Activity Report 2011-12

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“My light shall be in thee, my strength thy force.Let not the impatient Titan drive thy heart,Ask not the imperfect fruit, the partial prize.Only one boon, to greaten thy spirit, demand;Only one joy, to raise thy kind, desire.Above blind fate and the antagonist powersMoveless there stands a high unchanging Will;To its omnipotence leave thy work’s result.$OO WKLQJV VKDOO FKDQJH LQ *RG·V WUDQVÀJXULQJ KRXUµ– ‘Savitri’ by Sri Aurobindo Canto IV : The Vision and the Boon



CONTENTS 7 15ACTIVITY REPORT APRIL 2011 - MARCH 2012 25 33 Highlights 39 Patient Care 47 Education and Training 53 Consultancy and Capacity Building 59 Research 64 Manufacturing Ophthalmic Supplies 66 Central Functions Awards and Accolades Partners in Service Trustees and StaffPhoto CreditsDevi Kayalvizhi, Aravind–TirunelveliDr. Vivekanandan, Aravind–MaduraiJacques Vekemans, FranceMike Myers, USAPriya, Aravind–PondicherryRajkumar, Aravind–MaduraiSasipriya, LAICO–MaduraiSenthil Kumar, Aravind–CoimbatoreSukumar, Aravind–PondicherrySuresh Kumar, Aravind–MaduraiSusie Van Sickle, USAVijayakumar, AurolabWillie Davis, USA 3



ARAVIND EYE CARE SYSTEM VISION Eliminate needless blindness . . . MISSION PATIENT CARE . . . by providing compassionate and high quality eye care for all EDUCATION & TRAINING . . . by developing ophthalmic human resources through teaching and training CONSULTANCY & CAPACITY BUILDING . . . through capacity building, advocacy, research and publications RESEARCH . . . by providing evidence through research and evolving methods to translate existing evidence and knowledge into effective action OPHTHALMIC SUPPLIES . . . by making high quality ophthalmic products affordable and accessible to the vision impaired worldwide 5

The banyan tree in front of the centre was planted by Dr. V on March 21, 2005. Dr. V’s battle against The tree has become the symbol of the centre, representing perpetuity of Dr. V’s needless blindness, vision. The centre is named ‘Nithyatha’, the sanskrit word for perpetuity. on the one hand, is fought in hospitalAt the inauguration of ‘Nithyatha’ clinics, outreach camps, and operating rooms, where the challenges of preventable and treatable diseases are daily encountered in endless quantity and the truths and principles of science predominate. On the other hand, seeing meant more to Dr. V than getting light to the retina. It was about illuminating the inner life and recognising the deep spiritual reality which connects everything in the visible and ever- changing manifest world of our daily external reality... It is a battle against ignorance, anger, differences, intolerance, greed, unkindness, injustice and hatred – all forms of blindness. – Dr. Bill Stewart at the inauguration of Nithyatha6

HIGHLIGHTSAPRIL 2011 - MARCH 2012Keeping the Flame Alive Dr. R. Pararajasegaram presenting the memento to Mr. Gnanaraj, the architect of NithyathaThe Aravind Eye Care System’s three and a half decadesof growth and evolution have been driven by its The meditation hallcommitment to providing patient centred care withintegrity and compassion. An aspiration to sustainthis simple, yet powerful approach down the ages, ledto the inauguration of ‘Nithyatha’– a retreat centrethat celebrates the life, work and vision of Aravind’sremarkable founder, Dr. G. Venkataswamy. The centrewas inaugurated on October 2, by long–time friendand partner in sight, Dr. R. Pararajasegaram. It was aceremony of profound elegance attended by hundreds ofwell–wishers. Sri. Vijay Poddar, Sri Aurobindo Society,Pondicherry; Dr. Bill Stewart, Institute for Health andHealing, California; Dr. S.R. Krishnadas andMs. Deepa Krishnan from Aravind Eye Care Systemoffered felicitations. They shared stories about theirassociation with Dr. V and the tremendous impact hehas made on so many lives.The gallery depicting the story of Dr. V’s life The library The amphitheatre 7

An Encouraging New TrendIn recent years there has been a welcome change in the A Conscious Decision to Expandhealth seeking behavior of patients in the community.An increasing number of people in need of eye care are Today Aravind’s limited network of facilities providesnow showing up at hospitals on their own initiative close to 40% of all eye care in Tamil Nadu. In view of therather than passively waiting for an eye camp, or as was QHZ SDWLHQW WUHQGV D GHFLVLRQ ZDV WDNHQ WR VLJQLÀFDQWO\far too often the case, doing nothing at all to address expand Aravind’s network, starting with those areastheir condition. This encouraging shift in behavior from which high numbers of patients were travelingLV WKH IUXLW RI WKLUW\ ÀYH \HDUV RI LQWHQVH ZRUN LQ WKH VLJQLÀFDQW GLVWDQFHV WR UHDFK $UDYLQG 7KH ÀUVW PDMRUcommunity – decades of taking high quality care to initiative following this decision was the inaugurationtheir very doorstep and doing everything that needed of a large tertiary care Aravind Hospital in Salem onto be done to ensure that even the most impoverished November 27. This 42,000sq.ft. facility will cater tovillagers could access treatment on their own terms. the eye care needs of people across the spectrum in andHaving repeatedly experienced the instant and tangible around Salem. Guided by the same strategic thinking,EHQHÀWV RI WUHDWPHQW WKH FRPPXQLW\ QRZ VHHV YDOXH an eye clinic was opened on July 1 in downtownLQ DFFHVVLQJ FDUH DV VRRQ DV WKH QHHG LV IHOW (YHU\ ÀIWK Pondicherry. To further improve rural access, a series ofperson in India is in need of some form of eye care, and new vision centres was opened at Pongalur, Oothukuli,with this changing trend, the demand will continue to Srivilliputhur and Kadayanallur. Two more hospitalsincrease. It is now time for the providers to come up will be inaugurated soon – a hospital in Tuticorin onwith innovative ways to address this. May 4th and one in Udumalpet in June of 2012.Dr. Natchiar with Dr. Manohar Babu and the Aravind– Salem team8

Sharing the StoryDuring the year, another important event that renewedAravind’s spirit of service was the release of the much–DZDLWHG ERRN ¶,QÀQLWH 9LVLRQ +RZ $UDYLQG %HFDPHthe World’s Greatest Business Case for Compassion’,published by Berrett–Koehlers, USA and Harper Collins,India. It was the culmination of multiple years of researchand dedicated work by co–authors Ms. Pavithra Mehtaand Ms. Suchitra Shenoy. The book launch in the UnitedStates took place on November 5 in Berkeley, California.The Indian launch followed on January 29 and relatedevents were hosted across several cities in both countries.Written in engaging narrative form, this book studies theevolution, philosophy, organisational model, strugglesand future of Aravind Eye Care System. It is creatingripples across diverse spheres; social entrepreneurship,public health, corporate business and academia. Dr. P. Namperumalsamy and Ms. Pavithra Mehta with Mr. U. Sagayam, District Collector, Madurai and 0U 3 .DQQDSSDQ 3ROLFH &RPPLVVLRQHU 0DGXUDL DW WKH ¶,QÀQLWH Vision’ book launch Ms. Suchitra Shenoy and Ms. Pavithra Mehta 9

Mr. G. Srinivasan, President, GOVEL Trust presenting theDr. G. Venkataswamy Endowment Oration Award to Dr. MarilynT. Miller. On the right are Dr. P. Vijayalakshmi andDr. P. NamperumalsamyIn Dr. V’s MemoryThe third Dr. G. Venkataswamy Endowment Oration Dr. Pararajasegaram and Dr. G.N. Rao with Mr. R.D ThulasirajAward was presented to Dr. Marilyn T. Miller, at the inauguration of the Workshop on Eye Care ResearchProfessor of Ophthalmology, University of Illinois Priorities for Indiaat a beautiful function held at LAICO auditorium.Dr. Miller’s Oration lecture was titled “International Each year, LAICO organises the October Summit incollaboration, mentoring and teaching–a personal view”. honor of Dr. Venkataswamy’s tireless efforts to expandDr. Miller is a longstanding participant in international the boundaries of eye care. In 2011, a national workshopophthalmology, especially in educational activities in WR GHÀQH UHVHDUFK SULRULWLHV WR JHQHUDWH WKH HYLGHQFH DQGa number of countries. Her involvement with Aravind practices required for achieving the goal of eliminatingstarted three decades ago when Dr. Vijayalakshmi, avoidable blindness in India was held on October 8Chief, Paediatric Ophthalmology Service, Aravind– and 9. On October 21 and 22, the workshop on patientMadurai joined the paediatric ophthalmology section of safety and outcomes focused simultaneously on buildingthe University of Illinois as a fellow. Since then, systems and developing a healthy attitude towardsDr. Miller has visited Aravind multiple times, recognising and reporting errors so that appropriateparticipating in courses and meetings. More recently steps could be taken to prevent them in the future.she has been working with Dr. Vijayalakshmi on a study The last in this series, the workshop on Molecularof infants with microphthalmia in a rural community in Diagnostic Methods for Ocular and Systemic Pathogens,India. was jointly organised by Aravind and the Indian Association of Medical Microbiologists, of Tamil Nadu and Pondicherry.10

