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Dr Hening Naluria – Experiences after graduating residency program

EXPERIENCES AFTER GRADUATING RESIDENCY PROGRAM 

I joined several surgical outreach, namely Cambodia, Laos and Lombok. 

  1. a) Cambodia Surgical Outreach

Surgical outreach in Cambodia held on May 2019. It was carried out in the Kampong Chhnang village area. At that time, I was lucky to be able to do surgery with Dr. Reeta  Gurung and Dr. Sanyam Bajimaya from the Tilganga Institute of Ophthalmology. 

  • My activities during social service: 

❖ I work in the screening section. During screening we had to go to several health centers where we had to take a boat to cross the river so we could get  to that place.

Surgical Outreach, Kampong Chhanang

 

Surgical Outreach in Kampong Chhnang, Cambodia (2019) 

My activities during patients screening

❖ I have performed the following surgery:  

Type of Surgery Total Cases 
SICS  10 Cases 
Pterygium with conjunctival autografting  60 Cases 

Surgical Outreach, Cambodia 2019

Laos Surgical Outreach  

Surgical Outreach in Kampong Chhnang, Cambodia (2019) My thanks to Dr. Ranny (my right) and Dr. Chrea (my left). We worked well  together so that this surgical outreach could run successfully 

Surgical outreach in Laos held on October 2019. It was carried out in Viantiane at Thongpong Eye Hospital. At that time, I did surgery with Dr. Reeta Gurung.  • My activities during surgical outreach:  

❖ 3 October : Screening at Thongpong Eye Hospital  

❖ 4-6 October : Screening at Xaythany Hospital 

❖ 7 – 10 October : Screening at Thongpong Eye Hospital 

❖ 11 October : Set up and screening at Thongpong Eye Hospital 

❖ 12 October : 1st Surgeries 

❖ 13 October : 2nd surgeries 

❖ 14 October : Last surgeries 

❖ 15 October : Post operation examinations 

  • I have performed the following surgery:
Type of Surgery Total Cases  Remarks 
SICS  36 cases  I got a lot of experience in this surgical outreach. I have found many cases of brown cataract. We think this  patient came from a remote place but after we asked, it turned out that the patient came from a place not far  from the hospital. 

My new experience is working on a brown cataract case, which when I was studying in Nepal this case was  given to a consultant to do it.

 

 East Lombok Surgical Outreach  

East Lombok surgical outreach held on December 2019. It was carried out at Labuan Haji Hospital, East Lombok. At that time, I was in a teamwork with Dr. Wulan, Dr.  Irsan, Dr. Teguh, and Dr. Harir. They all are Indonesian Doctor.  

  • My activities during surgical outreach:  

❖ 5 November : Meeting with East Lombok health department employees 

❖ 6 – 9 November : Screening 

❖ 10 November : Screening and surgeries 

  • I have performed the following surgery: 
Type of Surgery Total Cases  Remarks 
SICS  5 cases  These five cases are very important to improve my surgical skills because these cases are difficult cases that I have  never done before. I was lucky there was Dr. Harir who always convinced me that I could do it and she also taught me  some tricks so that I can perform the surgery smoothly and successfully.

 

 

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Dr Hening Nalurai’s experiences during Residency Program

  1. EXPERIENCES DURING RESIDENCY PROGRAM
  2. Introduction

My journey to become an eye specialist began when I participated in the surgical outreach at Jombang, East Java, Indonesia in April 2015, the surgical outreach was  held for 3 days and my job was to examine visual acuity. 

On the day of the interview for student admission (September 2015), accompanied with two gentlemen, I went to National Academy of Medical Sciences (NAMS).  I thought the two gentlemen are NAMS employees. In the interview room, I found out the two gentlemen were my interviewers, during my study, it turned out that they are  Saiju Sir and Govinda Sir, who is the Director of Hospital Service and the Academic Director of Tilganga Institute of Ophthalmology respectively. They only gave one suggestion  that I must be fluently in speaking Nepali, I was immediately stressed. 

The day after the interview day, I was invited to participate in surgical outreach at the Pullahary Monastery. There I met for the first time with Dr. Sanduk Ruit,  where I met him in the operating room. While operating he told me “Hening, don’t be afraid, you are safe during your study in Nepal, welcome to Tilganga”. In that surgical  outreach I learned to see the course of surgical outreach as a whole and I was asked to help in block room, where the block room is a place to give anesthesia in the eye.  

My activities in Tilganga began with meeting Reeta Ma’am. She greeted me in her room and asked if you could speak Nepali. With confidence I answered “mathi  hernus and tala hernus”. She asked again “do you know what that means”. I just answered “mathi hernus is look down and tala hernus is look up”. She just laughed and said  “good”. After a few days I just realized that what I said was reversed, which is “mathi hernus is look up and tala hernus is look down”. One month later I found out she was a  CEO at Tilganga Institute of Ophthalmology.  

On November 2015, I began to join the residency program, I just got to know 3 words of Nepali Language, “Namaste, Tala (down), mathi (up)”, every time I said  that, the all other person laughed. Then from 3 words increased to 9 words ” kukhura ko masu (chicken-food), khau (eat), basnus (sit), vok lagyo (hungry), daya (right), baya  (left), kaan ma hernus (look at my ear), aankha kholnus (open your eye), aankha banda garus (close your eye)”. Speaking English can be great, but if we can’t speak Nepali it  can be stressful, because what we face every day are patients who speak Nepali. I remember an Indonesian proverb about “Wherever ground is stood on, the sky is held  high” (Wherever we live, we must observe the local custom). I ended up to have a Nepali to English dictionary, but after opening it, I more get a confusion then I cancelled  to buy. So, I decided to learn by listening my friend how they speak to the patient. After 6 months finally I can speak to patients using Nepali, and until now I can speak Nepali 

fluently to the patients. I believe a person’s success is measured by the ability to communicate. The ability to communicate and accept all parties is an asset for the progress  of study, so that everything goes well. 

I was also fascinated by all the consultants and employees who often used the stairs even though there was a lift. Once when I came out of the canteen, I was  waiting for the lift to go downstairs. I met Saiju sir and he said “don’t use lift, we have to exercise”. I only answered yes sir, I still use the lift. Then on the same day, I was  stuck in the lift for quite a long time. And I pray “God forgive me because I did not hear the Saiju Sir’s words”. Regarding time, Saiju sir became my mentor.  

  1. Experience as first year resident

During my study, I got room facilities at the Tilganga hostel, which is provided for residents who came from out of town and foreign residents. There are ten rooms  in total, eight rooms for residents who want to stay, and two rooms for residents who have emergency duties. At that time, only three residents always stayed at the hostel,  namely one resident from second year (Dr. Suresh Rasaily) and two residents from third year (Dr. Hom Bahadur Gurung and Dr. Samyek Shakya), they all came from Nepal. The total of first year residents are 6 residents, including one resident from Indonesia (me), one resident from Maldive (Dr. Mohammed Azzam), four residents from Nepal  (Dr. Isha Shrestha, Dr. Ramita Kharel, Dr. Kaushal Pokhrel, and Dr. Rabindra Singh Thakuri). 

 

Kharel, Dr. Isha Shrestha, Dr. Mohammed Azzam)—from left to right (2016)

 

a) Our activities in Outpatient Department (OPD) and Operating Theater (OT)

Our activities as first year residents are to go to Outpatient Department from Sunday till Friday at 8 am until the completion of the patient and follow the schedule  made by seniors. During the first two months, each first year resident attended a second senior year for orientation, that’s when we learn how doing eye examine,  managing a therapy and how to educate patients. Because I also need to learn Nepalese, so in the first two months I did it by listening to my seniors how they speak  Nepali.  

In the third month, first year resident has been given a slit lamp, so we can examine the patient and we are obliged to consult a senior before sending the patient  home, it continues until the first 6 months. Six months later we are trusted to discharge the patient if we are sure, if we feel difficulties we can consult and discuss with  second year seniors. There is a rule if we want to consult with seniors, we cannot consult directly to consultants. We have to be a tiered consult, first we have a consult to second year seniors, if second year seniors have insufficient idea about the patient, both of them will go together to consult with third year resident. If third year  resident doubt on his or her decision concerning the patient, then we will consult to a fellow, and finally to a consultant. This regulation was enforced so that all residents  can learn together to resolve the case. 

