HEALTHWATCH
Gift of sight
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Three million people suffer due to corneal disorders. But only 12,000 corneal transplants are done in India every year. As the Eye Donation Fortnight comes to a close, Dr. KAUSHIK, Dr. MOHAN RAJAN and Dr. SUJATHA MOHAN write of the need to increase awareness.
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Loss of transparencey in the cornea results in loss of vision.
THE cornea is the window of the eye. It is a transparent structure and its main function is focussing light on the retina thereby allowing us to see. When removed from the eye, it resembles a small glass button. Loss of transparency results in loss of vision. This may happen due to injuries, infections, or even chronic problems like rheumatoid arthritis and leprosy.
Most successful
Corneal transplant or keratoplasty is an operation in which abnormal or diseased cornea is replaced by donor corneal tissue and sutured. The graft may be partial thickness (lamellar) or full thickness (penetrating). Of all the organ transplants, corneal transplants are most successful.
In India, there are approximately 12 million blind and of these three million are due to corneal disorders - 26 per cent of whom are children. On the contrary, only around 12,000 corneal transplants are being done in India every year.
Organ donation in general, and eye donation in particular, is a sensitive issue. In many Asian countries, strong cultural and religious beliefs of rebirth have a negative influence on eye donation. No major religion bans eye donation.
Lack of awareness
Many are not even aware of the needs and benefits of eye donation and many myths are being disseminated rapidly. The impact of this shortage is most glaring in developing countries like India where corneal blindness accounts for a large proportion of curable blindness.
Lack of awareness about the process and details of eye donation is the single biggest obstacle to eye donation. The second is people's inhibitions. What is required is a systematic campaign to eradicate doubts. A third problem are people who in spite of knowledge and intention are not motivated at the time of grief. This is where grief counsellors are important.
Any one of any age or sex can pledge to donate his/her eyes after death, even if he/she has undergone eye surgery, has cataract or is wearing glasses.
The eyes of a deceased can be donated even if not pledged earlier. The eyes have to be removed within six hours of death. So inform the nearest eye bank or collection centre. The eye removal takes only 10-15 minutes and does not cause any disfigurement.
Procedures
The donated corneas are transplanted to a patient on the waiting list. An eye donation gives sight to two blind people. The hospital does not levy any charge for the donor cornea but charges a very nominal cost only for the surgical procedure.
On receiving a call, Eye Bank personnel are dispatched without delay where the eyes are collected by a surgeon and transported to the lab and processed. Formalities are reduced to a minimum — signing the consent form for removal of eyes, mandatory according to the Government of India rules.
The eyes are then cleaned, inspected and swabs taken for microbiological assessment. Corneal tissue is analysed and graded on morphological and functional criteria. Tests are also done to rule out AIDS and Hepatitis. The tissue is stored under optimal conditions in specialised media. It is then distributed and utilised by recognised corneal surgery units. There are a few conditions, which contraindicate to eye donation like AIDS, Hepatitis and Rabies.
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Improve awareness
Using social workers in hospitals to explain to patients and their relatives about eye donation.
Grief counselors to motivate the next of kin at the time of death.
Eye donation pamphlets and consent forms can be distributed to general practitioners.
Particulars of eye bank can be displayed in major hospitals, nursing homes, clinics and public places.
Publicity through short video films in waiting halls of hospitals and railway stations. Celebrity endorsements go a long way.
Creating awareness in rural areas through teachers, social workers and medical staff.
Satellite television, press and radio can play a major role in creating awareness.
Voluntary organisations can increase awareness by organizing charity shows, competitions and other such means.
Public lectures by ophthalmologists and eye bank staff at schools, colleges, associations, trade unions, and other such places.
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