A Commitment to Transfering KnowledgeTraining and education have always been important Jagriti Yatris at Aravind – Maduraifor Aravind which has long recognised that highquality patient care is possible only with a well– Aravind Madurai appears to have become a favoritetrained and motivated workforce. To strengthen its stop on the Jagriti Yatra each year. In 2011, for the 3rdtraining activities and to promote the same elsewhere, consecutive year, Aravind was visited by a group ofAUROSHIKSHA, a web portal geared to assist roughly 400 young “service pilgrims” who spent the dayophthalmic educators, was launched on July 25 by observing and learning about the organisation’s work.Dr. P. Namperumalsamy, Chairman – Emeritus of The visitors brought with them brimming enthusiasm,Aravind Eye Care System at a function graced by D VHQVH RI DGYHQWXUH DQG D NHHQ DVSLUDWLRQ WR ÀQGDr. Suzanne Gilbert from SEVA Foundation, USA and LQQRYDWLYH VROXWLRQV WKDW EHQHÀW WKH JUHDWHU JRRG 7KHmany others. AUROSHIKSHA is an initiative of LAICO Aravind Eye Care System was delighted to play a smalldeveloped with support from the Seva Foundation. role in fostering their journey.For the third time, Aravind Eye Hospital, Tirunelvelitook the lead in organising the 59th Annual Meeting ofthe Tamil Nadu Ophthalmic Association (TNOA). Thiswell organised and well attended meeting was furtherenriched by the presence of India’s former President,HE Shri Dr. APJ Abdul Kalam, who inaugurated theworkshop and inspired the ophthalmologists in hisinimitable way.Aravind’s internal training capabilities were furtherenhanced by a cutting–edge 3D surgery recordingand viewing system. A generous gift made possible bywell–wisher Dr. David Chang of the United States, thiscamera makes it possible for trainees to witness surgicalnuances in far greater detail. Dr. R. Ramakrishnan and Dr. P. Namperumalsamy with Dr. APJ Abdul Kalam at the inauguration of TNOA’s Annual meeting 11

Strengthening Eye Care ManagementProgrammesJointly sponsored by the International Agency forthe Prevention of Blindness and the World HealthOrganization, the Regional Workshop on Preventionof Avoidable Blindness and Visual Impairment inSouth East Asia Region was conducted at LAICO.7KLV VHVVLRQ ZDV DWWHQGHG E\ JRYHUQPHQW RIÀFLDOV DQGother representatives from nine different countriesin this region. Each representative presented his/hercountry’s current status in eye care and discussed themain challenges and bottlenecks to service delivery. Thefocus was on achieving universal coverage, as well as thecreation of monitoring systems and identifying potentialareas for international collaborations.Recognising LAICO’s innovative approach and itspositive impact on issues in the eye care industrythrough capacity building, focused training andresearch, the Federation of Indian Chambers ofCommerce and Industry (FICCI) presented it with theHealth Care Award at a grand award ceremony, held inNew Delhi on September 8. Dr. Carl Kupfer with Dr. V Homage to Dr. Carl Kupfer (1928-2011)12 'U &DUO .XSIHU ZDV DSSRLQWHG DV WKH ÀUVW GLUHFWRU of NEI when it was established in 1968 and stepped down from his position as director on July 15, 2000 at 72 years of age. Dr. Carl Kupfer was a good friend and a strong supporter of Aravind. Dr. V’s and Aravind’s association with him goes back many decades. At Aravind, he will always be cherished as the one who sowed the seeds of research way back in 1981 and built Aravind’s initial capacity in it. Through his championing of operations research, epidemiologic studies and randomised clinical trials, Dr. Kupfer has left a lasting legacy in ameliorating vision loss from cataract and a number of major eye diseases, including Eale’s Disease, diabetic retinopathy and glaucoma.

Dr. Paul Palmberg with the Aurolab AADI teamTwo Decades of Continuous InnovationAurolab’s continuous innovations in the manufactureRI H\H FDUH SURGXFWV KDYH VLJQLÀFDQWO\ LQÁXHQFHG WKHway eye care is being delivered to millions. Completingtwo decades of excellent service, the institute has comeup with a wide array of eye care products, the mostimportant one being the Aurolab Aqueous DrainageImplant (AADI), a cost–effective drainage device usedin management of glaucoma refractory to conventionalglaucoma treatment. The silicone lab was inauguratedon August 15. With a fully equipped silicone labin place, Aurolab in co–ordination with Aravind’sOrbit, Oculoplasty and Ocular Oncology Service hasstarted developing stents for lacrimal intubation andprosthetics.To mark the twentieth anniversary, elaboratecelebrations were organised in January 2012. Culturalperformances staged by the staff added colour to thewhole event, which was distinguished by the presenceof the entire senior leadership team and staff of Aravind. Aurolab staff performing a cultural programme at Aurolab’s 20th anniversary celebrations 13

Research Advisory Committee members Dr. M.R.S. Rao and Dr. C. Mohan Rao at the ongoing research projects poster presentationduring the Committee meetingUnravelling the Mystery of Eye DiseasesMultidisciplinary studies are being conducted at the Weathering the StormDr. G. Venkataswamy Eye Research Institute tounderstand the biological mechanisms of several age– The serene work at Aravind Eye Hospital, Pondicherryrelated eye diseases. These studies pave the way to was severely disrupted by the devastating cycloneimproving existing treatment modalities. The institute ‘Thane’. Nature’s fury unleashed lashing rain and windshas been named a ‘Center of Excellence in Human raging at 150 km/h, resulting in extensive damagesMycotic Keratitis’ – a rare distinction, endowed by the to the hospital as well as the rest of Pondicherry.Government of India’s Department of Biotechnology. The cyclone struck on December 30 – the eve of a,W LV WKH ÀUVW FHQWHU RI LWV NLQG LQ WKH FRXQWU\ 7KH planned congregation (subsequently cancelled) ofresults of this study will enable the institute to develop the Aravind family in Pondicherry to celebrate thean effective drug for this disease, to which resistance New Year. Unwelcome as they are, disasters often docannot be easily developed. summon the best of the human spirit. This truth was seen in full effect at Aravind Pondicherry, where theView of the garden in front of Aravind–Pondicherry–Thane effect team rallied together to care for their patients despite the extensive damages, power outages and shortage of essential commodities. Staff members whose KRPHV ZHUH GDPDJHG ZHUH VXSSRUWHG ÀQDQFLDOO\ DQG otherwise. Thanks to the valiant work of the collective, just three months after what was described as one of Pondicherry’s biggest natural disasters, there was little trace of its visit on the hospital grounds.14

PATIENT CARE Patient care and eliminating needless blindness continue to be the primary focus of Aravind’s work. This priority is evidenced by the continuous growth in the sheer numbers of people served year after year. In the year ending March 2012, Aravind handled 2,838,689 outpatient visits and performed 349,274 surgeries – a 10% increase from the previous year. To put the numbers in perspective, just the increase alone, of 34,000 surgeries, exceeds what most large hospitals perform in a year. Such growth is possible only because of the trust that the patients place in the Aravind organisation and, more importantly, the Aravind team, which builds such trust through their hard work and compassionate endeavours.

Performance Madurai Theni Tirunelveli Coimbatore Pondicherry April 2011 - March 2012 493,950 74,795 246,744 335,078 223,136 155,328 21,247 67,484 110,866 71,431 OUTPATIENTS Paying (new+review) 82,263 64,865 Free (new+review) 19,521 3,938 18,377 5,160 OUTREACH 106,986 20,731 45,963 Comprehensive free eye camps 4,619 3,346 1,639 12,855 10,005 Diabetic retinopathy screening camps 2,872 5,792 Refraction camps 14,783 655 678 School eye screening 1,294 2,710 - 29,120 4,273 15,617 - through base hospitals 464 507 1,225 School eye screening 685 - 22,290 - - - 23,149 24,138 - through vision centres 2,301 28,472 School eye screening by Lavelle project 2,203 7,109 - 8,269 Paediatric eye screening - 46,387 43,241 - 456,357 Mobile van refraction camps 609,312 Vision centres 88,366 19,031 49,812 22,414 Community eye clinics 199,577 509,331 40,055 28,546 (including city centre) 74,945 45,845 50,960 946,138 85,900 TOTAL OUTPATIENT VISITS 33,232 53,211 756 SURGERIES 68,540 6,440 26,417 2,042 Paying 73,864 6,039 24,629 3,196 1,044 Free (direct + camp) 628 291 142,404 12,479 51,046 827 212 TOTAL SURGERIES 1,030 612 502 378 SURGERIES IN DETAIL 94,301 9,686 32,932 908 Cataract surgeries 2,335 180 1,155 1,030 Trab and combined procedures 3,828 28 785 18,760 9,752 Retina and vitreous surgery 1,061 - 246 1,622 1,297 Squint correction 813 3 429 2,098 1,512 Keratoplasty 1,670 195 296 1,076 Pterygium 400 14 133 844 Ocular injuries 2,950 115 1,024 85,900 50,960 Lacrimal surgeries Laser procedures 26,301 1,975 11,467 Other orbit and oculoplasty surgeries 3,125 195 1,055 Others 2,881 88 778 Refractive surgery 2,739 - 746 TOTAL SURGERIES 142,404 12,479 51,046

