"Powerpoint presentations can be a good resource for a refresher course but never for primary learning": Prof. Amod Gupta

Amod GuptaPadmashri Dr. Amod Gupta, a respected teacher-of-teachers, is known all over the world. A passionate teacher and researcher, Dr. Gupta retired from Advanced Eye Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh after an illustrious career spanning over four decades. In this interview, he replies to the questions asked by Dr. Tandava Krishnan.

eOphtha: You have been a teacher for more than 3 decades. You have seen the transition from bed side teaching to teaching which predominantly hinges on a power point presentation. Your thoughts on it.

Answer: Very interesting question at a time when ppt. presentations hold sway in the class room and the conference hall. There is no way a ppt. slide can substitute a bedside/clinical exam. For us in Ophthalmology ‘the bedside’ is ‘the slit lamp side’. When you examine a patient on the slit lamp, each step in the exam is preceded by a question in our mind, do I see flare? Do I see Iris atrophy?  Or do I see new vessels in the angle? When you discover what you are seeking it forms a long lasting memory. Seeing  the same sign on a power point slide is a passive phenomenon like watching  a movie, in that it  is an information in the first place you are not actually seeking, and  this unsolicited information is  likely to be lost sooner than later. Click here to read the full interview

Generic drugs: boon or a bane

Tandava Krishnan

I first heard about generic drugs 20 years ago when Cipla an Indian company came up with generic versions of antiretroviral drugs (drugs used to manage cases of HIV/AIDS). Management of HIV/AIDS, hitherto expensive and beyond the reach of many patients finally became affordable.  Health organisations like WHO which were grappling with high burden of the disease especially in African and Asian countries finally found an economical way of reducing the disease morbidity. It was a matter of pride for every Indian, especially those in the medical fraternity.  Despite such a spectacular impact, why are significant sections of doctors wary about prescribing generic drugs? Click Here

7 things I wish I knew before starting private practice

Dr Deepak Garg

Private practice is one of the common answer for, what after residency/ after  fellowship questions !.   Unfortunately, even though we become brilliant ( atleast hope to ) doctors ,we sadly lack  the exposure to the  business side of the  healthcare.   Many of us either lack guidance from the right people or more frequently take advice from the other doctors  which  is from  the same perspective  I personally think it is important to keep learning different things  beyond medicine  to improve productivity and efficiency while running a successful practice  Its been 10 years since my residency and i have certainly learnt few things over this period  some of them the hard way . Click here

5 Tips for the Postgraduate to Start Publishing

Dr. Sabyasachi Sengupta

Post graduation can be a daunting task with a lot to imbibe in very little time. In ophthalmology, the science is changing ever so rapidly that a three-year residency period is almost too little to grasp the nuances of the subject. In addition to learning examination skills, you have to learn surgical skills and read literature to keep yourselves updated. Amongst all this, how do you find time to publish papers during residency? Does it really matter whether you publish any papers during this time? Are there any advantages you score over your peers if you manage to publish a few papers? Dr. Sabyasachi Sengupta shares his tips for the postgraduates. Click here to read

5 Tips To Achieve Ideal Rhexis

Pioneered and popularized by Howard Gimbel, capsulorrhexis is probably the most challenging task to learn in cataract surgery. In other words once a good rhexis is done half the battle is won. All the post-graduates and beginners struggle to do a ideal rhexis. Dr. Rohit Rao  and Dr. Charudutt Kalamkar share small tips and tricks to do rhexis better. Click here

Smart Apps for the Smart Ophthalmologists

Dr. Rwituja Thomas, Dr Rohit Rao and Dr Ashwin Mohan

Since the dawn of the smart-phone era, medicos of all specialties have had various apps at their disposal; either for educational purposes or simply as a clinical tool to be used in their outpatient departments. In the field of ophthalmology, we have a wide variety of apps designed for functions ranging from auto-refractometry to learning how to create a continuous curvilinear capsulorhexis. There are multiple apps that many of may still not have heard of or got around to using, so we haveve classified them into categories for easy reference. Click here

KISS: Keep it simple silly

Dr.Tandava Krishnan

One day we saw a patient who was recently given an injection inside the eye for a retinal condition. He had come for a review and examination revealed that he had developed a tear in the retina which resulted in detachment of retina, thereby causing decreased vision. Needless to say, the patient was anxious because his vision had deteriorated further after the injection. While we were struggling to explain (and failing miserably at that!) to the patient about how the two entities were different, a senior consultant reviewed his file and spoke to him thus, “Imagine you had a leaking tap in your house. The plumber has just come in to repair the problem when the power goes off in the house. Your eye condition is something similar, before the injection could rectify the problem inside your eyes; a newer more serious issue has cropped up.” Surprisingly, the patient who till then seemed to be unsure about what was happening, understood the seriousness of the situation and urged us to do whatever was needed to set things right. Click here

Dear doctor, look before you leap!

