinical )

11. Surgical Management of Glaucoma in Sturge-Weber Syndrome. Amit P, Shantha B, Ronnie G, Vijaya L, Manish P – Journal of Glaucoma. Nov 2015 ( clinical )

12. Surgical management of malignant glaucoma: a retrospective analysis of fifty eight eyes. Balekudaru S1, Choudhari NS2, Rewri P3, George R1, Bhende PS3, Bhende M3, Lingam V1, Lingam G3. J Glaucoma. 2016 Aug;25(8):674-80. doi: 10.1097/IJG.0000000000000400.

13. Incidence and Management of Glaucoma in Vogt Koyanagi Harada Disease. Pandey A1, Balekudaru S, Venkatramani DV, George AE, Lingam V, Biswas J.Eye (Lond). 2016 Mar;30(3):362-8. doi: 10.1038/eye.2015.231. Epub 2015 Nov 13. ( clinical )

14. Diurnal intraocular pressure fluctuation and its risk factors in angle-closure and open- angle glaucoma. \Srinivasan S1,2,3, Choudhari NS2,4, Baskaran M2,5, George RJ2, Shantha B2, Vijaya L2Am J Ophthalmol. 2015 Mar;159(3):482-9.e2. doi: 10.1016/j.ajo.2014.11.030. Epub 2014 Nov 26. ( clinical )

15. Glaucoma in modified osteo-odonto- keratoprosthesis eyes: role of additional stage 1A and Ahmed glaucoma drainage device-technique and timing.Iyer G1, Srinivasan B2, Agarwal S2, Shetty R2, Krishnamoorthy S2, Balekudaru S2, VijayaL2.IJO , 2014 Jan;62(1):55-9. doi: 10.4103/0301-4738.126182. ( clinical )

16. Comparison of saccadic reaction time between normal and glaucoma using an eye movement perimeter. Mazumdar D, Pel JJ, Panday M, Asokan R, Vijaya L, Shantha B, George R1, Van Der Steen J. Am J Ophthalmol. 2012 Nov;154(5):913-4; author reply 914. doi: 10.1016/j.ajo.2012.07.010. ( clinical )

17. Change in iris parameters with physiological mydriasis. Ganeshrao SB1, Mani B, Ulganathan S, Shantha B, J Glaucoma. 2011 Aug;20(6):392-7.doi: 10.1097/IJG.0b013e3181e87efc. ( clinical )

18. Outcomes of bleb excision with free autologous conjunctival patch grafting for bleb leak and hypotony after glaucoma filtering surgery. Panday M1, Shantha B, George R, Boda S, Vijaya L. ( clinical )

19. Prevalence, incidence and risk factors for the development of glaucoma in patients with aniridiaCorresponding author: Dr.ShanthaBalekudaru 1 DNB. Co-authors:Dr. Nandhini Sankaranarayanan 2 Dr. Sumita Agarkar3 Accepted for publication in JPOS.

20. Stereoacuity in mild , moderate and severe glaucoma LakshmananYamuna , George R , Ophthalmic and physiological optics , 33(2), 172-178

21. Anterior Ischemic Optic Neuropathy precipitated by acute primary angle closure ChoudhariN , George R , Kankaaria V , Sunil GT IJO , 2010 , sep - oct 58 ( 5) , 437-40

22. Management of secondary angle closure glaucoma ParivaradhiniA , Lingam VJ curr Glaucoma practice 2014 ,jan - april : 8 ( 1) , 25-32

23. Long term change in central corneal thickness from glaucoma perspective Choudari N, George R ,Raju P , Asokan R , Vijaya L IJO 2013 ,oct 61 ( 10 ) 580 – 4

24. rospective Evaluation Of Early Visual loss following glaucoma filtering surgery in eyes with split fixations ShanthaB , George R , panday M Vijaya L J Glaucoma 2014 , 23 : 211- 218

25. Follow up of primary angle closure suspects after laser peripheral iridotomy using UBM and Ascan biometry for a period of 2 years Krishna kumarRamani, BaskaranMani , Ronnie George , Vijaya Lingam J Glaucoma 2009 , 18 :521-527

