Today morning I entered the Temple of the Eye.This mission is God's mission. The country salutes Sankara nethralaya.

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1 BHARAT RATNA PROF. A.P.J. ABDUL KALAM INAUGURATES Newer technology in SN - Super Vision Bharat Ratna Prof. A.P.J. Abdul Kalam, Former Principal Scientific Adviser to the Government of India has inaugurated the Allegretto Wave Excimer Laser and dedicated the Mrs. Madhuram Narayanan Surgical Complex in a function at Music Academy, Chennai on 12th December Today morning I entered the Temple of the Eye.This mission is God's mission. The country salutes Sankara nethralaya. The Most exciting and recent development in refractive surgery is customized corneal ablation, which takes into account the optical imperfections of each individual eye. This is supposed to achieve a visual acuity better than what one had before the procedure - a phenomenon called 'Super Vision'. Sankara Nethralaya now offers this exciting technology to patients with myopia, hyperopia, astigmatism and selective corneal disorders. The IOC Excimer Laser wing at the SN has acquired a wavefront - guided Excimer Laser System (Allegreto) - the first such system in South India. Mrs Madhuram Narayanan Surgical Complex

2 Mrs. Madhuram Narayanan Charitable Trust and Foundation have long been generous patons of Medical and Vision Research Foundations. The trustees of these twin bodies - Sri K.S. Narayanan, the elder statesman of the Sanmar Group of Companies, his sons - Sri N Sankar and Sri N Kumar, Chairman and Vice Chairman respectively and Mrs Chandrasekar, have for years gone beyond charity to provide sustained comprehensive. In their own way of honouring the memory of Mrs Madhuram Narayanan, who herself had taken keen interest in various healthcare projects, this surgical complex at Jagadguru Sri Chandrasekarendra Saraswathi Nethra Nilayam, was dedicated to the nation on 12th December Inside The Quest for Perfect Vision Amarthithi Programme Community Service Nethralaya News CONFERENCES 4 consultants attended the 'First Singapore Eye Research Institute International Meeting and Second Symposium of the Asia Pacific Society of Eye Genetics' held at Singapore on 26th September Their research papers were well received. Dr.Tarun Sharma, Vitreo Retinal Consultant, attended the 105th Annual Meeting of the American Academy of Ophthalmology, New Orieans between 11th to 14th November 2001 and presented a paper titled "Intraocular Cysticercosis: Clinical characteristics and visual outcome after surgery". SPECIAL CAMPS A vision screening camp was conducted in the Narikoravar (Gypsy) area located at Kotturpuram in Chennai in co-ordination with Udavum Ullangal one of the charitable organizations in the city. The optometry students from Elite School of Optometry participated with enthusiasm for eye examnination. Majority of those screened were children. NEWS BRIEFS 10th January 2002 was the Aradhana Day of the Kanchi Maha Periyava. Sankara Nethralaya celebrated the function with the opening of seventh floor in Mahyco Block for the Vitreo Retinal Services. SN congratulate DR.S.Natarajan, Chairman, Aditya Jyot Eye Research Institute, Mumbai (our former Vitreoretinal fellow and consultant) on becoming the Scientific Committee Chairman of the All India Ophthalmological Society. Sankara Nethralaya Women Auxiliary as a measure of raising funds for their chartiable work had sponsored a Dance Drama on Kalidasa's Abhijana Shankuntalam, staged by the Temple of Fine Arts International on 6th October 2001