Dr.Tandava Krishnan

Couple of years ago, I sat through a presentation by a doctor. His topic was, “Importance of sterilisation process in an operation theatre”. He started his presentation by putting up a picture of road traffic accident and said,” We all are good at driving vehicles but it just takes one accident for people to lose their lives. Sterilisation is also similar! A small slip here, a little laxity there and we all end up with a big catastrophe of post-operative infection.”
As doctors, we strive to keep our patients happy. We read newer books and journals, attend conferences and participate in hands on refresher courses to familiarise ourselves with the latest developments in the medical field so that we may do what is best for our patients. Sometimes we go beyond the call of our duty to ensure that the patient is not inconvenienced. This could be in the form of working extra hours or on holidays or working without charging the patient. These measures might sometimes be at the cost of sacrificing one’s personal life. One might call it the “call of duty”! But how far should we be going in this pursuance of keeping the patient happy. This was the question that came to my mind when I heard a friend narrate an incident he faced. Click here

How l published 35 papers in the best Ophthalmology journals during Residency

Dr. Sabyasachi Sengupta

Publishing papers in scientific journals is the biggest boost you can get. It is an adrenaline rush that is understood only when experienced. Even after having achieved a few recognitions and awards, including the DNB gold medal, I still find it exhilarating to work on papers and get tremendous joy when a paper is accepted in a journal.
Publishing is a great habit to develop early in your career and once you have a few papers under your belt, the habit literally turns into an addiction and you keep striving to publish more. There are many successful surgeons when you look around, but there are only a few researchers who have made it big in India. As a resident, there is plenty of scope to publish papers (especially from India) and make your mark. I also feel that getting peer recognition is much faster when you publish meaningful studies that influence practice patterns rather than by doing good surgery alone. This will eventually translate into more patients seeking your services and help build a successful practice. 
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"Dream big and chase it. You will reach your destination. " Dr GN Rao

Dr.Gullapalli Nageshwara Rao is the founder chairperson of LV Prasad Eye Institute (LVPEI). He has been the force behind the growth of LVPEI into an institute of international acclaim. In this email based interview given to Dr.Tandava Krishnan, he answers questions on topics pertaining to Community ophthalmology, career in research, role of LVPEI in education and optimal use of medical resources Click here to read the interview


How to Present a Scientific Paper

Dr. Jyotirmay Biswas

It's true that Computer is indeed a boon to a scientist making a presentation. Yet it is important that the presenter himself is adequately prepared for a good presentation. He needs to plan carefully and follow a few basic steps.
A good scientific presentation starts from the time a paper is conceived. If you want to present a good paper, ensure that the concept is good, well thought, designed aptly, results well analysed and valid conclusions are made. You should have your ground work done and write the draft of the paper, before embarking on a presentation. A well-written draft will provide the frame work of a good presentation.
Your work starts as soon as you hear that the paper has been accepted. After acceptance, you need to plan the slides, the slide text and rehearsals to fine-tune the talk.

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Doctor heal thyself!                                                           

Tandava Krishnan Pankanati

One day, after a check-up I declared a baby to be out of danger. The baby had recently undergone LASER treatment for a vision threatening condition known as Retinopathy of prematurity(ROP) The parents who had been stoic and composed till then suddenly broke down. It was as if a burden had been lifted of their back. I knew exactly what they were going through. For we had been through a similar experience in the past...


One month before our son was due for delivery, we visited our obstetrician. An abdominal ultrasound scan was suggested by the doctor. When we were ushered into the scanning room, the first question asked by the Sonologist (London trained) was, “Are you a diabetic or a hypertensive?” A negative answer was met with a bizarre retort from the sonologist. “How can that be possible?  Usually you people tend to develop something by this stage of pregnancy!” She managed to sound both incredulous and disappointed in the same tone. With that introduction, she went about the motions of doing a scan. She found something on the scan that caught her attention. She asked us for the previous scans which we immediately supplied. Disappointment was writ large on her face when she realised that the previous scans were done elsewhere.

