AECS Report 2016-17

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Beauty is Joy!Beauty touches our soul, making us feel alive.Visitors to Aravind have often remarked at the various expressions of beauty they see at Aravind.In particular, they have admired the beautiful designs at the entrance of the buildings on specialoccasions. A result of the meditative artistry of Aravind’s skilled housekeepers, the designs often reflectthe theme of the occasion. Over the years, they have gained mastery over the art, which requiresdeftness of the hand, mental discipline and concentration.The designs, made using flowers, colour powder and sand, also denote a prayer:May anyone crossing this threshold carry with them only joy and beauty. The cover and several pages in this report carry images of some of the designs by the housekeeping staff across all Aravind facilities.2

The vast universal suffering feel as thine:Thou must bear the sorrow that thou claimst to heal;The day-bringer must walk in darkest night.He who would save the world must share its pain.If he knows not grief, how shall he find grief’s cure?If far he walks above mortality’s head,How shall the mortal reach that too high path?If one of theirs they see scale heaven’s peaks,Men then can hope to learn that titan climb.God must be born on earth and be as manThat man being human may grow even as God.- Sri Aurobindo, from Savitri, Book VII, Canto VI 3

CONTENTS 9 15Highlights 27Patient Care 33Community Outreach 57Education and Training 67Consultancy and Capacity Building 77Research 82Manufacturing Ophthalmic Supplies 89Central Functions 94Recognitions and Achievements 96Aravind Eye Foundation 97Partners in Service Trustees and Staff Photo Credits Iruthayaraj P, Aravind-Pondicherry Mohan Raja S, Aravind-Tirunelveli Mike Myers, Volunteer, USA Rajkumar M, Aravind-Madurai Ramesh V, Aravind-Madurai Saravanan S, Aravind-Pondicherry Senthil Kumar P, Aravind-Coimbatore Seran I, Aravind-Salem4

Gandhiji’s ideas of celibacy, non-violence, truthfulness, and simple life appealed to many people in theyounger generation. His movement was not just political; there was also an effort to review the traditionaldharma or culture of ancient India.The Bhagavad Gita became popular and people started reading it to understand Kharma yoga.I remember well reading it in those days.At the same time Swami Vivekananda becamevery popular with us. His speeches were sopowerful and inspiring, they made me lookforward to doing something challenging andgreat.I also read the teachings of Sri RamakrishnaParamahamsa, who had very little schooling,but who had known God in person. All thesecontacts influenced our thinking greatly in thosedays. We were not thinking of amassing moneyas our goal in life.We always aspired to some perfection in ourlives, like the realisation of God, or the reachingof higher level of consciousness in Yoga. - Dr. Govindappa Venkataswamy 5

EYE CARE SERVICESMISSION: Provide compassionate and quality eye care affordable to allARAVIND EYE HOSPITALSTertiary Eye Care Centres - 6(Speciality Care, Research & Training)Madurai 1976 I Tirunelveli 1988 I Coimbatore 1997Pondicherry 2003 I Salem 2011 I Chennai 2017Secondary Eye Care Centres - 6(Cataract Services, Speciality Diagnosis)Theni 1985 I Tirupur 2010 I Dindigul 2010 I Tuticorin 2012Udumalpet 2012 I Coimbatore City Centre 2014Aravind Community Eye Clinics - 6Out-Patient Eye Care Centres(Comprehensive Eye Examination, Treatment of minor ailments)Melur 2004 I Tirumangalam 2005 I Cumbum 2008Madurai City Centre 2009 I Sankarankovil 2010Pondicherry City Centre 2011Aravind Vision Centres - 61Primary Eye Care Centres(Comprehensive Eye Examination)Free Eye Screening Camps(Community Outreach Programmes)More than 2,500 camps were conducted through which577,350 patients were screened and92,022 surgeries performed in the year-ending March 2017Aravind Eye Banks5,356 eyes were collected and 2,792 eyes were utilised forsurgery in the year-ending March 20174,067,265 outpatient visits were handled and 463,124surgeries and laser procedures were performed in the year-endingMarch 2017 ARAVIND EYE VISION: Eliminate

EDUCATION AND TRAINING Aravind Postgraduate Institute of Ophthalmology Lions Aravind Institute of Community Ophthalmology MISSION: Develop ophthalmic human resources through teaching and training Over 9,000 candidates trained from 100 countries 1,401 papers published RESEARCH Aravind Medical Research Foundation Dr. G. Venkataswamy Eye Research Institute MISSION: Provide evidence through research and evolve methods to translate existing evidence and knowledge into effective action Basic and translational research I Clinical research I Operations research Product development in eye care 129 research papers published ; 19 scholars received Ph.D CONSULTANCY AND CAPACITY BUILDING Lions Aravind Institute of Community Ophthalmology MISSION: Enhance eye care through capacity building, advocacy, research and publications Sharing best practices at Aravind I Advocacy in eye care I Publications 335 hospitals from 28 countries (including India) received consultancy services in eye care management OPHTHALMIC SUPPLIES Aurolab MISSION: Make quality ophthalmic products affordable and accessible to the vision impaired worldwide Intraocular lens I Pharmaceuticals I Suture needles Equipment I Surgical blades I Special products Products exported to more than 160 countries worldwideCARE SYSTEMNeedless Blindness

Aravind completes four decades in eye careSilver Jubilee Celebrations8

HIGHLIGHTS 2016-17The past year at Aravind was punctuated by a series of milestones. At one level, the trust ofOctober 2016 marked the completion of four decades of the millions of patients is acompassionate service for sight. Aurolab and Uvea services blessing.celebrated 25 years of work. At the same time, itA number of challenges in the external environment also also challenges thecharacterised the past year.To bring about greater financial organisation to preservetransparency, the Government of India demonetised the and strengthen this trustRs. 500 and Rs.1,000 notes overnight. It was a surprise move, catching in it.everyone unprepared.To add to the challenge, the Chief Ministerof Tamil Nadu passed away, paralysing the state government.Theuncertainties arising out of the two events further aggravated themood in the state, already besieged by a total failure of the monsoon,considered to be one of the worst in recorded history.The acute crunch in cash flow in the community, political uncertaintyand a failed monsoon should have had a dramatic and dampeningimpact on the patients seeking eye care, which is largely elective innature. While there is no evidence of the impact of the happeningson the market, in general, at Aravind, the growth in patient volumewas spectacular. Surgeries, including laser procedures and intravitrealinjections, grew by 10%, which translates to about 40,000 additionalsurgeries during the year.The number of out-patient registrationsalso saw an increase, recording an unprecedented over four millionvisits in the course of the year. Aurolab, too, experienced a similargrowth, with revenues increasing by 16%, buoyed by robust exports.The overall record growth during a year characterised by adversity isa testimony to the faith people have in the Aravind Eye Care System(AECS).While Aravind has established itself as a provider of high-quality eyecare at affordable prices, it is becoming increasingly clear that it is thecompassionate care and the trust it builds, which is resulting in theconsistent growth of its services. At one level, the trust of the millionsof patients is a blessing, at the same time, it also challenges theorganisation to preserve and strengthen this trust in it. 9

Infrastructure Mr. R.D. Thulasiraj and Dr. R.D. Ravindran with Mr. Mohammed Nasim, MP, Honorable Minister for Health and Family Welfare,The construction of Aravind Eye Hospital in Chennai Government of Bangladeshprogressed as per schedule, aiming for inaugurationin the coming year. Over the years, Aravind-Chennai started yielding results. Bangladesh Rural Advancementis expected to grow into a centre of excellence in Committee (BRAC), the world’s largest NGO hasservice providing eye care in significant numbers to established three vision centres as a pilot venture, withthe people of Chennai, its adjoining areas as well as Aravind’s full involvement. BRAC intends to scale itthe neighbouring districts in Andhra Pradesh and up to 20 centres immediately and eventually expand itKarnataka. For the proposed Aravind Eye Hospital across the entire nation. Dr. R.D. Ravindran, Chairman,at Tirupati, all the procedural requirements leading AECS and Mr. R.D. Thulasiraj, Executive Director,to the approval of the building plans are in hand. The LAICO during their visit to Bangladesh in Decemberconstruction will begin in mid-2017. 2016, shared with the country’s Health Minister, the details of the functioning of a vision centre and its Aravind Eye Hospital at Coimbatore is operating potential impact. This resulted in the sanctioning ofbeyond its capacity and needs to urgently expand its an initiative to establish 400 vision centres across theinfrastructure. With the purchase of the land adjoining country. Within India, the State Governments of Uttarthe hospital, this has now become a possibility. During Pradesh, Uttarakhand, Jharkhand and Chhattisgarhthe year, four vision centres have been added taking have all initiated actions towards establishing visionthe total to sixty one. It is interesting to observe that centres. These are at various stages of development.this network of sixty one vision centres handled Looking at the combined population coverage ofover 524,000 outpatients visits during the year, farsurpassing the total number of patients seen throughcomprehensive free eye camps. This initiative has themakings of a major innovation in the offing, of a strongalternate model to eye camps for providing care in thecommunity.Scaling of Vision CentresAt the last retreat of the Aravind Eye Care System, anaudacious goal was proposed to promote the conceptof primary eye care to cover a population of a billion.Consistently promoting the concept by buildingevidence of vision centres’ impact and effectiveness, hasAravind Eye Hospital-Chennai10

Bangladesh and the various states in India working onthis, it is likely that this audacious goal of reaching abillion people could soon become a reality.Cancer Genetic Testing CentreRetinoblastoma, the cancer of the eye is the most Participants to the workshop on Practicing Responsible Medicinecommon intraocular tumour among children.Unfortunately half of these are inherited. Aravind trust stemmed out of providing eye care in an ethicalMedical Research Foundation (AMRF) has developed and responsible manner. This was not just about beinga cost-effective genetic testing methodology to help responsible for those who came to the hospital, but alsopredict the disease in siblings, offspring and secondary exhibiting the same responsibility towards those whotumours in the same patient. On October 26, 2016 a need but were not seeking care. The exploration wasgenetic testing laboratory was inaugurated at Aravind- around expanding this notion across all of healthcare.Madurai. Even though, the number of people who will The workshop brought about a deeper understandingdirectly benefit from this centre will be small, in the of what responsible medicine is and how it could becoming years, it will play a significant role in reducing put into practice to benefit both the patients and thethe occurrence of retinoblastoma and other inherited hospitals - a true win-win paradigm.eye cancers. The facility extends its services to patientsbeyond AECS at an affordable cost. The other important workshop was on Priorities in Paediatric Eye Care Services, intervention models andOctober Summit research. Jointly organised by Aravind and USAID, this international workshop brought together practitionersOriginally conceived as a platform to discuss issues of paediatric eye care from thirteen countries.relating to effective delivery of eye care programmes andservices, October Summit, over the years has developedan expectation amongst the healthcare fraternity.Bringing together people from diverse backgrounds,this year too, the summit witnessed several significantactivities. The most sensitive and significant event wasaround the topic of Practicing Responsible Medicine. Thiswas conducted in a think tank mode, going beyondeye care into the overall practice of medicine. Aravindrealised that its strength and building communityLighting the lamp and opening ceremony at the inauguration of Cancer Genetic Testing Laboratory at Aravind-Madurai 11

Dr. Suzanne Gilbert receives Dr. G.V. Endowment Award 2016. With her are (L-R) Dr. R.D. Ravindran, Dr. P. Namperumalsamy,Mr. G. Srinivasan and Mr. R.D. ThulasirajThe major highlight of the October Summit was shared with many other eye hospitals across severalthe Dr. G. Venkataswamy Endowment Oration, countries through structured training programmes.delivered by Dr. Suzanne Gilbert of Seva Foundation. During the October Summit, a long-felt need wasHaving known Dr. Venkataswamy for almost 30 years, fulfilled with the release of the Community Outreachshe largely spoke about his life and contribution to eye Manual, a valuable compilation of all informationcare in her oration titled Compassion in Action; Living a Life necessary for effective outreach. This was a culminationof Service. of many years of work by Mr. R. Meenakshi Sundaram, Aravind’s Outreach Manager and Seva volunteers, One of the hallmarks of Aravind’s service continues Ms. Julie. D. Johnston and Ms. Susan Spinola and theto be its outreach work. Each year 2,500 eye camps are Aravind Communications team that provided editorialconducted. This vast experience is being continually inputs and feedback.Dr. Marilyn Miller addressing the audience at the workshop on Priorities in Paediatric Eye Care Delivery12