Tirupur Dindigul Salem Total36,469 57,355 19,332 1,486,859 114 - - 426,470 - - - 320,808 - - - 33,063 - - - 46,984 - 613 - 31,750 - - - 2,989 - - - 51,410 - - - 44,495 - - - 4091 - - 7,109 234,695 - - -40,674 57,968 9,332 152,057 2,838,6892,024 2,949 1,451 170,290 Key to the ground-breaking 61 - - 178,984 Aravind approach is a unique ‘assembly-line’2,085 2,949 1,451 349,274 treatment method that increases productivity by1,683 2,109 822 227,976 a factor of ten, combined 34 20 14 6,536 with an innovative non- - 1 18 8,900 profit model that uses the - - - 2,226 fees of wealthier patients to - - 2 2,286 subsidise free service delivery 11 31 30 3,875 to the bulk of its poorer - 2 6 1,435 clientele. 28 - 6 6,061 ²  7RS  %HVW 1*2V 259 716 507 69,737 E\ 7KH *OREDO -RXUQDO 44 48 8 7,394 26 22 7,443  - - 38 5,405 -2,085 2,949 349,274 1,451

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REACHING OUT Aravind’s extensive community outreach programmes invest tremendous energy in reaching out to rural patients through various kinds of eye camps and vision centres. 2,831 camps were conducted, through which 1,035,826 patients were screened and 85,721 patients underwent surgery in the year ending March 2012.5HIUDFWLRQ FDPSV ZHUH H[WHQGHG WR RWKHU WDUJHW JURXSV 7KH IRFXV QRZ LV RQ HVWDEOLVKLQJ PRUH YLVLRQ SULPDU\LQFOXGLQJ PHPEHUV RI 3DUHQW 7HDFKHU $VVRFLDWLRQV LQ H\H FDUH FHQWUHV ZLWK ORZ²FRVW WHOHPHGLFLQH IDFLOLWLHVVFKRROV DQG HPSOR\HHV RI 7DPLO 1DGX 6WDWH 7UDQVSRUW RIIHULQJ UHDO²WLPH FRQVXOWDWLRQ ZLWK RSKWKDOPRORJLVWV&RUSRUDWLRQ DQG VR RQ LQ WKH EDVH KRVSLWDOV $ WRWDO RI  SDWLHQWV ZHUH H[DPLQHG WKURXJK WKH  YLVLRQ FHQWUHV LQ WKH \HDU6LJKW)LUVW VHPLQDU DW $UDYLQG ² &RLPEDWRUH HQGLQJ 0DUFK  SightFirst Seminar on Diabetic Retinopathy (DR) 7KH DQQXDO 6LJKW)LUVW VHPLQDU IRU WKH RIÀFH KROGHUV RI /LRQV &OXEV WR HGXFDWH WKHP RQ FRPPRQ H\H GLVHDVHV ZDV KHOG DW $UDYLQG ² &RLPEDWRUH RQ 6HSWHPEHU  ZLWK DQ HPSKDVLV RQ GLDEHWLF UHWLQRSDWK\ $URXQG  PHPEHUV IURP GLIIHUHQW FOXEV SDUWLFLSDWHG 6FUHHQLQJ IRU GLDEHWHV DQG GLDEHWLF UHWLQRSDWK\ ZDV GRQH IRU WKH PHPEHUV

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Outreach PerformanceApril 2011 - March 2012 Madurai Theni Tirunelveli Coimbatore Pondicherry Tirupur Dindigul Total1. Regular Comprehensive Eye Camps 351 106 275 371 255 -- 1,358 Camps 106,986 20,731 45,963 82,263 64,865 -- 320,808 Patients examined 19,885 5,481 10,275 18,410 16,192 -- 70,243 Glasses advised 16,480 4,974 8,369 15,052 13,945 -- 58,820 Glasses ordered 12,767 3,156 5,637 13,452 9,448 -- 44,460 On the spot deliveries -- % 77% 63% 67% 89% 68% 76%2. Diabetic Retinopathy Screening Camps 28 26 14 109 19 -- 196 Camps 4,619 3,346 1,639 19,521 3,938 -- 33,063 Patients screened 2,295 1,763 5,411 1,502 -- 11,657 Diabetics identified 686 1,009 -- 1,911 DR Patients identified 327 269 135 171 1953. Refraction Error Camps 59 14 27 68 27 -- 46,984 Camps 15,149 14,783 2,872 5,792 18,377 5,160 -- 12,820 Patients examined 5,013 1,061 1,798 5,735 1,542 -- 8,696 Glasses prescribed 4,442 1,442 4,790 1,219 -- Glasses Ordered 3,293 927 3,198 -- 68% On the spot deliveries 74% 591 868 67% 746 -- % 64% 60% 61% 129 8144. Eye Screening of School Children- BH* 39 8 14 33 33 -2 209,426 Schools 188 94 42 400 88 -2 31,750 Teachers trained 53,366 16,269 19,431 68,009 51,538 - 813 12,770 Total strength-children screened 4,273 1,294 2,710 12,855 10,005 - 613 Children examined by ophthalmologist 2,663 750 938 4,964 3,423 - 32 20 Children with eye defects 69 24,3835. Eye Screening of School Children - VC* 6 4 2 4 4 -- 2,989 Schools 30 34 4 - 1 -- 1,407 Teachers trained 6,671 4,943 4,581 3,444 4,744 -- Total strength-children screened 685 464 507 655 678 -- 403 Children examined by ophthalmologist 323 299 272 238 275 -- 1,272 Children with eye defects 349,558 51,4106. School Children Screening Camps by Lavelle Project (AEH - TVL & PDY) 16,503Schools -- 258 - 145 -- 436 754 - 518 -- 44,495Teachers trained -- 164,696 - 184,862 -- 1,228 22,290 - 29,120 --Total Strength-children screened -- 8,509 - 7,994 -- 423 387Children examined by ophthalmologist -- 1,400Children with eye defects -- 94 7,1097. Paediatric Camp 13 11 139 10 263 -- 2,394 Camps 2,203 2,301 23,149 1,225 15,617 -- 2,037 Children examined -- Refractive error 222 114 417 91 384 -- 40 Glasses prescribed 163 48 48 44 120 -- 234,695 Glasses ordered 163 38 43 26 117 -- Other defects identified 176 107 380 143 594 208. Mobile Van Refraction Camps - 94 -- - -- 4 Camps - 7,109 -- - -- 78,203 Patients screened - 2,394 -- - -- Glasses prescribed - 2,037 -- - -- 63 Glasses ordered 39. Vision Centres 14 8 6 5 5 2 - 73,854 Centres 88,366 46,387 43,241 28,472 24,138 4,091 - New + Review - 86 Outpatients / day 21 19 26 18 16 1010. Community Eye Clinics 21 1- - -- Centres -- New + Review 41,624 19,031 17,548 - - -- Outpatients / day 67 61 57 - - 11. City Centre 1 - 1 -1 -- Centres 33,321 - 32,264 - 8,269 -- New + Review - - 34 -- Outpatients / day 107 104* BH - Base Hospitals; VC - Vision Centres