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25 Basic Questions from Residents to the Academic Directors of Three Premium Eye-care Institutes in India

Compiled by Team eOphtha


Residency in ophthalmology is getting tougher by the day. During the tenure of residency, one is filled with innumeraiChatble questions which they feel someone could help them with. This collated questionnaire is an effort in that front. It has a few relevant and common questions which a resident in ophthalmology faces every day. And who better than the heads of education of the top three ophthalmology institutes of the country to answer these questions.  We have the three doyens of academics answering and guiding the basic queries during residency program. 


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What I learnt as a doctor

Dr. Tandava Krishnan

“Get into the medical course and your life is made”, was the advice often given by elders during our school days. I am currently 36. I got admitted into a medical college 18 years ago on my birthday. To put it simply, half of my life has gone into training and then applying what I have learnt in this field. Throughout my life I had adjectives like hardworking, brilliant, intelligent so on and so forth thrown at me. However, a cursory look at my bank balance makes me wonder if there is any justification for such adjectives! Of course, a lot of people would surmise that bank balance is hardly the correct yardstick to judge a doctor’s life. If clinical excellence and financial success are the parameters to grade a doctor’s success, a 2x2 table can be designed to fit doctors into one of the four groups depending on the presence or absence of the two attributes.(I am not sure if my community medicine teachers in Mangaluru would approve of my application of a 2x2 table!).
Dichotomy in the medical field:  At school, we were taught about the binary system of numbers and I used to wonder as to how so much of information can be incorporated using just two numbers. However, early on in my medical college I realised that a lot of things can happen around two somewhat opposite entities.

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Medical Omerta: The doctors’ oath of silence and how far would you go to keep it that way?

Dr.Tandava Krishnan

The Supreme Court of India on 1st July 2015 awarded a compensation of 1.8 crore rupees as damages to a girl who was rendered blind due to lack of timely referral by paediatricians for Retinopathy of prematurity(ROP) check up. It reminded me of a similar incident during my fellowship. A child with both eyes stage 5 ROP with closed funnel retinal detachment was referred to the hospital. After the consultant broke the sad news to the parents, a flurry of questions followed which was patiently answered to. Finally, the visibly shaken mother asked,” Doctor, had the paediatrician referred the child on time to an ophthalmologist, could the vision have been saved.” It was a very tricky question, considering the hospital’s policy of not passing adverse comments on the work done by other Doctors. The answer by the consultant was,” I do not know if the vision could have been saved but I am pretty sure that the child is alive only because of the good work done by the paediatrician.”

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Ramblings of a white bearded Ophthalmologist

Dr. Quresh Maskati

It gives me great pleasure to interact with fellow ophthalmologists through this blog. Those of you who are reading this but for some strange reason  are  not yet AIOS members; please assume I am annoyed with you. You may even stop reading at this point. To the rest of the "normal" readers, I wish you a wonderful 2016
Let us start at the beginning and recount a couple of interesting episodes from my student days in GS Medical College and KEM Hospital, Mumbai.

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First among equals

Dr.Tandava Krishnan

“What makes a doctor successful?” This was the question that always figured in my mind ever since I decided to be a doctor. And by successful, I did not mean prosperous (financially) but an ability to gain the trust of his/her patients. Logically, every doctor reads the same set of books does the same battery of investigations and prescribes the same set of medicines. So the fact that patients seem to flock to some doctors more than the others intrigued me. The candid reply I got when I posed this question to a surgery professor was, “You need to be a back bencher in a class to become a successful doctor!”

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“There is no “right” or “wrong” technique for cataract surgery.”

Interactive session with Dr.Uday Devgan, MD, FACS, FRCS(Glasg)

eOphtha: First of all, where in the evolution of cataract surgery, is phacoemulsification placed if we consider the room for future development too?

Uday Devgan: Ophthalmology is a field that is always moving forwards – never sitting still. And while we see phacoemulsification as a great procedure now, there’s no doubt that there will be a better procedure in the future. Look at today – the way you do cataract surgery now is quite different that it was done just 10 years ago. Just think: what if we could emulsify the cataract while still in the capsular bag using a femtosecond laser, then make a small 1-mm peripheral rhexis through which we would aspirate the entire lens material, and then fill the capsular bag with an injectable polymer which would provide accommodation? I’m simply daydreaming about the future, but there will be something better for sure.

eOphtha: What are the areas where one can improve comprising the method or the surgical skills?

Uday Devgan: Surgeons must be able to use both hands comfortably. All resident or registrar surgeons should practice doing their daily activities such as brushing teeth, shaving, eating, or even writing with their non-dominant hand. No matter how surgery evolves, it will require a surgeon and if you are adept at using both hands you will have an advantage.

