Dr. Dharmakanta Kumbhakar
Donation of eye tissue can allow transplantation of the cornea and the sclera. In India, we have an estimated 4.6 million people with corneal blindness that is curable through corneal transplantation made possible by eye donation. According to the National Programme for Control of Blindness 2012–13 report, only 4,417 corneas were available in 2012–13 against a whopping requirement of 80,000 – 1, 00,000 per year.
The cornea is the clear surface at the front of the eye which covers the colored part of the eye and is the main focusing element. It allows light to pass through to the retina, giving sight. When the cornea becomes cloudy from disease, injury, infection or any other cause, vision will be drastically reduced. Corneal transplants restore sight to people who are partially or completely blind due to corneal damage following a genetic condition, illness or injury. Cornea transplant is the surgical procedure which replaces a disc-shaped segment of an impaired cornea with a similarly shaped piece of a healthy donor cornea. More than 90% of corneal transplantation is carried out successfully and helps restore vision in people with corneal blindness. Corneal transplantation in infants born with cloudy cornea can make a big difference to their lives.
- Eyes can be donated only after death. 2. Eyes must be removed within 4 hours after death in summer season and within 6 hours after death in winter season. 3. Eyes can be removed by a registered medical practitioner only. 4. The eye bank team will visit the home of the deceased or the hospital to remove the eyes. 5. A small quantity of blood will be drawn to rule out communicable diseases. 6. Eye removal does not delay the funeral since the entire procedure takes 20-30 minutes only. 7. Eye retrieval does not cause disfigurement. 8. The identities of both the donor and the recipient are kept confidential. 9. It is illegal to buy and sell human eyes, organs and tissues.
Who can donate eyes?
Eye donors can be of any age group or sex. People who use spectacles, diabetics, patients with high blood pressure, asthma patients and those without communicable diseases can donate eyes. Persons with AIDS, Hepatitis B and C, Rabies, Septicemia, Acute leukemia (Blood cancer), Tetanus, and infectious diseases like Meningitis and Encephalitis cannot donate eyes.
When does donation take place?
The surgical removal of the eye tissue is performed soon after death usually within 4 hours after death in summer season and within 6 hours after death in winter season, ensuring the tissue is in the best possible condition for transplant. This also makes sure that the funeral arrangements are not delayed in any way. Because the removal causes no disfiguration, an open casket is still an option for the donor family.
How can a person become a donor?
The most important action a person can take is to tell his/her family and legal representative. Most States now require that families be offered the option of donation when a loved one dies. Families may give consent for donation. It is most helpful if they know in advance that she/he would like to donate her/his eyes. A donor card can serve as an indication to the family/ legal representative and hospitals of one’s intention to be an eye donor.
Few important points about eye donation:
- For relatives of the deceased: To donate eyes, the following procedures should be done by the relatives of the deceased. (1) Close the eye lids of the deceased. (2) Switch off the fan if any, directly over the deceased person. (3) Raise the head of the deceased slightly by placing a pillow underneath. (4) Contact the nearest eye bank as quickly as possible. (5) Give the correct address with specific landmarks and telephone number to enable the eye bank team to locate the place easily. (6) If the death certificate from the physician is available, keep it ready. (7) Eye donation can be done only with the written consent of the next of kin in the presence of two witnesses.
- After eye donation: (1) The donor’s family receives a certificate of appreciation from the eye bank. (2) The eyes are taken to the eye bank and evaluated by a trained eye bank staff. (3) Tests are carried out and the tissue is sent to the corneal surgeon. (4) The waiting list is referred and the recipient is called for corneal transplant. (5) Corneal transplant is performed. (6) Periodic follow-up of the recipient is done over time to ensure that the graft is successful.
- Services of the eye bank: (1) Availability of trained staff round the clock to attend the calls. (2) Evaluate and provide quality corneas to corneal surgeons. (3) Enable corneal research using eyes unsuitable for grafts, to find newer techniques, improve preservation methods and train corneal surgeons. (4) Increase public awareness on eye donation and eye banking. (5) Train doctors in eye removal procedures. (6) Develop and establish a network of eye donation centres.