First and second year residents taking turns to the Operating Theater and our job is to be an assistant, observe and learn the steps of the surgery, write the therapy  that will be given to the patient.

Outpatient Department, TIL
(left) General Outpatient Department for residents at Tilganga Institute of Ophthalmology (2016) (right) Outpatient Department look for residents where we have started using Electronic Medical Record (EMR) at Tilganga Institute of Ophthalmology (2017)

b) Presentations and Classes for Residents 

We also provide topics for presentations, which are held every Monday and Wednesday. All consultants and residents must attend. It was during the presentation  that our mentality and self-confidence were tested. Consultants do not hesitate to ask the presenters and other residents. We should focus on the topic being presented  and focus on opening our ears, oftenly a consultant calls our name on the sidelines of the presentation. There is another class for all residents, namely a class with a  teacher named DB Karki Sir, he is a senior ophthalmologist in Nepal. His classes are every Tuesday and Thursday.  

c) Minor Surgeries  

We are tutored by second year residents to learn about minor surgeries such as pterygium, chalazion, evisceration, eyelid and conjunctival repair then at the end  of the first year as residents we should be able to do it independently. 

d) Emergency Duty 

We also have started emergency duty, we are supervised by one second year or third year resident and one consultant. Senior is obliged to be in the hostel, so if  we run into difficulties we can consult to our senior and senior will come to the Outpatient Department to help us solve cases that we think are difficult. e) Surgical Outreach  

In September 2016, I had the opportunity to participate in surgical outreach held in Magelang and Purwokerto, Central Java, Indonesia. I came with the Nepali team  and my job was in the screening section, where I increased my skills and courage to make a decision whether this patient needs surgery or not. I also had the opportunity  to do pterygium surgery, so after joining from that surgical outreach my surgical skill for pterygium surgery was very good.  

Surgical Outreach, Magelang 2016
(left) Surgical Outreach in Magelang (2016) I was with Indonesian doctors (Dr. Teguh, Dr. Sri, Dr. Wulan, dan Dr. Harir)—from left to right (2016) (right) Surgical Outreach in Magelang (2016) I was with Nepali Team from Tilganga Institute of Ophthalmology

f) Periphery Posting

Our last year as a first year resident we will be sent to a periphery to learn about Small Incision Cataract Surgery (SICS), I was sent to Geta Eye Hospital in November  2016, I was well received in the hospital, and provided a room to stay, my room was on the second floor of hospital, my mentor for studying SICS is Dr. Suresh Raj Pant,  he is the Director of Geta Eye Hospital. I was 1.5 months there and managed to do SICS in 62 cases. There was an impressive experience. My patient (while doing SICS),  in the middle of the surgery process, the patient innocently said “Doctor, I want to go to the toilet to urinate”. I was immediately confused, and my mentor (Dr. Suresh)  came and asked why I looked confused. I said the patient wanted to go to the toilet. I think he want to take over the surgery, but he just said “Good, then finish it quickly”.  After that, every time before doing the surgery, I just pray that the patient will use diaper.  

 

Geta Eye Hospital Building 2016
(left) Geta Eye Hospital building 2016 (right) Outpatient Department at Geta Eye Hospital (2016)

3. Experience as second year resident

Our activities in second year of residency program were not much different from those of the first year. The different is our responsibility, now we have to share  our knowledge to first year residents who have just entered and handle general Outpatient Department. An Outpatient Department room contains one person from second  year resident who works together with one or two persons of first year residents. 

In the second year, residents have to present cases and journals. For emergency duty, we have to be ready if juniors need us for consultation and come to Outpatient  Department when juniors need the advices. 

4. Experience as third year resident

In third year of the program, we did not examine patients in general Outpatient Department. There are 8 subspecialties at Tilganga Institute of Ophthalmology  namely Pediatric Ophthalmology, Uvea, Neuro Ophthalmology, Retina, Cornea, Oculoplasty, Glaucoma, and Refractive Surgery Unit. We will go around the subspecialty clinic  every 1.5 months. Our activities at the subspecialty clinic is to examine new patients and who have been referred from general OPDs, while in the operating room we follow  consultants according to the subspecialty where we are posting. We also have to make presentations on cases and journals, and always ready for emergency duties.  

  • Surgical Outreach  

In the third year, every resident took turns being invited to participate in surgical outreach, at that time I had the opportunity to take part in surgical outreach at  Rolpa and Pullahari Monastery. My first surgical outreach was in Rolpa and the second was in Pullahari Monastery. It took two days and one night by bus to reach Rolpa. It  was the first time I did a cataract surgery at Rolpa. At night the whole team rested at the inn and will continue the journey again the next morning. I did surgeries in the  morning and screening in the afternoon. I did alternate surgery with general ophthalmology (Dr. Hom Bahadur Gurung), and I had the opportunity to operate from morning  until lunch time. I saw a lot of patients who came excitedly for surgery. There was an incident that impressed me, there was a grandfather who was accompanied by his wife,  the grandfather came using a stick, and after the surgery the grandfather came home without using a stick.

Surgical Outreach in Rolpa (2018)

I was very impressed when I joined the eye camp at Rolpa with Dr. Sanjita Sharma and Dr. Hom Bahadur Gurung. During the trip I said to Hom dai ” I want to go to  the toilet”. After the bus stops, he said “Hening, go to the toilet now and come back soon”. Then I asked him “where is the toilet?”. Hom dai answered “Didn’t you see the  largest toilet in the world?”. I’m astonished, OMG!!!, hopefully there are no snakes. 

I also had the opportunity to participate in the surgical outreach held at the Pullahari Monastery, only about two hours from Kathmandu. I joined at that surgical  outreach with Dr. Sanduk Ruit, Dr. Srijana Adhikari, and Dr. Sanjita Sharma. I have the task to teach junior the steps of Small Incision Cataract Surgery (SICS), manage the  complication as much as I can. In the that surgical outreach, I also taught the steps of SICS to an ophthalmologist from Tajikistan. We are also joined surgical outreach at the  Tilganga Institute of Ophthalmology. 

  1. a) TRAININGS, COURSES AND SYMPOSIUMS 

June 2018 Speaker 

XIVth Biennal SAARC Academy of Ophthalmology Conference 2018 In Conjunction with XXth Nepal Ophthalmic Society Annual Meeting. Choroidal Osteoma Masquerading as Posterior Uveitis (Poster). 

SAARC Academy of Ophthalmology. 

May 2018 Participant. 

Medical Education Training. 

National Academy of Medical Science, Bir Hospital, Kathmandu, Nepal. 

Jan 2018 Participant. 

Symposium on Minimally Invasive Glaucoma Surgery (MIGS). 

Tilganga Institute of Ophthalmology, Kathmandu, Nepal. 

Sept 2017 Speaker 

PIT 42 PERDAMI. 42nd Annual Sciantific Meeting.  

Outcome Surgery in Children with Unilateral Congenital and Developmental Cataract. 

PIT PERDAMI. 

May 2017 Participant. 

Corneal Symposium 2017. 

Tilganga Institute of Ophthalmology, Kathmandu, Nepal.

Dec 2016 Participant. 

Early Detection and Referral of Retinoblastoma – A reason to save sight and life. 

Tilganga Institute of Ophthalmology, Kathmandu, Nepal. 

June 2016 Participant. 

Advanced Cardiac Life Support Training. 

National Academy of Medical Science, Bir Hospital, Kathmandu, Nepal. 

April 2016 Participant. 

Research Methodology Training.  

National Academy of Medical Science, Bir Hospital, Kathmandu, Nepal 

Dec 2015 Participant. 

Retina Symposium 2015. 

Tilganga Institute Of Ophthalmology, Kathmandu, Nepal 

Dec 2015 Participant. 

Emerging Interventions in Oculoplasty. Cadaveric Dissection Course for Endoscopic Dacryocystorhinostomy. Tilganga Institute Of Ophthalmology, Kathmandu, Nepal. 