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The lost goat and one ophthalmologist

Dr Jyotirmay Biswas

After joining the medical profession, almost all doctors came to know that apart from treating a patient, he has to give sympathetic answers to all the queries that arise deep down in the hearts of the patients.  These questions according to cricket terminology, come to you as “good length” or “too wide”.  You have to listen carefully, patiently, and answer.  After finishing the questionnaire, he can ask the same question once again.  Don’t feel bad about that.   After the patient has finished asking questions, the patient’s wife will again ask the same questions separately, then the patient’s uncle and then the patient’s cousin, who had come with him but was all along standing outside puffing at a cigarette or had gone out to have tea, will come back and ask the same questions.  After that, the patient will find out somebody, who is known to the doctLostgoator and through him will ask the same questions about a week later.  He may ask the same questions while having ice-cream together with you having been invited to the same wedding party.  That’s also no problem for you.  At least don’t make the patient understand that you are ill at ease.  But the problem is different - most of the time that relative or friend cannot remember the good name of the patient.  You have seen Sandipan Mukherjee or Malabika Gupta, but the patient’s relative knows him or her by the name Bubun or Tumpa.  This is also natural.  Because these days you have to be so busy with yourself that you cannot afford to remember the good names of all, and your distant relations.  A patient will obviously have questions, because he is not well.  Doctors also do the same things when they fall ill and go to other doctors.  And in fact ask much more than the laymen.  So it is the duty of all doctors to free the patient as soon as he has diagnosed the illness, from the net a claustrophobic atmosphere of all those unanswered questions into the fresh air of  transparent idea about his disease.  It is quite possible also.  But some of them again want to go back and wrap themselves with the net of the same ignorant questions over and over again.  Some call them, “Doubting toms!”  Tagore himself had written “It is possible to understand only half of what we call love, only half of what goes on deep down in the heart of a human mind, who on earth has understood the whole of it ever ?”.  Tagore knew about that, farsighted great soul that he was !  But you, ya you, have to make the patient understand everything, everything about diabetes mellitus from your medicine textbooks, which took you seven years to understand.  Actually some of them do go through books like “easy allopathic treatment” and then their sole aim is to findout whether what you are telling is tallying with what they have read or not !

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The Day My Patient Died

Dr. Quresh B. Maskati

DeadThis patient had come from 1200 km away. He was a 35 year old male with rheumatoid arthritis with bilateral corneal opacities with bilateral peripheral corneal melts. In addition, the left eye had facial palsy with corneal exposure on attempted lid closure. Vision was only perception of light with accurate projection both eyes.  He had multiple medical problems besides his rheumatoid arthritis. He gave history of stroke with left sided hemiparesis 6 months prior. There was still residual weakness of motor function left upper extremity as well as left facial palsy as mentioned earlier. He had aortic stenosis with aortic regurgitation. However, he had been investigated extensively by a local cardiologist, including 2D echo studies and pronounced “fit for surgery”.


After discussion with my anaesthetist, it was decided to do bilateral amniotic membrane transplant with left eye lateral one-third tarsorapphy under general anaesthesia. She felt that the ejection fraction of the heart was good, the aortic condition was stable, and recent ECG showed no changes. It was also economically advantageous for the patient as he could go back to his home after 4 days. The risks of surgery and anaesthesia including death, were clearly explained to the patient and accompanying relatives.

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An autobiography of an unknown uveitis specialist

Dr. Jyotirmay Biswas

I know autobiography is usually written by great man e. g a great leader, president of a country, political leaders, a great sportsman, especially a cricketer, even a CBI director, or election commissioner. The great Nirod C Chowdhury wrote an autobigraphy of an unknown Indian. These autobiographies often disclose startling facts, relationships which sometimes cause real uproar in the society. Actually such controversies increase the sale of the book. I thought of writing this memoir not to raise any controversy or preach anything.  To the best of my knowledge an autobiography has never been written by an uveitis specialist. Probably their life has often remained within haze of flare or cells in the fluid in the anterior chamber of the eye or in the vitreous cavity.


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Tips to prepare for the DNB, Ophthalmology Examination

Interactive session with Sabyasachi Sengupta DO, DNB

eOphtha: Congrats Sabyasachi!! What is the secret of your success?

Sabyasachi: Thank you very much for those kind words. I am humbled. There is no magic formula for success but a combination of hard work, perseverance and a little bit of luck does the trick.

eOphtha: How should one proceed to prepare for the DNB, Ophthalmology exam??

Sabyasachi: The approach to preparing for any examination must be simplistic i.e. what to read and where to read it from and finally How to read everything in a short time. These are the 3 core ingredients that, if planned and executed well, can bring success.

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