Valedictory function of the 100thInstruments Maintenance courseService Beyond Aravind Responsibility (RSR) programme at Aravind-Madurai, the ophthalmology residents visited orphanages onThe spontaneous desire amongst the staff to support special occasions, presented toys and clothes to thefellow human beings in distress is now emerging into disadvantaged children there, and spent quality timean annual activity. Now in its third year, Angaadi, the with them. Sale of products made by visually challengedgreat charity fest was a grand success, with the whole- people was also organised to support them for the thirdhearted dedication and commitment of all employees. consecutive year.The event was held on December 17, 2016 at Maduraiand later in Aravind-Pondicherry. This year’s proceeds Instruments Maintenance Course Hitswere donated to Aishwaryam Trust recognising its Centumexceptional service in palliative care, andM.S. Chellamuthu Trust, for its inspiring work in Aravind pioneered the concept of having an internalsupporting and rehabilitating mentally challenged instruments and equipment maintenance departmentpeople. Similarly, through the Residents Social in an attempt to address an acute necessity. True to itsStaff members at the sale during RSR programme 13

Dr. S. Aravind with Dr. Jon Bjarni Thorsteinsson and Ms. Gudrun Mr. R.D. Thulasiraj at the Hilton Cataract Initiative reviewBjort Yngvadottir at Aravind-Madurai meeting in Dubai, U.A.Ephilosophy of sharing everything of value with others, During the year, the prestigious project funded bythis too soon translated into an offering as a training Conrad N Hilton Foundation to mentor and buildprogramme to facilitate other eye hospitals to set up capacity of five eye hospitals in Africa, came to an end.similar maintenance facility. The concluding review workshop was held in Dubai and it was also attended by Ms. Shaheen Kassim Lakha and This popular training programme was developed Mr. Robert Miyashiro of Conrad N.Hilton Foundation.by Professor V. Srinivasan and the first course was Dana center of John Hopkins is also engaged in thisoffered in October 1996. The extreme usefulness of effort. In spite of the significant progress made by thethis course resulted in sustained demand with this five African hospitals, Hilton Foundation recognised thefour weeks’ course being offered now six times a year. need for continued mentoring to make these hospitalsThe 100th course was conducted in 2016 and this in sustainable, echoing Aravind’s view on this. The requestitself was a cause for celebration. In addition to the 106 for the second phase of the project was approved withcourses offered at Aravind as of last year, this training a grant of $2 million. During the year, LAICO alsoprogramme is also offered offsite in different countries agreed to partner with Chinese Eye Hospital Alliance,to benefit clusters of hospitals in those regions. A total Operation Eyesight Universal and the Ministry ofof 20 such courses were offered in other countries Health, Bangladesh to help in strengthening identifiedbenefiting technicians from 22 countries. During the last eye hospitals in their respective network.year, four such offsite courses were offered, one each inAntigua (West Indies), Kenya, Egypt and Tanzania. LAICO had the honour of a visit by Ms. Gudrun Bjort Yngvadottir, Senior Vice President of LionsBuilding Sustainable Eye Care Club International and her husband Dr. Jon BjarniProgrammes Thorsteinsson in July 2016.LAICO’s capacity building work around hospitals, Standard Chartered Global Business Services Limitedvision centres and programmatic focus in underserved (formerly Scope International Private Limited) cameareas continues. During the year, LAICO as part of the forward to support some of Aravind’s innovation toconsortium of mentor hospitals under Seva, got support go beyond cataract services. Their support will helpfrom Standard Chartered Bank to mentor 11 hospitals. Aravind to make significant inroads into more effectiveThis along with grants from Seva–So-Hum project, management of corneal ulcers amongst the poor,Lavelle and Lions International saw the addition of 15 development of a new cornea preservative medium witheye hospitals during the year, taking the total hospitals antifungal agents, enabling more comprehensive eyementored to 335 spread across 28 countries. examinations in eye camps and enhanced diagnosis and management of Retinopathy of Prematurity (ROP) and corneal diseases.14

PATIENT CARE Like the branches on a tree, ourAs Aravind's first facility in Madurai completes forty years in lives may grow ineye care service, the organisation looks back with a sense of different directions,gratification, on the impact it has had, on the lives of millions of yet our rootsvisually impaired persons. remain as one!Like the banyan tree, which spreads its roots, Aravind is poisedto set foot in Chennai, the capital city of Tamil Nadu, to spreadits eye care services. Situated in Noombal village, on thecity’s Poonamallee High Road, Aravind-Chennai will be theorganisation’s biggest facility and will primarily cater to peoplefrom Chennai, Vellore, Tiruvallur and Kancheepuram, as well asto those from adjoining parts of Andhra Pradesh. 15

Performance: April 2016 - March 2017 Total Madurai Theni Tirunelveli Coimbatore Pondicherry OUT-PATIENT VISITS HOSPITALS 2,221,659 666,738 92,856 336,723 412,945 323,952 Paying (New+Review) 550,374 180,576 21,503 81,524 123,241 102,535 Free (New+Review) OUTREACH Comprehensive camps 337,671 94,955 16,205 45,727 87,952 76,803 10,503 Diabetic Retinopathy screening camps 32,703 10,826 2,553 1,879 10,652 7,071 Workplace refraction camps 52,345 8,488 3,884 12,723 10,230 10,795 - School children examined by Aravind staff* 61,447 - 2,271 5,498 34,199 8,809 Paediatric eye screening 75,425 124,772 1,110 1,669 827 71,819 217,272 Mobile van refraction camps 17,759 107,754 - - 16,711 - Total Out-patients through Outreach* 577,350 26,023 67,496 160,571 175,297 VISION CENTRES 524,269 61,607 116,287 41,230 63,229 COMMUNITY EYE CLINICS/CITY CENTRES 193,613 22,883 31,954 - 31,022 TOTAL OUT-PATIENT VISITS 4,067,265 1,297,112 224,872 633,984 737,987 696,035 SURGERIES 242,344 86,170 7,123 37,028 50,990 35,468 128,758 48,554 3,590 16,256 29,648 21,327 Paying 32,096 2,964 10,249 22,429 19,684 Free walk-ins 92,022 Outreach TOTAL SURGERIES 463,124 166,820 13,677 63,533 103,067 76,479 *Of the 324,096 children screened by teachers, 262,649 were found to be normal taking the total outreach screening to 839,999 Growth in Out-patient Visits and Surgeries since inception in 1976 Since inception, Aravind Eye Hospitals have handled over 52 million out-patient visits and performed over 6 million surgeries. OUT-PATIENT VISITS 4,000,000 SURGERIES 500,000 3,000,000 400,000 2,000,000 300,000 1,000,000 200,000 100,0001976 1986 1996 *Mar 2007 Mar 2017 1976 1986 1996 *Mar 2007 Mar 201716 March 2007 statistics includes months from January 2006 to March 2007 * From year 2007, the statistics is for the financial year, April to March

Tirupur Dindigul Salem Tuticorin Udumalpet CBE CC Changing Scenario48,642 76,326 137,191 59,458 34,288 32,540 Aravind model of eye care delivery is 12,797 - famed for its unique business model7,528 - 11,498 9,172 that ensures self-sustainability of the system in spite of offering its services - - 12,747 3,282 - - free or at a highly subsidised rate - - 45 - - - to over half of its patients. When 383 - 1,126 - 2,378 - the hospital began, only 30% of the 287 - 1,895 - - - patients actually paid for the services - - - - - - and yet it remained financially - - 1,048 - - - sustainable. Over the years, the ratio 670 - 16,861 2,378 - of paying patients crept up to 40%10,986 - - 3,282 13,658 - and now at 50%, half of Aravind’ s - - - - - - patients pay for the services. This is - not on account of any restrictions on free care to outreach patients67,826 76,326 165,550 71,912 63,121 32,540 or subsidised care to the walk-in patients in the free hospital. This2,687 4,127 12,808 2,711 1,931 1,301 shift towards paying services can be1,588 1,084 2,893 1,286 2,532 - attributed to the following: 3,157 - - The general growth in the 504 - 614 325 1,301 economy and paying capacity of4,779 5,211 18,858 4,611 4,788 the patients. - The hospital fees have remainedOut-patient Visits and Surgeries: April 2016 - March 2017 static over the past several years and thus the paying section is14% Free Outreach 20% Free Outreach possibly becoming affordable to13% Free Hospital* 28% an increasing proportion of the18% 52% Subsidised* population. VC, CC, CEC - The government health insurance55% Paying scheme for the poor, pays for Paying Base Hospital several non-cataract procedures. Base Hospital So, more patients from the “free” strata are now accessing care asOUT-PATIENT VISITS SURGERIES paying patients. The subspeciality surgeries have thus gone up * walk-ins to free hospital significantly and they have become VC-Vision Centre CC-City Centre CEC-Community Eye Clinics predominantly paying. In addition, there has been a positive change in the health-seeking behaviour of general public. Patients have started proactively coming in for treatment. This is substantiated by the steep growth in the direct free walk-ins – both out-patient visits and surgeries, in relation to eye camps. 17

Surgery Details: April 2016 - March 2017 Total Madurai Theni Tirunelveli Coimbatore Pondicherry Cataract surgeries 286,013 105,579 10,683 35,520 59,017 46,558 1,971 97 1,405 1,706 961 Trab and combined procedures 6,424 5,191 11 1,404 4,300 1,094 - 341 736 2,372 Retina and Vitreous surgery 13,739 821 - 407 778 278 2,469 533 1,543 369 Squint correction 2,449 507 268 264 532 2,612 4 687 933 1,108 Keratoplasty 2,425 2,912 1,115 1,895 396 2,493 76 781 875 Pterygium surgery 6,578 195 8,692 1,186 12,432 8,341 10,471 821 Ocular injuries 1,800 17,995 - 2,613 12,180 447 1,430 1,069 Lacrimal surgeries 5,632 7,356 1,843 4,772 8,833 3,388 63,533 3,329 5,349 Orbit and Oculoplasty surgeries 7,350 166,820 - 103,067 3,430 53 3,749 Refractive laser procedures 5,347 13,677 76,479 Retinal laser procedures 42,638 YAG laser procedures 51,364 Intravitreal injections (Anti VEGF and Steroids) 18,998 Other surgeries, Laser procedures and Injections 12,367 Total Surgeries 463,124 Major Events, Projects Diabetic Retinopathy (DR) in India. The Government of India has identified 12 states for the programme, and inAravind-Madurai, in 2016, successfully completed Tamil Nadu, Aravind-Tirunelveli is the nodal point.the pre-entry-level assessment of NABH certification,which ensures the quality of patient care and safety. The goal is to achieve reduction in avoidable blindnessOver the past six years, the hospital has taken elaborate due to DR through improved control of diabetes,efforts to standardise systems, procedures and policies; early detection, the treatment of sight-threateningdocument all the processes and to adhere to stringent retinopathy with high-quality and affordable treatment,standards of quality care and safety, as stipulated by the and through increasing awareness among theQuality Council of India. population. The approach involves establishing models of sustainable and scalable services for the detection Under the ‘Vision for All’ project, Aravind-Thenihas started screening for Retinopathy of Prematurity Inauguration of the QEDJT-DR project at Primary Health(ROP), in association with the Government Hospital, Centre in MukkudalCumbum, since February 2017. Several programmeswere conducted to raise awareness about ROPscreening amongst doctors and nurses. Posters andpamphlets on ROP were displayed in NICU wards inthe Government Hospital. Aravind-Theni screeneda total of eight babies and referred two of them withadvanced stage of the disease, to Aravind-Madurai forfurther evaluation and treatment. Supported by the Queen Elizabeth Diamond JubileeTrust (QEDJT), the Public Health Foundation ofIndia (PHFI) has introduced a programme to developintegrated services for the detection and treatment of18