  1. b) SCIENTIFIC WORK/PAPERS 

April 2016 – December 2017 Surgical Outcome of Eyelid Carcinoma, Thesis.

  1. c) CLINICAL EXPERIENCES  

May 2018 Tilganga Institute of Ophthalmology. 

– SICS : 5 cases 

Eye Camp 

April 2018 Pullahary Outreach Microsurgical Eye Clinic. 

– SICS : 27 cases 

– SICS together with MD Ophthalmology from Tajikistan : 23 Cases 

 Eye Camp 

 January 2018 Rolpa Outreach Microsurgical Eye Clinic (600 km from Kathmandu). – SICS : 15 cases 

Eye Camp 

June 2017 Tilganga Institute of Ophthalmology. 

– SICS : 5 cases  

 Eye Camp 

April 2017 Tilganga Institute of Ophthalmology. 

– SICS : 5 cases 

Eye Camp  

 Nov 2016 – Dec 2016 Geta Eye Hospital. Dhangadi, Nepal (Border of India). – Small Incision Cataract Sugery (SICS) : 62 cases 

Eye Camp  

September 2016 Magelang and Purwokerto Surgical Outreach  

– Pterygium Surgery : 181 cases 

  1. d) CLINICAL EDUCATION 

Retinoscopy : 70 cases  

Procedures (Investigation) 

– Visual Field : 9 cases  

– Indirect Ophthalmoscopy with fundus drawing : 10 cases 

– Ultrasonography : 12 cases 

– Biometry : 12 cases  

– Hess Charting : 10 cases 

– Diplopia Charting : 10 cases 

– Corneal Scraping : 10 cases  

– Fundus Fluorescein Angiography : 10 cases  

  1. e) SURGICAL EXPERIENCES

 

Surgery Observations Performed Surgery as First  

Performed Surgery Under  

Performed Surgery  

Assistant 

Supervisor 

Independently
Entropion  2  8
Ectropion  2  8
Chalazion  30
Pterygium  201
Strabismus  10
Dacryocystorhinostomy (DCR)  5  5
Dacryocystectomy (DCT)  1  5

 

Cataract Surgery (SICS)  3  142
Peripheral Iridotomy  4 5
Trabeculectomy  10
Evisceration 1 9
Enucleation 6 4
Retinal Detachment Surgery  (Scleral Buckling)  10
Vitrectomy  10
Ptosis Surgery  5 5
Penetrating Keratoplasty 7 3
Intravitreal Injection 3 5
Repair 

1. Lid Lacerations 

2. Corneal  

3. Scleral  

Conjunctival laceration 

 2

3

 2 6

3

3

 

Provisional Certificate - Dr Hening Naluria

Written by, Hening Naluria

Original PDF article can be viewed here: 1. Dr Hening Naluria – Experiences during residency program-converted

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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.

Group A  Group B
Dr Reeta  Dr Suman
Dr Govinda  Dr Rohit 
Dr Indira  Dr Anu
Dr Sanyam  Dr Leena
Dr Ben  Dr Srijana
Dr Rachana  Dr Raba
Dr Sushma  Dr Keepa
Dr Rojeeta  Dr Eli
Dr Shyam  Dr Pratibha 
Dr Smita  Dr Sanjita 
Dr Shashwat  Dr Malita
Dr Yogita  Dr Ang
Dr Hening  Dr Sagar
Dr Krishna  Dr Anil Parajuli
Dr Suresh  Dr Jyoti
Dr Bibek  Dr Santosh
Dr Samyek  Dr Prakash
Dr Reeta Rajbhandari  Dr Meena
Dr Pratibha Shahi  Dr Sudeep L Rajbhandari
Dr Pallavi  Dr Santosh Shah 
Dr Shyam S Yadav  Dr Sundip
Dr Nischal  Dr Anil Regmi
Dr Alisha  Dr Ansu Malik 
Dr Seema  Dr Prabin Kumar Yadav

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 - examining patient

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. 

Operating Theatre, Cornea Perforation repair, lens aspiration and anterior vitrectomy TIL
Operating Theater at Tilganga Institute of Ophthalmology (2020) I did corneal perforation repair, lens aspiration and anterior vitrectomy
Kanti Children's Hospital 2020 - Dr Hening Naluria
Kanti Children’s Hospital (2020) We as fellows have an additional task, namely to go to a children’s hospital to do a Retinopathy of Prematurity (ROP) screening on babies born prematurely.
  1. ACTIVITIES
  2. a) The presentation of disease topics in children.

 

NO DATE TOPIC
1.  28/01/2020  MOTOR EVALUATION IN STRABISMUS
2.  25/02/2020  HORIZONTAL STRABISMUS
3.  13/4/2020  WEAKENING PROCEDURE IN STRABISMUS SURGERY
4.  11/5/2020  STRENGHTHENING PROCEDURE IN STRABISMUS SURGERY
5.  15/6/2020  COMPLICATIONS IN STRABISMUS SURGERY
6.  18/8/2020  TRANSPOSITION SURGERIES AND MINIMAL INCISION STRABISMUS SURGERY
7.  8/10/2020  JOURNAL PRESENTATION “SECONDARY INTRAOCULAR LENS IMPLANTATION FOLLOWING  INFANTILE CATARACT SURGERY: INTRAOPERATIVE INDICATIONS, POSTOPERATIVE” 
8.  12/11/2020  NYSTAGMUS 

 

  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) : 
NO  DATE  NAME  AGE  EYE  

RIGHT EYE/LEFT EYE (RE/LE)

 DIAGNOSIS  CROSS CHECK AND COMMENT OF IMMEDIATE FACULTY (THEORY, SKILL & RESULT)
1.  3/1/2020  SUBIKA YADAV  18 Y  LE  EXOTROPIA
2.  9/1/2020  ANJU KHADKA  18 Y  RE  EXOTROPIA
3.  16/1/2020  SAMIR KUNWAR  16 Y  RE  RESTRICTIVE STRABISMUS (ESOTROPIA)
4.  23/1/2020  ROSHANI SHRASTHA  12 Y  BE  EXOTROPIA
5.  29/1/2020  LAXMI SHRESTHA  26 Y  RE  EXOTROPIA
6.  29/1/2020  SANTA LAL DESHAR  59 Y  LE  THYROID EYE DISEASE WITH HYPOTROPIA 
7.  6/2/2020  VIYA KATHIWODA  7 Y  BE  EXOTROPIA 
8.  6/2/2020  JAMUNA SHARMA  23 Y  RE  EXOTROPIA 
9.  8/2/2020  PRANJAL SUBEDI  11 Y  BE  ESOTROPIA 
10.  12/2/2020  RANJITA MAHATARA  19 Y  RE  EXOTROPIA 
11.  13/2/2020  KRISHMA JOSHI  25 Y  LE  EXOTROPIA WITH HYPOTROPIA 
12.  14/2/2020  SANTOSHI SUNUWAR  25 Y  RE  EXOTROPIA

 