26. Follow up of primary angle closure suspects after laser peripheral iridotomy using UBM and Ascan biometry for a period of 2 years Krishna kumarRamani, BaskaranMani , Ronnie George , Vijaya Lingam J Glaucoma 2009 , 18 :521-527

27. Rectifying calibration error of Goldmann application tonometer is easy Choudari N , Moorthy KP , Kumar M , George R , Senthil S , Vijaya L Indian Journal of Ophthalmology 2014 ,nov 62 (11) , 1082 - 1085

28. Platueu iris configuration and dark light changes in anterior segment optical coherance tomography Ulaganathan S , GaneshRao SB , Basakaran M , Srinivasan S , Shantha B , Vijaya L Ophthalmic surg Lasers and Imaging 2010 , march 9 1-4

29. Ahmed Glaucoma Valve in eyes with pre existing encircling element ChoudariNS ,Shantha B , George R IJO 2014 , may 62 ( 5) 570 -4

30. Management of complications in glaucoma surgery VijayaL , George R , Shantha B IJO 2011 jan59 :

31. Cupped disc with normal Intraocular pressure :the long road to avoid misdiagnosis ChoudariN ,Neog A , Goerge R IJO 2011 ,nov - dec 59 ( 6)

32. Shrirao N, Khurana M, Mukherjee B. Prostaglandin-associated periorbitopathy. Indian J Ophthalmol. 2016 Jun;64(6):459. doi: 10.4103/0301-4738.187676

33. Mona Khurana. Clinical Associations of long anterior zonules: a review. PPCR 2015, Sept-Oct;1(3):85- 89.

34. Khurana M. Diagnosis and Management of Normal Tension Glaucoma. Tamil Nadu Journal of Ophthalmology 2015

35. Mangaement of Elevated intraocular pressure associated with subluxated / dislocated lenses by combining trabeculectomy with adjunctive MMC with lensectomy,vitrectomy and scleral fixated IOL DavidRL ,Balekudaru S , George RJ , Sen P , Lingam V Journal of glaucoma , 2016 , july 25 ( 7) , 686-90

Epidemiological Studies

1. Importance of population based studies in clinical practice George R ,Asokan R , Vijaya L IJO 2011 , 59 :

2. Prevalence and Causes of vision loss in Central and South Asia : 1990 - 2010 Jonas JB , George R , Asokan R , Vijaya L Global Burden of Disease Study

3. Glaucoma in India , estimated burden of disease, Ronnie Goerge , Ramesh S , Lingam Vijaya J Glaucoma , 2010 , 19 : 391- 397

4. Perimetric severity in hospital based and population based glaucoma patients Ramesh SV , George R , raju P , sachi D , Vijaya L ClinExpOptom2010 ,sep : 93 ( 5) , 349-53

5. Angle closure in the developing world : What does future hold ? George R ,vijaya L Clinexp Ophthalmology 2012 , aug 40 ( 6) 533-4

Genetic studies

1. Genome-wide association analyses identify three new susceptibility loci for primary angle closure glaucoma. Vijaya L, George R et al, Nature Genetics. 2012 Oct; 44(10):1142-6

2. ABCC5, a Gene That Influences the Anterior Chamber Depth, Is Associated with Primary Angle Closure Glaucoma - Ronnie George, Vijaya L, NagaswamySoumittra, Vedam L. Ramprasad, NaushinWaseem, AzhanyYaakub, Kee-Seng Chia, Kumaramanickavel G, Bhattacharya, MingzhiZhang,Donald T. Tan, Yik-Ying Teo, Saleh A. Al-Obeidan - PLoS Genet 10(3): e1004089. doi:10.1371/journal.pgen.1004089

3. A common variant near TGFBR3 is associated with primary open angle glaucoma. Philomenadin FS, Asokan R, Ronnie G, Vijaya L – Hum Mol Genet. 10 th April 2015

4. Genetic association of SNPs near ATOH7, CARDIO, CDKN2B, CDX7 and SIX1/SIX6 wiith the endophenotypes of primary open angle glaucoma in Indian population. Sharmila F, Rashima A, Vishwanathan N, Ronnie G, Vijaya L, Sripriya S – PLOS ONE 2015.