Tirupur Dindigul Salem Tuticorin Udumalpet CBE CC3,829 3,896 12,192 3,580 4,252 907 There is no other hospital like this in the world! 44 42 119 60 - 19 If we go to other hospitals, the nursing staff 2 - 458 - - 1 hesitate to touch and wipe the water flowing - - - - - - from the eyes. Even if they do, it is with a bit of 1 - 48 - - 1 aversion. To the contrary, here, the sisters are 77 409 32 24 welcoming, they touch us, hold our hands, and 101 3 84 - 14 - accompany us. If there is watering in our eyes, 7 - 121 - 3 7 they wipe it off gently. This compassionate care 121 59 - 43 itself will heal half the disease. 10 106 129 - - - Kaliammal, Ramanathapuram 46 - - 37 - Aravind-Madurai - 1,763 - - 2,319 807 - 288 - 1,067 - - 706 - 827 469 - 268 73 - 11 33 20 18,858 4,611 1,3014,779 5,211 13 4,788 and treatment of DR, which are integrated into the exhibition and sessions on eye care. On the occasion Government of India’s health system at every level. The of World Allergy Week, Aravind-Salem organised programme works with state governments, and private an awareness-programme for patients afflicted with eye care and physician partners to screen people with vernal keratoconjunctivitis and their family members Type 1 and Type 2 diabetes for DR. Aravind-Tirunelveli on April 23, 2017. On World Sight Day (October 13), inaugurated the project in the Primary Health Centre at Aravind-Madurai, in collaboration with the Madurai Mukkudal on November 30, 2016. Ophthalmologists Association, conducted an awareness talk on ophthalmic diseases and the importance of eye Aravind-Coimbatore observed Presbyopia care. Awareness Week from April 11 to 16, 2016, with an Presbyopia Awareness Week at Aravind-Coimbatore World Allergy Week programme at Aravind-Salem 19

In order to ensure most accurate diagnoses, quality workshop was arranged for Aravind doctors as part oftreatment and patient satisfaction, the speciality clinics the Phaco excel CME held at Pondicherry in July.invested in latest diagnostic and treatment procedures. The ReLOAD (Review Learning on AdvancementCataract Services and Development) Phacoemulsification workshop was conducted at Aravind-Madurai in collaborationAurolab designed square-edge Polymethyl Methacrylate with Alcon from March 25-26, 2017. Thirteen(PMMA) intraocular lens (IOL) in order to reduce doctors from Aravind-Madurai, Tirunelveli,Posterior Capsule Opacification (PCO) amongst Small Pondicherry and Coimbatore participated in thisIncision Cataract Surgery (SICS) patients. Through a workshop which covered both basics and advancesprospective randomised controlled trial with a follow in phacoemulsification including complicationup of over 9 years, it was found that the square edge management. At the hands-on wet lab session, eachIOLs significantly reduced PCO compared to the doctor performed anterior vitrectomy, managedconventionally used round edge PMMA IOL. Based on posterior capsule rupture and practised insertion of iristhis study results and clinical experience, all Aravind hooks in animal eyes. Similar workshop was arrangedEye Hospitals are now using square edge PMMA IOLs for external ophthalmologists from September 24-25,where indicated. 2016. Approximately 60% of Aravind’s phacoemulsification A study conducted by the London School of Hygienepatients undergo surgery under topical anaesthesia. and Tropical Medicine, Aravind Eye Hospitals and AllThe rest 40% and all SICS surgeries were done under India Institute for Medical Sciences, New Delhi foundretrobulbar or peribulbar block. With these needle that Indian women who cook with biomass fuels suchtechniques, there is a risk of globe perforation. To make as wood, crop residues and dried dung instead of cleaneranaesthesia safe and comfortable to the patients, the fuels such as gas were nearly 50% more likely to developclinic has started administering subtenon’s anaesthesia cataracts. This research finding was released in a pressat Aravind-Madurai. This will soon be introduced to all meet conducted on May 24, 2016 at Aravind-Madurai.Aravind Eye Hospitals. Retina Services To introduce this method, a workshop was conductedat Aravind-Madurai for doctors and theatre nurses Under the Retinopathy of Prematurity Eradication-Savefrom all Aravind Eye Hospitals on November 30, 2016. Our Sight (ROPE-SOS) project, Aravind-CoimbatoreThe workshop included lectures, wetlab training, has been providing ROP screening services to rural areasobservation and hands-on training. Following this via telemedicine. In the last year, a total of 4,897 babiestransition, it is found that the chances of anaesthesia were screened and 1,001 babies were diagnosed to havecomplications have reduced and patients are more some form of ROP. Out of this, 87 babies (162 eyes) werecomfortable because they do not feel the prick. treated for blinding ROP. The rest were given other forms of intervention such as Avastin injection, laser The department regularly invests in equipping thesurgeons in managing complex cases. A secondary IOLParticipants to ReLOAD Phacoemulsification workshop Waiting area of the renovated Retina Clinic at Aravind-Tirunelveli20

Inauguration of DR screening project at PHC in With gratitudeKarikkalampakkam Aravind Eye Care System would like to place onand vitrectomy. Other findings such as haemorrhages record its grateful appreciation to State Bank of Indiawere found in 142 babies, cataract in six babies, of for its generous contribution to purchase Spectraliswhich, five have undergone surgery and one baby is OCT, an ophthalmic imaging platform.being followed up. Retina Clinic at Aravind-Tirunelveliwas renovated to provide better care and comfort to the first DR screening was held at Karikkalampakkam onpatients and the new facility was inaugurated on June December 27, 2016.22, 2016. Paediatric Ophthalmology and Adult Aravind-Pondicherry introduced opportunistic Strabismus Servicesscreening model for Diabetic Retinopathy (DR) incollaboration with Primary Health Centres (PHCs) in The department at Coimbatore has launched binocularPondicherry. Diabetes patients in the community are vision assessment and vision therapy, which helpasked to visit the PHC on a scheduled day to collect diagnose eye problems associated with accommodation.free diabetes medications for the month. The hospital This is extremely useful in the cases of children abovewill use this opportunity to screen these patients for the age of 8 and young adults. Both office-based andDR. The PHC personnel are made aware of the need to home-based exercises using computers are in practice. Ascreen diabetes patients for DR. A total of 27 primary total of 80 children have benefited through this therapyand 2 community health centres are included. The during the past 5 months.Awareness programme on World Sight Day at Mannar Thirumalai Naicker College, Madurai 21

At Aravind-Madurai, the department has acquired now participating in regular discussions in an attemptVideo NystagmoGram (VNG), to record eye movement to initiate projects of relevance in clinical managementto document and differentiate various types of of glaucoma as well as in deciphering molecularnystagmus. VNG provides ideal conditions for the mechanisms underlying the disease. Of the projects thatobservation, measurement and analysis of eye movement have been submitted for possible funding, the proposaland is a step forward in the diagnosis and management on the role of microRNA in regulation of glucocorticoidof nystagmus. It will also act as a base for future signalling in Ssteroid-induced glaucoma and that onresearch in the field of eye movement disorders. VNG characterisation of trabecular meshwork stem cells incan also be used to track eye movements in children pathogenesis of glaucoma have received grant supportwith special needs. The unique design makes it possible from funding agencies. A pilot study was conducted tofor the system to be used with or without a chin rest, design a web-based glaucoma counselling platform inmaking it convenient for use even in infants who Tamil to enhance treatment adherence and follow up inotherwise do not co-operate for examination. persons with glaucoma. Under the aegis of ORBIS Refractive Error Among In the clinical management of glaucoma, non-Children (REACH) Project, the department arranged penetrating deep sclerectomy surgery has beenan eye care-awareness exhibition on the occasion of introduced for persons with advanced visual field loss,World Sight Day. Posters on refractive error, optical in whom conventional surgery carries higher risk ofillumination and ROP were displayed. Around 400 complications.children and their parents visited the exhibition.Dr. P. Vijayalakshmi, Chief, Paediatric Ophthalmology Aravind-Pondicherry is conducting a randomisedand Adult Strabismus Services, Aravind-Madurai control trial comparing shared medical appointmentinteracted with the public and clarified their doubts system with the classic one-on-one type of patient-on paediatric eye care during the programme aired by doctor interaction. Done in collaboration with LondonAll India Radio Madurai Rainbow FM 103.3. At the Business School and Harvard Business School, thisawareness programme organised in Mannar Thirumalai trial will give insights about the patients’ and doctors’Naicker College, Madurai, Dr. A.S. Jamuna gave a perceptions on shared medical appointment. Ifpresentation on paediatric eye problems, symptoms and proven successful, this can be implemented for othertreatment facilities to a group of about 250 students. chronic ocular conditions like diabetic retinopathy. Aravind-Pondicherry has introduced Carbon dioxideGlaucoma Services Laser assisted sclerectomy surgery, which is a non- penetrating glaucoma surgery, to tackle patientsGlaucoma Research Forum has been initiated by with open angle glaucoma. It has also started a novelAravind Medical Research Foundation under the outreach model, where fundus evaluation is done withmentorship of Dr. VR. Muthukkaruppan, its former handheld fundus camera, which will help improveDirector. Senior clinicians from Glaucoma services are screening of not only glaucoma but also all the posterior segment diseases.Fundus evaluation using handheld fundus camera in an eye campat Aravind-Pondicherry Spectralis ASOCT in the Cornea clinic at Aravind-Madurai22

Cornea Services Cancer genetic testing laboratory at Aravind-MaduraiAravind-Coimbatore started performing Descemet’s the genetic analysis more efficient, a strategy wasMembrane Endothelial Keratoplasty (DMEK), made to analyse the gene in a sequential manner. Basedan advanced endothelial lamellar keratoplasty on these research findings, a cancer genetic testingprocedure, promising better results as compared to laboratory was established at Aravind-Madurai onthe conventional Descemet’s Stripping Automated October 26, 2016 with funding support from AravindEndothelial Keratoplasty (DSAEK). This is performed Eye Foundation and Mr. Shyam Prakash Gupta. Theon selective patients. centre helps predict the disease in siblings, offspring and secondary tumours in the same patient through the The cornea department at Aravind-Madurai has won Ring of Hope fund.a grant of around 2 crores INR, with the help of whichit is equipped with the latest imaging facilities - Oculus To highlight and spread awareness on retinoblastoma,5 scan for dry eye and related diseases and Spectralis Aravind-Madurai and Aravind-Coimbatore, organisedAnterior Segment Ocular Coherence Tomography special programmes on the occasion of World(ASOCT) for corneal thickness profile. This grant has Retinoblastoma Awareness Week.made it possible for patients with corneal ulcers whocannot afford the cost of treatment- receive it totally Low Vision Services and Visionfree of cost. Partial support from this grant will also Rehabilitation centrebe used to further enhance the quality of indigenouslydeveloped corneal preservative medium, Cornisol. At Aravind-Madurai, digital resource centre was set up to help persons with severe visual impairment lead an The cornea department at Aravind-Salem received independent life. Persons with visual impairment areaccreditation from the Government of Tamil Nadu to educated and trained to use computers with the helpperform corneal transplantation surgeries under theHuman Organ Transplant Act.Orbit, Oculoplasty and Ocular OncologyServicesRetinoblastoma is the most common intraoculartumour among children. Aravind has been treatingretinoblastoma cases and found very good resultsin those who came in at the early stage. Towardsidentifying the cause of the disease, Aravind’s researchinstitute has carried out an analysis of the genes. Newermethods were developed to identify the broad spectrumof mutations present in the RB1 gene. Further to makeParticipants at the Retinoblastoma Awareness Week celebration Awareness programme on low vision at Aravind-Tirunelveliat Aravind-Coimbatore 23