13.  19/2/2020  ASMITA GAIRE  21 Y  RE  EXOTROPIA WITH DVD 
14.  21/2/2020  SUSHMA YONJAN  30 Y  LE  EXOTOPRIA WITH SMALL HYPERTROPIA 
15.  21/2/2020  AYUSH KAPARI  9 Y  LE  ESOTROPIA
16.  26/2/2020  SUMINA MAJHI  31 Y  LE  EXOTROPIA 
17.  12/3/2020  BUDIRAM PUN  28 Y  LE  DIPLOPIA + EXOTROPIA 
18.  19/3/2020  LAXMI ADHIKARI  41 Y  LE  EXOTROPIA
19.  7/5/ 2020  JESSICA BADHA  7 Y  BE  EXOTROPIA
20.  14/5/2020  RANJU YADAV  35 Y  LE  EXOTROPIA
21.  16/5/2020  RUBY KHATOON  16 Y  LE  EXOTROPIA
22.  23/5/2020  SASRIKA BASNET  10 Y  BE  ESOTROPIA
23.  30/5/2020  RIPU PASWAN  35 Y  LE  EXOTROPIA
24.  6/6/2020  ASHMITA NAUPANE  17 Y  LE  EXOTROPIA 
25.  11/6/2020  BHARAT KHATRI  10 Y  BE  ESOTROPIA
26.  13/6/2020  PRATIK SRESTHA  15 Y  LE  EXOTROPIA 
27.  4/7/2020  KUSHAL DHAKAL  20 Y  RE  EXOTROPIA 
28.  9/7/2020  BIRENDRA KARKI  19 Y  RE  INFERIOR OBLIQUE OVERACTION
29.  14/7/2020  SUKRASHYA TRITAL  21 Y  LE  EXOTROPIA
30.  14/7/2020  NIRANJAN SHRESTHA  22 Y  LE  DIPLOPIA + ESOTROPIA 
31.  1/8/2020  MAMATA DEVI DAS  39 Y  LE  6TH PALSY 
32.  2/8/2020  SACHIN BANIYA  18 Y  LE  EXOTROPIA
33.  6//8/2020  SAMIKSHYA YADAV  11 Y  BE  ESOTROPIA
34.  9/8/2020  RABINA BAJU  22 Y  RE  INTERMITTENT EXOTROPIA
35.  13/8/2020  ANISHA THAPA  18 Y  RE  EXOTROPIA
36.  15/8/2020  PREKSHYA TAMANG  15 Y  LE  EXOTROPIA

 

37.  1/10/2020  PUNITA KUMARI YADAV  20 Y  RE  ESOTROPIA
38.  9/10/2020  AASHA SHRESTHA  26 Y  RE  EXOTROPIA
39.  8/10/2020  ASHMA SHRESTHA  22 Y  LE  ESOTROPIA
40.  12/10/2020  GANESH BC  31 Y  RE  EXOTROPIA
41.  1/11/2020  SHYAM KUMAR YADAV  21 Y  LE  ESOTRPIA
42.  5/11/2020  RABI BAJU  30 Y  LE  EXOTROPIA
43.  7/11/2020  SHYAM KUMAR YADAV  21 Y  LE  ESOTROPIA + INFERIOR OBLIQUE OVERACTION 
44.  12/11/2020  NANI CHHORI MANIKAR  53 Y  RE  EXOTROPIA
45.  11/11/2020  MOHAN PATHAK  18 Y  RE  ESOTROPIA S/P SQUINT SURGERY
46.  21/11/2020  DIPESH GURUNG  44 Y  LE  EXOTROPIA
47.  28/11/2020  SAISTA SEKH  15 Y  RE  EXOTROPIA
48.  1/12/2020  RAJUN TAMANG  18 Y  LE  EXOTROPIA
49.  3/12/2020  ANISH SHRESTHA  20 Y  LE  EXOTROPIA
50.  6/12/2020  SABINA SHANKAR  19  LE  ESOTROPIA
51.  7/12/2020  ALKA RANJIT  24 Y  LE  EXOTROPIA
52.  24/12/2020  MANJU MEKA  22 Y  LE  ESOTROPIA
TOTAL CASES (PERFORMED INDEPENDENTLY): 52 CASES  ORTHOPTICS EVALUATION: 52 CASES

 

b) Hess charting (Performed Independently):

 

NO  DATE  NAME  AGE  EYE  

(RE/LE)

 DIAGNOSIS  CROSS CHECK AND COMMENT OF IMMEDIATE FACULTY (THEORY, SKILL & RESULT)
1.  16/1/2020  SAMIR KUNWAR  16 Y  RE  RESTRICTIVE STRABISMUS (ESOTROPIA)
2.  12/3/2020  BUDIRAM PUN  28 Y  LE  DIPLOPIA + EXOTROPIA 
3.  1/8/2020  MAMATA DEVI DAS  39 Y  LE  6TH PALSY 
4.  5/10/2020  SWECCHA ADHIKARI  26 Y  LE  6TH PALSY 
5.  5/10/2020  BHADRA SINGH DHIMAL  57 Y  LE  ESOTROPIA + HYPOTROPIA 
TOTAL CASES  

(PERFORMED INDEPENDENTLY): 5 CASES 

 HESS CHARTING: 5 CASES 

 

 

c) Diplopia charting (Performed Independently): 

 

NO  DATE  NAME  AGE  EYE  

(RE/LE)

 DIAGNOSIS  CROSS CHECK AND COMMENT OF IMMEDIATE FACULTY (THEORY, SKILL & RESULT)
1.  16/1/2020  SAMIR KUNWAR  16 Y  RE  RESTRICTIVE STRABISMUS (ESOTROPIA)
2.  12/3/2020  BUDIRAM PUN  28 Y  LE  DIPLOPIA + EXOTROPIA 
3.  1/8/2020  MAMATA DEVI DAS  39 Y  LE  6TH PALSY 
4.  5/10/2020  SWECCHA ADHIKARI  26 Y  LE  6TH PALSY 
5.  5/10/2020  BHADRA SINGH DHIMAL  57 Y  LE  ESOTROPIA + HYPOTROPIA 
TOTAL CASES  

(PERFORMED INDEPENDENTLY): 5 CASES 

 DIPLOPIA CHARTING: 5 CASES 

 

  1. d) Surgical Activities. 
  2. a) Observations: 
NO  DATE  NAME  AGE  EYE  

RIGHT EYE/LEFT  EYE 

(RE/LE)

 DIAGNOSIS  PROCEDURE NAME 
1.  9/1/2020  SARITA TAMANG  18 Y  LE  EXOTROPIA  LATERAL RECTUS (LR) RECESSION AND MEDIAL RECTUS (MR)  RESECTION 
2.  9/1/2020  SAGAR CHHETRI  9 Y  LE  EXOTROPIA  LR RECESSION AND MR RESECTION
3.  9/1/2020  SARASWOTI KC  49 Y  LE  ESOTROPIA (ET) + DIPLOPIA  MR RECESSION
4.  9/1/2020  RITESH PARIYAR  9 Y  RE  LAMELLAR CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
5.  16/1/2020  EVA CHHANTYAL  5 Y  RE  POSTERIOR POLAR CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
6.  16/1/2020  GINAT KHATUN  1 Y  LE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY
7.  16/1/2020  ASHOK MAGAR  4 Y  RE  TRAUMATIC CATARACT + CORNEAL SCAR  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
8.  23/1/2020  GINAT KHATUN  1 Y  LE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY
9.  23/1/2020  SABIN TAMANG  3 Y  RE  APHAKIC EYE POST CONGENITAL CATARACT SURGERY  SECONDARY IOL IMPLANTATION
10.  23/1/2020  SUGAM THAPA  4 Y  LE  LAMELLAR CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
11.  23/1/2020  KUSH KUMAR  5 Y  RE  LAMELLAR CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
12.  23/1/2020  ROSHNI KUMARI  10 Y  RE  MEMBRANOUS CATARACT  LENS ASPIRATION + IOL
13.  23/1/2020  ABHISHEK BK  8 Y  LE  APHAKIC EYE POST TRAUMATIC CATARACT EXTRACTION  SECONDARY IOL IMPLANTATION

 

14.  30/1/2020  SADIKSHA PAUDEL  4 Y  RE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
15.  30/1/2020  NAWANG GALE  9 Y  LE  PEDIATRIC CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
16.  6/2/2020  ROSHNI KUMARI  10 Y  LE  MEMBRANOUS CATARACT  LENS ASPIRATION + IOL
17.  6/2/2020  RHYTEM THAPA  12 Y  RE  POST PUPILOPLASTY + MEMBRANECTOMY  IOL EXCHANGE
18.  6/2/2020  SADIKSHA PAUDEL  4 Y  LE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
19.  6/2/2020  PRANISHA GALE  7 Y  LE  TRAUMATIC CATARACT + POST CORNEAL PERFORATION  REPAIR  SUTURE REMOVAL + LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
20.  13/2/2020  BISHAL RAI  11 Y  RE  TRAUMATIC CATARACT  LENS ASPIRATION + IOL + SYNECHOLISIS
21.  27/2/2020  JEEVAN BIKRAM SIGH  3 Y  RE  LAMELLAR CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
22.  27/2/2020  SHREYASHI PANDEY  1 Y  RE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
23.  12/3/2020  SAMYOG SHRESTHA  7 Y  LE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
24.  12/3/2020  BASANTA RANA  5 Y  LE  TOTAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
25.  12/3/2020  NIKESH RAUT  11 Y  RE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
26.  12/3/2020  MAHENDRA ROKAYA  6 Y  RE  LAMELLAR CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
27.  19/3/2020  SAMYOG SHRESTHA  7 Y  RE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
28.  19/3/2020  MAHENDRA ROKAYA  6 Y  LE  LAMELLAR CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
29.  19/3/2020  SON OF DURBHA  

