Vitreo-Retina

Fellowship program in vision eye hospital is running very successfully. 

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Vitreo-Retina

Fellowship program in vision eye hospital is running very successfully. 

Fellowship in Vitreo Retina 

Objective: 

  • Describe principles of posterior segment pharmacology (eg, antimicrobial, anti – inflammatory and growth factors), with emphasis on bioavailability, mechanism of actions, relative efficacy, safety, and potential complications. The fellow should be able to formulate fortified antibiotics and antifungal medications. 
  • Perform examination techniques, of indirect ophthalmoscopy (20D, 78D, 90D).
  •  Effective knowledge & competency in interpretation of FFA & OCT of Macula 
  • Skill in B-Scan ultrasonogram & correlation with clinical findings.
  •  Identify developmental anomalies of anterior and posterior segment, their impact on visual development, and their management (eg, Iris, lens, retina, optic nerve and choroid). 
  • Diagnose and formulate management plans to effectively manage common diseases / disorders involving the vitreo-retina and macular diseases.
  • Diagnose and formulate management plan for infectious and inflammatory conditions of posterior segment disorders.
  • Skill in laser including pan retinal photocoagulation, Barrage laser, Grid laser, Modified grid laser, focal laser and laser hyaloidotomy. 
  • Develop skills needed for the medical and surgical evaluation and management for posterior segment diseases problems, including vitreous Biopsy, intravitreal antibiotics / anti – VEGF. Fellows should be familiar with vitreous biopsy interpretation of microbiology results. 
  • Diagnose surgical retinal conditions and appropriate in time referral.

Contents of the Fellowship

  •  Clinical skills 
  • Clinical Evaluation 
  •  Procedures 
  •  Investigations
  •  Surgical skills
  •  CME/Journal presentation
  •  Research work

Clinical Skills 

  • Recite fundamentals of posterior segment anatomy, physiology, microbiology and wound healing. 
  • Describe principles of immunology, including autoimmunity and pathologic responses of the posterior segment.
  •  Acute and chronic intermediate uveitis and posterior uveitis to include both infections and noninfectious etiologies.
  •  Acute and chronic infective endophthalmitis (including bacterial, viral and fungal).
  •   Diabetic retinopathy including no proliferative diabetic retinopathy, proliferative diabetic retinopathy, vitreous hemorrhage and tractional retinal detachment. 6. Retinal vascular occlusion including central retinal vein occlusion, branch retinal vein occlusion, hemiretinal vein occlusion, central retinal artery occlusion, branch retinal artery occlusion and cilioretinal artery occlusion. 
  • Non infectious inflammatory diseases of the retinal and vitreous including. Intermediate uveitis Vogt-Koyanagi Harada syndrome, vasculities and sympathetic ophthamia. 
  • Posterior uveitis and vasculitis. 
  • Macular disease including age related macular degeneration, neovascular (exudaive) age related macular degeneration, central serous. 
  •  Chorioretinopathy, macular dysrophy and macular degeneration.
  •   Posterior scleritis. 
  •  Infectious disease of retina and vitreous including tuberculosis, toxopasmosis. 
  • Management of exudative RD 14. Retinopathy of prematurity 
  •  Be able to appropriately perform laser procedures of vitreo-retinal diseases. 
  •  Tumors of the posterior segment, such as choroidal osteoma, choroidal hemangioma, choroidal melanoma, choroidal metastasis and retinoblastoma. 
  • Diagnosis of surgical conditions of retinal diseases. 
  •  DR screening online/at community hospital. 
  •  Distant video consultancy. 
  •  Clinical activity at branch / community level eye hospitals.

Investigation Skills 

Fundus photographs:

 Posterior Pole (central picture)

 Field 30o (Disc central and macular central pictures) Field 30o (Disc central, macular central and temporal to macula picture)

 Field 50o (Disc central, disc superior, Disc inferior and disc temporal picture) Montage 50o 

Fundus fluorescein angiography (FFA) 

Optical coherence tomography (OCT)

 B-Scan

 Field analysis in retinal dystrophy / other retinal disease ICGA ERG/EOG (Electrophysiological tests) 

OCT angiogram 

Procedure Skills 

Retinal Laser 

Panretinal photocoagulation (PRP) 

Barrage laser Grid laser Modified Grid laser Focal Laser 

Yag laser Hyaloidotomy 

Posterior Subtenon injection Intravirteal anti – VEGF LIO in adult LIO in Child / ROP laser inj intravit / antimicrobials

Surgical Skills 

Assessment and emergency management of posterior segment trauma, including endophathamitis, 

Central retinal artery occlusion, and intraocular foreign body. 

Skill in posterior-segment surgery, including pars plaana vetrectomy, vitreous biopsy, PVD induction, 

intraocular antibiotics / steroid / andt VEGF.

 Performpars-plana lensectomy. Skill in retinal detachment surgery including belt buckle, vitrectomy, endolaser, fluid air exchange, 

PFCL-silicone oil exchange, silicone oil insertion. Skill in diabetic vitrectomy including membrance peeling, endolaser, fluid-gas exchange. 

Surgical management of diabetic retinopathy, retinal vascular occlusion and Uveitis. 

Fundamental Knowledge in macular hole surgery. Surgical management of dislocated lens / IOL and SF- IOL.

 Perform conventional RD surgery. Silicon oil removal surgery. Performing sutureless PPV (23G / 25G / 27G) Identify and management of complications of silicon oil. 

Surgical management of choroidal detachment. 

Management of immediate post-operative complication of RD surgery or other retinal surgery.

Identify preoperative complication of retinal surgery & management.

Vitreo-Retina fellowship

 

Total duration of fellowship 18 months