A person with special needs being examined at Aravind-Madurai Dr. P. Vijayalakshmi addressing the audience at the half-day course for the care givers of children with autismof special software as well as smart phones with Talk special children as well as doctors on the importanceback option. Training is offered for orientation and of vision assessment and intervention in childrenmobility as well as to use non-optical devices. A total of with autism. The programme included lectures and10 persons with visual impairment benefited from this demonstrations. About 90 persons including teachersin the last year. It has started preparing audio materials and parents of students from Sparks Vidhyalaya,for the different school curricula and university syllabi. Madurai participated in the course held on NovemberThe centre has introduced Ausion, an innovative 27, 2016.mobility device for persons with visual impairment. Theeffectiveness of this device is being evaluated. February being observed as Low vision awareness month, Aravind-Tirunelveli and Aravind-Madurai A protocol to perform comprehensive cognitive vision conducted exhibitions to create awareness amongassessment for children with autism is developed. patients and public about vision rehabilitation services.A total of 120 children with autism were examined On March 1, 2017, Aravind-Tirunelveli conducted afor both functional and cognitive vision. The clinic similar programme for the teachers of children withis working on standardising this protocol to extend special needs from schools under Sarva Shikshait to all children with special needs. The department Abhiyan. About 90 teachers attended the programme.has developed a kit for these children to improve theircognitive visual performance. Uvea Services To build the capacity of the department, Uvea Services at Aravind-Madurai, the first dedicatedMs. H. Jeyaseeli Flora, Vision Rehabilitationist visited facility of its kind in India, completed 25 years of itsthe New Mexico School for the Blind, Albuquerque service in restoring vision to many. Throughout thisto observe techniques of vision assessment and journey, treating nearly 60,000 new uveitis patients,intervention. She also visited various institutes in the department has brought many laurels to AravindKansas and observed early intervention and community especially in the area of research and publications.based rehabilitation programmes for children with The work done by the team helped in establishingdisabilities. She also had opportunities to interact with leptospiral uveitis and trematode related uveitisexperts in cortical visual impairment disorders and as distinct clinical entities. The department hasautism. At the Conference of Association for Education contributed to developing the next generation ofand Rehabilitation of the Blind and Visually Impaired ophthalmologists specialised in uveitis across theheld in New Mexico from February 8-10, 2017, she country and around the world. As part of the silverspoke about the vision rehabilitation services offered at jubilee celebrations, a conference titled UVEA 360°Aravind. was conducted at Aravind-Madurai, which provided a holistic approach towards the diagnosis and Low Vision Services and the Department of Paediatric management of uveitis.Ophthalmology jointly organised a half day course atAravind-Madurai to educate teachers and parents of24

Aravind Integrated Eye Bank Services Mr. D. Saravanan receiving the Sightlife Award for eye bank(AIEBS) facilities in cities) to effectively improve eye donationAravind Eye Banks play a crucial role in the prevention process. Nurses in these facilities are in close contactof corneal blindness by procuring, processing, and with the community and play a great role in spreadingpreserving corneas and subsequently utilising these the message of eye donation. Training programmes werefor transplantation surgeries. Eye banks at Aravind- organised for doctors, nurses and support staff of urbanMadurai, Coimbatore, Tirunelveli and Pondicherry health posts in Madurai with the active participationhave been brought under the umbrella term, Aravind of the district administration. Following this, staff fromIntegrated Eye Bank Services (AIEBS). these centres help through prompt notifying of deathsDr. M. Srinivasan, Director Emeritus-Aravind Eye to AIEBS.Care System was unanimously selected as Director ofAIEBS. AIEBS mobilise the community in facilitating Several awareness programmes on eye donationeye donation and almost 80% of the eyes received are were organised on various occasions in educationalthrough community participation. institutions, industries and hospitals. Social media was effectively used in taking the message to the community. The centre opened at Kumbakonam for facilitating Tissues collected by AIEBS were shared with othereye donation process completed two years of excellent hospitals on request. Training in eye banking wasservice. It conducts several awareness programmes in provided to three eye bank technicians, a counsellor andthe community to enhance its reach and motivate the an ophthalmologist.general public to support eye donation. A total of 746eyes were collected through this centre in the last year. SightLife Awards for AIEBSA similar collection centre was opened in Aravind-Salem on October 1, 2016 . It was a proud moment for Rotary Aravind International Eye Bank at Aravind-Madurai when it received the AIEBS collaborates with various hospitals under Governance and Strategic Direction Award at thethe Hospital Cornea Retrieval Programme (HCRP). Annual Meeting of SightLife held in New Delhi onA total of 50 pairs of eyes were received from a donor March 4, 2017. Aravind-IOB Eye Bank Coimbatorehospital under the HCRP in February 2017, the highest received the award for Excellence in Eye Banking.ever collection from a hospital in a month. Currently, AIEBS observed 31st National Eye Donation Fortnightthrough HCRP, AIEBS works with 11, governmental between 25th August and 8th September, 2016 withand private hospitals. In appreciation of their support awareness rallies, talks and exhibitions.towards eye donation, AIEBS donated chairs, trolleyand fans to various government hospitals to improvepatient comfort. AIEBS have joined hands with urbanhealth posts (government-run primary health careMr. K. Veera Raghava Rao, IAS, District Collector, Maduraifelicitating the family members of eye donors on the occasion ofEye Donation Fortnight celebration Statistics 2016 - 2017 Particulars Eyes collected Eyes utilised Madurai 2,127 1,210 Coimbatore 1,458 920 Pondicherry 1,269 361 Tirunelveli 502 301 Total 5,356 2,792 25

Eye Donation FortnightAravind-Madurai Aravind-Theni Aravind-Pondicherry Aravind-Tirunelveli Aravind-Coimbatore26

COMMUNITY OUTREACH Aravind realises that its strength is notScreening eye camps have been an integral part of Aravind just about beingsince inception. Over the years, the structured way of responsible for thoseorganising camps has resulted in Aravind developing a well- who come to thedefined outreach system, which now conducts 50 camps hospital but also abouta week with the help of a vast network of sponsors and exhibiting the sameorganisers. In 2016-17, Aravind conducted 2,522 camps in responsibility towardsthe community, workplaces and schools, through which it those who need to butscreened 577,350 patients; of these, 92,022 underwent surgery. are not seeking care. 27

Release of Community Outreach in eye care. Mr. R. Meenakshi Sundaram, SeniorManual during October Summit Manager-Community Outreach, AECS, contributed the chapters to the manual. Seva volunteers, includingCommunity participation Ms. Julie Johnston and the Aravind Communicationsis very essential for running team, helped with the proof reading and editing. Dr. G.eye camps in a sustainable Natchiar, Director Emeritus-AECS, released the manual.manner. The community partners act as a bridge for the Dr. R. Pararajasegaram and Dr. Suzanne Gilbert receivedcommunity to access eye care services. To acknowledge the first copies.the support of these partners and social serviceorganisations, Aravind organises Sponsors’ Day in its Annual Meet on Outreach Planningvarious centres once every two years. In 2016, Aravind’sbase hospitals in Madurai, Coimbatore, Tirunelveli and Aravind’s outreach teams across the centres meet everyPondicherry celebrated Sponsors’ Day. year to review the performance and share best practices, so as to improve the services to benefit many more in Sharing knowledge and best practices has always the community. Aravind-Coimbatore hosted the annualbeen a core activity at Aravind. Efforts spanning a meeting in January 2017.decade came to fruition on October 1, 2016, whenAravind released a manual, titled Reaching the Unreached: Awareness CreationCommunity Eye Care Outreach in Developing Nations. Themanual exhaustively details the various aspects to be Lions Clubs have always been supporting Aravindconsidered to ensure the success of outreach initiatives in its various blindness-prevention activities. Every year, Aravind conducts eye care-awareness sessions - SightFirst Seminar - for the new office bearers of Lions Clubs. On August 14, 2016, Aravind-Madurai conducted the SightFirst seminar for the team of President, Secretary and Treasurer of Lions District 324-B3. Similarly, Aravind-Pondicherry and Aravind- Coimbatore conducted seminars for new office bearers of other Lions Clubs on August 28 and September 11, 2016, respectively. Aravind has been organising school children screening camps to identify cases with refractive errors and other eye problems. With a view to ensuring teachers’ support to the initiative, Aravind, in 2016 organised an eye care-Annual planning meet of the Outreach team held at Aravind-Coimbatore28

Dr. R. Venkatesh addressing the participants of SightFirst visited the Aravind vision centres to know more aboutSeminar at Aravind-Pondicherry its operational model; some of the significant teams included senior officers from the Institute of Secretariatawareness programme for Government/Government- Training and Management (ISTM), Government ofaided school headmasters in Tirunelveli. About 160 India, New Delhi; TOMS a for-profit company basedperson attended the programme, which mainly covered in the United States; Kewa Pueblo Health Corporationcommon eye diseases in children. (KPHC), New Mexico, USA; and Operation Eye Sight Universal, Canada.Various states in India, such as As a way of reaching out to the general public, Chhattisgarh, Jharkhand and Uttar Pradesh are in theAravind arranged awareness programmes in the forms of process of replicating the Aravind model. BRAC, onerallies, talks and exhibitions on the occasions of World of the largest NGOs in the world, operating out ofDiabetes Day, World Glaucoma Week and World Sight Bangladesh has replicated the model in three locationsDay. and has made a commitment to reach out to one million people by 2018.Vision Centres Peopled by ophthalmic technicians, Aravind visionThe Aravind model of primary eye care delivery has centres are able to reach 40% of the community in thebeen well-acclaimed in many fora, and this model is first year, rising to 75% in the following year, and areincreasingly being sought-after by eye care providers equipped to resolve 91% of the problems locally. In thein India and other countries. In the year ending March last financial year, vision centres were opened at Sivagiri2017, close to 200 visitors from various organisations (April 24), Tiruvennainellur (June 3), Kuniyamuthur (October 28) and Sithayankottai (November 25). In 2016-17, the vision centres handled a total of 524,269 outpatient visits. In addition to providing eye care services, the vision centres proactively involve in eye care-awareness programmes by organising camps on different occasions and for targeted communities. Aravind has regularly arranged Continuing Medical Education (CME) programmes to update vision centre technicians on the latest developments in the field and, thereby, improve the quality of care.Dr. R. Ramakrishnan addressing the school headmasters at Aravind-Tirunelveli 29

Vision Centres inauguratedfrom April 2016 to March 2017 SithayankottaiSivagiri Kuniyamuthur TiruvennainellurSponsors’ DayAravind-Madurai Aravind-Pondicherry Aravind-TirunelveliAravind-Coimbatore30

World Glaucoma Week Aravind-Pondicherry Aravind-TheniWorld Diabetes Day Aravind-Tirunelveli Aravind-SalemEye care awareness programme and camp organised by vision centres.... . at Tiruppuvanam . . at Alanganallur 31