CANDIDATES TRAINED 2011-12TOTAL CANDIDATES : 550POSTGRADUATE COURSES 4 SHORT TERM - PARAMEDICAL COURSES ϳDiploma in Ophthalmology (2 years) 12 KƉƟĐĂů ŝƐƉĞŶƐŝŶŐ ;ϯ ŵŽŶƚŚƐͿ 6Master of Surgery in Ophthalmology (3 years) ϭϯ OT Techniques (2 months) ϭϬŝƉůŽŵĂƚĞ ŽĨ ƚŚĞ EĂƟŽŶĂů ŽĂƌĚ ;ϯ LJĞĂƌƐͿ ϭϯ ZĞĨƌĂĐƟŽŶ dĞĐŚŶŝƋƵĞƐ ;Ϯ ŵŽŶƚŚƐͿ ϯWŽƐƚ K E ;Ϯ LJĞĂƌƐͿ KƌƚŚŽƉƟƐƚ ;ϲ ŵŽŶƚŚƐͿ ϯ WĂĞĚŝĂƚƌŝĐ EƵƌƐĞ ;ϯ ŵŽŶƚŚƐͿ ϭLONG TERM - OPHTHALMOLOGY FELLOWSHIP 9 WĂĞĚŝĂƚƌŝĐ ŽƵŶƐĞůůŽƌƐ ;Ϯ ŵŽŶƚŚƐͿ ϲAnt. Segment / Intraocular Lens Microsurgery (2 years) 6 KĐƵůĂƌŝƐƚ ;ϯ ǁĞĞŬƐͿOrbit & Oculoplasty (18 months) ϵ &ƵŶĚƵƐ &ůƵŽƌĞƐĐĞŝŶ ŶŐŝŽŐƌĂƉŚLJ ϱWĂĞĚŝĂƚƌŝĐ KƉŚƚŚĂůŵŽůŽŐLJ Θ ^ƚƌĂďŝƐŵƵƐ ;ϭϴ ŵŽŶƚŚƐͿ 11 ĂŶĚ hůƚƌĂƐŽŶŽŐƌĂƉŚLJ ;Ϯ ŵŽŶƚŚƐͿGlaucoma (2 years) ϭϰ ϮϮZĞƟŶĂ sŝƚƌĞŽƵƐ ;Ϯ LJĞĂƌƐͿ 11 MANAGEMENT COURSES OFFERED AT LAICOCornea (18 months) 4 DŐƚ͘ WƌŝŽƌŝƟĞƐ ŝŶ LJĞ ĂƌĞ ĞůŝǀĞƌLJ ;ϭ ǁĞĞŬͿ ϱϮComprehensive Ophthalmology (2 years) Mgt. Training for Eye Care Programme DĂŶĂŐĞƌƐ ;Ϯ ǁĞĞŬƐͿ ϭϳSHORT TERM - FELLOWSHIP (FOR INTERNATIONAL CANDIDATES) DŐƚ͘ dƌĂŝŶŝŶŐ ĂŶĚ ^LJƐƚĞŵƐ ĞǀĞůŽƉŵĞŶƚ ĨŽƌ ϲ ,ŽƐƉŝƚĂů ĚŵŝŶŝƐƚƌĂƚŽƌƐ ͬ DĂŶĂŐĞƌƐ ;ϰ ǁĞĞŬƐͿKƌďŝƚ ĂŶĚ KĐƵůŽƉůĂƐƚLJ ;ϲ ŵŽŶƚŚƐͿ ϭ WƌŽũĞĐƚ DĂŶĂŐĞŵĞŶƚ ĨŽƌ LJĞ ĂƌĞ ;ϰ ǁĞĞŬƐͿ 34 LJĞdžĐĞů ʹ džƉĂŶĚŝŶŐ 'ůŽďĂů LJĞ ĂƌĞ tŽƌŬĨŽƌĐĞ ϯϵSHORT TERM - CLINICAL COURSES through Excellence in Training (4 Days) ZĞƐĞĂƌĐŚ DĞƚŚŽĚŽůŽŐLJ ;ϱ ĂLJƐͿ ϭϲECCE - IOL Microsurgery (1 month) 20 ŽŵŵƵŶŝƚLJ KƵƚƌĞĂĐŚ ĂŶĚ ^ŽĐŝĂů DĂƌŬĞƟŶŐ ϮϮ ŽĨ LJĞ ĂƌĞ ^ĞƌǀŝĐĞƐ ;ϰ ǁĞĞŬƐͿSmall Incision Cataract Surgery (1 month) 35 /ŶƐƚƌƵŵĞŶƚ DĂŝŶƚĞŶĂŶĐĞͲ ĨŽƌ dĞĐŚŶŝĐŝĂŶƐ ;ϲ ǁĞĞŬƐͿWŚĂĐŽĞŵƵůƐŝĮĐĂƟŽŶ ;ϭ ŵŽŶƚŚͿ ϰϲ Participants at the Management Training for Eye Care Programme ManagersDiagnosis & Management of Glaucoma (1 month) 37>ĂƐĞƌƐ ŝŶ ŝĂďĞƟĐ ZĞƟŶŽƉĂƚŚLJ DĂŶĂŐĞŵĞŶƚ ;Ϯ ŵŽŶƚŚƐͿ ϰϭ^ŚŽƌƚ dĞƌŵ dƌĂŝŶŝŶŐ ŝŶ sŝƚƌĞĐƚŽŵLJ ;sŝƌƚƵĂůͿ ;Ϯ ǁĞĞŬƐͿ ϴDĂŶĂŐĞŵĞŶƚ ŽĨ ZĞƟŶŽƉĂƚŚLJ ŽĨ WƌĞŵĂƚƵƌŝƚLJΘ WĂĞĚŝĂƚƌŝĐ ZĞƟŶĂů ŝƐŽƌĚĞƌƐ ;ϭ ŵŽŶƚŚͿ ϲKƌŝĞŶƚĂƟŽŶ ƚŽ WĂĞĚŝĂƚƌŝĐ KĐƵůĂƌ ŶĂĞƐƚŚĞƐŝĂĨŽƌ ĂŶĂĞƐƚŚĞƟƐƚƐ ;ϭ ŵŽŶƚŚͿ ϭ24

EDUCATION AND TRAININGIn the year ending March 2012 Aravind postgraduate students in ophthalmology participating in– Forty two candidates emerged as ophthalmologists a workshop at LAICO from Aravind Postgraduate Institute of Aravind’s mission to provide Ophthalmology through the three streams of the highest quality eye care to postgraduate programmes all people also means offering² 7ZR KXQGUHG DQG ÀIW\ QLQH RSKWKDOPRORJLVWV the finest training to those underwent fellowship programmes and short term individuals who provide the courses in various specialities of ophthalmology. services. Educating providers– Eight candidates underwent fellowship in eye necessitates the same attention hospital management at LAICO to detail and striving for– Forty one attended various short term courses excellence that has governed the conducted for ophthalmic paramedical staff delivery of eye care at Aravind– Two hundred and eight attended the various short since its inception. term management and skills development courses offered by LAICO for staff of various hospitals from around the worldAt the experiential learning part of the Training 25

Over a two-year period of In-House Training training, a metamorphosis takes place. The intensive residential Every year Aravind Eye Hospitals take young girls, programme combines lessons in train them in–house for two years and recruit them the classroom with on-the-job as ophthalmic assistants, ophthalmic technicians, training and specialisation. orthoptists, counsellors, medical record technicians, maintenance technicians, housekeeping staff and staff Senior nurses are the chief of opticals and laboratories. In the year ending March decision makers for 70 percent of 2012, more than 530 girls were recruited at the different all the activity that takes place in $UDYLQG (\H +RVSLWDOV DQG WKH 'U * 9HQNDWDVZDP\ Aravind’s operating rooms and Eye Research Institute. patient wards. ² IURP ¶,QÀQLWH 9LVLRQ·26

Online Eye Care Education Continuing Medical Education Programmes Organised by Aravind EyeAUROSIKSHA, the e–learning solution developed by HospitalsLAICO, was launched globally in July 2011 and has, sofar, registered 600 active users across the globe. Apart CME on Ocular Infectionsfrom lessons on eye care, a new subcategory called¶*HQHUDO +HDOWKFDUH· KDV EHHQ FUHDWHG ZKLFK FRQWDLQV Aravind–Madurai, July 23a series of lectures by prominent speakers on topics The Department of Ocular Microbiology, AravindWKDW DUH DSSOLFDEOH WR DOO ÀHOGV RI KHDOWKFDUH $ VHULHV RI Medical Research Foundation conducted a one daylectures on glaucoma has also been included recently, CME under the auspices of the Tamil Nadu andZKLFK ZDV IRXQG WR EH RI LPPHQVH EHQHÀW WR JODXFRPD Pondicherry Chapters of the Indian Associationfellows and trainees. Steps are underway towards of Medical Microbiologists (IAMM). This CMEPLJUDWLQJ $UDYLQG·V 0/23 WUDLQLQJ PDWHULDO RQOLQH had comprehensive sessions covering all areas of ocular infections and aspects of specimen handling,Dr. M. Srinivasan inaugurating the CME on Ocular Infections transportation and interpretation of culture. Founder’s Day CME on Paediatric Ophthalmology Aravind–Madurai, October 1 As part of commemorating the birth anniversary of 'U * 9HQNDWDVZDP\ IRXQGHU RI $UDYLQG (\H &DUH System, a continuing medical education programme on Paediatric Ophthalmology and Adult Strabismus was organised by the department at Aravind – Madurai. Faculty and participants of the Founder’s Day CME on Paediatric Ophthalmology 27

A practical session at 22nd PG Update in Ophthalmology International Symposium on Diabetic Retinopathy and Retinal Vascular Diseases22nd PG Update in Ophthalmology Aravind– Madurai, January 7 – 8Aravind–Coimbatore, October 10 – 14All aspects of ophthalmology, including updates in the Aravind TIFAC–CORE in Diabetic RetinopathyÀHOG ZHUH FRYHUHG V\VWHPDWLFDOO\ IRU WKH SDUWLFLSDWLQJ conducted a two–day International Symposium onpostgraduate students from various institutions. 'LDEHWLF 5HWLQRSDWK\ DQG 5HWLQDO 9DVFXODU 'LVHDVHV 7KLV LV WKH ÀIWK LQWHUQDWLRQDO V\PSRVLXP RQ 'LDEHWLFGLAUCONS 2011 Retinopathy conducted by the centre and was attended by around 150 participants. Several excitingAravind–Coimbatore, November 20 developments which have taken place rapidly inThis one–day live surgical session brought together the management of diabetic retinopathy, especiallyaccomplished Glaucoma specialists from all over the in pharmacotherapy were discussed during thecountry. Current concepts in surgical management of symposium.Glaucoma were demonstrated to the participants. CME for Paramedical Ophthalmic AssistantsInternational Symposium on Diabetic Retinopathy and RetinalVascular Diseases LAICO–Madurai, January 29 A total of 99 participants attended the CME organised for Tamil Nadu paramedical ophthalmic assistants. Clinical sessions on cataract, refractive error, diabetic retinopathy, paediatric blindness, corneal disorders, low vision and contact lens were arranged as part of the CME. A one day training programme on “Paediatric Ophthalmology” was organised for government ophthalmic assistants by the Department of Paediatric Ophthalmology and Strabismus at Aravind Eye Hospital, Coimbatore on March 11. A total of 41 ophthalmic assistants from the district primary healthcare centres in Coimbatore, Tirupur, Erode and Nilgiris participated.28

Workshops and Conferences Organisedby LAICOWorkshop on Eye Care Research Priorities for Workshop on Patient Safety for Aravind EyeIndia HospitalsOctober 8 – 9 October 21 – 22The purpose of this workshop was to develop research This internal workshop for the Aravind staff orientedplans and identify priorities, with a focus on improving the participants to the concept of patient safety andcoverage, which will lead to improved control of the importance of continuous monitoring in order toavoidable visual impairment and blindness in India over eliminate medical errors in the hospital. A total of 110the next 10 years. A total of 25 participants attended the VWDII IURP WKH ÀYH KRVSLWDOV UHSUHVHQWLQJ DOO SDWLHQW FDUHworkshop. departments participated in the workshop. PRISM 2012 March 10 – 11 Around 150 participants attended this annual national conference on healthcare management conducted by LAICO for the seventh consecutive year. It provided a forum for the hospital administrative professionals to keep themselves updated with the latest happenings in the hospital management sector.A group session at the Workshop on Patient Safety for AravindEye Hospitals Participants of the Workshop on Eye Care Research Priorities for India 29