3 in Chennai. A CD on "Sai Kirthanas" a musical offering to Bhagwan Sri Sathya Sai Baba by vocalist Smt. Soumya, composed by Dr.Shankar A lyer of USA, was released by Mr. M Saravanan, Board Member on this special occasion. CALL 1919 TOLL FREE The Chennai telephones have offered a 4 digit toll free number to make the eyedonation calls to Sankara Nethralaya. The number is HAVE YOU CHANGED YOUR ADDRESS? ARE YOU RECEIVING MORE THAN ONE COPY OF EYELIGHTS? Please let us Know Contact: Editor, Eyelights Sankara Nethralaya, 18, College Road, Chennai information@sankaranethralaya.org N E T H R A L A Y A N E W S A W A R D S A N D A C H I E V E R S Lions Club of Central Madra recognized the service of Sankara Nethralaya's Jaslok Community Ophthalmic Centre with the I Care award to JCOC. On behalf of Sankara Nethralaya, our chairman Dr. S S Badrinath, Mr Venkatesh, our staff and Mr Ganesh of Tulsi trust received the award from Ln G V Raman, Ln Harinarayanan, Ln Jayaraman and Ln S Raghavan. Andhra Prasad State Ophthalmic Society Silver Jubilee Conference Committee conferred the honor of Humanitarian Service Award to our chairman Dr S S Badrinath in its silver jubilee celebrations which was held on 28th September 2001 at Sarojini Devi Eye Hospital. Dr.S S Badrinath also received the Dr K S Roy Award in recognition of his services in the field of Ophthalmology from the Indian Medical

4 Association in a function held at Sri Ramachandra Medical College, Pour on 28th October The prestigious " Gnana Oil Ambassador for Peace" Award was given to Dr S S Badrinath in a function at VGP temple of world peace at Injambakkam, Chennai on 18th November The Indian association of Medical Microbiologists (IAMM) Junior Best Paper Prize for the year 2000 was given to Ms K Priya, PhD scholar at the Silver Jubilee annual congress of IAMM, The prize was given for the oral presentation entitled " Application of rapid aetiological diagnostic methods on intraocular specimens in viral retino choroiditis". Ms. Sripriya, Junior Research fellow at the Genetics department got the "Outstanding Research Award" at the Singapore conference for her work on 'Diabetic Retinopathy an inducible Nitric oxide Synthase gene'. At the All India Ophthalmological Society meeting held in Ahmedabad on 3rd January 2002, the prestigious Rangachari Award was won by our vitreoretinal fellow, Dr Malhar H Soni for his topic titled " Ultrasound biomicroscopic correlation in intraocular inflmmation - a study of 233 eyes". Individual session prize were won by Dr Sudha K Ganesh, Uveitis consultant and Dr Kaushal Bhavsar. A D D I T I O N A L F A C I L I T Sankara Nethralaya, the hospital wing of Medical Research Foundation, has created about 8000 sq.ft of additional floor space for outpatients by addiing one more floor to the existing Mahyco Block. This floor being the 7th floor is exclusively alloted to the vitreoretinal services. There are 26 consultation rooms, patient's waiting hall, a surgery fixing center and separate rooms for outpatient diagnostic and curative procedures such as Fundus Flourescein Angiography, Ultrasonography, Argon laser and diode laser photocoagulation, Photo dynamic therapy, Electro Retinography and Ultrasound biomicroscopy. This floor is named after Sri Gopal Jyot G.H.Bhaktha Memorial Foundation of Mahuva, Surat district, Gujarat. Mr. N.G.Patel, the managing trustee of this foundation has extended substantial financial support. He inaugurated this floor in a function held on 1st October 2001.

