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*Situation 2: At Super Specialty Facility in Metro location where higher-

               end technology is available


                   a)  Clinical Diagnosis:
                       Using slit lamp, 90 D lens and indirect ophthalmoscope.

                   b)  Investigations:
                       FFA
                       OCT
                       ICG angiography
                   c)  Treatment:

                          Laser
                          PDT
                          TTT
                          Anti VEGF therapy: Intra vitreal bevacizumab

                                                           Intravitreal ranibizumab
                                                           Intravitreal pegatanib sodium.

                       Standard Operating procedure
                        a.  In Patient: Not necessary
                        b.  Out  Patient:  This  is  the  standard  operating  procedure  for  diagnosis  and
                            treatment such as laser, PDT.
                        c.  Day  Care:  This  is  required  if  intra  vitreal  injections  are  to  be  the  mode  of
                            treatment.

               V.      WHO DOES WHAT? AND TIMELINES


                       Designation    Role
                       Doctor         Diagnosis of AMD

                                      Interpretation of investigations
                                      Treatment:  Requires  skills  in  Intra  vitreal
                                      injection and laser delivery.
                       Nurse          Vision recording
                                      Counselling for treatment and prevention
                                      Maintaining proper follow up
                       Technician  Fundus photography for documentation

                                      Performing FFA, ICGA,OCT .


               VI.  FURTHER READING / REFERENCES

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