I don’t think I can express in words how nervous I was the day
before I visited the Sankara
Nethralaya Academy.
As a 15 year old girl who has not tried many things out of her comfort zone, I
was certain this would be a great challenge. I had heard many great things
about this foundation from my parents, and although one part of me wanted to
see what this program was like, another part of me was very apprehensive. This
was the first time I visited Chennai, the weather was hot, and in addition I
did not know a single word of Tamil. So
to sum it up, I was almost 100% sure that I would be extremely uncomfortable
both socially and physically. What I actually experienced was in fact the exact
opposite of what I had predicted, and I’m still laughing at myself for feeling
like I would be out of place, because I’ve realized at Sankara Nethralaya, it
is impossible for anyone to feel out
of place. My parents and I were greeted by a warm smile from Mr. Sivakumar in
the PR department the very moment we walked in and enjoyed the hospital tour
led by Ms. Sreedevi and Mr. Mahalingam, who had sacrificed their entire day
just for us. When we went to meet Dr. Badrinath, the chairman emeritus, I
noticed how simple and humble he was, and I knew right away I had come to an
amazing place.
The rest of the week I worked at the JCOC with Dr. Kumari, and I
really appreciated that she took the time to explain to me everything she was
doing to the patient. Mr. Sivakumar at the JCOC also inspired me to pursue my
dream of becoming a doctor and he would always encourage me. Everyone was so
friendly and welcoming, and I made friends easily. The next week when I visited
the Teleophthalmology center, Dr. Sheila John made sure I got the best
opportunities. Dr. Sheila John was extremely hospitable and ensured that I was
comfortable and ate wellJ. She also explained about the goal
of the department in reaching out patients across India,
Africa and Europe as well as the research that
is currently ongoing to serve patients in remote areas even more efficiently by
applying mobile phone technology. She introduced me to her staff of
optometrists, and they were very friendly and hard-working. I went to
Thiruvallur on a camp with them and I enjoyed it thoroughly. I’ve fallen in
love with this wonderful foundation, and I promised myself that I would come
back year after year and contribute as much as possible.
The first and
most interesting place I saw was the JCOC. On my very first day, I was awed by
the organized process every patient went through. The first test I saw was the
DBR test. A patient was undergoing this
test so the doctor could find out the power of the intraocular lenses. I
observed that the patients were of limited financial resources, many were
illiterate and several did not even have slippers on. I was so happy that
Sankara Nethralaya was doing something so big for the patients who did not have
anything to give to them in return. Dr. Kumari told me that 80% of the patients
that visit are for cataract surgery because the cataracts easily form with
aging. I also learned the names of all of the machines. When I used to go for
regular eye tests in California,
I never really knew what I would always put my chin on and press my forehead
against. I know now that it is the digital biometer, and it is connected to the
computer. Dr. Kumari explained to me that the scanning of the eye was called
the A-scan and the ultrasound is used in this scan. The auto refractometer
determines the power of the patients’ eyes so the doctor can find out the lense
required. She explained to me that glaucoma is a silent killer of the eye and I
was even able to look at a few patients who unfortunately had it. I was also
fortunate enough to meet two wonderful interns, Pradipta and Usha, who let me
examine the patients with them. The patients
spoke Tamil, Telugu, or Hindi, so the optometrists were also required to
know those three languages very well. On my second day, I saw a little boy
whose right eye had been badly bruised by a ball a year ago. At that time, the
doctors removed the foreign body in his eye by doing an intraocular surgery and
he was told to come back after a year. His eye was much better and he was
extremely happy. Every patient has their own file and the doctors have a very
organized way of entering the information in and then converting it to a huge
graph. 90% of the patients that come for cataract surgery have high blood
pressure. Because a lot of the general health factors also affect the eyes, the
cataracts are easily formed. Dr. Kumari showed me a fully-matured cataract in
the eye of an older lady. The cataract had covered the entire eye and it looked
like a mixture of green and brown. She was not even able to see how many
fingers the doctor held up just 15 cm away from her. I saw another lady whose
cornea was thinning. Dr. Kumari shined a flashlight into her eye and showed me
the cornea. They ask the patient to look at a fixed point (the wall or their
finger) and they take a tube-like device to measure the pressure of the eye. I
watched Dr. Kumari first put some eye drops in the patients’ eyes and then run
the device over their cornea. The device was connected to the computer, and it
kept track of everything. The doctor held a knob which was attached to the
digital biometer and nudges it forward. Each time it was nudged, a beeping
sound was made, and this was the sound of the computer collecting the results from
the device. I was amazed at all of the wonderful technology being used and the
next time I visit, I would love to take a closer look at all of the machines.
The patients need to get this procedure done so that they can report for their
operation the next day. Before they sit down in front of the digital biometer,
Dr. Kumari put some eye drops in their eyes. I
thought that this was to clean or dilate their eyes. I observed that
most of the patients had trouble following simple instructions like looking at a
fixed point or opening and closing their eyes when they were told to. Because
they came from remote areas, they did not understand what was going on and were
not able to do what the doctors told them to.
