Dr. Sowmya R

MS,FMRF, FAICO

Senior Consultant, Department of Pediatric Ophthalmology and Strabismus, Sankara Eye Hospital,Bengaluru.

9 articles

Dr. Sowmya R, works as a senior consultant in the Dept of Pediatric Ophthalmology and Strabismus at Sankara eye hospital, Bengaluru. She has been given the best student award every year in her school days. She graduated from Vijayanagara institute of medical sciences Bellary as the Best outgoing student of her batch. Finished her postgraduation from Mysore medical college and stood second for the university. Being passionate about strabismus, did her fellowship from Sankara Nethralaya Chennai in 2010. Post fellowship she joined Sankara eye hospital. Actively involved in teaching and mentoring DNB students, fellows in pediatric ophthalmology and strabismus in the institute. She has been a chief instructor for IC at state conferences every year and co-instructor at all India conferences. Been invited for talks at various conferences and CMEs. She has been instrumental in organizing the annual postgraduate update program 3rd eye PG UPDATE at her institute for the last 8 years. She has won the best video award at SPOSI 2016 and best paper in optics session at Karnataka state conference 2018. She is very passionate about teaching and making the subject simple and interesting. She has nearly 12 publications in various indexed journals. Modified Nishida s procedure (newer transposition procedure) for MED published in Jaapos was the first report ever of this procedure for MED. Apart from teaching and surgeries, she enjoys photography, writing and traveling

  1. Articles 12 May 2026 8 min read

    Ten Caveats in Primary Posterior Capsulorhexis and Anterior Vitrectomy in Pediatric Cataracts

    Unlike in adults , the risk of risk of developing visual axis opacification (VAO) after cataract surgery in children is nearly 100%.[1,2] Hence the need for primary posterior capsulotomy (PPC) and anterior vitrectomy (automated/manual) in pediatric cataract surgeries.Let us answer the few salient features of PPC and AV in following ten questions , 1. Why PPC is needed? The anterior hyaloid face in infants and young children is highly reactive and closely linked to the posterior capsule. It serves as a scaffold for the accumulation of lens epithelial cells and other inflammatory cells, resulting in VAO in almost all cases.[3,4] The VAO will continue to have the amblyogenic effect nullifying the purpose of cataract surgery in the child. Further the amblyogenic effect of VAO increases as the age of the child decreases. Therefore, PPC with/without anterior vitrectomy is necessary to determine the ultimate visual outcome of cataract surgery in young children. Further In addition, PPC may al

    Dr. Disha Agarwal · Dr. Sowmya R, MS,FMRF, FAICO
  2. Students Gallery 2 Apr 2021 13 min read

    How to examine a case of strabismus ?

    There is no substitute to good history obtained at the start of the examination As history gives us a direction to look for, and find pertinent signs aiding in diagnosis and management. The various presenting complaints could range from abnormal head posture, deviation noticed by parents or friends, intermittent eye closure, double vision and so on. Some important points to be noted in patients with squint include, Family history of squint and wear of glasses (amongst parents, siblings and distant relatives) Personal history starting from birth history- Factors such as prematurity and birth weight, nature of delivery (normal/forceps/cesarean) Deviation – the age at which it was noticed, the direction of deviation (inward/ outward/ other) the eye deviated, constant or intermittent nature of deviation. Further, if deviation becomes more obvious when the child is inattentive, tired or ill. The diurnal or cyclic pattern if any also has to be noted. Any history of convulsion, illness or tra

    Dr. Sowmya R, MS,FMRF, FAICO · Dr. Prerana Tripathi, DO, DNB, FICO
  3. Articles 1 Apr 2021 12 min read

    Duanes Retraction Syndrome Made Ridiculously Simple

    Synonyms: Stilling–Turk–Duane syndrome. Duane Retraction Syndrome is a type of congenital cranial dysinnervation which occurs in 1-4% of strabismus cases. It has varied presentation mostly involving variable horizontal duction deficits, with narrowing of the palpebral fissure and globe retraction on attempted adduction, occasionally accompanied by upshoot or down shoots Etiopathogenesis Various theories have been proposed earlier for the cause of DRS but currently, the most accepted theory is that of innervational anomalies which leads to all the features of DRS. It is considered to be a part of congenital cranial dysinnervation syndrome as it’s a developmental anomaly of the 6th cranial nerve or its nucleus leading to innervational deficiency of lateral rectus muscle which might be associated with secondary innervational abnormality with Medial rectus. The lack of normal innervations of lateral rectus was proved by electromyographic studies. It is also associated with paradoxical inne

    Dr. Prerana Tripathi, DO, DNB, FICO · Dr. Sowmya R, MS,FMRF, FAICO
  4. Articles 1 Apr 2021 9 min read

    Esotropia Made Simple for the Postgraduates

    As like other strabismus, esodeviation can be, True esodeviation Pseudo esodeviation A prominent epicanthic folds 1, 2 Negative angle kappa in high myopes. True esodeviation can be either comitant or incomitant 1,2 A. Comitant I. Accommodative esotropia. Refractive accommodative esotropia (normal AC/A ratio) Non Refractive accommodative esotropia (high AC/A ratio) Hypo accommodative esotropia (reduced NPA) Partially accommodative esotropia II. Non-accommodative esotropia Essential infantile esotropia Non-accommodative convergence excess Acquired esotropia Acute Onset esotropia Divergence insufficiency or paralysis Cyclic esotropia Recurrent esotropia III. Microtropia IV. Nystagmus blockade syndrome. B. Incomitant Paralytic - Neurogenic (VI nerve palsy) Nonparalytic- Myogenic (ocular myasthenia) A & V pattern syndromes Duane’s retraction syndrome Mechanical – restrictive esodeviation Congenital fibrosis syndrome Acquired Dysthyroid eye disease Trauma to the orbital wall Myositis (IOID)

