Physician eased load of squint patients, peers

Even before being accepted to medical school, B.T. Maskati, MS, DOMS, FICS, watched his older brother perform ophthalmic procedures, inspiring him to follow the same path.

B.T. Maskati

“My elder brother, 10 years elder to me, was an ophthalmologist and a very good surgeon,” Dr. Maskati told Ocular Surgery News in a telephone interview. “I used to go on vacation and see his surgery. Gradually, I started assisting him.”

Upon Dr. Maskati’s acceptance to medical college, he brought some of his brother’s tools.

“When I joined medical college, I brought his cataract instruments, and while dissecting the first 2 years of anatomy, I would use the instruments to remove the cataract,” he said. “It sounds funny, but that’s how I got into it, and by the time I finished my 2 years of anatomy, I was so well-versed in ophthalmology that I used to teach the final-year students.”

This kind of preparation allowed Dr. Maskati to be one of only two students, out of 20, who passed the rigorous testing in his medical school.

By that time, he had published three or four papers, one of which was on histoplasmosis in the eye.

“The ocular lesion was such that it could have been toxoplasmosis or histoplasmosis, and the histoplasmosis test was positive,” Dr. Maskati said. “Nobody had described the macular lesion, which is almost like toxoplasmosis. This is a fungal condition, a fungal disease, so it is fairly rare all over the world.”

But Dr. Maskati’s passions would develop in other areas of ophthalmology – from teaching and education to lessening the financial burden of his peers and the social burden of children with squint.

Teaching legacy

After graduation in 1958, Dr. Maskati joined K.E.M. Memorial Hospital as an assistant professor.

He eventually became a professor, head of the department and, upon his retirement in 1983, professor emeritus.

“By that time, I must have taught postgraduate students [who] are all over the world,” Dr. Maskati said. “Having traveled over the world … they find out that I am there.”

He relayed a story of his travels to Lubbock, Texas, in the United States, where his daughter was living. A heart problem put Dr. Maskati in the hospital, and the next day, four of his former students arrived.

“That’s how my students have spread all over the world,” he said. “I’m usually in contact with them.”

National Board of Examinations

In addition to teaching students in the classroom or operating arena, Dr. Maskati had an impact on how Indian medical students – not just within ophthalmology – received their certification when he helped found the National Board of Examinations.

The aim of the board, established in 1975, is to raise standards in all of India and eliminate regional differences in testing, he said.

“We wanted to … equalize the standard of the postgraduate degree, and that’s why we founded this National Board of Examination to the extent that if a student is from Bombay, he is not examined in Bombay,” Dr. Maskati said.

Currently, the board conducts postgraduate and postdoctoral examinations in more than 50 disciplines.

“It has made a big impact. And today, the diplomate of the National Board is considered equivalent or even more than master of surgery,” he said.

In 2000, the National Board of Examinations honored Dr. Maskati with the Outstanding Teacher Award.

Lessening the financial burden

Dr. Maskati said another of his greatest achievements was the elimination of duties on ophthalmic instruments, which he worked toward throughout his vice presidency of the All India Ophthalmic Society and achieved during his presidency.

“When I was president, the duty on all the high-tech instruments, like even microscopes, lasers and so on was 105%, which smaller town people and even big town people couldn’t afford and couldn’t recover the money from the patients because [duties] were so expensive,” he said.

During his vice presidency, he took 20 trips to speak with government officials in Delhi to discuss this problem, he said.

“I gathered all the statistics and files and found out that there are a number of people who can afford to go to foreign countries and get operated,” Dr. Maskati said.

At that time, Prime Minister Indira Gandhi had introduced a 20-point economic program, in which one point declared every Indian had the right to see.

“Because of that, I prevailed on the finance minister to relax this [duty]. In his budget, he made it 40%, but I was not satisfied. I went again, and in his final financial bill, he completely removed it,” Dr. Maskati said. “That was one of my greatest achievements, so that all over the country, young surgeons, small town people could afford a microscope and intraocular lenses, which were not made in India at that time.”

Squint camps

Another of Dr. Maskati’s social concerns is not as easily solved, as it concentrates on surgically treating squint, or strabismus as it is also known.

Since 1968, Dr. Maskati has conducted four to five squint operative camps every year, in which he and other surgeons treat about 80 children over the course of 2 days.

He was motivated to begin the first camp upon his realization of the impact of squint on girls of marriageable age in a dowry society, Dr. Maskati said.

“In India, squint is a social, economic evil” that you won’t find elsewhere, he said. “In India we have a dowry system. The girl, if she’s squinting, she’ll find it hard to find a match.”

He also said he likes to treat school-age children who may feel a sense of insecurity when attending school.

“In the interiors of India, people don’t know that the squint can be 100% corrected, which is one of my specialties,” Dr. Maskati said. “The judgment of correcting the muscle is more important than the surgery. You must know exactly which muscles to correct and how much to correct to make the eyes totally straight. So that is what I have been teaching.”

Today, at almost 83 years of age, Dr. Maskati conducts two eye camps per year.

“Now, of course, I don’t operate for the last 5 years, and my son operates, but I still go for the evaluation of the patient,” he said.

Dr. Maskati said more ophthalmologists are performing squint surgery and conducting eye camps such as his because cataract camps have dwindled.

Today, cataract requires more equipment, time and facilities than it used to, so it is more difficult to do in a small town, he said.

In the “good old days, I must have done about 100,000 cataract operations, but those were 15 to 20 minutes [for] one cataract, and we used to do 250 to 300 per day, with six tables with six surgeons,” Dr. Maskati said.

“When I came to know about [squint’s effect on society], I said this is a good opportunity to go around the country” and help others, Dr. Maskati said.

For more information:

• B.T. Maskati, MS, DOMS, FICS, can be reached at the Maskati Eye Clinic, Harishankar Building, First floor, 23, M. Karve Road, Opp. Charni Road Railway Station (East), Mumbai 400 004, India; +91-22-2382-2973; fax: +91-22-2388-5822; Web site: www.maskatieyeclinic.com.