5 The reception and appointment counters have been shifted to a new venue in the ground floor of Mahyco block which was modified and reconstructed. The physician rooms, Emergency department are being shifted here for better coordination and patient services. Over the past three years, SN has achieved the unique distinction of having performed the largest number of corneal transplants in India. The C U Shah Eye Bank has played a key role in this success. An important component of an Eye Bank is the specular microscope which enables us to immediately evaluate the quality of donor eyes. Mr. Lal Chand K Nichani, President of Sindhi Chamber of Commerce, Chennai, motivated M/s Lakhi Trust, donated Rs. 5 lakhs towards the purchase of a new specular microscope. Our sincere thanks to him and the donors who believe in the philosphy of SN. AN ACE FOR CHARITY 2nd January 2002 marked a charity auction show at Taj Coromandel conducted by Vijay Amritraj on the occasion of the Tata Open Tennis tournament. The audience included prominent names such as the former Indian cricket captain Kapil Dev, K.Srikkanth, Simone Tata, Anand Amritraj, Mr. Ravi Krishnan International Management Group, Mose Navarra and Mahesh Bhupathi. The proceeds of Rs lakhs, went to Sankara Nethralaya. Karol Kucera, the Slovakian tennis player and Martin Lee, the British tennis player visited the Jaslok Community Ophthalmic Centre for the Tata Open Tennis Championship held in January KNOW YOUR OM TRUST COMMITTEE MEMBERS Dr. B.G. Adhinarayanan Mr.S.Venkatraman Mr.Shanker Iyer Mr.S.V.Acharya Dr.T.S.Surendran President Vice-President Secretary Treasurer Trustees

6 Ms. Nirmala Vasan Mr.Ram Akella Mr.Ramachandran Potti Mr.Parthasarathi Chakravarthy Dr.Subramanya Rao Mr.Arthur Goldberg Mr. Ram Dhingra INFORMATION CENTERS IN CHENNAI Sankara Nethralaya has opened satellite information and counseling centers to provide information regarding the facilities provided here and also to facilitate appointments for consultations and surgeries. These centers provide spot appointment facilities for Lasik excimer laser and cataract patients. Please contact Information Center C U Shah Rural Eye Hospital No. 8 GST Road, St Thomas Mount, Chennai Phone : Information Center Shenoy Nagar Complex 19, Ist Main Road, East Shenoy Nagar, Chennai Phone : THE QUEST FOR PERFECT VISION This is the story of an adventure that began 1000 year ago. It has been enacted in one of the most exquisite theatres we will ever know - the eye. Let us enter the precincts of the theatre to get an idea of what happens, each time the curtain rises.

7 Whenever we look at an object, light rays enter the eye. The cornea and the lens try and focus the rays in to the retina. If the image falls exactly on the retina, we have normal vision. If the eyeball is longer than it should be, the focus lies in front of the retina and we have a defocused image and the eye is said to be myopic or short-sighted. If the eyeball is smaller than it should be the focus lies behind the retina and the eye is said to be hyperopic or farsighted. Whether focused or defocused, the retina captures an inverted image of the object.. Each photon sets up a biochemical cascade that converts lights energy into electrical energy. What goes on behind the retina is ever more fascinating. In a feat computation that far surpasses that of the best known computer, these electrical signals are channeled to the cortex of the brain, networking with tens of billions of neurons. The image itself is recaptured in all its colour, motion form and depth and all this in a quadrillionth of a second - an awesome phenomenon that has become the holy grail of vision research. The diversity in Nature is yet another of her secrets we have not been able to fathom. Why has she endowed some creatures with the speed of lightening and made others so painfully slow? Why has she gifted some with the freedom of flight and shackled others to the earth? Why are some of her children blind as a bat and others as sharp as an eagle? What the human eye can read from a distance of 20 ft. and eagle can see from more than 80 ft. A human being has to crane his neck to inspect a cricket field, but a bird, smaller than the palm of his hand can see it all and a lot more by not so much as even having to turn its little head. It probably hurts the pride of man, that as far as vision is concerned, he takes a backseat to the birds. But what makes man the crown of creation is the unique ability to study and understand himself and to improve upon himself. It is no surprise then that he has authored the script of his own saga. one of the most exciting chapters of which is his quest for perfect vision. This quest really began in the 10th century when the Chinese invented the first framed lenses to correct defective vision. It was very much later that contact lenses were introduced. Sako in 1939 was the first to suggest that by making incisions on the cornea, one could change the curvature, and by doing so could alter the refraction of the eye. And so for the next 50 years, the cornea subjected itself to the well-intentioned zeal of the corneal refractive surgeon. The moment of glory was reserved for an illustrious son of the soil. Dr. R Srinivasan at the IBM laboratories in New York. In 1983, he ushered in the dawn of a new era when he discovered that the Excimer Laser was exactly the tool that the refractive surgons was looking for. The Excimer laser, is an ultraviolet laser, with a wavelength of 193mm, generated by an argon fluoride gas mixture. By etchings made on a strand of human hair. Dr Srinivasan demonstrated the icredible precision and uniformity of laser ablations on biological tissue. The energy in each photon of laser ablations on biological