Outreach Performance April 2016 - March 2017 Total Madurai Theni Tirunelveli Coimbatore Pondicherry Tirupur Salem Tuticorin Udumalpet CBE CCSCREENING CAMPSComprehensive Eye Camps 1,530 369 110 276 363 279 - 110 23 - - Camps 337,671 94,955 16,205 45,727 87,952 76,803 - 12,747 3,282 - - Patients examined 18,468 11,280 17,011 20,964 - 2,686 478 - - Glasses prescribed 74,449 15,405 3,562 13,286 16,579 - 2,307 425 - - Glasses delivered 60,584 32,096 3,292 9,290 22,429 19,684 504 3,157 614 325 - Patients operated 92,022 2,964 10,249 Diabetic Retinopathy Screening Camps Camps 309 57 71 32 83 65 - 1 - - - - Patients examined 32,703 10,503 2,553 1,879 10,652 7,071 - 45 - - - - Diabetics screened 16,851 4,518 2,477 1,530 4,524 3,772 - 30 - - DR Patients screened 1,771 380 276 244 565 303 - 3 - - Refraction Camps 239 47 18 62 33 57 5 7 - 10 - Camps - 2,378 - Patients examined 52,345 10,826 3,884 12,723 10,230 10,795 383 1,126 - 349 - Glasses prescribed - 234 - Glasses delivered 19,057 4,294 1,701 5,111 3,524 3,729 42 307 - - - On the spot deliveries 15,812 3,907 1,552 4,348 2,906 2,551 35 279 11,259 2,890 1,202 3,513 1,666 1,898 - 90 Refraction Camps by Mobile Unit 77 - - - 64 - - 13 - - - Camps 17,759 - - - 16,711 - - - Patients examined - - - 2,675 - - 1,048 - - - Glasses prescribed 2,850 - - - 1,830 - - - Glasses delivered 1,973 - - 175 - - 143 Eye Screening of School Children-Base Hospital Schools served 179 10 18 51 51 26 5 18 - - - Camps 176 5 18 51 49 31 5 17 - - - Teachers trained 1,650 146 133 713 4 654 - - - - - Total children in school 245,582 17,333 26,341 82,638 41,291 51,839 1,476 24,664 - - - Children screened by ophthalmologist 54,250 1,291 2,271 5,498 34,199 8,809 287 1,895 - - - Children received glasses 7,965 493 1,081 2,108 1,539 1,930 17 797 - - - Children id. with eye defects other than RE* 2,504 54 258 584 638 765 4 201 - - -Eye Screening of School Children-Vision Centres Schools served 3 3 - - - - - - - - - Camps 2 2 - - - - - - - - - Teachers trained 2 2 - - - - - - - - - Total children in school 2,383 2,383 - - - - - - - - - Children screened by ophthalmologist 280 280 - - - - - - - - - Children received glasses 66 66 - - - - - - - - - Children id. with eye defects other than RE* 47 47 - - - - - - - - -School Children Screening Camps-Projects School served 403 403 - - - - - - - - - - Camps 59 59 - - - - - - - - - - Teachers trained - - - - - - - - - - - - Total children in school 76,131 76,131 - - - - - - - - - Children screened by ophthalmologist 6,917 6,917 - - - - - - - - Children received glasses 2,587 2,587 - - - - - - - - Children id. with eye defects other than RE* 462 462 - - - - - - - - Paediatric Eye Screening Camps 130 - 3 6 6 115 - - - - - Camps 75,425 827 71,819 Children examined - 1,110 1,669 - - - - - Refractive errors 1,762 31 1,432 Glasses prescribed 836 - 78 221 19 814 - - - - - Glasses delivered 827 10 814 Other defects identified - 3 - 40 920 - - - - - 1,028 - 3 - - - - - - - 18 50 - - - - -VISION CENTRES 61 25 7 11 5 9 2 - - 2 - Centres 524,269 217,272 61,607 116,287 41,230 63,229 10,986 - - 13,658 - New + Review Out-patients / day 28 29 28 34 30 23 18 - - 22 -COMMUNITY EYE CLINICS AND CITY CENTRESCentres 6 3 1 1 - 1 - - - - -New + Review 193,613 107,754 22,883 31,954 - 31,022 - - - - - Outpatients / day 104 116 74 103 - 100 - - - - - *Refractive Error32

EDUCATION AND TRAININGOver the years, Aravind has increasingly refined its teaching We are the sum of ourfacilities, course structure and methodologies to attract the decisions. I shall alwayscountry’s best students. Today, it is one of India’s most esteemed be glad that I chose totraining institutes for ophthalmology. Since 2016, Aravind- spend two very importantSalem has been allotted four DNB seats. In the last year, 51 years of my life at Aravind-doctors completed postgraduation in ophthalmology,126 Tirunelveli. I did not justophthalmologists completed long-term fellowships and 173 receive an educationcompleted short-term fellowships in the various sub-specialities there that would carvein ophthalmology. A total of 237 people received training in my career, but I learnt avarious areas of eye care management, and 35 people underwent number of very importanttraining in various ophthalmic technician courses. life lessons, which have helped me evolve as anApart from this, nine conferences were conducted as CME for individual, too.ophthalmologists at various Aravind facilities. A total of 93 articleswere published in peer-reviewed journals. - Dr. Meghana Tanwar, DNB student inOphthalmologists travelled far and wide to present scientific Ophthalmology, Aravind-papers, posters and videos at various workshops and courses inIndia and around the world. Seven Aravind Medical Officers went Tirunelvelito premier eye institutes in the United States to gain exposure intheir areas of clinical interest. 33

Candidates Trained 2016-17 Total Candidates: 622 POSTGRADUATE COURSES 7 13 Diploma in Ophthalmology (2 years) 15 Master of Surgery in Ophthalmology (3 years) 16 Diplomate of the National Board (3 years) Post DO DNB (2 years) 13 LONG-TERM OPHTHALMOLOGY FELLOWSHIP 10 Anterior Segment / Intraocular Lens Microsurgery (2 years) 13 Orbit & Oculoplasty (18 months) 16 Paediatric Ophthalmology and Strabismus (18 months) 24 Glaucoma (2 years) 23 Retina Vitreous (2 years) Cornea (18 months) 4 Comprehensive Ophthalmology (2 years) 22 Fellowship in General Ophthalmology Fellowship in Uvea (18 months) 1 SHORT-TERM CLINICAL COURSES FOR OPHTHALMOLOGISTS 33 Small Incision Cataract Surgery (1 month) 36 Clinical Observership Programme in Diagnosis and 51 Management of Glaucoma (1 month) Lasers in Diabetic Retinopathy Management (2 months) 1 Vitrectomy (Virtual) (2 weeks) Management of Retinopathy of Prematurity and Paediatric 7 Retinal Disorders (1 month) Orientation to Paediatric Ocular Anaesthesia for 1 Anaesthetists (1 month) 2 Neuro-Ophthalmology (3 months) 42 Phacoemulsification SHORT-TERM PARAMEDICAL COURSES Optical Dispensing (3 months) 6 OT Techniques (2 months) 4 Refraction Techniques (2 months) 8 Orthoptist (6 months) 5 Ocularist (3 weeks) 8 Fundus Fluorescein Angiography and Ultrasonography (2 months) 4 MANAGEMENT COURSES 42 Management Priorities in Eye Care Delivery (1 week) 17 Management Training and Systems Development for 5 Hospital Administrators / Managers (4 weeks) Project Management training for Eye Care (2 weeks) 31 Eyexcel - Expanding Global Eye Care Workforce 56 through Excellence in Training (4 days) Research Methodology (5 days) 1 Medical Records Management (2 weeks) Management Training for Eye Care Programme 29 Managers (2 weeks) 7 Fellowship in Eye Hospital Management Community Outreach and Social Marketing of Eye 20 Care Services (3 weeks) 28 Instrument Maintenance - for Technicians (4 weeks) Training in Eye Bank Techniques (1 month) 134

CMEs and Training Programmes held at AravindCourse on Instruments Care and Maintenance inan Eye HospitalAravind-Salem, May 27-29, 2016Twenty-four participants from eight different hospitalsin and around Salem, Karur and Namakkal districtsattended the course. The team serviced more than 40ophthalmic equipment and instruments brought by theparticipants to the workshop.CME on Infectious Uveitis Course on Instruments care and maintenance, Aravind-SalemAravind-Salem, June 19, 2016 Dr. Karl Golnik, Professor of Neuro-Ophthalmology,The CME was organised in association with the Cincinnati Eye Institute, USA; Dr. Prem Subramanian,Uveitis Society of India and the Salem Ophthalmic Professor and Division Head, Neuro-Ophthalmology,Association. A total of 62 participants attended the University of Colorado School of Medicine, USA andCME. Apart from Aravind faculty, Dr. S. Sudharshan, Dr. Peter Macintosh, Assistant Professor of Neuro-and Dr. Parthapratim Majumder, Medical Consultants, Ophthalmology and Oculoplasty, Illinois Eye and EarUvea Clinic, Sankara Netralaya, Chennai handled the Infirmary, Chicago, USA, handled the sessions.sessions. PG Refresher Course in OphthalmologyUpdate on Neuro-Ophthalmology(UNO-2016) Aravind-Madurai, September 1-3, 2016 Aravind-Madurai hosted the three-day South ZoneAravind-Coimbatore, July 30-31, 2016 Refresher Course, organised by the Academic ResearchThe seventh update aimed at orienting the participants Committee of the All India Ophthalmological Societyto the slowly changing trend of visual debilitation. (ARC-AIOS), with support from Sun Pharma. TheA dry lab session was held in the hospital premises on faculty comprised doctors from Aravind Eye Hospitals,July 29, 2016, which attracted more than 180 doctors. Sankara Nethralaya, Chennai; Arasan Eye Hospital,Dr. D. Chandrasekhar, Medical Officer, Aravind- Erode and Centre for Sight, Hyderabad. A total of 175Coimbatore and Dr. N. Siddharth, Medical Officer, exam-going postgraduates from Tamil Nadu, Kerala andAravind-Udumalpet conducted a quiz. A total of 330participants attended the update. In addition to Aravindand national faculty, international faculty, includingSeventh Update on Neuro-Ophthalmology (UNO-2016) at Aravind-Coimbatore 35

Dr. K.G. Srinivasan at the AIOS-Sun Pharma PG Refresher organised as part of the CME. A total of 95 participantsCourse in Ophthalmology from Tamil Nadu, Kerala and Karnataka attended the CME.Andhra Pradesh participated in the course. Interactivebrainstorming sessions were conducted with a focus Phaco Excel 2016on enhancing the participants’ skills in all the sub-specialties of ophthalmology. Aravind-Pondicherry, November 12-13, 2016 Cataract surgery is rapidly developing and newCME on Low Vision Aids phacoemulsification has transformed it into refractive surgery, which is now in common practice around theAravind-Salem, September 11, 2016 world. With the advancement in phaco machines andThe CME aimed to update knowledge of personnel technologies, revolutions have been experienced in thisworking in the field of low vision and rehabilitation. field. Phaco Excel 2016, with its all-inclusive, integratedThe faculty included Dr. B. Manohar Babu, Chief emphasis on advanced surgical techniques, aimed toMedical Officer, Aravind-Salem; Dr. Sandra Ganesh, help practising ophthalmologists and transitioningMedical Consultant, Paediatric Ophthalmology and surgeons alike in both understanding and optimisingAdult Strabismus Services, Aravind-Coimbatore; phaco technology. The CME included scientificDr. A. Fathima, Medical Consultant, Cataract Services, sessions, workshops and live surgery. A total of 280Aravind-Tirunelveli and Dr. K. Ilango, the then Chief, participants attended the CME. Resource personsVision Rehabilitation Services, Aravind-Madurai, included Dr. Ehud Assia, Medical Director, Meirand Ms. H. Jeyaseeli Flora, Vision Rehabilitationist Medical Center, Ein-Tal Eye Center, Israel; Dr. GaborAravind-Madurai. Dr. Tanuja Britto, Senior Medical Scharioth, Senior Consultant, Aurelios Augenzentrum,Consultant, Low Vision Services, Joseph Eye Hospital, Recklinghausen, Germany and Dr. Lisa Park, AssociateTrichy was the guest faculty. Hands-on sessions were Professor, New York University School of Medicine. It also included faculty from various Aravind EyeCME on Low Vision Aids, Aravind-Salem Hospitals and other eye care facilities in the country. Workshops on Sterilisation and Aseptic Techniques Aravind-Madurai Aravind-Madurai, along with the Tamil Nadu State Blindness Control Society and National Health Mission organised the workshop for staff nurses and theatre assistants working in ophthalmic operation theatres in the government hospitals of Tamil Nadu. This five-day residential workshop was conducted in three batches (December 2-7, and 16-21, 2016 and January 6-11, 2017) Participants to Phaco Excel 2016 at Aravind-Pondicherry36