    Dr. Sowmya R, MS,FMRF, FAICO
  5. Articles 1 Apr 2021 18 min read

    Learn from the Masters Tips & Tricks in the Management of Pediatric Cataract 2

    Read Learn from the Masters Tips & Tricks in the Management of Pediatric Cataract 1 After the discussion on the etiology of pediatric cataracts, and about when and how to operate we go further to know about choosing the IOL formulae, IOL material and power of IOL to be implanted in children. Also, an insight into the post-operative rehabilitation with follow up eOphtha: Considering the varied opinions in choosing the IOL formulae for pediatric cataracts , what’s the formulae used in your practice ? Do you use different formulae in microphthalmic eyes? Dr. Bharti Gangwani : I use Holladay 1 for young children and small eyes with AL < 22 mm and SRK/T for older children with AL > 22 mm. No I do not use different formula in microphthalmic eyes though many of these eyes are left aphakic if the eye is really small. Dr Kalpana Narendran : SRK - T formula is used. If Axial length 22 – SRK T. Dr. Sudarshan Khokhar: We use modified SRK 2 or SRK/T formula for IOL power correction for all eyes. We

    Dr. Sowmya R, MS,FMRF, FAICO
  6. Articles 1 Apr 2021 26 min read

    Learn from the Masters: Tips & Tricks in the Management of Pediatric Cataract 1

    Cataracts in children are one of the most common cause of avoidable blindness. The incidence is in the range of 1.8 to 3.6/10,000 per year and the prevalence is about 1.03 per 10,000 children (0.32– 22.9/10,000). Management at the right time and the right way goes a long way in rehabilitating them . To understand the current practices in management of pediatric cataract Dr. Sowmya R. spoke to a few experts across India. Dr. Bharti Gangwani (Bharti Nihalani) is a practicing Pediatric Ophthalmologist, Assistant Professor of Ophthalmology and also the Director of Clinical Research for the department of Ophthalmology at Boston Children’s Hospital, Harvard medical school. She is actively involved in teaching Pediatric Ophthalmology to the residents and fellows. She has about 50 publications in peer and non-peer reviewed journals, books and review articles. She is a co-editor of a renowned book in strabismus management called “Learning strabismus surgery-A case-based approach”. She has focus

    Dr. Sowmya R, MS,FMRF, FAICO
  7. Articles 1 Apr 2021 8 min read

    Intermittent Exotropia Simplified for the Postgraduates

    Intermittent exotropia (IXT) is the most common type of strabismus in children as well as adults, especially in the Asian and South Asian populations. Owing to the intermittent nature of exotropia there is usually good binocular function and stereoacuity at near fixation Small-angle exotropia is observed in normal neonates which usually disappears by the age of 2-4 months. Most adults will have small exophoria usually less than 10 when fully dissociated. Epidemiology Like all forms of strabismus, exotropic deviations can be manifest or latent, and if the former, intermittent or constant. Intermittent exotropia is by far the most common form of manifest XT. Exodeviations occur about one-third less frequently than esodeviations in North America and Europe and occur more frequently in the Asian population. Intermittent exotropia is more common in females with a ratio of 2:1 (F: M). Intermittent exotropia usually noticed by parents in early childhood (2-5 years). Clinical features Intermit

    Dr. Amr Mohamed · Dr. Sowmya R, MS,FMRF, FAICO
  8. Articles 1 Apr 2021 16 min read

    Peek into the Past - Strabismus as a Subspecialty in India

    The most exciting thing is to revisit and know when and how it all started. As the saying goes, "You've got to always go back in time if you want to move forward," so what better way than to talk to pioneers in the field of strabismus to know the past to forge into a great future in strabismology. Dr. Sowmya R spoke to the pioneers in the field to know the history of strabismology and share their experiences. Dr. Pradeep Sharma MD, FAMS. is currently working as the Professor and Head of Section of Pediatric Ophthalmology, Strabismus, and Neuroophthalmology at Dr. RP Centre, AIIMS, New Delhi. He is also the Vice President of the Ophthalmic Research Association at RPC, AIIMS. After having finished his graduation ( 1979) and postgraduation (1982) at All India Institute of Medical Sciences, New Delhi, he did his Fellowship for Advanced training in strabismus in the USA at Jules Stein Eye Institute UCLA, Wills Eye Hospital Philadelphia and Richmond awarded by International Strabismological

    Dr. Sowmya R, MS,FMRF, FAICO
  9. Articles 1 Apr 2021 6 min read

    Monocular elevation Deficit/ Double elevator palsy

    Definition: Double elevator palsy is classically defined as a congenital inability to elevate one eye, with the limitation more in abduction than adduction.1 MED is most often associated with ptosis/pseudoptosis. The word Double elevator palsy was coined by Dunlap to describe the weakness affecting both muscles of elevation i.e. superior rectus and inferior oblique. Pathogenesis/Theories: 2 Superior Rectus palsy: Superior rectus is the main elevator in abduction, adduction, or primary position. Thus, the defective elevation can be explained by the presence of superior rectus palsy alone. Inferior rectus restriction: Subsequently it was found that inferior rectus restriction can also cause such a limitation. The word double elevator palsy is a misnomer, Nearly 70% of cases, the cause for limitation was found to be IR restriction and not palsy. This was confirmed in several studies using saccadic velocity measurement and forced duction test. Supranuclear palsy: The nucleus for upgaze is

    Dr. Tarika Perikal · Dr. Sowmya R, MS,FMRF, FAICO