8 tissue. The energy in each photon of this laser is 6.4ev, enough to destroy intermolecular bonds - thus the term photoablation. The uniqueness of this laser is its ability to remove tissue with sub-micron precision, without causing thermal damage to surrounding cells. When it is focused at the center of the cornea, the laser causes a flattening of the central cornea and this corrects myopia. When directed to remove an annular ring of tissue from the mid periphery, it causes a relative central steepening of the cornea, to correct hyperopia. Thus began photo refractive keratectomy (PRK) which promised greater safety and long term stability than any of the incisional methods attempted so far. In the course of the next few years, the limitations of the technique came to light. To offset these limitations a modification called Lasik was suggested, where the same treatment, based on the same principles, was performed under a corneal flap. A fundamental question often asked is : Does refractive surgery restore perfect vision? This leads to an even more fundamental question - Is "normal" vision the same as perfect vision? The answer to both questions, in fact, is "No?". We have always known that the human eye is an imperfect optical system that suffers from several aberrations. 'Aberrations' are cosmic phenomena. Looking up into the starry night sky is much like looking up from a swimming pool - the disturbances of the outer layers of the atmosphere producing distortions. It was Babcock in 1953 who first suggested that modifications made in the telescopic system could compensate for those distortions. He thus introduced in the important concept of "adaptive optics" in The most dramatic application of Adaptive Optics was with the Hubble Telescope. Initial pictures taken by the Hubble were frightfully distorted. But when this was recognized to be due to atmospheric aberrations, a 'sensor' to measure the aberrations and deformable mirrors to compensate for those aberrations were introduced into the system. The difference this made to the quality of pictures taken by the Hubble was dramatic. Ever since then the Hubble has been sending us pictures of amazing clarity, bringing us images of a universe that we would otherwise never have seen. Borrowing this technology from astronomy, and applying it to visual science, David Williams in 1997 first used the Hartman Shack aberrometer to measure the aberrations of the human eye. Present day aberrometers are able to compute all the data with complex mathematical equations and represent them in the form of 3 dimensional maps.

9 There are at least 20 different kinds of aberrations described in the human optical system. They are categorized into 'orders' and numbered according to their meridional frequency. What we have been correcting so far by spectacles or by refractive surgery has only been the 2nd order aberrations (i.e. spherical and cylindrical refractive errors). All the others remain. If we could, therefore, use the wave front aberrometry maps to guide the laser, it could, theoretically correct all the other aberrations as well.this would lead to "customized corneal ablation" - which, like a well tailored suit, could address the optical requirments of each individual eye and possibly aim at "Super Vision", the vision of an eagle. This may well prove to be a turning point in the history of Refractive surgery. " India will transform into a developed nation before the year A billion people are our resource for the national transformation". The visionary who authored these words was none other than Dr. Abdul Kalam, - the very person who inaugurated the new "Allegretto wave" "Excimer Laser. We, at Sankara Nethralaya hope to be a part of the "national transformation" he dreams of. Dr. Prema Padmanabhan W O R L D C L A S S R E S U L T S Pioneers Sankara Nethralaya was among the first to introduce PRK to India in 1993, followed, 4 years later by Lasik. A team that includes 4 refractive surgeons, a trained ophthalmic nursing assistant, and an in-house biomedical engineer has perfromed almost 5000 procedures so far. Freedom from Glasses Our results with Lasik have been very encouraging. 95% of patients undergoing this procedure have fully functional vision without glasses restored by Lasik. This result compares favourably with the best refractive surgery centers in the world. Importantly, we have not encountered a single case of postoperative infection so far with these procedures. "Super Vision" The Allegretto Wave Excimer Laser instrument at Sankara Nethralaya that was recently inaugurated by Dr.Abdul Kalam, empowers us to aim for "Super Vision", the vision of an eagle. It belongs to the 3rd generation of Excimer Laser has several features which make it the