Dr. P. Sundaresan during his visit to Dr. Markus Preising Laboratory, 'U +DULSUL\D DW WKH WK $VLD 3DFLÀF $VVRFLDWLRQ University of Giessen, Giessen, Germany of Cataract and Refractive Surgeons (APACRS) conference, Seoul, KoreaDr. Rathinam at the ORBIS supported Teaching and Training Programme organised at Tilganga Hospital, Kathmandu, Nepal Dr. Mohideen Abdul Kader with 'U 3DUDUDMDVHJDUDP DW :+2 2IÀFH *HQHYD Switzerland Mr. R.D. Thulasiraj with the participants of Community Eye Health Workshop at Fundacion Vision, Paraguay Mr. Albert G. Mulley, Director, The Dartmouth Center for Health Care Delivery Science, with Mr. R.D. Thulasiraj and Dr. S. Aravind at the Salzburg Global Seminar, Salzburg, Austria30

Dr. M. Srinivasan with Dr. Sujatha Das at LVPEI, Bhubaneswar Dr.P. Namperumalsamy with Dr. Michael Gaynon, who planting a sapling on the occasion of the Prof. C. S. Bhaskaran did fellowship in Boston with Dr. Namperumalsamy Endowment Lecture during 1977–78 at ARVO–2011 Conference Dr. Mohideen Abdul Kader with Dr. Tarek Shaarawy and fellows at Geneva University Hospital, Geneva, SwitzerlandAravind team at the American Academy of Ophthalmology Conference with Dr. Alvan Balent and Dr. Linda Balent Dr. R.D. Ravindran delivering the key note address at The King’s Fund Annual Conference, London, UKDr. S. Aravind at the World Eye Health II Seminar, Casey Eye Institute, Portland, USA 31

Internal Capacity Building Two research methodology workshops were conducted IRU WKH PHGLFDO RIÀFHUV LQ WKH PRQWK RI -DQXDU\ DQGApart from workshops and seminars, doctors and staff February. The workshops were intended to guide thego to renowned eye care institutions worldwide to participants interested in clinical research and to shareXSGDWH WKHLU H[SHUWLVH LQ WKHLU UHVSHFWLYH ÀHOGV /LVWHG WKH LQQRYDWLYH DSSURDFKHV WKHUHLQ $URXQG ÀIW\ PHGLFDObelow are the staff who underwent internal capacity RIÀFHUV EHQHÀWWHG IURP WKHVH VHVVLRQVbuilding programmes in the last year:RETINA AND VITREOUS SERVICE Paper writing workshop was conducted for doctors'U 73 9LJQHVK and LAICO faculty at Aravind–Coimbatore on July 11.NEURO OPHTHALMOLOGY SERVICE This workshop mainly focused on orienting the staff toDr. Kiruba Evangeline Paul national and international standards for writing articlesDr. S. Padmavathy and case reports. Apart from the structured Instruments Maintenance courses for ophthalmologists and technicians, an exclusive course for the sales personnel of Aurolab was held in January 2012 to help them tackle problems they may come across while handling equipment. Conferences AttendedDr. T.P. Vignesh with Dr. Hendrik Scholl at Wilmer Eye Institute, Aravind staff and doctors enjoy an esteemed status atBaltimore, USA various international and national fora owing to the large volume of patients they see and the uniqueness of the cases they handle. Several of them have been honored as guest faculty or invited speakers for different sessions, whereas a few have also been given opportunities to demonstrate live surgeries at various conferences. Aravind faculty are also invited to deliver guest lectures at various prestigious institutions on special occasions. A list of conferences that Aravind staff DWWHQGHG FDQ EH DFFHVVHG DW $UDYLQG·V ZHEVLWH www.aravind.org Publications 2011-12Dr. Padmavathy and Dr. Kiruba with Dr. Prem Subramaniam at Aravind staff contributed more than 60 publicationsWilmer Eye Institute, Baltimore, USA to various peer reviewed journals. A complete list of SXEOLFDWLRQV LV RQ $UDYLQG·V ZHEVLWH www.aravind.orgInternal Training ProgrammesThe weekly Grand Rounds session held on everyThursday updates the doctors on recent developmentsand provides a platform to share the rare ophthalmiccases they have dealt with. Teleconferencing sessionswith eminent ophthalmologists from foreignuniversities and hospitals are also arranged at times forsharing of knowledge.32

CONSULTANCY AND CAPACITY BUILDINGLinocut print by Richard Roode – a gift to LAICO from Dr. Timothy Visser, A major part of LAICO’s Eerste River Hospital, Cape Town, South Africa activities focuses on enhancing the capacity of existing and new eye hospitals worldwide for comprehensive organisational development through sharing the best practices in eye care. It works in collaboration with several international voluntary organisations. LAICO’s consulting services are now offered to 278 eye hospitals worldwide, with the addition of five more hospitals in the year ending March 2012. 33

Strengthening other Eye HospitalsTwo Vision Building Workshops were conducted in nine eye hospitals in India. The LAICO team undertook-XQH DQG 1RYHPEHU SURYLGLQJ WUDLQLQJ WR ÀYH KRVSLWDOV follow up visits to eye hospitals in India, Bangladesh,which included two hospitals from Bangladesh, one South Africa, and Tibet.from Nigeria and the rest from India. Discussions were held with senior management teamAs part of the SF 1588 – Enhancing Eye Care Services at of the Catholic Eye Hospitals and Eye Foundation,Lions Eye Hospitals in India project specially designed Nigeria as part of the ICO and IAPB structured capacityVision Building Workshops were organised for the building process.selected hospitals that have undergone the ManpowerManagement Development Programme prior to 2007. OfWKH  /LRQV (\H +RVSLWDOV LGHQWLÀHG  KRVSLWDOV KDYHundergone training at the three workshops conductedin the months of August, October and January.Needs Assessment visits supported by SightsaversInternational (SSI) and International Agency for thePrevention of Blindness (IAPB) were carried out in Dr. K. Tiruvengada Krishnan at Kham Eye Centre, Dartsedo, TibetParticipants of the SF – 1588 workshop with Lions Past International President and current LCIF Chairman Ln. Sid Scruggs III and hiswife Judy Scruggs34

LAICO – FHF Initiative in China Developing Eye Care Resource Centre inJiangxi Province, China, August 8 – 15 EgyptThe Fred Hollows Foundation – China, in association Aravind team consisting of Mr. R.D. Thulasiraj,with LAICO, organised a workshop for its partner Executive Director, LAICO; Dr. Sivakumarhospitals in Jiangxi Province in order to develop an eye Chandrasekhar, Consultant, Cataract and IOL Service,care services business plan. As part of that, a 3 member Aravind – Tirunelveli and Ms. K.M. Sasipriya, Faculty,team from Aravind made needs assessment visits to LAICO visited Al Noor Foundation, Cairo, Egypt as partthree county hospitals at Taihe, Pengze and Poyang in of IAPB Capacity Building initiative to support Al Noor/the second week of August. More than thirty members EICO (Egypt Institute of Community Ophthalmology)attended the workshop, which was scheduled for 3 in their mentoring initiative. The team participated indays. a round table meeting to outline strategy and produce an action plan for EICO in Egypt and the Middle East Region. They also visited two hospitals in Luxor Governorate in Upper Egypt to get a better understanding about the eye care delivery system and the type of hospitals EICO would be working with. The LAICO team also outlined the support LAICO would extend through IAPB Capacity Building Grant that would strengthen EICO through the mentoring process. This meeting was also attended by EICO’s partners– Seva Foundation, International Eye Foundation, CBM International, Kilimanjaro Centre for CommunityMr. Franco Francis, Dr. Manoranjan Das and Mr. Suresh Kumar with part of the Ophthalmology (KCCO) andparticipants of LAICO–FHF workshop at Jiangxi Province, China Dr. Pararajasegaram and representatives from the Ministry of Health, Egypt. Aravind team with EICO partners 35

Cataract Initiative in Mr. R.D. Thulasiraj with Dr. Leon Ellwein, Dr. G. Pokhrel andSub-Saharan Africa others at the Data Review and Analysis MeetingThe Hilton Foundation wanted to Near Vision Impairment Follow - up Studyunderstand the reasons for low levels of cataract Data Review and Analysis Meetingsurgeries in Sub–Saharan Africa and to do somethingproactively in that regard. Prof. Alfred Sommer at the Guangzhou, China, March 19 – 21School of Public Health, Johns Hopkins University, The main objective of this meeting was to developBaltimore, US was requested to lead this exploration, recommendations for the screening and refractivereviewing available data and experiences in order correction of near vision impairment in low– andto understand the barriers and potential strategies middle–income country settings. Principle investigatorsaddressing them. In this context Mr. R.D. Thulasiraj from seven study sites–Guangzhou and Beijing forwas invited to meetings in Baltimore (June 27) and Abu China, Durban for South Africa, Los Angeles forDhabi (February 13), recognising the extensive work the United States of America, Madurai for India,being done by LAICO in several African countries. Kathmandu for Nepal and Dosso for Niger presented the analysis and results of the WHO supported study.Mr. R.D. Thulasiraj with the participants of Cataract Initiative Meeting at Baltimore, USA36

