I arrived in India several days ago and immediately dived into the rigorous training schedule that is a hallmark of LVPEI.  As primarily an observer for these first few days, I’m starting to take in the scale and significance that LVPEI has for eye care in the region.

As a little background,

Established only 32 years ago, the hospital system serves a population of over 50 million from the southern Indian states of Telangana, Odisha and Andhra Pradesh.   The sheer magnitude and efficiency of the operations here are awe-inspiring.  To meet the needs of the region, the hospital system a central “flagship” hospital in Hyderabad as well as three other massive tertiary campuses in surrounding regions.   To access smaller cities and towns, there are 19 secondary sites, each with their vision screening programs, clinics, and operating rooms.

At these sites, fellows and residents each spend almost a year operating with complete independence: it is a core component in their training.   Surgically, these sites perform cataract extraction and pterygium excision primarily, however, they always have the safety net of any of the four tertiary centers to refer complicated cases, complications or patients who require subspecialty management.   Feeding into these secondary centers is an expansive network of 180 vision centers and “vision guardians” who are individuals from the community trained to recognize basic eye disease and visual deficits.  This network serves to connect small towns and rural villages to the secondary centers.  This pyramid of escalating care is a central part of how LVPEI can deliver such effective care to such a large patient population.  Over the next few weeks, I am excited to learn more about how the LVPEI system works as well as gaining familiarity with the Aravind model when I travel to Madurai next month.

Tomorrow, I have been assigned my first MSICS cases of this fellowship.  I will be operating under the mentorship of Dr. Swapna, and I look forward to challenges and rewards that lie ahead…

The featured photo is the main clinical wing; each floor is dedicated to one or two specialties.

These last two are the new wing for “sight savers” which is a higher payment tier that not only financially supports the hospital but allows for 50% of the patients to get treatment completely free of charge.  The hospital had a full-time artist commissioned who made all of the art for the hospital.  There are so many beautiful paintings around the hallways, and each clinic it would be impossible to capture them all.  There are so many paintings around the hallways, and each clinic it would be impossible to capture them all.  Also, I’ll see if I can get better external photos of the hospital, the lighting was odd when I tried this evening.

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During that experience, I decided to apply to medical school and subsequently moved back to Texas to study at the University of Texas Medical School in San Antonio.  My initial interest was in infectious disease, instead, however, ophthalmology found itself as the perfect fit for my interests and an ideal specialty to launch a career in global medicine.  Throughout the residency, Wills Eye Hospital has facilitated every interest and has provided every opportunity towards furthering this endeavor.  Since my acceptance to Wills Eye in 2015, I have been following the Academic Global Ophthalmology fellows’ blog while eagerly awaiting the opportunity to embark on this incredible year.

The post We welcome our 2019-2020 AGO Fellow: Dr. John Anhalt appeared first on Center for Academic Global Ophthalmology.

I first learned about LV Prasad well before my time here.  My grandmother was treated at its Kallam Anjali Reddy campus in Banjara Hills multiple years prior. It was the only place she trusted for her glaucoma, and once I entered into a residency in Ophthalmology, she would frequently recall her experiences as a patient there. She would often describe the impressive quality of the facility and the high level of treatment and care she would receive by the fellows and attendings.

With this in mind, I was overjoyed to spend a month here as a MSICS trainee. The first and foremost principle I learned at LVPEI is a dedication to the craft through high-quality research and patient care. LVPEI is and has always been a thought leader in many fields of ophthalmology such as the creation of the SLET technique for limbal stem cell deficiency after ocular burns. Thanks to the innumerable patients that walk through LVPEI’s centers around India, and the meticulous data collection through its proprietary EHR, LVPEI stands to make huge breakthroughs in the field of Ophthalmology through incredible data sets. Questions that other research institutes may not be able to answer through small sample sizes are virtually negated at LVPEI.

The next principle was altruism. LVPEI functions similarly to every major eye institute I have seen in America and Europe from prepping the patient to surgery to examining the patient postoperatively. However, LVPEI is able to deliver care to all backgrounds regarding their payor status. The way they do it is through the sight-savers program or a tiered payor system in which patients who are able to pay for their care subsidize the care for 4-5 “non-paying” patients. LVPEI also has a wealth of secondary cataract centers around the surrounding regions that host fellows and residents who can offer cataract surgery for all communities of all backgrounds.

The last principle was excellence. Every fellow is required to punctual, consistently well dressed and groomed, and to pay attention to every detail. This diligence is carried over to the clinical care of patients where every detail (small or large) is documented and attended to. This is especially true also in the surgical setting in which excellence is demanded and pursued by the consultants starting from installation of dilating drops, to delivery of the cataractous lens in MSICS. There is no doubt in my mind I am a better physician, surgeon, and person for participating in this culture.

On a more personal level, through LVPEI I was fortunate to see and treat patients with vision disabling cataracts through MSICS surgery. It was hard not to feel a special kinship with the patients I operated on. It was hard not to feel that the stories of my patients were ones of my own, of my uncle’s, of my grandmother’s. I am truly thankful to the chair of LVPEI Dr. Rao and LVPEI for being an incredible host and to Dr. Feldman and the Wills CAGO program for this special trip to the motherland.

Here are some attached photos of the trip including a photo with my co-trainee Ameeta who is a wonderful friend and surgeon who will be hopefully practicing in the Delhi area in the coming year and my surgical mentor Dr. Revathy who is a cornea, refractive, and cataract surgeon at LVPEI and easily one of the best surgeons I have ever seen.

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