5. Correlation of aqueous humor lysyl oxidase activity with THF-b levels and LOXL1 Genotype in pseudoexfoliation. Gayathri R, Corneal K, Sharmila F, Sripriya S, Sripriya K, Manish P, Shantha B, Ronnie G, Vijaya L, Narayanaswamy A – Curr Eye Research 2016 Oct; 41(10): 1331 – 1338

6. enome-wide association analyses identify three new susceptibility loci for primary angle closure glaucoma. Vithana EN 1 , Khor CC, Qiao C, Nongpiur ME, George R, Chen LJ, Do T, Abu-Amero K, Huang CK, Low S, Tajudin LS, Perera SA, Cheng CY, Xu L, Jia H, Ho CL, Sim KS, Wu RY, Tham CC, Chew PT, Su DH, Oen FT, Sarangapani S, Soumittra N, Osman EA, Wong HT, Tang G, Fan S, Meng H, Huong DT, Wang H, Feng B, Baskaran M, Shantha B, Ramprasad VL, Kumaramanickavel G, Iyengar SK, How AC, Lee KY, Sivakumaran TA, Yong VH, Ting SM, Li Y, Wang YX, Tay WT, Sim X, Lavanya R, Cornes BK, Zheng YF, Wong TT, Loon SC, Yong VK, Waseem N, Yaakub A, Chia KS, Allingham RR, Hauser MA, Lam DS, Hibberd ML, Bhattacharya SS, Zhang M, Teo YY, Tan DT, Jonas JB, Tai ES, Saw SM, Hon DN, Al-Obeidan SA, Liu J, Chau TN, Simmons CP, Bei JX, Zeng YX, Foster PJ, Vijaya L, Wong TY, Pang CP, Wang N, Aung T. Optom Vis Sci. 2012 Apr;89(4):483-8. doi: 10.1097/OPX.0b013e31824c3731. ( genetics )

7. A common variant near T GF BR3 is associated with POAG Li Z, AllinghamRR ,MAni B , George r , Vijaya L Human MoleculaeGenetics , 2015 , july 1:24 ( 13) 3880- 92

8. Genetic associations of SNPs near ATOH 7 , CARD N 2B, CDC7 and SIX/ SIX6 with theendophenotypes of primary open angle glaucoma in Indian population PhilomenadinFS ,Asokan R , george R , VIjaya L Plos one 2015 march 23 : 10 ( 3)

 
Director Dr. B Shantha
Deputy Director Dr. Ronnie Jacob George
Consultants Dr. Kumar Ravi (kolkatta)
Dr. Manish Panday
Dr. Mayav J Movdawalla
Dr. Mona Khurana
Dr. Nandini Sankaranarayanan
Dr. Nagalekshmi Ganesh
Dr. Parivadhini A
Dr. Prashant Srivastava (kolkatta)
Dr. Prerna Kedia (Kolkatta)
Dr. Rathini Lilian David
Dr. Sushmitha S
Dr. Sujatha V K
Dr. Surajit Sen (kolkatta)
Dr. Trupti Sudhir Patil
Dr. Vijaya L
Director - Glaucoma
Dr. B Shantha
Sankara Nethralaya (Main Campus)
No. 41 (old 18), College Road,
Chennai - 600 006, Tamil Nadu, India
E-Mail ID: drbs@snmail.org
Tel: 91-044-28271616 (12 lines)
Deputy Director - Glaucoma
Dr. Ronnie Jacob George
Sankara Nethralaya (Main Campus)
No. 41 (old 18), College Road,
Chennai - 600 006, Tamil Nadu, India
E-Mail ID: drrg@snmail.org
Tel: 91-044-28271616 (12 lines)