Dr. Srinivas K Rao

DO DNB FRCSEd

Director, Darshan Eye Clinic, Chennai Head, Cornea Service, Rajan Eye Care Hospital, Chennai Head, Cornea Service, Sunetra Family Eye Care Center, Kolkata Visiting Ophthalmologist, Madras Medical Mission, Chennai Visiting Professor, Chinese University of

8 articles

Dr. Srinivas K. Rao DO, DNB, FRCSEd has worked as a Senior Consultant at Sankara Nethralaya for 15 years before joining as Professor in the Chinese University of Hong Kong from September 2004 till August 2006. Since October 2006 he is Director of Darshan Eye Care and Darshan Surgical Centre, Chennai. He is also Visiting Professor, Sri Ramachandra Medical University, Cornea Head at Sankara Hospital, Pammal, and Sunetra Eye Care, Kolkata, and Ophthalmic Consultant to Madras Medical Mission, Chennai. He is Visiting Professor, Chinese University of Hong Kong, and Honorary Professor at the Shantou Medical University in China. He has published extensively in these areas and is much sought after as a speaker and teacher. He has authored multiple books in the areas of Cataract, refractive surgery, and Corneal diseases. He is actively involved in efforts to promote knowledge in the management of Corneal Diseases, and Mentors Fellows in his CORNEA Fellowship program. He has produced a Module called HOST (Handbook of Ocular Surface Treatment) which will serve as a comprehensive resource for the diagnosis and management of problems of the Ocular Surface. He is also currently the President of the Cornea Society of India.

  1. Articles 4 Aug 2021 10 min read

    How to Present a Case of Corneal Ulcer in the Examination

    1. Obtain a detailed history : a. A history of injury and the injuring agent - some pointers from this would be the occurrence of fungal infections in injuries with vegetable matter/insect wing cases; bacillus infections in patients with broomstick injuries; gram-positive infections with metal foreign bodies and so on b. A history of past such similar episodes - typically, this suggests the possibility of viral infections c. History of contact lens use - in such cases, while there is the possibility of a sterile infiltrate, especially if such infiltrates are present at 3 and 9 o? clock periphery, it is imperative to keep in mind serious infections such as pseudomonas d. Prior treatment history - obtain a detailed history of the name of antibiotic used, the frequency of use suggested, and the compliance of the patient with therapy. Failure to respond to adequate dose and duration of appropriate antibiotics suggests the possibility of a fungal or parasitic infection. e. Pain, discharge,

    Dr. Srinivas K Rao, DO DNB FRCSEd
  2. Articles 20 Jul 2021 12 min read

    Pterygium: A Review

    Introduction A pterygium is a fibrovascular, wing-shaped encroachment of the conjunctiva onto the cornea, usually in the horizontal meridian of the palpebral fissure. Histopathology shows hyaline degeneration with elastotic proliferation. Risk factors Exposure to ultraviolet light and environmental microtrauma to the ocular surface is thought to predispose to pterygium formation. A localized limbal stem cell dysfunction, possibly related to ultraviolet induced damage and a genetic predisposition has also been postulated. Pathogenesis Pterygium pathogenesis can be considered as occurring in two stages: the initial disruption of the limbal corneal-conjunctival epithelial barrier, and the progressive “conjunctivalization” of the cornea characterized by cellular proliferation, inflammation, connective tissue remodeling, and angiogenesis Morphology Head—the part which rests on the cornea Neck— constricted portion seen at the limbus Body – remaining bulk of mass Cap—a semilunar infiltrating

    Dr. Ramya Subramaniam, DNB · Dr. Srinivas K Rao, DO DNB FRCSEd
  3. Articles 2 Apr 2021 20 min read

    Corneal Topography

    WHAT IS CORNEAL TOPOGRAPHY? Corneal topography is the study of the shape of the corneal surface. Traditionally, such measurements were limited to the near-spherical central portion of the anterior corneal surface. With the advent of corneal refractive procedures, the necessity to study the more peripheral parts of the cornea and to understand better the optics of both the anterior and posterior corneal surfaces has spawned a number of new devices that allow the clinician to better understand corneal shape, power, and optical performance. EVOLUTION OF CORNEAL TOPOGRAPHY KERATOSCOPY: It is the evaluation of the corneal surface using circular mires reflected from its surface. The earliest device designed to perform this function was the PLACIDO’S DISC, developed by Antonio Placido. It consists of equally spaced alternating black and white rings with a hole in the centre to observe the patient’s cornea. The central opening houses a convex lens for magnification and to aid the examiner’s ac

    Dr. Srinivas K Rao, DO DNB FRCSEd · Dr. Ramya Subramaniam, DNB
  4. Articles 1 Apr 2021 10 min read