Regional Workshop on Prevention Onsite Trainingof Avoidable Blindness and VisualImpairment in SEAR Dr. Preethi Pradhan, Faculty – LAICO and Ms. Muthulakshmi, Nursing Supervisor, Aravind –LAICO, September 22 – 24 Madurai, facilitated a workshop for the counselling staff of He Eye Hospitals, Dalian and Shenyang, and alsoThe workshop was conducted with the intention of Yunan Red Cross Eye Hospital, China from April 15 – 17.taking forward the action plans formulated by WHO Thirty four counsellors participated in this workshopfor the prevention of avoidable blindness and visual supported by ORBIS International.impairment into an execution phase. This workshopwas co–sponsored by IAPB and WHO and funded Dr. Tanpreet Pal Singh, IOL Service, Aravind – Madurai,by CBM, ORBIS, Sightsavers and The Fred Hollows visited Sala Uno Eye Hospital, Mexico City, Mexico,Foundation. Thirty four participants from South East to train the surgeons in SICS. Discussions revolvedAsia Region (SEAR) countries like Bangladesh, Bhutan, around standardisation of clinical and surgicalIndia, Indonesia, Myanmar, Nepal, Sri Lanka, Thailand protocols, quality assurance parameters, sterilisation,and Timor Leste participated. instrumentation, cost–effective practices and ocular anaesthesia.Diabetic Retinopathy Project EvaluationDiabetic Retinopathy (DR) projects supported by Dr. Tanpreet Pal Singh with the staff of Sala Uno Eye Hospital,Sightsavers International aim to improve the quality of Mexico City, Mexicolife of DR patients and reduce the incidence of avoidableblindness due to diabetic retinopathy by establishingsustainable DR services in the project area. As part ofthis project, evaluation visits were carried out to foureye hospitals in India.Participants of the Regional Workshop on Prevention of Avoidable Blindness and Visual Impairment in SEAR 37

Mr. Poornachandran, Prof. V. Srinivasan and Mr. Gowthaman with the participants of the Instrument Maintenance Workshop atKCCO, TanzaniaProf. V. Srinivasan, Mr. S. Poornachandran and Infrastructure Leasing and Financial Services LimitedMr. J. Gowthaman, Instruments Maintenance to collaborate with two more diabetes centres. Of theDepartment, Aravind – Madurai were at KCCO to run total 3,115 diabetes patients screened, 555 cases werean Instruments Maintenance Course sponsored by IAPB LGHQWLÀHG ZLWK 'LDEHWLF 5HWLQRSDWK\in June. Seventeen participants from eight countriessuch as Burkina Faso, Burundi, Kenya, Madagascar, Hobnob Project for Diabetic RetinopathyRwanda, Tanzania, Uganda and Zambia participated. ScreeningProjects Hobnob technology for the screening of diabetes patients for retinopathy in mobile outreach campsEye Care for a Million Children - Lavelle Paediatric was implemented with support from Mr. Aron B.Eye Care Project Hall, CEO, Hobnob Inc, California, USA. Hobnob’s solution provides one of the most reliable and highlyAs part of the project, around 30 awareness programmes available internet access solutions for remote oron paediatric and other eye diseases were organised. mobile situations. Since the Hobnob solution uses the894 preschool teachers and 1,789 school teachers were latest wireless technologies, there are no applicationtrained to identify eye problems among school students restrictions.and children at Anganwadi centres. A total of 381,879school students and 36,402 Preschool children (0 – 5 Primary Eye Care through Vision Centresyears) were screened, and spectacles were provided to Aravind established four more vision centres with10,259 students with refractive error. The project has support from Aravind Eye Foundation and SEVA,supported 127 paediatric cataract surgeries and 20 laser Canada.procedures for Retinopathy of Prematurity. Ph.D AwardedDiabetic Retinopathy Screening in Associationwith Diabetologists / Diabetes Centres Ms. Preethi Pradhan was awarded a Ph.D by the Indian Institute of Technology, Chennai for her studyAravind Eye Hospital, Madurai has been working with ´+5 SUDFWLFHV WKDW LQÁXHQFH SDWLHQW VDWLVIDFWLRQ DQGtwo Diabetes centres in the screening of diabetics for employee satisfaction”. She did her research under theRetinopathy. One more Diabetes center has joined guidance of Mr. R.D. Thulasiraj.this network and the hospital has signed MoU with38

RESEARCH Research activities at Aravind, over the years have evolved into a significant establishment contributing extensively to identifying possible causes of eye diseases and improving methods of prevention and treatment. The Aravind Medical Research Foundation has established its identity in the field of ophthalmic research with its state- of-the-art infrastructure at par with international standards. Various studies are being carried out in collaboration with prestigious international research institutes. A “Centre of Excellence on Human Mycotic Keratitis” has been established and is the first of its kind among eye research institutes in India. 39

Basic Research 2011-2012Dr. G. Venkataswamy Eye Research Institute, Aravind Medical Research FoundationThe institute is now focusing on a multidisciplinary Molecular Geneticsapproach to understanding the disease processesof major age–related eye diseases such as Diabetic Currently, research on identifying genetic variationsRetinopathy, Glaucoma, Age–Related Macular responsible for common eye diseases like Cataract,Degeneration and Cataract, as well as ocular Corneal Dystrophies, Diabetic Retinopathy,infections. Such a comprehensive study at the level of Oculocutaneous Albinism, Leber’s Hereditary Opticgenome, transcriptome and proteome is of paramount Neuropathy, Aniridia, Leber Congenital Amaurosis,importance for improving basic knowledge and applying etc., is underway. The department has recently initiatedWKH UHVHDUFK ÀQGLQJV LQ FOLQLFDO SUDFWLFH ,Q DGGLWLRQ WKH studies to understand the molecular mechanisms ofinstitute is also involved in translational research and various eye diseases at the level of gene expression andFOLQLFDO JHQHWLFV IRU WKH LPPHGLDWH EHQHÀW RI SDWLHQWV SURWHLQ PRGLÀFDWLRQVand their families.Now a “Centre of Excellence on Human Mycotic 7KH GHSDUWPHQW KDV DOVR LGHQWLÀHG WKH FDQGLGDWH JHQHKeratitis” is established with substantial funding from for Congenital Hereditary Endothelial Dystrophy'HSDUWPHQW RI %LRWHFKQRORJ\ *RYHUQPHQW RI ,QGLD DQG in collaboration with the Singapore Eye ResearchWKLV LV WKH ÀUVW RI LWV NLQG DPRQJ H\H UHVHDUFK LQVWLWXWHV ,QVWLWXWH DQG WKH 8QLYHUVLW\ RI $OEHUWD 6WXGLHV DUHLQ ,QGLD DOVR EHLQJ FRQGXFWHG WR FRQÀUPLQJ WKH ELRWLFDELRWLF factors responsible for globe anomalies, such asDNA sample preparation for Real Time PCR microphthalmos and anophthalmos. Subsequent to a special glaucoma screening camp conducted for a large family in 2010, the department is currently performing genetic screening to identify the novel gene(s) causing Primary Open Angle Glaucoma in association with 8QLYHUVLW\ RI ,RZD 5HVHDUFK RQ UHWLQREODVWRPD currently focuses on the genetic, epidemiological and histological aspects of the disease. Mutations in the retinoblastoma (RB1) gene are being characterised.40

proteomic analysis to understand in detail the inter– relation between different factors inducing DR and to LGHQWLI\ SUHGLFWLYH ELRPDUNHUV LQ WKH YLWUHRXVVHUXP Stem Cell Biology$QDO\VLV RI LQÁDPPDWRU\ FHOOV LQ OHSWRVSLUDO XYHLWLV SDWLHQWV XVLQJ The department is involved in characterising human)ORZ F\WRPHWHU corneal epithelial Stem Cells (SCs), with reference to LGHQWLÀFDWLRQ RI VSHFLÀF PROHFXODU PDUNHUV IRU VWHPImmunology cells. This involves confocal microscopy, expansion of 6&V LQ GLIIHUHQW FXOWXUH FRQGLWLRQV DQG ÁRZ F\WRPHWU\The department mainly deals with the immuno– &XUUHQWO\ LGHQWLÀFDWLRQ RI HSLWKHOLDO VWHP FHOO QLFKHpathology of infectious eye diseases, especially or microenvironment is the primary focus. Further,/HSWRVSLUDO 8YHLWLV ZKLFK LV DQ LQÁDPPDWRU\ UHVSRQVH expansion of epithelial cells is performed in complianceto systemic infections by Leptospira. Mechanism of acute with Good Manufacturing Procedure for reconstructingdevelopment of cataract, auto–immunity (antigenic WKH FRUQHDO HSLWKHOLXP LQ OLPEDO VWHP FHOO GHÀFLHQWmimicry between human lens proteins and leptospiral patients.proteins) and the host immune response in Leptospiral8YHLWLV SDWLHQWV DUH DOVR EHLQJ VWXGLHG Ocular PharmacologyStudies on the proangiogenic cytokines and vascular This department is involved in studying the mechanismgrowth factors in relation to the pathogenesis of Eales’ for improving various treatment modalities, withDisease and Diabetic Retinopathy are also being carried reference to the pharmacokinetics of drugs meantout. Results of the studies conducted at the institute for ocular use. This study helps in determining theFRQÀUPHG WKDW '5 LV DQ LQÁDPPDWRU\ GLVHDVH DQG WKH concentration achieved at the desired site and frequencyPDMRU VRXUFH IRU WKHVH LQÁDPPDWRU\ F\WRNLQHV LV 5HWLQDO of drug intake. The department also focuses on thePigmented Epithelium. A recent collaborative study SDWKRJHQLF PHFKDQLVP RI 'LDEHWLF 5HWLQRSDWK\ WR ÀQGZLWK 4XHHQ·V 8QLYHUVLW\ %HOIDVW KDV HVWDEOLVKHG WKH out a strategy to inhibit the aldose reductase pathwayUROH RI LQÁDPPDWRU\ F\WRNLQHV LQ LQGXFLQJ SUROLIHUDWLRQ and its role in secretion of Vascular Endothelial Growthof retinal capillaries. Now the study is in the realm of Factor (VEGF). Another study on the mechanism of age related macular degeneration tried to understand&RQIRFDO DQDO\VLV RI LPPXQRVWDLQHG FRUQHR OLPEDO VHFWLRQV WR 3DFNLQJ RI VLOLFD JHO LQWR JODVV FROXPQ IRU WKH SXULÀFDWLRQ RI $(LGHQWLI\ QLFKH FHOOV XVLQJ FROXPQ FKURPDWRJUDSK\ 41