10 optimal tool to achieve our goals in Refractive Surgery. It allows customized corneal ablation. An active eye tracker ensures perfect centration of treatment. The 'flying spot' laser ensures a smooth and precise ablation The rapid firing rate hastens the entire procedure. This instrument is housed at the IOL Excimer Laser Wing at the JKCN complex on SN and offers "walk-in" appointments for anyone desirous of its services. Suitable Candidates Who is asuitable candidate for corneal refractive surgery? You must be at least 18 years of age, with a stable refraction for the past 6 months. You should not have any serious eye disease You should not have any connective tissue disease eq., rheumatoid arthritis If you use contact lenses, discontinue their use for at least 2 weeks prior to laser treatment. For Further Information please contact: IOC EXCIMER LASER WING Sankara Nethralaya 21, Pyecrofts Garden Road, Chennai information@sankaranethralaya.org Fax: Phone: WALK IN FOR IMMEDIATE SERVICE Pearls of Wisdom - Books from Nethralaya Twelve of our consultants contributed to the creation of a unique book on disorders affecting the eye in AIDS which was edited by our Ocular pathogist and Uveitis specialist Dr J Biswas. This Book was released by Dr Uton Muchter Rafei,

11 Regional Director, World health Organization (New Delhi) at the Inagural function of the 3rd International Conference on AIDS in India held on 1st December 2001 at IMAGE auditorium, Chennai. (Picture) The 3rd edition (2001) of the "Text Book of Medical Biochemistry" by Dr S Ramakrishnan, Biochemistry department has been published by M/S Orient Longman Ltd, Chennai. So far thirteen reprints have been made and this book is followed in medical institutions in India and abroad. A M A R T H I T H I P R O G R A M M E Can we count on you? Celebrate the birth of a child by helping a blind child see. Immortalize the memory of a loved one by restoring vision to a poor blind person. It costs you very little to have this service performed every year on a day of your choice in perpetuity. Your family can participate in these acts of generosity and gain happiness at the thought that every year, for as long as Nethralaya lasts, one poor person will get sight. Transparency makes anything trustworthy. We let the donor know where his/her money is spent before and after the donation is made through the "Amarthithi Programme". In this donation scheme, the donation is given for one free surgery on a fixed date specified by the donor. The donor's name is displayed on the board in the main reception hall on that day. You will also receive details of the person whose life has taken a new turn as a result of your magnanimity. We request all our readers to reflect on this appeal and we hope that you too will see the light and come forward to help Sankara Nethralaya in this endeavour. Make this your cause Sincerely, Editors, Eyelights

12 C O M M U N I T Y S E R V I C E Free 46% Paying 54% Free 42% Paying 58% Free 37% Paying 63% OUT PATIENTS TOTAL SURGERIES CATARACT & INTRAOCULAR LENS IMPLANT R E V E N U E F O R E G O N E - R s. 8 4, 0 0 0, WÉÇtà ÉÇ fv{xåxá S.No. Name Amount of Donation 1 AMARTHITHI Rs. PROGRAMME a. Free Minor operation such as Cataract - once annually on a poor patient on 10,000 a fixed date to be specified by the 20,000 donor and to be performed perpetually. Note: Please tick the amount you wish to donate in the box nearby. For S.No. 1 and 2, Month and Date on which surgery to be done.in the month of... b.free Major operation such as Retinal Detachment surgery once annually on a poor patient on a fixed date to be specified by the donor and to be performed perpetually. 2 SUPPORT Date (Signature of the Donor) NETHRALAYA BY ONE TIME CONTRIBUTION OF: a. Cataract 1,000 Name S

