Reflection from Dr Hening Naluria (full ANV scholarship, resident at Tilganga Institute of Ophthalmology and Pediatric Ophthalmologist)

I. EXPERIENCES DURING PEDIATRIC OPHTHALMOLOGY AND ADULT STRABISMUS FELLOWSHIP PROGRAM (JANUARY 1, 2020 – DECEMBER 31,2020):

a) In first 7 months (Before 16th August 2020), I have done:

i. Academic duties

o Have done presentations on different topics of children ocular diseases, once in a month.
o Have been doing a research with the topic “Outcomes of Secondary Intraocular Lens Implantation in Nepali Children with Congenital Cataract” (The supervisor is Dr. Srijana Adhikari, MD – Pediatric Ophthalmology and Strabismus Consultant).

ii. Clinical duties

• To handle teleconsultation for a pediatric patient who stay out of Kathmandu city
• To do emergency duty 2-3X in a week. In this emergency duty fellow has to perform emergency surgery including therapy management of the patients
• The activity from Sunday to Friday is working in Out Patient Department (OPD)
• Tuesday and Thursday is the day for surgery

b) From 16th August 2020 till 23rd September 2020, there were some changes in clinical duties:

i. We followed a new duty roster from OPD “LOCKDOWN ROSTER” (attached file). In this lockdown roster, we (fellow and staff) were divided into 3 Groups (I am in Group C). Therefore, the number of patients that I examined in OPD had decreased.

Note : The names with bold characters are the fellows of Tilganga

ii. There are no changes for academic duties:

• The fellow’s presentations were done by True Conf or Zoom App.
• There are no changes concerning the research, because the data were collected from Electronic Medical Records (EMR) of Tilganga.
• c) From 24th September 2020 till 16th December 2020, there were some changes in clinical duties:

We (fellow and staff) were divided into 2 Groups (I am in Group A). Thereafter, the number of patients that I examined in OPD had increased.

Note : The names with italic characters are the fellows of Tilganga 

1. d) From 17th December 2020 till 31st December 2020, all fellows came daily to OPD.

Everyone thinks this pandemic has an effect on my fellowship program, but it is not. This pandemic brings me luck, in fact my performance can be  optimal. It is proven that from January 1, 2020 – December 31, 2020, I can complete the target for clinical and surgical skills

Pediatrics is unique, I will tell you about the uniqueness below: 

Pediatric ophthalmology is very difficult because it demands patience. Because young children are difficult to communicate with, we must  first approach them. Only then can the patient be cooperative. Even if we have succeeded in approaching the patient, there are still other  obstacles, even though the head and eyes did not move but still they moved their arms and their legs. They pull my pen and they often  made my slit lamp up and down. 

1. ACTIVITIES
2. a) The presentation of disease topics in children.

1. b) Research. 

• Research proposal with topic “Secondary Intraocular Lens Implantation in Nepali Children with Congenital Cataract”. The proposal was approved by the reviewers from Tilganga Institute of  Ophthalmology. 
• The research is in writing process for publication.  

1. c) Procedures.  
2. a) Orthoptics evaluation (Performed Independently) : 

b) Hess charting (Performed Independently):

c) Diplopia charting (Performed Independently): 

1. d) Surgical Activities. 
2. a) Observations: 

1. b) Performed Surgery as First Assistant :

c) Performed Surgery Under Supervision:

1. d) Performed Surgery Independently:

III. SUREFIRE TIPS TO ACHIEVE THE TARGET DURING MY FELLOWSHIP PROGRAM 

a) Below are surefire tips to achieve the target:

b) Another fortune that I got during the pandemic was that immigration provided relief for all foreigners who were in Nepal, tourist visa which is supposed to be for 5 months was realized into one year.

IV. CERTIFICATE 

Written by, Hening Naluria