Dr. S.R. Rathinam addressing the audience at Uvea 360°consisting a total of 68 participants. Topics covered Education and Research, Chandigarh; Vasan Eyeincluded cataract surgery protocols, aseptic protocols, Hospital, Vijayawada; Kasturba Medical College,operation theatre work flow, OT cleaning and infection Manipal and Prabha Eye Clinic, Bengaluru shared theircontrol. A similar workshop was conducted for District valuable experiences. Further, Dr. Arul Rajamurugan,Programme officers on February 3, 2017 with the main Rheumatologist from Government Rajaji Hospital,focus on prevention of endophthalmitis. Madurai and Dr. K.G. Srinivasan from K.G.S. MR and CT Scans, Madurai, shared their vast knowledge on theUvea 360° - A Holistic Approach to Uveitis subject. A total of 155 delegates attended the CME.Aravind-Madurai, January 28-29, 2017 Update on Cornea DisordersThe CME was organised on the occasion of the UveaDepartment at Aravind completing 25 years of service. Aravind-Salem, March 25, 2017The distinguished faculty comprised Professor Narsing The update was handled by Aravind CorneaA Rao, Professor of Ophthalmology and Pathology, Consultants Dr. M. Srinivasan, Aravind-Madurai;University of Southern California, USA; Professor Dr. R. Revathy, Aravind-Coimbatore; Dr. B. ManoharEmmett T. Cunningham, Director of the Uveitis Service, Babu and Dr. J. Anuja, from Aravind-Salem. A total ofCalifornia Pacific Medical Center, USA and Dr. Edoardo 120 participants attended the CME, which consistedBagalivo from Switzerland. In addition to 14 Aravind of scientific sessions, talks and a quiz programme. Anfaculty, experts from Sankara Nethralaya, Chennai; informal get-together of participants withL.V. Prasad Eye Institute, Hyderabad and Dr. M. Srinivasan was arranged, where fellows andBhubaneshwar; Postgraduate Institute of Medical postgraduate students presented cases to the senior faculty.Workshops on Sterilisation and Aseptic Techniques for OphthalmicOperation Theatre at Aravind-Madurai Inaugural ceremony of Update on Cornea Disorders at Aravind-Salem 37

Internal Capacity Building Dr. Seema Ramakrishnan, Cornea and Refractive Surgery Services, Aravind-PondicherryEvery year, Aravind sends ophthalmologists tocollaborating institutions in the United States, where May 11-24, 2016they can observe clinical procedures specific to Dr. Seema Ramakrishnan visited Cornea Clinic attheir area of expertise under eminent clinicians and UCSF, where she met Professors in Ophthalmolgy-implement the learning in their practice at Aravind. Cornea Services, Dr. Thomas M. Lietman and Dr. DavidFollowing is the list of doctors who underwent the Hwang. She also interacted with Dr. Jennifer Rose-capacity building programme in 2016. Nussbaumer, Assistant Professor, Cornea Services. She also visited Dr. David Chang’s facility in Los Altos,Dr. P.S. Vivek, Glaucoma Services, California, and at Jules Stein Eye Institute, University ofAravind-Madurai California, Los Angeles (UCLA), she observed under Dr. Anthony Aldave and Dr. Sophie Deng.March 23 - May 5, 2016Dr. P.S. Vivek visited the Glaucoma Department of Dr. Neelam Pawar, Paediatric Ophthalmology andMoorfields Eye Hospital, London where he had the Adult Strabismus Services, Aravind-Tirunelveliopportunity to observe various consultants, includingProfessor Sir Peng Khaw. At Wilmer Eye Institute, September 14 - October 18, 2016Johns Hopkins University, Baltimore, he spent time to Dr. Neelam Pawar was at Jules Stein Eye Institute,observe glaucoma specialists, Dr. Pradeep Y. Ramulu, UCLA, where she did observership under the guidanceDr. Harry Quigley, Dr. David Friedman and Dr. Henry of Dr. Joseph Demer, Chief, Paediatric OphthalmologyJampel. He attended their weekly lectures/grand and Strabismus Division. She had the opportunity torounds. observe his famous functional coil MRI and MRI in high myopic eyes, decompensated esophoria. She had the Dr. Vivek visited California Pacific Medical Center opportunity to learn some points on his original concept(CPMC) where he observed glaucoma consultants of pulley mechanism in rectus muscle insertion, pulleyDr. Marc Lieberman, Dr. George Tanaka, Dr. Sunita dimensions in etiology of strabismus as well as on theRadhakrishnan, Dr. Terri Pickering and Dr. Jason techniques of adjustable strabismus surgeries in veryBacharach. He also got the opportunity to observe elderly patients Dr. Neelam spent with Dr. FedericoDr. Robert Stamper, Director, Glaucoma Clinic, G Velez, Consultant, Department of PaediatricUniversity of California, San Francisco (UCSF). He Ophthalmology and Adult Strabismus, and learntattended the Uveitis grand rounds at CPMC which was essential tips in paediatric cataract management,chaired by Dr. Cunningham. He attended the ARVO intermittent exotropia management and the conceptconference in Seattle and presented a poster. of binocular summation in intermittent exotropia. She interacted with Dr. Sherwin Isenberg, Consultant,Dr. P.S. Vivek with Dr. Robert Stamper at Wilmer Eye Institute Dr. Seema Ramakrishnan with Dr. Stephen McLeod and Dr. Tom Lietman at UCSF38

Department of Paediatric Ophthalmology and cases of Birdshot choroidopathy, which is rare in India.Strabismus, who taught her some of the unique She observed that intravitreal injections, Ozurdex andexaminations in checking lateral versions of movements. Lucentis are very commonly administered in the out-Dr. Neelam also spent time with Dr. Kevin Miller, patient department. Dr. Anuradha also attended theHead, Cataract and Refractive Surgeries, UCLA and rounds after the clinic, where all the doctors and thewas exposed to clinical activities and procedures and technicians come together to discuss the condition ofsubstantially learnt about IOL power calculations in patients. This offers a chance for identifying patientspost LASIK patients, astigmatism management and who are not doing well; get a second opinion fromHumanoptics artificial iris. colleagues and plan for a proper follow-up. At Wilmer Eye Institute, Dr. Neelam observed under She also participated in the investigators meetingDr. David Guyton, Chief, Department of Paediatric of the First line Antimetabolites as Steroid sparingOphthalmology and Strabismus and attended his Treatment (FAST) trial held in Chicago.lectures on Optics and Refraction. He shared hisexperiences on adjustable adult and paediatric Dr. R. Jayagayathri, Orbit, Oculoplasty and Ocularstrabismus surgeries. She had an opportunity to observe Oncology Services, Aravind-Pondicherrycases of Inverted Browns syndrome, Dragged FoveaSyndrome and unique tests in the field of strabismus. September 26 - October 28, 2016 Dr. R. Jayagayathri visited Bascom Palmer Eye Institute,Dr. V.K. Anuradha, Uvea Services, West Palm Beach, University of Miami, Florida whereAravind-Coimbatore she observed orbital decompression and fracture repairs. While there, she also learnt the art of oculoplastySeptember 19 - October 18, 2016 photography skills from Dr. Bradford Lee, ConsultantDr. V.K. Anuradha visited Proctor I. Foundation, Oculoplasty Surgeon.UCSF and attended the Uveitis Clinics with Dr. NishaAcharya, Associate Director, and Dr. John A Gonzales, Later, she visited the Kellogg Eye Center, UniversityAssistant Professor. She gained an insight into the of Michigan, Ann Arbor where she observed state-of-treatment they follow in cases of Herpetic stromal the-art technology like Stryker SONOPET and surgerieskeratitis and CMV anterior uveitis. She attended using 3D navigational technique.the weekly grand rounds and had the privilege oflistening to Dr. Srinivas Sadda, Associate Professor of Dr. Jayagayathri also observed Dr. Alon Kahana,Ophthalmology, Keck School of Medicine, Doheny Eye Senior Consultant in Oculoplasty, who demonstratedInstitute, University of Southern California. navigational surgeries. She obseved Dr. Hakan Demirci, Ocular Oncologist and Oculoplasty Surgeon perform lid At Wilmer Eye Institute, Dr. Anuradha attended reconstruction techniques. She also met Dr. Victor M.the Uveitis Clinic with Dr. Jennifer Thorne, Chief, Elner, Specialist in Ocular Pathology and OculoplastyDivision of Ocular Immunology. She witnessed a few Surgeon, who emphasised the anatomical basics for being a good surgeon.Dr. Neelam Pawar with Dr. Sherwin Isenberg at Jules Stein Dr. R. Jayagayathri with Dr. Brad Lee at Bascom PalmerEye Institute Eye Institute 39

Dr. Jayagayathri attended the weekly grand rounds out substantial work in Graft Versus Host Disease.and participated in the International Ophthalmology Dr. Mangala also observed workup procedures andnight there, where she had the opportunity to meet treatment protocol of patients at the Infirmary.Dr. Alan L. Robin, Associate Professor Ophthalmologyand International Health, Johns Hopkins University, Later, she visited an eye bank in Chicago, whereBaltimore and Dr. Hugh Taylor, pioneer in Community she observed the preparation of the precut tissues forOphthalmology, Australia. DMEK and DSEK. Upon request, she handled a session and provided wetlab training on Small Incision CataractDr. P. Mangala, Cornea Services, Surgery (SICS) for the postgraduates there.Aravind-Coimbatore Dr. Ashok Vardhan, Aravind-MaduraiSeptember 29 - November 4, 2016Dr. P. Mangala visited Massachusetts Eye and Ear Dr. Ashok Vardhan spent a year as a clinical researchInfirmary, Boston and observed Dr. Roberto Pineda, fellow at the Wilmer Eye Institute beginning inDirector, Cornea and Refractive Services. She had an September 2015. He was sponsored by Dr. Davidopportunity to observe him perform keratoplasty, Friedman and Dr. Pradeep Ramulu for the fellowshipparticularly Descemet’s Membrane Endothelial and under their guidance he was exposed to variousKeratoplasty (DMEK). She also observed various ongoing studies at the Dana Center for Preventivecomplicated cataract surgeries and secondary IOL Ophthalmology, Johns Hopkins University. Heprocedures. participated in studies on hypertension amongst patients visiting the glaucoma clinic, and a glaucoma Dr. Mangala attended the Cornea and Refractive screening project, “STOP GLAUCOMA” for the AfricanSurgery sub-speciality day at the Annual Meeting of Americans. He attended classes on biostatistics at theAmerican Academy of Ophthalmology. While there, Bloomberg School of Public Health. Dr. Pradeep Ramulushe also attended two wetlab sessions organised by and Dr. Alan Robin mentored him in writing an AravindSightLife, where she got an opportunity to observe study on systemic disease association in patients withlive DMEK and endosertor Descemet’s Stripping Pseudoexfoliation Syndrome, which will be publishedEndothelial Keratoplasty (DSEK) injectors. in JAMA in April 2017. He also visited the University of IOWA and Kellogg Eye Center and learnt about their At the Illinois Eye and Ear Infirmary, Chicago, research division setup. His one year stint at WilmerDr. Mangala observed Dr. Elmer Tu, Director, Cornea has helped firm Aravind’s collaboration with them andServices. She also attended clinics with Dr. Joel equipped him with knowledge on designing studies,Sugar, Professor of Ophthalmology, Cornea Services. reviewing articles and statistical analysis. His aim is toShe saw a number of endothelial keratoplasties. facilitate research activities at Aravind, improving theFurther, she attended clinics with Dr. Sandeep Jain, quality and quantity of research projects.Associate Professor, Cornea Services who has carriedDr. P. Mangala with Dr. Roberto Pineda at Massachusetts Eye Dr. Ashok Vardhan at Wilmer Eye Instituteand Ear Infirmary40