    Ten Pearls for Descemet's Membrane Detachment Repair

    1. Embryology Understanding the embryological development of the cornea helps us appreciate the reasons for a Descemet's membrane (DM) detachment during surgery. After the lens vesicle separates from the surface epithelium, a wave of mesenchyme forms the primary corneal stroma. A second wave then forms the endothelium, which secretes the DM. The DM, hence, has a potential plane of separation from the corneal stroma, which we use to our benefit in DMEK surgery and which works against us in an inadvertent DM detachment. Throughout the life of an individual, the DM thickens as the posterior non-banded layer is secreted by the endothelium. The anterior fetal banded layer tends to remain the same. However, in most instances, the separation happens between the DM and the cornea stroma1. The thickness of the DM varies between 10 and 15 microns, increasing with age. DM does not regenerate after any damage2. 2. Cataract Surgery and DM Detachment A post-cataract DM detachment occurs in 0.26% of

    Dr. Amanda Mohanan · Dr. Sanjeev P Srinivas · +1 other
  5. Articles 1 Apr 2021 14 min read

    Corneal Trauma and its Management

    Introduction The cornea is prone to a variety of injuries by virtue of its location as the window of the eye. Apart from chemical injuries, physical trauma to the cornea can range from epithelial abrasions to loss of integrity of the stroma. Corneal injuries of this nature can occur in two distinct populations – in young children from play-related activities, and in young adults from due to their work environment. Although the general principles of management are not too different, special consideration in the pediatric population must be given to the timing of appropriate surgical interventions as the developing visual system in children is prone to amblyopic visual loss. Males are usually more prone to ocular injury than females; this is seen clearly in children, while the ratio of boys vs girls involved in accidents with ocular trauma is 4:1 [1]. The injuries can be caused by large blunt objects often resulting in ruptures of other parts of the ocular coats as well. On the other han

    Dr. Sanjeev P Srinivas · Dr. Amanda Mohanan · +1 other
  6. Articles 1 Apr 2021 11 min read

    Ten Tenets One Should know on Conjunctival Hooding

    Ocular surface anatomy The ocular surface, in a strict sense, consists of the cornea and its major support tissue, the conjunctiva. In a wider anatomical, embryological, and also functional sense, the ocular mucosal adnexa (i.e. the lacrimal gland and the lacrimal drainage system) also belong to the ocular surface. The ocular surface occupies approximately 2.2 cm2 of the human body surface area [1]. The homeostasis of this small area is, however, extremely important for clear vision and comfort. The cornea is one of the most densely innervated structures in the body and hence, surface changes can result in significant discomfort apart from vision loss. The clarity and tectonic integrity of the cornea are maintained by a number of mechanisms, and one of the most important of these is the intactness of the surface epithelium. The limbus provides a constant source of epithelial cells to maintain the normal turnover of the corneal surface but can be impacted by multiple noxious influences

    Dr. Sanjeev P Srinivas · Dr. Amanda Mohanan · +1 other
  7. Articles 1 Apr 2021 11 min read

    Ten Tenets on Corneal Collagen Crosslinking

    Corneal collagen crosslinking (CXL) is a minimally invasive procedure that is currently the gold standard treatment to arrest the progression of corneal ectatic conditions. It promotes the induction of crosslinks in stromal collagen of the cornea, thereby strengthening and stiffening the cornea in ectatic conditions. 1.HISTORY It was observed that corneas in diabetic patients were stiffer due to the natural crosslinking occurring from glycosylation and hence had a lower incidence of keratoconus. Based on this observation, various experiments were conducted to crosslink the cornea manually using chemical agents and sugar aldehydes. Following multiple trials, it was found that this could be safely done by making use of the photochemical reaction induced by the absorption of UV light by riboflavin.1 The first in vivo study was done by Wollensak et al., and they reported in 2003 that CXL was effective in stopping the progression of moderate to advanced progressive keratoconus, in 23 eyes f

    Dr. Amanda Mohanan · Dr. Sanjeev P Srinivas · +1 other
  8. Articles 1 Apr 2021 14 min read

    Ten Pearls for The Management of Pseudophakic Corneal Edema

    Corneal edema refers to the accumulation of excess fluid in the corneal layers, with a loss of corneal clarity, resulting in vision loss. The normal cornea maintains a state of 78% hydration due to a complex interplay between stromal swelling pressure, the barrier function of the epithelium and endothelium, endothelial pump, tear evaporation and intraocular pressure [1]. Any condition that interferes with this balance causes a loss of homeostasis and accumulation of fluid. 1. The Natural History of Corneal Edema In the early stages of corneal edema, reduced vision is often related to an irregular corneal surface and can interfere significantly with daily activities. This impact on vision is often underestimated by quantitative visual acuity measurements in standard lighting conditions using high contrast charts, as in a refracting lane. Initially, these patients often experience blurred vision on awakening, owing to the accumulation of fluid in the closed eye state during sleep. As the

    Dr. Sanjeev P Srinivas · Dr. Amanda Mohanan · +1 other