13 Surgery on an Indigent Patient b. Retinal Detachment Surgery on an Indigent Patient 3 One Operation Theatre 4 One Consultation Room or Patient Room 3, Address ,00,000 City State 2,00,000 Country Pincode 5 One Bed in General Ward 1,00,000 Tel.: Res. Off.. 6 Hospital Medical 25,000 & Fax. Equipments above Life Membership 25,000 N.B. Donations to MEDICAL in "FSN Association' RESEARCH FOUNDATION are exempt under section 80G and 35 AC of the Income Tax Act. Donations to VISION RESEARCH FOUNDATION are exempt under Section 35(1)(ii) of the Income Tax Act. A N A P P E A L Dear friend, The Sankara Nethralaya family extends to you Season's Greetings. Described as a privatized public hospital, Sankara Nethralaya was founded in 1978 as a novel experiment in providing quality eye care to our people. You may be aware that our state-of the art equipment and facilities benefit not only those who can afford to pay, but also our free service community - 50% outpatients and 36% inpatients were treated completely free last year. We offer only one standard of care for all the best. Commitment to quality is manifest in Sankara Nethralaya being the first eye hospital in Asia to be accorded the ISO 9002 certification.

14 Sankara Nethralaya is probably the only charitable non-profit organization which has a full time salaried professional core.our consultants don't practice outside or hop from one hospital to another. They concentrate their energies in only one institution so the ultimate service is for the patient, and only for the patient. It is cost effective for consumers as the organization is non-profit and charitable. None other than Mr. Nani A Palkhivala has described Sankara Nethralaya as the best run charitable organization in India. our country. India deserves no less. We meet our recurring expenditure from the hospital collections, Expansions require public support - donations. We need your support. Won't you support an organization with accountability, creditability and transparency in its functioning? Our achievemnets over the past two decades are in no small measure due to the continued cence our friends, such as you. We hope that you will continue to support us to achieve our common goal of providing excellent vision care to the people of Sincerely yours, DR.S.S.BADRINATH CHAIRMAN, Medical Research Foundation Dr. T.S.SURENDRAN Medical Director Medical Research Foundation YES,I WANT TO HELP Your donation are income tax exempt and are eligible for 100% or 125% tax deductions. Get maximum income tax benefit with the deductions while supporting our cause. Medical Research Foundation 35AC tax exemption affords 100% deduction Vision Research Foundation 35 (i) (ii) exemption affords 125% deduction OM Trust in USA 100% IRS tax exemption

15 For questions about tax exempt status and contributions, please contact Dr.S S BADRINATH, Chairman, Sankara Nethralaya (UNIT OF MEDICAL RESEARCH FOUNDATION) 18 College Road, Chennai Phone , Fax: (044) , INTERNET chairman@sankaranethralaya.org WEBSITE: Mr S V ACHARYA, Treasurer, Ophthalmic Mission Trust Inc. (OM Trust) 14613, Pommel Drive, Rockville, MD 20850, U.S.A. Phone: (301) INTERNET omtrust@hotmail.com The issue of Eyelights is sponsored by: Also Visit "Give Online" through M/s. Rampion Eyetech Pvt.Ltd. Kalash, New Sharda Mandir Road, Paldi, Ahmedabad M/s.Apex Laboratories Pvt.Ltd.,44,Gandhi Mandapam Road, Kotturpuram,Chennai Edited & Designed by Dr.M.Baskaran & Dr.Navin Jayakumar. Typeset by A&S Diizyn. Printed at Gnanodaya press, Chennai