NAUPANE 

 7 M  RE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY
30.  19/3/2020  GAURANGA KAFLE  4 Y  LE  TOTAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
31.  19/3/2020  NIKESH RAUT  11 Y  LE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
32.  22/3/2020  TABSUM KHATOON  7 Y  RE  RETINOBLASTOMA  EUA + TTT
33.  22/3/2020  BABY. DIPENDRA SUNAR  4Y  RE  RETINOBLASTOMA  EUA + EVALUATION SOCKET
34.  22/3/2020  NAIRA SAIBO  1 Y  LE  RETINOBLASTOMA  EUA + TTT
35.  4/6/2020  AADITYA THAPA  7 Y  RE  TRAUMATIC CATARACT  ANTERIOR VITRECTOMY + MEMBRANECTOMY + IOL + SUTURAL  REMOVAL 
36.  2/7/2020  MIRAV PAUDEL  3 Y  RE  APHAKIC EYE POST CONGENITAL CATARACT SURGERY  SECONDARY IOL IMPLANTATION 
37.  2/7/2020  BABY OF ANJALI  

MAHARJAN

 4 M  RE  TOTAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY
38.  9/7/2020  MIRAV PAUDEL  3 Y  RE  APHAKIC EYE POST CONGENITAL CATARACT SURGERY  SECONDARY IOL IMPLANTATION 
39.  9/7/2020  URJA MAHARJAN  8 Y  RE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
40.  9/7/2020  AMINA SHAHI  4 M  BE  CORNEAL OPACITY + MICROCORNEA + LE CHOROIDAL  COLOBOMA  EXAMINATION UNDER ANESTHESIA + LE SURGICAL PI
41.  9/7/2020  RAJU THARU  7 M  RE  TOTAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY
42.  9/7/2020  SAMIK CHAULAGAIN  5 Y  RE  APHAKIC EYE POST CONGENITAL CATARACT SURGERY  SECONDARY IOL IMPLANTATION
43.  16/7/2020  RAJU THARU  7 M  LE  TOTAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY
44.  16/7/2020  SAMIK CHAULAGAIN  5 Y  LE  APHAKIC EYE POST CONGENITAL CATARACT SURGERY  SECONDARY IOL IMPLANTATION
45.  16/7/2020  JOHANA MAHARJAN  6 Y  RE  APHAKIC EYE POST CONGENITAL CATARACT SURGERY  SECONDARY IOL IMPLANTATION

 

46.  23/7/2020  JOHANA MAHARJAN  6 Y  LE  APHAKIC EYE POST CONGENITAL CATARACT SURGERY  SECONDARY IOL IMPLANTATION
47.  23/7/2020  JOHN PARIYAR  7 Y  RE  CONGENITAL CATARACT  RE LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
48.  23/7/2020  SHADEV THAPA  29 Y  RE  THIRD NERVE PALSY  EXTERPATION OF LATERAL RECTUS WITH RESSECTION OF MEDIAL  RECTUS
49.  22/9/2020  RANI KUMARI CHAUDARY  4 Y  RE  TRAUMATIC CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL
50.  22/9/2020  ANISHA TAMANG  1 Y  RE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL 
51.  29/9/2020  DINESH BOHARA  11 Y  RE  CONGENITAL CATARACT  LENS ASPIRATION + IOL
52.  6/10/2020  PUSPA PUN  5 M  RE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY 
53.  6/10/2020  DEV RAJ SHAHI  8 Y  LE  APHAKIC EYE  SUTURE REMOVAL + SECONDARY IOL 
54.  6/10/2020  HRIDAYA SHAHI  10 M  RE  CONGENITAL CATARAT  LENS ASPIRATION + ANTERIOR VITRECTOMY 
55.  6/10/2020  ANISHA TAMANG  1 Y  RE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL 
56.  5/11/2020  AMRITA BELBASE  9 Y  RE  POSTERIOR POLAR CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY
57.  5/11/2020  AARAV BHATTARAI  9 Y  RE  POSTERIOR POLAR CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY
58.  5/11/2020  SAIDEEP SHRESTHA  10 M  RE  NUCLEAR CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY
59.  5/11/2020  SIMRAN THAPA  1 Y  RE  TOTAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY + FOLDABLE IOL
60.  5/11/2020  NIRVIK POUDEL  1 Y  RE  TOTAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY
61.  10/11/2020  ARBAN ANSARI  8 M  LE  TOTAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY
62.  10/11/2020  DEEPYANSH JAISWAL  2 Y  RE  RE TOTAL CATARACT, LE LAMELLAR CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY + FOLDABLE IOL 
63.  10/11/2020  AMRITA BELBASE  3 M  LE  TOTAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
64.  12/11/2020  NIRVIK POUDEL  1 Y  LE  TOTAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
65.  12/11/2020  SAIDEEP SHRESTHA  10 M  LE  NUCLEAR CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
66.  12/11/2020  AARAV BHATTARAI  9 Y  LE  POSTERIOR POLAR CATARACT  LENS ASPIRATION + FOLDABLE IOL
67.  19/11/2020  ARBAN ANSARI  8 M  RE  TOTAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
68.  19/11/2020  MASUM ALI  7 Y  LE  TRAUMATIC CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY + SUTURE REMOVAL + IOL 
69.  26/11/2020  KHIMALA POUDEL  4 Y  RE  TRAUMATIC CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY + FOLDABLE IOL
70.  26/11/2020  SAPRINSHAH PANDEY  6 M  RE  CONGENITAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
71.  26/11/2020  SHRIYANSH KHADKA  4 M  RE  TOTAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
72.  3/12/2020  DEEPYANSH JAISWAL  2 Y  LE  RE TOTAL CATARACT, LE LAMELLAR CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY + FOLDABLE IOL 
73.  3/12/2020  SHRIYANSH KHADKA  4M  LE  TOTAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
74.  3/12/2020  SAPRINSHAH PANDEY  6 M  LE  CONGENITAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
75.  3/12/2020  RITIK NEPALI  15 Y  RE  LAMELLAR CATARACT  LENS ASPIRATION+ IOL
76.  3/12/2020  MOHAMMAD TABEZ  2 Y  RE  TOTAL CATARACT + NYSTAGMUS  LENS ASPIRATION+ANTERIOR VITRECTOMY + FOLDABLE IOL 
77.  10/12/2020  SAMRACHANA GAIRE  5 M  RE  POSTERIOR POLAR CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
78.  10/12/2020  MOHAMMAD TABEZ  2 Y  LE  TOTAL CATARACT + NYSTAGMUS  LENS ASPIRATION+ANTERIOR VITRECTOMY + FOLDABLE IOL 
79.  15/12/2020  ALISH LIMBU  6 M  RE  TOTAL CATARACT + NYSTAGMUS  LENS ASPIRATION+ANTERIOR VITRECTOMY
80.  17/12/2020  SHRIYANSH JAISWAL  1 Y  LE  TOTAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY + FOLDABLE IOL

 

81.  17/12/2020  SAMRACHANA GAIRE  5 M  LE  POSTERIOR POLAR CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
82.  24/12/2020  KARUN GIRI  3 Y  LE  TRAUMATIC CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY + IOL 
83.  24/12/2020  RIYANSHA ADHIKARI  10 M  LE  TOTAL CATARACT  LENS ASPIRATION+ANTERIOR VITRECTOMY 
84.  31/12/2020  SUNIL DAS CHAUDARY  29 Y  RE  3RD NERVE PALSY  LR RECESSION + MR RESECTION 
TOTAL CASES  