the role of macular carotenoids in inhibiting the who are at risk of developing retinopathy. Acute phaseaccumulation of A2E. Studies are underway to proteins such as haptoglobin, ceruloplasmin, hemopexinunderstand the relation between the level of Vitamin C were differentially regulated in diabetes. Based on thisLQ WKH SODVPDDTXHRXV DQG OHQV FDWDUDFW IRUPDWLRQ study, the department proposed that the analysis of haptoglobin expression and other protein changes couldProteomics be used as a predictive biomarker for early diagnosis and disease progression.The study of proteins and their interactions, collectivelyFDOOHG SURWHRPLFV LV DQ HPHUJLQJ ÀHOG LQ KHDOWKFDUH Microbiologyresearch. At Dr. G. Venkataswamy Eye Research,QVWLWXWH WKH IRFXV KDV EHHQ RQ WKH SURWHRPLFV RI RFXODU This department focuses on understanding theÁXLG IURP 'LDEHWLF 5HWLQRSDWK\ )XQJDO .HUDWLWLV pathogenesis and virulence factors of micro organismsand Primary Open Angle Glaucoma patients with the that cause ocular infections, especially Aspergillus,hope of identifying biomarker(s). This would help to Fusarium Pseudomonas and Staphylococcus species.understand the population at risk, so that effective One of the major studies underway is to understandtreatment strategies can be planned in a cost–effective host – immune response in patients with bacterial ormanner. IXQJDO FRUQHDO XOFHUV 7KH ÀQGLQJV RQ WKH YLUXOHQFH factors of Pseudomonas are helpful for developingThe tear proteins of corneal ulcer patients were modalities for better treatment options. Research isexamined and compared with healthy control samples underway to identify the type of Staphylococcus Aureusto understand the pathogenesis of fungal keratitis. that causes eye infection and to develop an effectiveStudies at the institute have demonstrated that antibiotic against this.WKH SURWHLQ SURÀOH RI WHDUV IURP DQ LQIHFWHG H\H LVVLJQLÀFDQWO\ GLIIHUHQW IURP WKDW RI QRUPDO WHDUV WKXV '1$ EDVHG GLDJQRVLV RI 7UHPDWRGH ,QGXFHG 8YHLWLVindicating that tear samples can be used as surrogate FRQÀUPHG WKH HWLRORJ\ RI WKH GLVHDVH DQG FXUUHQWO\markers. Fungal pathogens were also characterised for the study focuses on how trematode enters the eye andWKHLU YLUXOHQFH EDVHG RQ WKHLU VHFUHWRPH SURÀOLQJ DV also the preventive measures for the same. The use ofwell as the virulence genes that are involved in disease advanced techniques, like real time PCR, helps in earlyprogression. GLDJQRVLV DQG WKH FRQÀUPDWLRQ RI HWLRORJ\ IRU RFXODU infections caused by bacteria, fungus and virus, therebyComprehensive serum proteomic analyses of diabetes facilitating timely treatment.and Diabetic Retinopathy patients were performedto identify biomarkers to distinguish those diabeticsPre–FKHFNLQJ WKH & FROXPQ RI WKH /&0606 '1$ H[WUDFWLRQ42

Ongoing Basic Research Workshops Conducted– Molecular genetics of albinism, diabetic retinopathy, Seminar on Proteomics – Principles, Methods and cataract, age–related macular degeneration, Applications retinoblastoma, keratoconus, exfoliation glaucoma, leber congenital amaurosis, anophthalmia and The focus was to disseminate knowledge and awareness microphthalmia, primary open angle glaucoma, amongst all interest groups related to proteomics in aniridia, Leber’s hereditary optic neuropathy, ,QGLD 7KH VHPLQDU ZDV MRLQWO\ RUJDQLVHG E\ WKH $UDYLQG blepharophimosis, ptosis, and epicanthus inversus Medical Research Foundation and the Proteomics syndrome, retinoschisis, familial exudative vitreo– 6RFLHW\ ,QGLD²0DGXUDL LQ $SULO ,W ZDV VSRQVRUHG E\ UHWLQRSDWK\ LQ WKH ,QGLDQ SRSXODWLRQ Tamil Nadu Council for Science and Technology and MS based companies.– Molecular insights and mechanism of infectious uveitis like trematode induced uveitis, leptospiral uveitis Workshop on Molecular Diagnostic Methods for Ocular and Systemic Pathogens– Characterisation of the host immune response during corneal infection with pathogenic fungi and bacteria, The last workshop in the October Summit series was Type 3 secretary virulence proteins of pseudomonas jointly organised by Aravind Eye Care System and the aeruginosa causing keratitis ,QGLDQ $VVRFLDWLRQ RI 0HGLFDO 0LFURELRORJLVWV Tamil Nadu and Pondicherry. The workshop answered– Biology of human limbal epithelial stem cells with a much felt need of microbiologists to learn and apply reference to their molecular signature, niche factors various molecular techniques in routine laboratory and establishing xenobiotic–free culture conditions testing. for their H[²YLYR expansion with GMP compliance Ph.D Awarded by Madurai Kamaraj University– 3URWHRPLF SURÀOLQJ RI VHUXPYLWUHRXVDTXHRXV KXPRUWHDU LQ GLDEHWLF UHWLQRSDWK\ ELRPDUNHUV – Ms. P. Murugeswari – 0ROHFXODU PHFKDQLVPV RI GLDEHWLF for primary open angle glaucoma, host pathogen UHWLQRSDWK\ interaction in human Aspergillus keratitis – Ms. B. Hemadevi – *HQHWLF DQG IXQFWLRQDO DQDO\VLV RI– 8QGHUVWDQGLQJ WKH SDWKRJHQHVLV RI GLDEHWLF )XFK·V (QGRWKHOLDO &RUQHDO '\VWURSK\ DQG &RQJHQLWDO retinopathy and age related macular degeneration +HUHGLWDU\ (QGRWKHOLDO '\VWURSK\ LQ ,QGLDQ SDWLHQWV.– Ocular pharmacokinetics of drugs meant for ocular use– Exploratory study on ascorbate (Vitamin C) and haptoglobin in cataract patients– Human organ culture anterior segment, ex–YLYR model for screening anti–glaucoma drugs$05) IDFXOW\ DQG SDUWLFLSDQWV RI WKH :RUNVKRS RQ 0ROHFXODU 'LDJQRVWLF 0HWKRGV IRU 2FXODU DQG 6\VWHPLF 3DWKRJHQV 43

