Someone once said, “Take every chance you get, because somethings only happen once”. Growing up,
many people have asked what career I want to pursue after college. This question has confused me in the past. However, I can now say that I have a definite answer: I want to be a Vitreoretinal Surgeon. This summer, I was fortunate to be provided the wonderful opportunity to participate in an ophthalmic training at the S.M. Vishwakarma Memorial Eye Hospital in Nagpur, India.

Which was founded by Dr. Rajendra Vishwakarma. The hospital is facilitated by Dr. Vishwakarma, his wife Ratna Vishwakarma, and his son Prateek Vishwakarma, and contains state of the art medical scales and instruments such as retinal cameras, tonometers, and autorefractors.

At my training experience, I was gifted the opportunity to participate in many useful career-enhancing activities such as patient interviews and patient record-building, optometric and ophthalmic testing, and live surgery viewing. This internship was very enlightening for me as it helped me to gain a better sense of the life and daily routine of an Ophthalmologist, and it also gave me more exposure to different specifics of ophthalmology and optometry. The following is a short story describes a few things I learned at my internship in India.
During my week-long training at the eye hospital, I learned about the methods which Ophthalmologists and Optometrists utilize in order to determine the measurement of a patient’s eyeglass prescription through a medical checkup. The first step in a checkup is to inquire their ailments and current quality of life. This provides a basis for what to look for in the ocular examination, and also establishes a comfortable connection with the patient.

The second step would be to check the patient’s medical and personal demographics to spot for any previously occurring or possibly inherited ailments. Third, comes a manual inspection of the eye through a Lumeron 320 microscope. To do this, the patient must sit vertically in a surgical chair and be positioned in the face holder with their eyes staring directly forward. Through this closer look, we can determine if a patient has any visible inconsistencies in their eye. Often, scleric deformities are spotted
through this technique. For the fourth step, patients take an eye test. Patients are positioned in a chair in front of a mirror which is reflecting an image. This image is what the patient must decipher. This visual acuity test determines the ratio of visibility that a patient has relative to 60 units of measurement. In many foreign nations these tests are in both shapes and letters as many patients at clinics are illiterate and have had no education. If the patient fails to even recognize any shape or color at all, the next check is whether they can detect hand movements from certain distances. If the patient fails to do so, they are noted down as NPL (No Perception of Light). In addition to this visual test, patients over the age of 40 are required to have a test of their eye pressure through a tonometer. The main purpose of the eye pressure test is to check if the pressure is high enough for possible Glaucoma. Glaucoma is a
disease which damages the optic nerve, which can often lead to blindness.

Therefore, it is important to check eye pressure during an eye exam. The patient’s eye are then dilated and doctors look at the back of their eye, the retina that has receptors to capture images and send them as electrical signals to the brain through the optic nerve. The last and final step in a regular ocular checkup would be to make a conclusion based on the symptoms and indicators the patient shows during the visit. During this time, the doctor will make any necessary changes to a patient’s prescription and
set up a treatment plan for either a surgery or required further checkups.

The overall process of the ocular checkup is very important as it affects the treatment and/or medications the patient will end up receiving.
Another wonderful learning experience I was exposed to at the hospital was learning about the anatomy and physiology of the human eyeball. This included understanding the different parts of the eye and each of their functions. I learned about the Cornea, Iris, Sclera, Lens, Pupil, and Intraocular Nerve. For example, The Cornea is the the topmost transparent section of the eye which protects the inner Iris, Lens, and Pupil. And the Sclera is in turn, the white of the outer eye which is a gelatin-like membrane. During his demonstration of the anatomy of the eye, Dr. Vishwakarma not only produced a model of the eye to help me better understand his terminology, but also showed a jar containing actual eyeballs dipped in a formaldehyde solution! He utilized
the eyes in the jar to showcase specimens of many different diseases in the eye.
Several of those eyes had excess cancer growth inside them or had pupillary problems.
That is most definitely a scene which I shall not forget!

I was able to observe and understand the roles of the surgical team inside the Operation Theatre. The most important and vital person is the Head surgeon who
performs the surgery. After that, comes the surgeon’s assistant who provides the surgeon with the medical tools they need to complete the surgery, and the record monitor: who records patient logs and surgery logs. Assists the surgeon by providing
the necessary equipment needed to complete the surgery. Nurses and assistants set up the Operation Theatre with sterilized instruments and linen required for the surgery.

However, the most exciting experience of all was the live surgery viewing. During my experience as a trainee, I viewed 4 surgeries, (All of which were performed by Dr. Prateek Vishwakarma) including 3 cataract surgeries and 1 pterygium surgery. The 2
types of cataract surgery I viewed were Phacoemulsification in which the internal lens of
the eye is emulsified through the help of an ultrasonic device, and then taken out of the
eye. Then an artificial lense is inserted through a small slit in the side of the eye and it
later unfolds in the eye. The second surgery I viewed was the extracapsular cataract
extraction in which the lens is manually broken, removed, and a new artificial lens is
slided through a 10 mm incision in the side of the eye. The pterygium surgery was a
completely different surgery which removed external growth from the Sclera and Cornea
of the eye in order to further help the patient’s vision and eye movement. During these
surgeries I was allowed to sit next to the head surgeon and operating table. I was also
allowed to view the surgery through an OPMI Lumera 700 Surgical Microscope. Even more, Dr. Vishwakarma himself sat next to me throughout the operation and narrated the multiple steps of the surgery to me, and the necessities behind them.
Overall, I believe that this was a very enlightening and eye-opening experience for me as a high school student to peer into the world of possibilities in the field of the Medical Sciences. After this internship, I now feel that I am more motivated to pursue
Ophthalmology as it is a field which I find to be full of wonderful opportunities.

I was amazed to see the variety of patients and their eye conditions, some of them were used to living with their problems and many of them could not afford the cost of surgery. Dr Vishwakarma offers concessions to the cost of surgeries and treatments
to many such patients and also travels to many of the remote areas of the country to perform treatments for charity. Learning about his contributions towards his patients made me realise how important eye doctors are, they make the world by helping people see better. No gift can be more precious than the “Gift of Vision”!