(OBSERVATIONS): 84 CASES 

 STRABISMUS: 5 CASES 

CONGENITAL CATARACT: 59 CASES  

TRAUMATIC CATARACT: 8 CASES  

IOL EXCHANGE: 1 CASE 

SECONDARY IOL IMPLANTATION: 8 CASES  

EUA + TTT: 3 CASES 

 

  1. b) Performed Surgery as First Assistant :
NO  DATE  NAME  AGE  EYE  

(RE/LE)

 DIAGNOSIS  PROCEDURE NAME 
1.  9/1/2020  SUBIKA YADAV  18 Y  LE  EXOTROPIA  LR RECESSION AND MR RESECTION
2.  16/1/2020  ANJU KHADKA  18 Y  RE  EXOTROPIA  LR RECESSION AND MR RESECTION
3.  23/1/2020  SAMIR KUNWAR  16 Y  RE  RESTRICTIVE STRABISMUS (ESOTROPIA)  MR RECESSION WITH HANGBACK AND LR EXPLORATION AND RESSECTION
4.  30/1/2020  ROSHANI SHRASTHA  12 Y  BE  EXOTROPIA  LR RECESSION 
5.  6/2/2020  LAXMI SHRESTHA  26 Y  RE  EXOTROPIA  RECESSION AND MR RESECTION
6.  6/2/2020  SANTA LAL DESHAR  59 Y  LE  THYROID EYE DISEASE WITH HYPOTROPIA INFERIOR RECTUS (IR) RECESSION 
7.  13/2/2020  VIYA KATHIWODA  7 Y  BE  EXOTROPIA  BE LR RECESSION
8.  27/2/2020  AYUSH KAPARI  9 Y  LE  ESOTROPIA  MR RECESSION 
9.  27/2/2020  KRISHMA JOSHI  25 Y  LE  EXOTROPIA WITH HYPOTROPIA  LR RECESSION WITH IR RECESSION
10.  6/8/2020  MAMATA DEVI DAS  39 Y  LE  6TH PALSY  MR RECESSION + SR TRANSPOSITION
11.  6/8/2020  SACHIN BANIYA  18 Y  LE  EXOTROPIA  LR RECESSION + MR RESECTION
TOTAL CASES 

(PERFORMED SURGERY AS FIRST ASSISTANT): 11 CASES 

 STRABISMUS: 11 CASES 

 

c) Performed Surgery Under Supervision:

 

NO  DATE  NAME  AGE  EYE  

(RE/LE)

 DIAGNOSIS  PROCEDURE NAME  CROSS CHECK AND COMMENT OF IMMEDIATE  FACULTY 

(THEORY, SKILL & RESULT)
1.  23/1/2020  UNIK BHUJEL  8 Y  LE  LEFT LOWER LID CHALAZION  LEFT LOWER LID CHALAZION EXCISION  HAVE DONE COMPLETE STEP
2.  30/1/2020  SABIN TAMANG  3 Y  LE  APHAKIC EYE POST  

CONGENITAL CATARACT  SURGERY

 SECONDARY IOL IMPLANTATION  HAVE DONE TUNNEL AND IOL DELIVERY INTO  SULCUS 
3.  6/2/2020  RESHMA MAGAR  22 Y  LE  EXOTROPIA  LR RECESSION AND MR RESECTION  HAVE DONE FORNIX INCISION, HOOKING THE  MUSCLE, CONJUNCTIVAL SUTURE
4.  6/2/2020  LAXMI SHRESTH  26 Y  RE  EXOTROPIA  LR RECESSION AND MR RESECTION  HAVE DONE FORNIX INCISION, HOOKING THE  MUSCLE, CONJUNCTIVAL SUTURE 
5.  13/2/2020  RABEYA BUSHRA  25 Y  RE  INTERMITTENT DIVERGENT  SQUINT  LR RECESSION AND MR RESECTION  HAVE DONE COMPLETE STEPS FOR 1 MUSCLE (LR  RECESSION)
6.  18/2/2020  SUJITA PHATAK  29 Y  RE  INTERMITTENT DIVERGENCE  SQUINT LR RECESSION AND MR RESECTION  HAVE DONE COMPLETE STEPS FOR 1 MUSCLE (LR  RECESSION)
7.  12/3/2020  SUJITA DAHAL  22 Y  LE  ALTERNATE EXOTROPIA  LR RECESSION AND MR RESECTION  HAVE DONE COMPLETE STEPS FOR 1 MUSCLE  (MR RESECTION)
8.  12/3/2020  REHAN NADAF  5 Y  RE  APHAKIC EYE POST  

CONGENITAL CATARACT  SURGERY

 SECONDARY IOL IMPLANTATION  HAVE DONE COMPLET STEP
9.  12/3/2020  NIRANJAN PATEL  10 Y  LE  TRAUMATIC CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL  HAVE DONE ANTERIOR CAPSULORHEXIS + LENS  ASPIRATION 
10.  17/3/2020  GANESH BC  31 Y  RE  EXOTROPIA  LR RECESSION + MR RESECTION  HAVE DONE COMPLETE STEPS FOR 1 MUSCLE  (MR RESECTION)
11.  19/3/2020  MAHENDRA  

ROKAYA

 6 Y  LE  CONGENITAL CATARACT  LENS ASPIRATION + ANTERIOR VITRECTOMY + IOL  HAVE DONE IOL DELIVERY INTO CAPSULAR BAG +  ANTERIOR VITRECTOMY + POSTERIOR  

CAPSULORHEXIS
12.  4/6/2020  AADITYA THAPA  8 Y  LE  TRAUMATIC CATARACT  ANTERIOR VITRECTOMY + IOL + MEMBRANECTOMY + SUTURE REMOVAL  HAVE DONE COMPLET STEP 
13.  20/10/2020  BEDHA NIDHI  

CHAPAGAIN

 58 Y  LE  MATURE CATARACT  SISCS + IOL  HAVE DONE CAPSULORHEXIS (CCC) 
14.  20/10/2020  SHYAM KRISHNA  SHRESTHA 51 Y  RE  MATURE CATARACT  SICS + IOL  HAVE DONE CAPSULORHEXIS (CCC)
15.  20/10/2020  LALITA SHAHI  55 Y  RE  MATURE CATARACT  SICS + IOL  HAVE DONE CAPSULORHEXIS (CCC)
16.  20/10/2020  SITA DEVI GHARTI  65 Y  LE  IMMATURE CATARACT  PHACO + IOL  HAVE DONE CAPSULORHEXIS (CCC) + CORTEX  WASH
17.  20/10/2020  RAJ KUMAR  

SHRESTHA

 43 Y  RE  IMMATURE CATARACT  PHACO + IOL  HAVE DONE CAPSULORHEXIS (CCC) + CORTEX  WASH

 

18.  19/11/2020  KESHARI GHARTI  MAGAR 81 Y  LE  IMMATURE CATARACT  PHACO + IOL  HAVE DONE CAPSULORHEXIS (CCC) + CORTEX  WASH
19.  19/11/2020  RAM BHAKTA  

SHRESTHA

 77 Y  RE  IMMATURE CATARACT  PHACO + IOL  HAVE DONE CAPSULORHEXIS (CCC) + CORTEX  WASH
20  19/11/2020  KUSUM KUMARI  KUMAL 58 Y  RE  IMMATURE CATARACT  PHACO + IOL  HAVE DONE PHACO CHOP
21.  19/11/2020  RUPA LAMA  54 Y  LE  IMMATURE CATARACT  PHACO + IOL  HAVE DONE PHACO CHOP
22.  19/11/2020  GAJENDRA  

BAHADUR  

ADHIKARI

 54 Y  RE  IMMATURE CATARACT  PHACO + IOL  HAVE DONE PHACO CHOP
23.  22/11/2020  KRISHNA KARKI  66 Y  RE  IMMATURE CATARACT  PHACO + IOL  HAVE DONE COMPLETE STEP
24.  22/11/2020  YODENDRA B  