Ongoing Clinical Research 2011-12Aravind Eye Hospitals & Postgraduate Institute of OphthalmologyCataract ² (IÀFDF\ DQG VDIHW\ RI %ULQ]RODPLGH  PJP/ %ULPRQLGLQH  PJP/ H\H GURSV VXVSHQVLRQ– Analysis of complication rates between phaco and FRPSDUHG WR %ULQ]RODPLGH  PJP/ H\H GURSV 06,&6 DW $UDYLQG (\H +RVSLWDO VXVSHQVLRQ SOXV %ULPRQLGLQH  PJP/ H\H GURSV solution in patients with open angle glaucoma or– Prospective Evaluation of Early Cataract Outcomes ocular hypertension. and Grading (PRECOG) – A multicentre, double–masked study of the safety– Clinical evaluation of Toric intraocular lens made by DQG HIÀFDF\ RI 7UDYRSURVW RSKWKDOPLF VROXWLRQ Aurolab 0.003% compared to TRAVATAN in patients with open angle glaucoma or ocular hypertension– APEX – A prospective, multicentric, randomised controlled, study on long term outcomes of – A prospective, randomised study to compare the SKDFRHPXOVLÀFDWLRQ ZLWK LQWUDRFXODU OHQV ULVNV DQG EHQHÀWV RI FRPELQHG YHUVXV FDWDUDFW implantation in Pseudo Exfoliation Syndrome surgery in primary open angle glaucoma with patients coexistent cataract.Cornea – Cost effectiveness analysis of anti glaucoma medications² 0\FRWLF 8OFHU 7UHDWPHQW 7ULDO ² ,, 0877 ² 6M|JUHQ·V ,QWHUQDWLRQDO &ROODERUDWLYH &OLQLFDO – Genetic analysis of MFRP (Membrane )UL]]OHG 5HODWHG 3URWHLQ DQG HYDOXDWLRQ RI $OOLDQFH 6,&&$ SKDFRHPXOVLÀFDWLRQ ZLWK RU ZLWKRXW DQWHULRU sclerostomy in nanophthalmic eyes.Glaucoma – Randomised, active comparator–controlled, three² $ SURVSHFWLYH QRQ²UDQGRPLVHG HIÀFDF\ DQG VDIHW\ months, open label clinical trial to compare the clinical trial, 1 year study with a 1 year extension to HIÀFDF\ DQG VDIHW\ RI UHIULJHUDWLRQ²IUHH /DWDQRSURVW HYDOXDWH WKH HIÀFDF\ DQG VDIHW\ RI $$', $XURODE (0.005%) and Latanoprost (0.005%) stored at $TXHRXV 'UDLQDJH ,PSODQW LQ FRQWUROOLQJ ,23 LQ refrigeration temperature in patients with open angle refractory glaucoma thereby preventing further glaucoma or ocular hypertension GDPDJH WR RSWLF QHUYH DQG YLVXDO ÀHOG ORVV – A prospective, randomised, controlled clinical trial² $ SKDVH ,,, UDQGRPLVHG DFWLYH FRPSDUDWRU² comparing topical medical therapy with Selective controlled, four–week, double–masked clinical trial Laser Trabeculoplasty (SLT) as initial treatment for WR FRPSDUH WKH HIÀFDF\ DQG VDIHW\ RI SUHVHUYDWLYH² RSHQ DQJOH JODXFRPD LQ VRXWK ,QGLDQ SRSXODWLRQ free MK–2452 (0.0015%) and preservative–free Timolol Maleate (0.5%) in patients with open angle ² 6SDUF²HIÀFDF\ DQG VDIHW\ RI À[HG GRVH FRPELQDWLRQ JODXFRPD RU RFXODU K\SHUWHQVLRQ LQ ,QGLD of Latanoprost 0.005% and Timolol 0.5% ophthalmic solution– A multicentre, open–label study to evaluate the VDIHW\ DQG HIÀFDF\ RI WZLFH²GDLO\  %LPDWRSURVW ² 0HUFN²&RPSDUH WKH HIÀFDF\ DQG VDIHW\ RI  %ULPRQLGLQH   7LPRORO RSKWKDOPLF preservative free MK –2452 (0.0015%) and solution (triple combination) in patients in preservative free Timolate Maleate (0.5%) in patients ,QGLD ZKR KDYH JODXFRPD RU RFXODU K\SHUWHQVLRQ with POAG and OHT ZLWK HOHYDWHG ,23 DQG DUH RQ WZLFH²GDLO\  %ULPRQLGLQH   7LPRORO RSKWKDOPLF VROXWLRQ – Research study: Genetic screening in a large family (dual combination) therapy with primary open angle glaucoma44

Retina Uvea– Barriers on availing the vitreo retinal surgery by the – Pilot study in preparation for the Ganciclovir– patients as advised in the outpatient department intravitreous versus systemic–cytomegalovirus UHWLQLWLV WULDO LQ $,'6 SDWLHQWV 3LORW *,9&\7 ² ,PSDFW RI GLDEHWLF UHWLQRSDWK\ RQ FDUGLDF RXWFRPH after coronary artery bypass graft surgery in Madurai ² $ SKDVH ,,, PXOWLQDWLRQDO PXOWLFHQWUH UDQGRPLVHG double–masked, study assessing the safety and² $  PRQWK SKDVH ,,, UDQGRPLVHG GRXEOH²PDVNHG HIÀFDF\ RI LQWUDYLWUHDO LQMHFWLRQV RI '(² WKUHH multicentre, active–controlled study to evaluate the doses) for the treatment of active, non–infectious HIÀFDF\ DQG VDIHW\ RI WZR GLIIHUHQW GRVLQJ UHJLPHQV uveitis of the posterior segment of the eye. RI  PJ 5DQLEL]XPDE 9V 9HUWHSRUÀQ 3'7 LQ patients with visual impairment due to choroidal – Etiology and immuopathogenesis of presumed neovascularisation secondary to pathologic myopia WUHPDWRGH LQGXFHG XYHLWLV LQ VRXWK ,QGLD– A prospective study of Transpupilary Thermotherapy – First–line Antimetabolites as Steroid–sparing (TTT) for chronic Central Serous Chorioretinopathy Treatment (FAST) uveitis pilot trial (CSCR) – Epidemiology of chronic–recurrent phase Vogt–– Radial optic neurotomy for ischaemic central retinal Koyanagi–Harada syndrome vein occlusion: a case–control study Orbit, Oculoplasty and Ocular Oncology– Brilliant blue dye for internal limiting membrane peeling in macular surgery – National retinoblastoma registry ² 7UDQVODWLRQDO UHVHDUFK WR JHQHUDWH FRUQHDOEXFFDO² ,QWUDYLWUHDO EHYDFL]XPDE DV D SUHRSHUDWLYH DGMXYDQW for diabetic macular tractional detachments with epithelial stem cells with GMP compliance for active new vessels corneal surface and socket reconstruction ² ,GHQWLÀFDWLRQ RI PLWRFKRQGULDO ELRPDUNHUV LQ– Retinochoroidal coloboma – a comparison of laser retinoblastoma barrage photocoagulation versus natural history – Clinical evaluation of silicone implant for primary or secondary volume rehabilitation of anophthalmic² 2&7 DQDO\VLV RI VXEUHWLQDO ÁXLG SRVW VFOHUDO EXFNOLQJ sockets surgery for retinal detachment – An open label, prospective clinical evaluation of VDIHW\ DQG HIÀFDF\ VWXG\ RI $XURVWHQW 6LOLFRQH PRQR– Management of rhegmatogenous retinal detachment canalicular lacrimal stent manufactured by Aurolab) with macular hole in the treatment of canalicular injuries and anomalies– Surgical management of optic nerve pits with Paediatric Ophthalmology macular schisis – Lavelle paediatric project: Eye care for million² 8VH RI ´KHDY\ %%*µ G\H IRU PDFXODU KROH VXUJHU\ children– Post–surgical epiretinal membrane: treatment and – Study on squint surgery barriers visual prognosis. – Effectiveness of sibling screening in children with– Subretinal neovascular membrane (SRNV) after ocular pathology LGLRSDWKLF YDVFXODU WHODQJLHFWHVLD W\SH  ,07 – Treatment of optic disc coloboma with pit and schisis.– A comparison of buckle vitrectomy Vs primary vitrectomy (retrospective study) 45

Clinical Trials 2011-12 Operations Research 2011-12Aurolab Lions Aravind Institute of Community Ophthalmology– Clinical evaluation of Toric intraocular lens made by – Assessment of the prevalence and socioeconomic Aurolab burden of near vision impairment caused by uncorrected Presbyopia (follow–up study)– Clinical assessment of AuroKpro– Randomised, active comparator–controlled, three – A cluster randomised trial of spectacle uptake for Refractive Errors across multiple delivery system months, open label clinical trial to compare the LQ VRXWK ,QGLD IXQGHG E\ &KDPSDOLPDXG UHVHDUFK HIÀFDF\ DQG VDIHW\ RI UHIULJHUDWLRQ²IUHH /DWDQRSURVW grant). (0.005%) and Latanoprost (0.005%) stored at refrigeration temperature in patients with open angle glaucoma or ocular hypertension² $ SURVSHFWLYH QRQ²UDQGRPLVHG HIÀFDF\ DQG VDIHW\ clinical trial, 1 year study with a 1 year extension WR HYDOXDWH WKH HIÀFDF\ DQG VDIHW\ RI $$', LQ FRQWUROOLQJ ,23 LQ UHIUDFWRU\ JODXFRPD WKHUHE\ preventing further damage to optic nerve and visual ÀHOG ORVV– Clinical evaluation of silicone implant for primary or secondary volume rehabilitation of anophthalmic sockets– An open label, prospective clinical evaluation of VDIHW\ DQG HIÀFDF\ VWXG\ RI $XURVWHQW 6LOLFRQH PRQR canalicular lacrimal stent manufactured by Aurolab) in the treatment of canalicular injuries and anomalies– Clinical evaluation of a new cartridge for the implantation of foldable intraocular lenses– A prospective, non–randomised, single arm, open ODEHO VWXG\ WR HYDOXDWH WKH VDIHW\ DQG HIÀFDF\ RI Polymethyl Methacrylate intraocular lens for treating the patients having cataract.46

MANUFACTURING OPHTHALMIC SUPPLIES By the dawn of 2012, completing twenty years of service, over ten million around the world have regained or improved vision through Aurolab ophthalmic supplies. Manufactured in compliance with strict quality assurance measures, over the years Aurolab’s innovative products, have revolutionised the way eye care is being delivered across the world. Deliberate efforts towards serving societal needs by making the products affordable and accessible have brought a noble identity to Aurolab in the market. 1992-2012 47

Aurolab completed two decades of service towards the With a fully established silicone lab in place, Aurolabelimination of needless blindness in January 2012. is now poised to produce various silicone implants and RWKHU UHODWHG SURGXFWV IRU WKH PHGLFDO ÀHOGTo mark this occasion, elaborate annual day celebrationswere held on January 21. The senior leadership team Right from Aurolab’s inception, dealers have playedand other key stake holders from Aravind Eye Care a pivotal role in extending the reach of its productsSystem were invited for the event. Dr. P. Balakrishnan, thereby widening the scope of the organisation. ForManaging Director shared the major activities of the WKH YHU\ ÀUVW WLPH WKH RUJDQLVDWLRQ RUJDQLVHG DQyear and Mr. R.D. Sriram, Director–Operations, outlined International Dealers Meet which was attended bythe growth of the organisation over the years and participants from Latin America, Africa and South Eastdetailed its future plans. This was followed by cultural Asia.events and a sumptuous dinner for all the guests andemployees. International Dealers interacting with the Aravind senior leadership teamCelebrations to mark the completion of twenty years in service forelimination of needless blindness48