Through the prism of inspiration - Dr. P. Vijayalakshmi.

“Try to be a rainbow in someone else’s cloud.” – Maya Angelou In 1672, Sir Issac Newton explained the optical phenomena of reflection, refraction, and dispersion and labeled the seven colours while dividing the spectrum of light. In 1950, was born a phenomenal woman who has a spectrum of qualities, dares to dream, stretches beyond horizons with diversified thinking, and has added colors to numerous lives. Here is the inspiring life story of one of the legendary women in ophthalmology who contributed toward changing the face of pediatric ophthalmology in India and worldwide. Youngest of the five children of her proud parents [Fig. 1], she finished schooling in her native village and later studied at Fatima College, Madurai tentatively. Destiny took her to join the medical college at Madurai. She considers Dr. Govindappa Venkataswamy (Dr. V), Dr. G. Natchiar, and Dr. Namperumalsamy (her elder brother) as the kind designers of her destiny. She then joined as a senior resident in a government hospital. In the evenings, she used to work at Dr. V’s clinic in Naicker New Street, in the outpatient department performing preliminary examinations, investigations, and refractions. Based on her newly developed interest, she pursued postgraduation in ophthalmology. She married Dr. M. Srinivasan in 1975 [Fig. 2]. After finishing her postgraduation, Dr. P. Vijayalakshmi joined as a resident medical officer of Aravind Eye Hospital (AEH) in 1976.[1] Mentored by Dr. V, she had a comprehensive training including assisting Dr. V as a nurse and working 10–12 hours a day. Dr. V imparted his wealth of knowledge and experience.Figure 1: Proud parents of Dr. P. VijayalakshmiFigure 2: Dr. M. Srinivasan and Dr. P. Vijayalakshmi as pillars of strength for each other (a) since 1975; (b) till date and foreverDr. P. Vijayalakshmi pursued her fellowship in pediatric ophthalmology and strabismus in 1982 at the University of Illinois, Chicago, under the kind guidance of Dr. Marilyn Miller [Fig. 3]. This marked the beginning of a new dawn, a new hope for the rise of pediatric ophthalmology in India. After returning, in 1983, she established, the leadoff department of pediatric ophthalmology and strabismus at AEH, Madurai. She collaborated with nongovernmental organizations and provided a helping hand to the school-going children and the children enrolled in Anganwadis, in the region around AEH. Indeed, it took a lot of strength and courage to build a powerful department, which has been able to provide eye care services to 85,000 children and nearly 2000 sight-restoring surgeries every year, with deep affection and love for their patients.Figure 3: Dr. P. Vijayalakshmi (extreme right), with her mentors – Dr. Govindappa Venkataswamy (left) and Dr. Marilyn T. Miller (center)“A very loving and affectionate mentor; and the pioneer to kickstart a composite Pediatric Ophthalmology fellowship in India, providing a comprehensive training in one program.” – Dr. Pradeep Sharma Dr. P. Vijayalakshmi’s thoughtfulness and consideration led to the birth of a fellowship program in the subspeciality in 1990, offering an 18 months’ training, and she has bequeathed her knowledge upon approximately 137 fellows till date, which included national and international ophthalmologists [Fig. 4]. She also trained several allied personnel in the field. “Viji ma’am (as the whole world addresses her) honed my skills, improved my confidence and showed me by example that it is possible to do world class work with limited resources. What I didn’t learn though was how to wear a simple elegant cotton saree and keep it crease free from morning 7 am to evening 7 pm.,” shares Dr. Sumita Agarkar. Viji ma’am, with her optimistic approach toward her students, has been a woman of few words, who is deeply loved and revered by her fellows. She passed on leadership traits, multitasking skills, and the essence of time management to her students, along with maintaining a balance between work and family. She taught women, in particular, to be team leaders in their own right confidently without being aggressive.Figure 4: Geographic distribution of her trainees over India (a) and worldwide (b)“Dr. P. Vijayalakshmi is not only a versatile squint surgeon but also a great speaker and a comrade in our specialty.” – Dr. T. S. Surendran Dr. P. Vijayalakshmi added sunshine to the pediatric ophthalmology world by contributing her intellect and by carrying out several clinical and epidemiological research projects which included population case surveillance for congenital rubella syndrome (carried out in collaboration with the Indian Council of Medical Research [ICMR] and World Health Organization [WHO]) and molecular studies on congenital cataract, globe anomalies, aniridia, Leber’s congenital amaurosis, retinitis pigmentosa, and oculocutaneous albinism through the Aravind Medical Research Foundation (AMRF). She has more than 125 publications to her credit and has authored chapters for eight books apart from her practical guides for pediatricians and orthoptists.