Working as consultant Pediatric and Neuro Ophthalmologist at ASG eye hospital Srinagar.
Professional and Educational Experience:
As a consultant I have run independent OPDs till 3:00pm followed by independent ORs in the evening every day, apart from general OPD I have to see specialist pediatric and Neuro-ophthal OPD, ROP screening and referral cases. Surgeries performed include simple and complex squint surgeries pediatric cataract surgery, Phacoemulsification with PCIOL implantation under topical anesthesia, trabeculectomy, syringing and probing, dacryocystorhinostomy, ptosis correction, ectropion and entropion surgery, pterygium excision with autograft, chalazion incision and curettage to be operated independently.
As I had the privilege to do the fellowship from one of the best institutes my academic, clinical and surgical training during these 2 years were as such
Basic Orientation: The first month was in ZEISS academy to strengthen the skills in clinical examination and basic diagnostics and also to get acquainted with the principles and guidelines being followed at the institute.
Clinical Rotation: During this period, I was rotated in the sub specialty with the entire faculty in the sub specialty and gain exposure. Duration of this period is 17 months which also includes one month posting in eye bank.
The following are the areas and techniques where the training is imparted
I was involved in all aspects of clinical diagnosis and was also trained in various diagnostic procedures
• Slit lamp bio microscopy
• Applanation tonometry
• Gonioscopy direct and indirect
• Indirect and direct ophthalmoscopy
• Biomicroscopic indirect ophthalmoscopy
• Perimetry, including automated perimetry
• Use of Argon and Nd YAG lasers
• Ultrasonography (A scan and B scan)
• Slit lamp photography
• OCT and FFA
• Evaluation of children with strabismus, cataract, glaucoma, oculoplastic, tumor related problems and vitreo-retinal disorders
Basic Cataract surgical skills (one month)
This period of the fellowship was meant to ensure that the fellow can competently perform standard cataract surgical procedures independently which included SICS and phacoemulsification in adults, so I had formal training in SICS and PHACO under supervision before I was posted in periphery were I worked as consultant ophthalmologist and operated all the cases independently apart from that I was trained 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, I worked in rotation with two cornea and anterior segment surgeons to learn the finer aspects of cataract surgery and was assisted by the faculty in performing cataract surgery on children. Eventually, started to perform pediatric cataract surgery independently.
During this posting, I had intense training to get well acquainted with basic and specialized clinical evaluation of all simple and complex strabismus cases and their complete management which included surgical techniques for the management of all types of strabismus cases. I initially assist during surgery and then move on to independent surgeries.
During this posting, I acquired an understanding of the basic examination techniques for adult glaucoma as well as pediatric glaucoma, and assist in the clinic and the operating room. I was trained in following surgical procedures
• 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, I work with the consultant and learn basic examination and management techniques for common pediatric oculoplasty problems as well as management of pediatric tumors particularly retinoblastoma. I was trained in doing syringing and probing of nasal lacrimal ducts, surgical management of ptosis, entropion, extropian and in specific got training for both external and endoscopic DCR surgery
During this posting with the consultant, I further improved my skills in indirect ophthalmoscopy and did basic work-up of vitreo-retinal diseases in children, including familial disorders, genetic retinal diseases, congenital eye anomalies and retinopathy of prematurity independently. During this period, I was specifically trained for evaluation and management of babies who are treated or screened for retinopathy of prematurity and surgery with lasers related to vitreo-retinal procedures in children. I had specific training in suture less (glued) and sutured SFIOL procedures other than that had training in the following
• 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)
Posting at Secondary Center: I was posted in the peripheral secondary center for a period of two months where I managed clinics and operated all sorts of cases independently and also gain expertise in managing a Secondary level center.
Clinical Associates: I worked as clinical associate for a period of 6 months where I had to take up institute’s responsibilities while being posted with the faculty. During this period, I had to manage my independent OPDs and theater. This period is specifically meant for developing skills of managing independent OPD and decision making of all the cases and their surgical management which includes simple and complex pediatric and neuro-ophthalmological cases.
This included complete clinical evaluation of all forms of strabismus and cataract and their plan of management, surgical plan and post-operative follow-up surgical procedures included
• Resection and recession of recti and oblique muscles
• All forms of specialized strabismus procedures like plication, advancement, Y-split, faden, loop myopexy, hang back procedure etc.
• All forms of recti and oblique muscle transposition procedures.
• Strabismus re-surgeries.
• All forms of congenital cataract surgeries which included lens aspiration ± posterior capsulorhexis ± anterior vitrectomy ± intraocular lens implantation.
• Lensectomy in ectopia lentis ± glued SFIOL
• Secondary in the bag/sulcus fixated IOL implantation.
In addition, all the fellows at the Institute deal with ophthalmic emergencies on rotation.
I had 6 months experience of working in pediatric ophthalmology department of G.B pant pediatric hospital where I had both administrative as well as clinical responsibilities which included
• Administrative responsibilities included indenting consumable and non-consumable materials.
• Making note of instruments required for smooth functioning of clinics and making requisition for the same and ensure there proper functioning and usage
• Clinical responsibilities included every day pediatric ophthalmological OPD along with ROP screening in the NICU and their LASER treatment.
Department of Ophthalmology Government Medical College, Srinagar University of Kashmir (April 2010 – May 2013)
Surgical and clinical training: This included 3-year training program with rotation in General Ophthalmology, Ophthalmic emergencies and Trauma, Optics and refraction, Oculoplastic clinics, Retina clinics, Glaucoma Clinics and Research Lab duties where all ocular investigations like OCT, FFA, B scan, Automated Perimetry, Corneal Topography, Pachymetry, Lasers were done. The duties included routinely one to two 24-hour duty in AE and one in ward every week. All work was supervised and guided either by senior registrar or consultant. In addition had to put progress notes of patients assigned to me in the concerned unit and had to present same to consultant on daily basis Besides assisted in more than 100 General ophthalmology procedures as second assistant and 150 General Ophthalmology procedures as first assistant which included cataract surgery (SICS), DCR, Pterygium excision, chalazion excision, dermoid excision, corneal tear repair, intravitreal injections etc.
Academics: During this period presented 15 case presentations and 5 seminar presentations apart from that we had to attend regular case presentations, seminars and CMEs. I was also responsible for regular bedside teaching of under graduate students and interns.
My Passion and persuasion for affordable health care system
I have been actively working for Al-Imdaad trust which was formed and started in 2012 to achieve its philanthropic objectives for overall development of society in the field of healthcare, education and social service by various doctors whose activities being organized by me as general secretary of the trust under the supervision of eminent social activist Mir Rehmatullah sahib. The primary objective of the trust is to provide affordable health care system for all, particularly to the weaker and poorer sections of the society. To begin with, I have organized various free medical camps in remote areas of J&K to provide health care facilities at the door step of people who were in need of it the most, we used to provide comprehensive medical consultations by specialist doctors of various fields (who are also working as voluntary members of the trust) along with free medications.
In this regard as the trust wants to move further ahead in providing need-based health care facility to our society in more concrete and practical form, so I along with my team have started the much-needed dialysis Centre at cost to cost basis. I along with my team are planning for various projects which are in pipeline like ophthalmological subspecialty institute and women and child care Centre.
Skills: Extensive experience in treating eye disorders.
Excellent verbal and written communication skills in English and Urdu. Excellent social and interpersonal skills for dealing with patients.
Presented a poster on phacoemulsification in complicated cases at Association of Community Ophthalmologist of India (ACOIN)
Life Member of Kashmir Ophthalmological Society, KOS
1800 1200 111
ASG Eye Hospital, Shrinagar
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