The optometrists
often had to work hard to make the patients comply with the instructions. These
patients were encouraged by the hope of glasses, and I could tell by the
expressions on their faces that they were eager to be treated and cured. Even
when the patients were speaking Tamil, I was able to understand a little bit of
what they were saying because Tamil sounded so much like my mother tongue,
Telugu. What I really enjoyed was helping
Dr. Kumari write information down from the patients’ personal files to
the huge graph where all the details were written down on. It was part of the
clearance for surgery and I wrote down all the values for the DBR, including
the K1, K2, K3, K4, AxL1, AxL2, age, sex,
name, and identification number. The only things I was asked not to take note
of were ACD, lens thickness, SRKII, EMM, and -1.00. I really liked doing that
job for Dr. Kumari, because I was able to see what exactly is most important
about the patients’ eyes before their surgeries are done. I also learned that
“pseudophilic” meant that the patient had already undergone surgery in that
area. I had to write pseudophilic for some of the slots in K3 and K4 because
the patient has already been treated in those areas.
I noticed the
next day that many of the patients had orange or yellow bands wrapped around
their hands. Also for some patients, the optometrist asks them to read a
certain line in a book instead of looking at the wall and reading the letters
off of it. This was obviously to test near and far-sightedness. Most of the
patients were myopic. I was also introduced to another machine which showed the
optometrist the zoomed in version of the eye, but the other side looked just
like a digital biometer with a screen that the patients are told to look into.
I thought it was really fascinating how people came up with the structure for
these machines. One of the things I found most interesting about this entire
experience was getting to know the life of the patient. In a report I read, it
said that 91.9% of the patients’ lives are much better after they had been treated.
I saw a little girl who looked as if she was in about 5th or 6th
grade walk in with her father. He was complaining because she would get scolded
at school for not being able to read properly. She needed treatment very
quickly. Later, Pradipta explained to me that rotitary nystagmus was her
condition. She spent most of her time at the autorefractometer, because they
needed to first determine the power of her eyes in order to get her treated as
quickly as possible. The youngest patient I saw was a little girl named Swathi
who was unfortunately suffering from the squint eye. I saw Kavitha, a senior
optometrist, take care of her. Before a patient was tested, a pH solution was
put in their eye so the doctor can see clearly. Because some of the patients’ eyes
are extremely sensitive to the light, they wear sun glasses to protect them
from the harsh light. If the patient has a fully matured cataract, the
autorefractometer is supposed to inform the doctor the size of the cataract so
that they can make new lenses for them and also be able to remove the cataract.
My first day at the
teleophthalmology center, I learned a lot.
An optometrist, Pearlson Prabhu, patiently explained to me the possible
diseases or problems which could occur in the eye, and explained to me very
well the process every patient went through for their check-up. When I went to
the camp at Thiruvallur with them the next day, I saw that the conditions were
much worse than the conditions I had observed at the JCOC. Most of the patients
in the village were physically or mentally challenged, and of course that was
the reason that they could not travel to the JCOC for their check-up. There
were four different stations, and I sat at the very last one, the counseling
department with one of Dr. Sheila John’s optometrists. Since I already saw how
the registration, slit lamp, and autorefractometer worked, I thought the
counseling station would be the best use of my time. To my surprise, most of
the patients spoke Telugu, not Tamil. I saw that most of the cases were
cataracts and were caused because of lack of general health, high blood
pressure, and diabetes (diabetic retinopathy). Some people from SCOPE were also
there observing, helping, and taking pictures. The process was simple- first;
the patient went to the registration and signed in. Then, they were led to the
slit-lamp and went through a few simple tests that would be easy for them to
follow. After that, they went to the auto refractometer where an optometrist
determined the power of each of their eyes. Lastly, they proceed to the
counseling department where an optometrist tells them exactly what their
condition is, and what steps they have to take next. If they require surgery
and do not have BP (which I noticed was pretty rare), they will be given a card
that they can bring with them to the JCOC the following week. If they have a
cataract and require surgery, but unfortunately have BP, they have to stay in
the village because an operation will further deteriorate their health. If they
do not require surgery at all, the optometrist will give glasses or medicine
and then let them leave. Usually the majority of the patients require surgery
because they live in a remote area and a good hygiene is very difficult for
them to keep. When we came back from the camp, Pearlson showed me the EMR and
how and what information was entered into the graphs. These were important
medical records and he helped me understand how the entire process works. He
also showed me the teleopthalmology website and I’m so happy that even when I
go back to California, I will be able to go through the website and discover
new things which interest me. I could go on to write an entire novel about how
much I was able to learn in just two weeks and I now know that the next time I
come to India, I will definitely set aside at least a month to come back and
learn more.
Meanwhile on the
first night I was here, I had slept with my contact lenses on, my cornea had
some abrasions in it, and I was a patient here! Dr. RDB examined my eyes several times during the week and gave me
some eye drops along with a prescription for glasses so I did not have to wear
my contact lenses too often. I am actually glad I was registered as a patient
although I had really come to volunteer because it helped me understand the
process so much better.
Although none of these patients could pay for their treatment and
were uneducated, the doctors treated them with as much respect and care as some
of the richest patients who came in to be tested. The friendly and hospitable
attitude of the doctors and the optometrists really impressed and inspired me,
and I realized why Sankara Nethralaya had such an excellent reputation. I’ve
whole-heartedly enjoyed every minute I’ve spent here and I will never forget
the kind people I met. In this prestigious foundation, there was not a single
optometrist or doctor who did not treat every patient like family, something
that I would also do if I were a doctor. Throughout these two weeks, I was able
to understand that Sankara Nethralaya’s mission is not to bring themselves
money and fame, but to give people from around India one of the most priceless
gifts possible- the gift of vision.