Commonwealth Eye Health ConsortiumThe Queen Elizabeth Diamond Jubilee Trust set up a five year programme in 2014 called “CommonwealthEye Health Consortium” (CEHC) with the aim of providing access to sub-specialist training and technologyadvancements in the field of eye health in many countries across the Commonwealth. Aravind Eye CareSystem (AECS) is one among the training centres taking a leadership role in this prestigious project andhas contributed the maximum number of training. Dr. N. Venkatesh Prajna, Director, Academics, AECSis also a member of the steering committee of the CEHC and coordinates this training across all theAravind centres. A total of 11 ophthalmologists from Nigeria, Kenya, Tanzania, Malawi and Rwanda havecompleted various long term fellowship training programmes of one year duration in the fields of Cornea,Retina, Glaucoma, Paediatric Ophthalmology and Orbit. Apart from this, eight other ophthalmologistsare undergoing this training programme currently. In addition, ophthalmic technicians have beenprovided with short-term training programme in Microbiology, Fundus Fluorescein Angiography andUltrasonography.Conferences Attended Elsewhere Dr. P. Sundaresan - Identification of six gene variants in Indian primary open angleAs conferences provide a better platform for sharing ofbest practices, learning and networking, staff at Aravind glaucoma patientsare always encouraged to participate in various forawithin the country as well as overseas. Given below is Dr. P. Sundaresan at US-ARVOthe list of various national and international conferencesattended by Aravind doctors, administrators/managers,LAICO faculty and scientists from Aravind MedicalResearch Foundation during April 2016 - March 2017:Association for Research in Vision andOphthalmology (ARVO)Seattle, USA, May 6-9, 2016Professor K. Dharmalingam and Mr. Naveen LukeDemonte- Antifungal defence proteins induced in tear fluid of mycotic keratitis patients: A quantitative proteomics study 41

Dr. P.S. Vivek Annual Conference of American Society of- Comparison of intra-operative injection of Mitomycin C Cataract and Refractive Surgery (ASCRS) (MMC) versus conventional sponge-applied MMC during double site phaco-trabeculectomy New Orleans, USA, May 6-10, 2016Dr. Haripriya Aravind Dr. Haripriya Aravind - Aravind Pseudoexfoliation (XFS) study 3 year post-operative results”. Instruction coursesDr. Siddharth Narendran - Preparing for surgical missions- Evaluation of macular and peripapillary choroidal thickness - iTrace educational symposium using enhanced depth imaging Spectral Domain Optical - Femtosecond laser-assisted cataract surgery: Where are we Coherence Tomography (SD-OCT) in patients with essential hypertension today?Dr. R. Venkatesh - Challenging phacoemulsification cases: Combining techniques- Environmental life cycle assessment and costs of phacoemulsification at Aravind Eye Hospital in Pondicherry, and technology India - High-volume, high-quality, cost-effective cataract surgery for- Comparison of new visual disturbances after superior Vs nasal/ temporal laser peripheral iridotomy: A prospective randomized the developing world trial- The photographer’s learning curve: Image quality over time As panelist for the following paper sessions: in non-mydriatic fundus photographs taken with a portable - Cataract surgery complications camera - Efficacy of intracameral Moxifloxacin endophthalmitis- Intraocular pressure reduction following phacoemulsification Vs. manual small incision cataract surgery: A randomised prophylaxis at Aravind Eye Care System controlled trial - Aravind Pseudoexfoliation Study: Three year post-operativeDr. Ashok Vardhan- Systemic diseases associated with ocular pseudoexfoliation results (Aravind Pseudoexfoliation study) - ECCE/SICSDr. Manish Tandon Dr. R. Venkatesh- Role of intravenous Methyl Prednisolone in closure of recent - IOP lowering after cataract surgery: Randomised trial post traumatic full thickness macular hole-a case series comparing phacoemulsification and manual small incisionHe also visited University of British Columbia, cataract surgeryVancouver, Canada as invited faculty and gave talks on: - Femtosecond laser-assisted cataract surgery: Where are we today?- Retinopathy of prematurity - different case scenarios and my - High-volume, high-quality, cost-effective cataract surgery for learning the developing world (Instruction course) Video Presentation- Role of intravenous Methyl Prednisolone in Traumatic full - My second innings with femtosecond laser-assisted cataract thickness macular holes surgery - Eye on emissions: Carbon footprint of cataract surgery inAravind team with Dr. David Chang at ASCRS Conference Aravind Eye Hospital - Traumatic cataract memoirs - Vacuum-assisted whole-globe holder: New simple and cost- effective device for wetlab training Dr. K. Veena Instruction Course - High-volume, high-quality, cost-effective cataract surgery for the developing world, Basics of SICS - Seeing the world through new lens-siblings screening to tackle childhood refractive error with sibling motivation card Dr. Mohideen Abdul Kader - Safe, simple, cost-effective method for intraocular lens exchange He also made an observation visit to Bascom Palmer Eye Institute, Miami, USA. Dr. Seema Ramakrishnan Instruction Course - High-volume, high-quality, cost-effective cataract surgery for the developing world - Management of surgically induced astigmatism and conversion - Vacuum-assisted whole-globe holder: New, simple and cost- effective device for wetlab training (Video presentation)42

- Comparison of the effect of Nepafenac 0.1% and Ketorolac Tromethamine 0.4% on post-phacoemulsification macular thickness: Prospective randomised studyDr. Sathya T Ravilla- Visual outcomes in hydrophobic and hydrophilic Toric IOLs - retrospective analysis- Wetlab training: Being prepared to handle complications during cataract surgery (Film)- Assuring quality and ensuring efficiency in high-volume settings (Instruction course)Annual Conference of Vision 2020: The Right to Dr. R. Venkatesh at NHS Scotland EventSight - INDIA NHS Scotland Event 2016Pune, India, June 4-5, 2016 Glasgow, Scotland, June 13-15, 2016 Dr. R. VenkateshDr. R.D. Ravindran, was involved in the design of the Keynote addressoverall programme along with the Vision 2020 India - Journey of Aravind in developing the organisational approachcommittee members. to quality over the last three decades Ms. K.M. Sashipriya took part in the designing of theleadership track of the conference. Mr. R.D. Thulasiraj Tele-e-Healthand Dr. R.D. Ravindran contributed as speakers in Organised by Telemedicine Society of Indiavarious sessions of the programme. Madurai, India, June 19, 2016Mr. Mohammed Gowth Dr. P. Namperumalsamy, delivered the special address- Use of data analysis for improving outreach services on Telemedicine-TelehealthMs. Dhivya Ramasamy- Training Resources for eye care Asia Pacific Tele - Ophthalmology SocietyMr. Sanil Joseph- Effectiveness of telemedicine in identifying diabetic retinopathy Beijing, China, June 19, 2016 Mr. B.S. Ganesh Babu cases - Aravind’s tele-ophthalmology initiativesDr. Usha Kim participated in the Vision Technician’smeeting held as part of the conference.Dr. K. Thiruvengadakrishnan, Ms. S. Sunytha,Mr. C. Gnanasekaran, Mr. N. Vikky Kumar,Mr. N. Vengadesan and Mr. M. Ranjith Kumarparticipated in the conference.Dr. P. Namperumalsamy being felicitated at the Tele-e-Health Mr. B.S. Ganesh Babu at the Asia Pacific Tele - OphthalmologyConference Society Meeting 43

Dr. R. Sharmila and Dr. Ganesh V. Raman at the European AMRF team at the 23rd Annual Meeting of IERG in HyderabadGlaucoma Congress in Prague, Czech RepublicEuropean Glaucoma Congress K. Kathirvel - Comparative genome analysis to identify genomic variants andPrague, Czech Republic, June 19-22, 2016Dr. R. Sharmila genes associated with drug resistance in ocular Pseudomonas- Comparison of surgical outcomes of trabeculectomy Vs. phaco- aeruginosa isolates K. Lavanya trab in eyes with POAG and PACG - Micro-RNA profiling of enriched corneal epithelial stem cellsDr. Ganesh V. Raman Madhavi Latha Yelchuri- Changes in central macular thickness and the effect of topical - Investigating the relationship between central Macular Pigment Optical Density (MPOD) and plasma carotenoids in Indian NSAID (Nepafenac) following phacotrabeculectomy population K. Manoj KumarInternational Diabetes Update 2017 - Comparison of variant calling pipelines for SNVs and InDels in exome data of normal and patient with eye diseaseChennai, India, July 29-31, 2016 Mohammad Hussain Dr. R. Kim - Identification of SIX6 gene variants in Indian primary open- Diabetic retinopathy: The Indian scenario, updates on screening angle glaucoma patients S. Mohammad Razeeth models in India - Effect of alkaline protease deletion in Aspergillus flavus KRP. Niranjana23rd Annual Meeting of Indian Eye Research - Zinc alpha-2 glycoprotein regulation in Aspergillus flavusGroup (IERG) - ARVO India Chapter keratitis Sandhya KrishnanHyderabad, India, July 30-31, 2016 - Understanding the role of complement regulatory protein factorProfessor K. Dharmalingam H in tear fluid of mycotic keratitis patients- Proteomics of eye diseases. S. Yogapriya- Proteomics for clinicians. - Structural and functional integrity of corneal endothelium afterDr. C. Gowripriya storage in cornisol, an indigenous intermediate corneal storage- Molecular signature of highly enriched corneal epithelial stem medium cells 9th International Symposium on UveitisDr. S. Senthil Kumari- Attenuation of lipofuscin bisretinoids (A2E) accumulation by Dublin, Ireland, August 18-21, 2016 Dr. S.R. Rathinam macular carotenoids in human retinal pigment epithelial cells - Trematode Uveitis in vitro Dr. B. Manohar BabuAswin Balaji - Rickettsial Uveitis- Effects of SB772077B on rock expression in human trabecular meshwork cellsT.S. Balaji- Assessing the role of RB1 mutations in chemo resistance of retinoblastomaA. Divya- Aspergillus flavus infection induced changes in the proteome of human corneal epithelial cell line (Best Paper Award)44

Dr. B. Manohar Babu at the 9th Internation Symposium on Dr. V. ManekshaUveitis, Dublin, Ireland - Orbital infections Dr. Seema RamakrishnanWCOA 2016 - 4th World Congress of Ophthalmic - Principles of open globe injury repairAnaesthesia American Academy of Ophthalmology –Chennai, India, September 3-4, 2016 Asian Society of Continuing Medical EducationDr. R. Venkatesh Summit 2016- Assuring quality and safety in high-volume cataract surgery New Delhi, Indis, September 9-11, 2016Annual Conference of Ocular Trauma Society of Dr. N. Venkatesh PrajnaIndia - Femto and Microkeratome flaps - Voriconazole Vs. Natamycin in treatment of fungal keratitisCoimbatore, India, September 4-5, 2016Dr. R. Kim FAST Trial Investigators’ Meeting- Traumatic Retinal detachment ManagementDr. Manoranjan Das Chicago, USA, October 14, 2016- Management of the co-existent corneal infections and injury He also shared inputs on the principles of corneal tear Aravind’s Uvea consultants, Dr. S.R. Rathinam, Dr. S. Balamurugan and Dr. V.K. Anuradha attended management at the Video Assisted Skill Transfer session the First-Line Antimetabolites as Steroid-sparingDr. Usha Kim Treatment (FAST) Trial investigators meeting- Orbital and adnexal trauma - Spectrum of orbital foreign Annual Conference of the American Academy of bodies and its management (Moderator) OphthalmologyDr. K. Naresh Babu- Traumatic posterior dislocation of lens / IOL’s - Management Chicago, USA, October 15-18, 2016 Dr. Rathinam Sivakumar was a panelist at the Uveitis sub-speciality day. She also visited Casey Eye Institute-Oregon Health and Science University at Portland and had discussions with Dr. James T Rosenbaum, Professor of Ophthalmology, Medicine, and Cell Biology. Dr. Neelam Pawar - Internal aberrations, Strehl Ratio, modulation transfer function, and corneal aspheric function after Femtosecond laser Assisted cataract surgery - Interocular symmetry of retinal nerve fiber layer and optic nerve head parameters measured by Cirrus HD-OCT in a normal paediatric populationDr. S.R. Rathinam, Dr. V.K. Anuradha and Dr. S. Balamurugan Dr. V.R. Vivekanandan and Dr. Karthik Srinivasan withwith Dr. Narsing Rao at the FAST Trial Investigators’ Meeting Dr. David Chang at the AAO Conference 45

