Paediatric Ophthalmology & Strabismus Fellowship review @ Aravind Eye Hospital, Madurai, Tamil Nadu

1. Duration of Fellowship

Currently structured as a 24-month program within the Pediatric Ophthalmology department.

Previously, the 18- or 24-month version included 6 months of general OPD postings at peripheral centers, primarily for those with less cataract numbers 

2. Phaco Training

No phacoemulsification surgeries are allotted to pediatric fellows.

SICS slots are available once a week, though your turns may be reduced due to OPD crowd and internal politics. So don't take this fellowship if you want to do lot of adult cataracts. 

However, you will be trained in:

-Pediatric cataract vitrectomy

-Bimanual I/A

-Use of phaco probes (note: NOT full phaco surgeries)

3. Surgical Start Timeline

Surgeries generally begin after 4 months, including:

Pediatric cataracts

Squint surgeries

4. Clinical Exposure

Excellent exposure to a wide spectrum of cases, including textbook and rare presentations.

Rotations include:

Orbit Clinic 2 weeks, mainly observation, workup of paediatric oculoplasty cases, may get 1-2 probings also (if you request the MOs)

Neuro-Ophthalmology- 1 month workup and present the cases to consultants. You will be expected to clear the OPD independently and cross check PG cases

ROP screening 2 weeks

Low Vision & CVI (Cortical Visual Impairment) Clinic posting for 2 weeks. But it's a part of Paeds clinic so you will be constantly involved 

5. Work Environment

Very hectic, especially during holidays and Saturdays.

Some faculty are supportive. Your rapport with seniors can influence cataract OT and strabismus observation chances. When the OPD gets busy, fellow posted in OT can be called to OPD, so that tends to be frustrating (this was happening 2 years back.. hopefully better now).

6. Training Support

Around the 3rd month, you receive 1 month of dedicated SICS training, usually mentored by a senior IOL fellow.

In squint surgeries, your first 1–2 cases will be supervised by a consultant or senior fellow. After that, you’re mostly on your own, with occasional support.

7. Surgical Hands-On & Case Numbers

Pediatric Cataracts

Minimum: 25 cases

Mostly developmental and traumatic cataracts (infant cases usually not given)

Additional opportunities:

Secondary IOLs

Membranectomies

consultants may give some steps in their cases also

Squint Surgeries

Horizontal squints: good numbers

Inferior obliques: Good exposure

Superior obliques: Few cases

Advanced procedures (transpositions, tucks, transplants): case access depends on availability and luck. If the case gets posted on your OT day. But by the end of the fellowship you would at least workup and do some cases

8. Duties

Cataract camps: Once a month

School screening camps: 2-3 per month during particular months around the year 

Night duties: Typically once a month.

9. Academics

Interbranch journal clubs: Every 2 weeks

Morning fellow classes: Conducted periodically

This fellowship is definitely hectic and can be mentally draining at times, especially with the workload, occasional toxic behavior, and internal politics. But if you're someone who can look past the noise, stay focused on learning, and take initiative, it's a place that will shape you into a confident, independent paediatric ophthalmologist.

You won’t get spoon-fed, but you’ll be exposed to a wide range of clinical and surgical cases

If you’re willing to put in the work and make the most of what’s offered, this fellowship can truly lay a solid foundation for your career.