THAPA

 67 Y  RE  IMMATURE CATARACT  PHACO + IOL  HAVE DONE COMPLETE STEP
TOTAL CASES  

(PERFORMED SURGERY UNDER SUPERVISION): 24 CASES 

 STRABISMUS: 6 CASES  

TRAUMATIC CATARACT: 2 CASES CONGENITAL CATARACT: 1 CASE 

SECONDARY IOL IMPLANTATION: 2  CASES  

PHACO + IOL: 9 CASES  

SICS: 3 CASES 

CHALAZION (I AND C): 1 CASE 

 

  1. d) Performed Surgery Independently:
NO  DATE  NAME  AGE  EYE  

RIGHT EYE/LEFT EYE  (RE/LE)

 DIAGNOSIS  PROCEDURE NAME  CROSS CHECK AND COMMENT OF  IMMEDIATE FACULTY 

(THEORY, SKILL & RESULT)
1.  15/3/2020  RAMESH BUDHATOKI  24 Y  LE  CORNEAL PERFORATION  CORNEAL PERFORATION REPAIR + INTRAVETRIAL  INJECTION (VANCOMYCIN + CEFTAZIDIME)
2.  15/3/2020  ANDHYA OLI  6 Y  LE  CORNEAL PERFORATION + IRIS  PROLAPS CORNEAL PERFORATION REPAIR + INTRAVETRIAL  INJECTION (VANCOMYCIN + CEFTAZIDIME)
3.  17/3/2020  AADITYA CHAUDARY  21 Y  LE  EXOTROPIA  LR RECESSION + MR RESECTION
4.  19/3/2020  REHAN NADAF  5 Y  LE  APHAKIC EYE POST CONGENITAL  CATARACT SURGERY SECONDARY IOL IMPLANTATION
5.  19/3/2020  SUNITA TAMANG  22 Y  LE  INTERMITTENT EXOTROPIA  LR RECESSION AND MR RESECTION
6.  20/3/2020  AAYUSH JOSHI  8 Y  RE  CORNEAL PERFORATION  CORNEAL PERFORATION REPAIR + INTRAVETRIAL  INJECTION (VANCOMYCIN + CEFTAZIDIME)

 

7.  12/6/2020  RAJU MIJAR  25 Y  RE  CORNEAL PERFORATION + ANTERIOR  + TRAUMATIC CATARACT + CAPSULE  RUPTURE  CORNEAL PERFORATION REPAIR + INTRAVITREAL  INJECTION (VANCOMYCIN + CEFTAZIDIME)
8.  15/6/2020  RAJU MIJAR  25 Y  RE  POST CORNEAL PERFORATION REPAIR  + TRAUMATIC CATARACT ANTERIOR  +CAPSULE RUPTURE  LENS ASPIRATION 
9.  21/6/2020  JOYESH SHRESTHA  2 Y  RE  RE CORNEAL LACERATION +  

TRAUMATIC CATARACT WITH  

ANTERIOR CAPSULE RUPTURE

 CORNEAL PERFORATION REPAIR + INTRAVITREAL  INJECTION (VANCOMYCIN + CEFTAZIDIME)
10.  25/6/2020  JOYESH SHRESTHA  2 Y  RE  TRAUMATIC CATARACT WITH  

ANTERIOR CAPSULE RUPTURE 

 LENS ASPIRATION 
11.  29/6/2020  KUL KUMAR RAI  37 Y  LE  EXOTROPIA  RECESSION AND MR RESECTION
12.  23/7/2020  JOHN PARIYAR  7 Y  LE  RE CONGENITAL CATARACT + LE  APHAKIA LENS ASPIRATION + ANTERIOR VITRECTOMY
13.  23/7/2020  NIRANJAN SHRESTHA  22 Y  LE  DIPLOPIA + ESOTROPIA  MR RECESSION
14.  26/7/2020  SUBIN TAMANA  6 Y  LE  CORNEA LIMBAL PERFORATION + IRIS  PROLAPSE  CORNEA LIMBAL PERFORATION REPAIR + IRIS  REPOSITION + INTRAVITREAL INJECTION  (VANCOMYCIN + CEFTAZIDIME)
15.  30/7/2020  SISHIR RAUT  10 Y  LE  PHTHISIS BULBI  SUTURE REMOVAL
16.  30/7/2020  DEV RAJ SHAHI  8 Y  LE  CORNEAL PERFORATION +  

TRAUMATIC CATARACT + ANTERIOR  CAPSULE RUPTURE 

 CORNEAL REPAIR + LENS ASPIRATION +  ANTERIOR VITRECTOMY 
17.  30/7/2020  HARI SHRESTHA  52 Y  LE  PSEUDOPHAKIA (POST SICS)  ANTERIOR VITRECTOMY 
18.  13/8/2020  NIRAJ BHATATRAI  17 Y  RE  APHAKIA  SECONDARY IOL IMPLANTATION 
19.  13/8/2020  RABINA BAJU  22 Y  RE  INTERMITTENT EXOTROPIA  LR RECESSION + MR RESECTION
20.  9/10/2020  PUNITA KUMARI YADAV  20 Y  RE  ESOTROPIA  MR RECESSION 
21.  9/10/2020  MADHAN KC  2 Y  LE  POST LENS ASPIRATION + ANTERIOR  VITRECTOMY MEMBRANECTOMY 
22.  15/10/2020  PRINCE PANDIT  10 Y  RE  UPPER LID AND LOWER LID  

CHALAZION

 CHALAZION EXCISION
23.  16/10/2020  MASUM ALI  7 Y  LE  CORNEAL PERFORATION + ANTERIOR  CAPSULE RUPTURE  CORNEAL PERFORATION REPAIR + LENS  ASPIRATION
24.  17/10/2020  AARUSH JAISWAL  3 Y  RE  POST OPERATIVE ENDOPHTHALMITIS  INTRA VITRAL INJECTION (VANCOMYCIN +  CEFTAZIDIME)
25.  18/10/2020  AASHA SHRESTHA  26 Y  RE  EXOTROPIA  LR RECESSION + MR RESECTION 
26.  18/10/2020  ASHMA SHRESTHA  22 Y  LE  ESOTROPIA  MR RECESSION + LR RESECTION
27.  20/10/2020  GANESH BC  31 Y  RE  EXOTROPIA  LR RECESSION + MR RESECTION

 

28.  28/10/2020  NALIM VIBHAKAR  70 Y  RE  CORNEL PERFORATION + IRIS  

PROLAPS + TOTAL HYPHEMA 

 CORNEAL PERFORATION REPAIR + HYPHEMA  WASH + INTRAVITREAL INJECTION  

(VANCOMYCIN + CEFTAZIDIME)
29.  28/10/2020  RUBINA TAMANG  16 Y  RE  CORNEL PERFORATION + IRIS  

PROLAPS + TOTAL HYPHEMA 

 CORNEAL PERFORATION REPAIR + HYPHEMA  WASH + INTRAVITREAL INJECTION  

(VANCOMYCIN + CEFTAZIDIME)
30.  10/11/2020  RAJU MIJAR  25 Y  RE  SECONDARY IOL  SECONDARY IOL IMPLANTATION
31.  10/11/2020  SHYAM KUMAR YADAV  21 Y  LE  ESOTRPIA  MR RECESSION + LR RESECTION
32.  10/11/2020  RABI BAJU  30 Y  LE  EXOTROPIA  LR RECESSION + MR RESECTION
33.  12/11/2020  SHYAM KUMAR YADAV  21 Y  LE  ESOTROPIA + INFERIOR OBLIQUE  OVERACTION  LR RECESSION + MR RESECTION 
34.  22/11/2020  TASHIM RAZA  6 Y  RE  CORNEL PERFORATION + IRIS  