Dr. Karthik Srinivasan Ms. G. Krishnaveni at the Regional consultation of the WHO collaborating centres in South East Asia Regionwas the invited faculty for Retina sub-speciality session.Dr. V.R. Vivekanandantook part as instructor in the course on MSICS. He alsogot an opportunity to observe Dr. David Chang duringsurgery.Dr. V.K. Anuradhaattended the instruction course on Paediatric Uveitisled by Dr. Janet Davis.Dr. R. Jayagayathriattended the instruction courses and the symposium onOrbit and Oculoplasty.Dr. P. Mangalaattended the Cornea, and the Refractive Surgerysub-speciality day.WHO Consultation on Prevention of Vision in the consultation which was organised forImpairment from Diabetic Retinopathy (DR) strengthening networks between WHO collaboration centres in South East Asia Region. Totally 82 WHOGeneva, Switzerland, September 21-23, 2016 collaboration centres from 11 countries participated inDr. R. Kim participated in the consultation. the consultation.North Zone Ophthalmic Society and Uttarakhand 7th Annual Conference of Association ofState Ophthalmic Society meeting Community Ophthalmologists of India and International Assembly of CommunityDehradun, India, October 17-19, 2016 OphthalmologyDr. Haripriya AravindPerformed live Femtosecond laser assisted cataract Trichy, India, October 21-23, 2016surgery Dr. R. RamakrishnanDr. Shah Hem - Magnitude of glaucoma in India- Comparative analysis of miRNA expression in infectious Vs 10th General Assembly of International Agency non-infectious corneal inflammation. for Prevention of Blindness (IAPB)Regional Consultation of the WHO Collaborating Durban, South Africa, October 27-30, 2016Centres in South-East Asia Region Dhivya Ramasamy - Patient comprehension and its impact on follow-upNew Delhi, India, October 20-21, 2016Ms. G. Krishnaveni and Dr. Ashok Vardhan participated LAICO team at the 10th General Assembly of IAPB46

R. Kumaragurupari Dr. R. Priyadarsini- Worldwide research productivity in paediatric eye health: A - Adult onset capillary hemangioma of lid bibliometric analysis Annual Conference of Glaucoma Society of IndiaN. Vengadesan- Delayed follow-up in patients with diabetic retinopathy in Palampur, Himachal Pradesh, India, November 4-6, 2016 Dr. R. Ramakrishnan southern India: Social factors and disease progression - Non penetrating glaucoma surgery - Is it relevant?V. Vijayakumar- Evaluation of a diabetic retinopathy screening strategy at He was one of the judges for video festival and one of the panelists for grand rounds. government primary health centres in southern IndiaB.S. Ganesh Babu Dr. Mohideen Abdul Kader- Eyeinfobase: An innovative approach in building global - Surgery in childhood glaucoma - What I would do for its repository blindness and morbidity data success?Mohammed Gowth Dr. Ravi Chandra- Role of telemedicine-enabled vision centres in enhancing eye - Long-term intraocular pressure (IOP) outcomes in patients care coverage-a retrospective study in a southern Indian undergoing Descemet’s stripping endothelial keratoplasty district Dr. Manju R PillaiR. Meenakshi Sundaram - Generic medications are great and cost-effective for India- Enhancing compliance of referrals from outreach for sub- Dr. S.R. Krishnadas speciality eye care - Quality of life and medical managementSanil Joseph Dr. R. Venkatesh- Prevalence and risk factors for myopia and hyperopia in an - Glaucoma surgery made easy with CO2 laser - experience and adult population in southern India- A comparison of post-operative outcomes among patients short-term outcomes undergoing day care Vs inpatient surgery for cataract in a - Opportunistic screening to tackle glaucoma south Indian eye hospital Dr. George V PuthuranK.M. Sashipriya - AADI: Why it should be the implant of choice for India: ease- Enhancing eye care delivery through organisational capacity building and efficacy Dr. Ganesh V RamanAll India Oculoplasty Conference - Inferior placement of tube: Indications, technique and outcomesVadodara, India, October 29 - November 1, 2016 Strategies to address DR and ROP: L.I.M.E –Dr. Usha Kim Challenge- Retinoblastoma: Our experience Kolkata, India, November 6, 2016She also performed live ptosis surgery.Dr. V. Maneksha Lessons in Marketing Excellence (L.I.M.E) is the- Centurion Syndrome country’s biggest and most keenly contested B-school challenge which is televised on CNBC-TV-18 inThe Aravind Glaucoma team with Dr. Alan Robin at the Annual Conference of GSI 47

Dr. Renu P. Rajan as a jury member at L.I.M.E Challenge Dr. George V Puthuran at TEDx Conferenceassociation with Hindustan Unilever. Dr. Renu P Rajan Annual Conference of Vitreo Retinal Society ofparticipated as a jury member for the L.I.M.E Challenge Indiaheld for the students of Indian Institute of Management,Kolkata. The students were given the challenge of Chandigarh, India, November 30 - December 5, 2016creating strategies to address the problem of Diabetic Dr. R. KimRetinopathy and Retinopathy of Prematurity. Convener for the scientific committeeTEDx Conference Chairman for the Surgical Retina session on Code RedHosted by IIT Patna, India, November 13, 2016 and also in the Awards sessionDr. George V Puthuran spoke about the Aravind modelof eye care delivery. Dr. Karthik Srinivasan - Nitinol basket for lens removalIndia Jugaad tour Dr. Prabhu Bhaskaran - Autologous free internal limiting membrane transplantation forBengaluru, India, November 20, 2016The Good Governance Institute, UK organised the India failed macular closure (Video)Jugaad Tour to expose senior officials in UK’s NationalHealth Service to innovative healthcare practices in Joint Congress of American Association forIndia. Dr. R. Venkatesh and Ms. Dhivya Ramasamy Paediatric Ophthalmology and Strabismusrepresented Aravind at the event held in Bengaluru. They (AAPOS) and Strabismus and Paediatricfacilitated a learning session to discuss the Aravind Ophthalmological Society of India (SPOSI)model and its lessons for the UK’s healthcare system. Jaipur, India, December 2-4, 2016Dr. R. Venkatesh at the India Jugaad tour Dr. P. Vijayalakshmi - Childhood visual impairment: Detection, assessment and rehabilitation - Epidemiology of eye disease - birth to three years in a tertiary eye centre in India Dr. Shashikant Shetty - Orbit trauma - Evaluation of Nystagmus Dr. A. Rupa - Electro retinography as a diagnostic tool in childhood visual impairment Dr. Sathya T. Ravilla - Attainment of binocularity following late alignment for early onset strabismus - Paediatric cataract: Are we seeing a changing trend? Dr. Navdeep Kaur - Management of head posture in Duane’s Retraction Syndrome (DRS) with Nystagmus48

Aravind Alumni Meet at the AAPOS and SPOSI conference- Intraocular lens power calculation errors for (up to five years) - Retinal nerve fiber layer thickness and optic disc parameters paediatric eyes in Indian population in anisometropic amblyopia by cirrus HD-OCT in paediatric populationDr. Pooja Kewlani- Outcomes of surgical correction in partially accommodative - Optical Aids: A ray of hope for children with low vision in southern India esotropiaDr. Pallavi Patil Dr. R. Meenakshi- Joubert syndrome with bilateral hypotropia - Study of etiology, clinical features and management of exo-- Optical iridectomy in childrenDr. Palak Makwana tropia patients attending strabismus clinic at a tertiary centre- Functional outcomes of botulinum toxin injection in acute sixth Dr. Neelam Pawar - Interocular symmetry of retinal nerve fiber layer and optic nerve palsyDr. Shruti Agarwal nerve head parameters measured by Cirrus HD-OCT in- Ocular Trauma Score (OTS): A valid tool as a prognostic paediatric population Dr. Thushara indicator in paediatric traumatic cataract - Outcome of collagen corneal cross linking for paediatricDr. Sahithya keratoconus- A rare case series of high myopia in full term infants Dr. Ifeoma EzegwuiDr. Kruti Shah - Glaucoma following childhood cataract surgery- Outcomes of surgical management of traumatic bilateral Dr. K. Samyukta Sadasivan - Interesting case presentation - A case of optic nerve aplasia superior oblique palsyDr. R. Meenakshi, Dr. Neelam Pawar, Dr. Rutika Sadguru Conclave 2016- Clinical spectrum and neuroimaging in paediatric optic Chitrakoot, Madhya Pradesh, India, December 7-8, 2016 neuritis: A case series Dr. P. Vijayalakshmi - Journey 1990-2016.Dr. P. Vijayalakshmi at the Sadguru Conclave 2016 - Visual rehabilitation of children after cataract surgery - Convenor for the session on Rehabilitation for children with visual impairment - Management of strabismus in high myopia 10th Congress of the Asia Pacific Vitreo Retina Society Bangkok, Thailand, December 8-10, 2016 Dr. Venugopal Reddy - Neurofibromatosis with bilateral peripheral avascular retina Dr. Renu P. Rajan - Traumatic endophthalmitis: Profile and treatment outcomes 49

Dr. Manoranjan Das at the 5th Biennial Scientific Meeting of Dr. Ganesh V. Raman being felicitated at the 7th AnnualAsia Cornea Society Conference of the Bangladesh Glaucoma Society5th Biennial Scientific Meeting of Asia Cornea Dr. R. NaveenSociety Photo ContestSeoul, Korea, December 9-11, 2016 - DendriteDr. N. Venkatesh Prajna - Posterior polymorphous dystrophy- Efficacy of oral voriconazole in severe fungal keratitis - Fungal colonization of BCL - Schiempflug image of PentacamHe also participated in the debate titled Infections: Surgery Dr. Nilam Gohlilor Medical treatment - Evaluation of drug reservoir function of Human AmnioticDr. Lalitha Prajna Membrane (HAM) for use as medicated membrane for corneal- Laboratory perspective on best practices in the management of disorders using a model drug - Prednisolone - Tear protein zinc alpha 2 glycoprotein as species specific bio ocular infection marker for fungal keratitisDr. Ashish Kumar, Dr. N. Venkatesh Prajna Dr. Hitha Sara Sajeev- Detection of corneal scars by corneal cellscope, a smartphone - Human amniotic membrane: Biological bandage and drug delivery tool camera attachment - A rare combination of Francois and Fuchs dystrophy with true- Sclera as a tissue carrier for Aurolab keratoprosthesis exfoliation - Corneal OSSN (Photo contest) performed for peripheral ulcerative keratitis. Dr. Lakshey DudejaDr. Manoranjan Das, Dr. Ashish Kumar - Complement factor as a predictor of clinical outcome in- No bubble, no trouble: Long-term results of optical deep Aspergillus flavus keratitis patients anterior lamellar keratoplasty Photo contest - Conjunctival rhinosporidiosis7th Annual Conference of the Bangladesh - Coats ringGlaucoma Society - Confocal image of fungal hyphae with 90’ branching - Confocal Image of fungal hyphae with 45’ branchingDhaka, Bangladesh, India, December 15, 2016 Dr. Komal MehtaDr. Ganesh V. Raman - Vision Centres as a means to reduce corneal blindness- Tips and tricks of managing angle closure disease - Conjunctival hemangioma (Photo contest)- Aurolab Aqueous Drainage Implant (AADI) Dr. Rohan Agashe - Microsporidial KeratoconjunctivitisKeracon - Macular corneal dystrophy - Screening for novel mutations inLavasa, Maharashtra, December 15-17, 2016 the Carbohydrate Sulfotransferase 6 (CHST6) gene of patientsDr. Arunkumar Panigrahi in south Indian population and determination of genotype- Role of topical mitomycin in Ocular Surface Squamous phenotype correlation Neoplasia (OSSN)- Corneal intraepithelial neoplasiaPhoto contest- Bee sting- Confocal image of Acanthamoeba cyst- Confocal image of fungal hyphae50