[1] She also collaborated with several international premier foundations like Public Health Laboratory London, International Eye Foundation, Pan American Health Organization (PAHO), United States Agency for International Development (USAID), Orbis,[2] International Council of Ophthalmology (ICO), and Queen Elizabeth Diamond Jubilee Trust (QEDJT). “Mere hard work, which is dedicated to the service of humanity, without expectations, will bring more happiness and peace in the later years of life.” – P. Vijayalakshmi In 2014, she had the foresight to expand her low vision program to include kids with periventricular leukomalacia and cerebral visual impairment (CVI). Dr. Linda Lawrence, who in 2015 worked with Dr. P. Vijayalakshmi (through USAID), adds that, “The early intervention program for the assessment and intervention of CVI, gained its own place in the low vision centre and has served as the ideal model across Aravind Eye Care System (AECS) and beyond.” The sunset in the lives of the children affected by CVI and autism was converted into a beautiful sunrise by her ability to identify the difficulties faced by these children [Fig. 5] and their families, along with development of several interventional programs.Figure 5: (a) Dr. P. Vijayalakshmi with Joyce Mein, Principal, Orthoptics School, Leeds London, UK, learning the art of holding prisms right; (b) Viji ma’am examining and interacting with her lovable patient“Vision rehabilitation does not cure or restore lost sight. But good care and therapy makes these children with no or negligible vision come alive,” believes Dr. P. Vijalylakshmi.[3] Her efforts put pediatric eye care high on the health-care map by pledging a comprehensive and holistic approach to treating the children for all ocular disorders. Dr. P. Vijayalakshmi took pediatric eye care beyond the hospital-based care. She pioneered the model of screening school children with the help of school teachers followed by vision technicians. She created a unique model on refractive errors among school-going children, in collaboration with Orbis International, based on service and research which, in 3 years, screened 4,00,000 children and provided 14,000 spectacles. The model was developed with the motive of attaining sustainability without any funding agency. Dr. P. Vijayalakshmi and her multidimensional personality truly deserved to receive a long list of accolades including the Lifetime Achievement Award at the Sadguru Conclave Meet in 2016, from the Strabismus and Pediatric Ophthalmological Society of India (SPOSI) in 2017, and by the Tamil Nadu Ophthalmological Association in 2022. She has also been awarded the Dr. Ishwar Chandra oration award in 2003, Dr. D. Sundareswaran Endowment oration award in 2003, Dr. K. Subramanian oration award in 2007, Dr. Joseph Gnanathickam oration award in 2009, Dr. Kalidas Bhattacharya Memorial Award in 2010, and the TACO oration award in 2016. Dr. P. Vijayalakshmi recognized the darkness in the lives of her patients and established a world-class vision rehabilitation center for undertaking functional vision assessments and early intervention programs. She is also one of the core group members under pediatric low vision rehabilitation committee of the American Association of Pediatric Ophthalmology and Strabismus (AAPOS). She also interconnected nutritional health to treat blindness due to vitamin A deficiency. She improved retinopathy of prematurity (ROP) screening by creating a network with the neonatal intensive care units, and therefore screened approximately 1510 neonates. In the past decade, she researched in depth on inherited eye diseases, helped in carrying out diagnosis in vivo, and provided genetic counseling and gene therapy. While her list of achievements is long, she has maintained her humility and grace, and stays grounded, dwelling in focused calm with no egoistic element. A devoted daughter, an ideal wife, a marvelous mother, a meticulous surgeon, a knowledgeable teacher, and an encouraging soul who has nurtured pediatric ophthalmology like a mother, Dr. P. Vijayalakshmi is courageous and enjoys her journey fearlessly while being completely immersed in service. A positive mindset like hers manifests unimaginable visions while appreciating the ebb and flow of life, along the way. A little beam of sunshine, a subtle petrichor of fresh rain, a drizzle of raindrops, and a spectator ready to be inspired, all the elements are required to appreciate the hidden scenic beauty of a rainbow. We thank her for her contributions and for adding colors of joy and positivity through her “prism of inspiration.”