PROLAPS

 CORNEAL PERFORATION REPAIR + INTRAVITREAL  INJECTION (VANCOMYCIN + CEFTAZIDIME)
35.  26/11/2020  ANKIT KUMAR SAH  3 Y  LE  PCIOL + DENSE PCO  MEMBRANECTOMY
36.  26/11/2020  NANI CHHORI MANIKAR  53 Y  RE  EXOTROPIA  LR RECESSION + MR RESECTION 
37.  26/11/2020  YODENDRA B THAPA  47 Y  LE  IMMATURE CATARACT  PHACO + IOL 
38.  1/12/2020  TENZING TASHI SERPA  6 Y  RE  LOWER LID CHALAZION  CHALAZION EXCISION
39.  3/12/2020  MOHAN PATHAK  18 Y  RE  ESOTROPIA S/P SQUINT SURGERY  MR RECESSION 
40.  7/12/2020  HARKA BAHADUR NEPALI  66 Y  LE  CORNEL PERFORATION + IRIS  

PROLAPS

 CORNEAL PERFORATION REPAIR + INTRAVITREAL  INJECTION (VANCOMYCIN + CEFTAZIDIME)
41.  7/12/2020  AMODH KUMAR SAH  19 Y  RE  FULL THICKNESS LOWER EYELID  LACERATION WITH EYELID MARGIN  INVOLVED  LOWER LID LACERATION REPAIR
42.  10/12/2020  AARADHYA MAGAR  4 Y  RE  APHAKIA + DENSE PCO, POST LENS  ASPIRATION DUE TO TRAUMATIC  CATARACT MEMBRANECTOMY + IOL IMPLANTATION +  IRIDECTOMY
43.  10/12/2020  TSHERING TAMANG  76 Y  RE  MATURE CATARACT  SICS + IOL 
44.  10/12/2020  SER BAHADUR LUNGELI  76 Y  LE  IMMATURE CATARACT  PHACO + IOL 
45.  11/12/2020  SUNIL THAPA MAGAR  26 Y  LE  CORNEL PERFORATION + IRIS  

PROLAPS

 CORNEAL PERFORATION REPAIR + INTRAVITREAL  INJECTION (VANCOMYCIN + CEFTAZIDIME)
46.  18/12/2020  BHOLA NATH  

KHATIWODA

 67 Y  RE  IMMATURE CATARACT  PHACO + IOL
47.  18/12/2020  KARKESWARI NEUPANE  71 Y  LE  IMMATURE CATARACT  PHACO + IOL
48.  18/12/2020  ISHORIPERSHAD  

LAMICHHANE

 72 Y  RE  MATURE CATARACT  SICS + IOL
49.  18/12/2020  LILIYASATI CHAUDHARY  58 Y  RE  MATURE CATARACT  SICS + IOL
50.  18/12/2020  DUDHA RAM TAMANG  56 Y  RE  MATURE CATARACT  SICS + IOL
51.  15/12/2020  RAJUN TAMANG  18 Y  LE  EXOTROPIA  LR RECESSION + MR RESECTION
52.  15/12/2020  ANISH SHRESTHA  20 Y  LE  EXOTROPIA  LR RECESSION + MR RESECTION
53.  15/12/2020  SABINA SHANKAR  19  LE  ESOTROPIA  MR RECESSION
54.  17/12/2020  SUMINA THING  15 Y  LE  LAMELLAR CATARACT  LENS ASPIRATION + IOL
55.  17/12/2020  AAYUSH JOSHI  8 Y  RE  POST CORNEAL PERFORATION REPAIR  SUTURE REMOVAL 
56.  22/12/2020  ALKA RANJIT  24 Y  LE  EXOTROPIA  LR RECESSION + MR RESECTION

 

57.  24/12/2020  SANDHYA OLI  6 Y  RE  TRAUMATIC CATARACT  SUTURE REMOVAL + LENS  

ASPIRATION+ANTERIOR VITRECTOMY + IOL
58.  24/12/2020  NOOR JAHAN BEGUM  55 Y  LE  IMMATURE CATARACT  PHACO + IOL 
59.  30/12/2020  PADAM BAHADUR  

TAMANG

 84 Y  RE  IMMATURE CATARACT  PHACO + IOL 
60.  30/12/2020  JANUKA SHRESTHA  53 Y  LE  IMMATURE CATARACT  PHACO + IOL 
61.  30/12/2020  JINGMET LAMA  60 Y  LE  IMMATURE CATARACT  PHACO + IOL 
TOTAL CASES 

(PERFORMED SURGERY INDEPENDENTLY): 61 CASES

 STRABISMUS: 16 CASES  

TRAUMATIC CATARACT: 5 CASES  CONGENITAL CATARACT: 2 CASES MEMBRANECTOMY: 3 CASES 

SECONDARY IOL: 3 CASES 

PHACO: 8 CASES  

SICS: 4 CASES  

CORNEAL PERFORATION REPAIR: 12  CASES 

SUTURE REMOVAL: 3 CASES 

EYELID REPAIR: 1 CASE 

CHALAZION (I AND C): 2 CASES ANTERIOR VITRECTOMY : 1 CASE  INTRAVITREAL INJECTION : 1 CASE

 

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

 

a) Below are surefire tips to achieve the target:

Investigation  Curriculum Target  

(Independent)

 Realization 

(Independent)

 Remarks  

(Surefire tips to achieve the target)
Diplopia Charting  5 cases  5 cases  Because the work system in OPD was divided into 3 groups and then divided into 2 groups. So if my duty at OPD was off, I used that time to learn Orthoptics Examinations, Diplopia Charting and Hess Charting. In the Orthoptics  Examinations Room there were 3 highly experienced staff (Mrs. Saraswoti, Mr. Saroj, Mr. Rupesh). They taught me  gradually how to do these procedures correctly, until I really feel confident doing it independently.
Hess Chart  5 cases  5 cases 
Orthoptics Examinations  –  52 cases 

 

Surgery  Curriculum Target  

(Independent)

 Realization  

(Independent)

 Remarks  

(Surefire tips to achieve the target)
Strabismus  10 cases  16 cases  My schedule in the operating room is on Tuesday and Thursday. The most difficult in doing strabismus surgery is to  make a decision which eye to be operated and how long (millimeters) to cut the eye muscle. Making easier to  determine how long (millimeters) should I cut the eye muscle, I make a planning the length of eye muscle that should  I cut within the surgery that have been planned, prior to strabismus surgery. When the mentor came, I immediately  showed to my mentor the notes I had made and discussing it with her. Usually during the discussion, the mentor  accidently gave her experience that I would never find from the book. I think my mentor appreciate me and she gave  many opportunities to do strabismus surgery.
Emergency Surgery:  

(Corneal perforation  

repair, eyelid repair,  

anterior vitrectomy)

 –  Corneal perforation repair:  12 cases  

Eyelid repair: 1 case  

Anterior vitrectomy: 1 case Intravitreal injection: 1 case 

Total cases: 15 cases

 During my fellowship program in Nepal, I lived in the Tilganga’s apartment located inside the building of Tilganga  Institute of Ophthalmology. And make it easier for me to examine the patients when I was the first on call for  emergencies. Whenever I was needed by juniors could immediately assist them to examine patients in the clinic. This  accommodation also contributes me to do surgery on holiday. That’s why I have had so many patients with eye injury  that needed surgery.
Pediatric cataract  

(Include traumatic  

cataract, secondary IOL,  and IOL exchange)

 5 cases  Traumatic Cataract: 5 cases  Secondary IOL: 3 cases  Congenital Cataract: 2 cases  Membranectomy: 3 cases  

Total Cases: 13 cases 

 I got the advantage when doing emergency duty because I got the opportunity to perform surgery on injured eyes.  Later, these patients require further surgery according to the severity of the trauma such as cataract surgery,  secondary intraocular lens implantation. Because I was the one who performed the surgery during emergency duty,  so I had the opportunity to perform further surgeries. After I performed several surgeries in the traumatic cataract  cases, my mentor then gave me the opportunity to do surgery for the congenital cataract and several other surgeries  needed to improve my surgical skills. 
Chalazion (I and C)  –  2 case  I got a bonus between surgery schedules
Suture removal  –  3 cases 
Phacoemulsification  –  8 cases  I also had the opportunity to learn phaco during my fellowship program 
SICS  –  4 cases

 

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 

Dr Hening Naluria

 

Written by, Hening Naluria

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Alif Ardiansyah’s journey

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