Eye bank must be called at the right time rather than just filling a donor pledge form and forgetting about it

Does the willingness to donate eyes end with just filling the pledge form in an eye bank? Is Madurai catching up in eye donation?

Eye donation appears to be picking up with people who never approached an eye bank coming forward to donate eyes when someone died in the family.

The family of 49-year-old Ravi Chidambaram of Sadhasiva Nagar in Madurai among the recent additions to the eye donor list. The gesture of a family member calling the eye bank of Aravind Eye Hospital on January 9 has motivated others in the family. “It was a spot decision taken by me when my 68-year-old aunt Meena Marimuthu died in Pudukottai last month. When her body was brought to Madurai, I convinced my relatives to donate her eyes. Immediately, we called Aravind hospital and a medical team collected the cornea within six hours of her death. Today, other aged persons in my family want to donate their eyes after death,” says Mr. Chidambaram.

But there was initial apprehension among his relatives that the eyes might get disfigured once donated. But doubts were set aside after they realised that his aunt’s eyes would give the gift of sight to two others. “It is important to make the call to the eye bank at the right time rather than just filling a donor pledge form and forgetting about it,” he says.

Ophthalmologists say corneal blindness is a major challenge, and availability of corneas far below the requirement. N.Venkatesh Prajna, Chief of Cornea Clinic, Aravind Eye Hospital, says pledging of eyes is not a direct marker for eye donation. He cites the example of a family in Madurai which came forward to donate eyes as a social cause.

A senior railway employee in Madurai lost his 23-year-old son a month back, and in that moment of grief he called Dr. Prajna to say, “You helped him with cataract surgery when he was alive. Now, you must again help my son by grafting his eyes and giving sight to persons waiting to see the world.” Dr. Prajna recalls, “This boy had renal problem for some time. He was working in a company in Chennai and I did cataract surgery on him a year back. When his father called me, I was moved. We grafted his son’s eyes and they were used for two young persons.”

In Madurai, corneal grafting is performed only at Government Rajaji Hospital (GRH) and the Aravind Eye Hospital. Both have a memorandum of understanding to encourage eye donation through grief counsellors who talk to family members when a death occurs.

Eye donation is encouraging in the Department of Ophthalmology of GRH. For the first time, its eye bank has crossed the 100 cornea mark and it has become eligible to apply for additional funds from the National Eye Bank Association of India.

P. Thiyagarajan, Professor and Head of Department of Ophthalmology, GRH, and Programme Manager of District Blindness Control Society, says eye donation is picking up owing to the success of the Hospital Cornea Retrieval Programme. “As per last year’s study, India requires one lakh corneas but only 22,000 usable corneas were available. The GRH eye bank collected 110 corneas since April last year. I find that people have started realising the importance of eye donation,” he says.

The Rotary Aravind International Eye Bank, which was started in 1998, is carrying out a community-based cornea retrieval programme through 35 collection centres at various places.

According to its manager D. Saravanan, the cornea can be preserved only for four days and so persons in the waiting list will undergo cornea transplant immediately. When a cornea is received by the eye bank, it will be evaluated for quality and usable ones preserved for transplantation and the rest goes for research.

Dr. Prajna says when people pledge their eyes for donation, they have to inform their near and dear ones so that when the time comes, their wish can be fulfilled.

“In Aravind Eye Hospital, we are doing corneal grafting either free of cost or at a very nominal rate because the magnanimity of the eye donor should be respected. It is done for a social cause and should not be commercially exploited,” Dr.Prajna says.

The conversion rate of filling a pledging form to actual donation is low because people move locations or family members are not aware of their intention to donate.

M. Veerasamy, ophthalmic assistant, Karungalagudi Primary Health Centre, says preventable blindness needs more attention and eye donation can pick up only with public participation. “Those who want to donate eyes must write on a poster and keep it at a prominent place in their house, because family members forget to inform the eye bank at the time of grief. Filling eye donor card alone is not enough,” he emphasises.

Dr .Thiyagarajan says only about 60 per cent of the corneas collected from donors are of usable quality. Most of the corneal blindness cases are among children due to eye injuries, infections, malnutrition, and congenital disorders.

At GRH, there is networking among all wards in the hospital so that when a patient dies, the eye bank is informed. Grief counsellors then motivate the relatives to donate eyes of the deceased.

At Aravind Eye Hospital, a special medical team is always ready to attend to calls for grafting the cornea at the donor’s house. Dr. Prajna says, “We do three or four cornea transplants in a day and like the railway employee, every person should be passionate about eye donation and sensitise family members so that eye donation becomes a movement.”

Mr.Veerasamy, who has been conducting awareness programmes in rural areas, feels that a stage should come when family members call the eye bank as part of funeral arrangements.

A recent example is the case of 64-year-old Meena of Usulangulam near Sayalkudi in Ramanathapuram district. She had cornea transplant (therapeutic keratoplasty) on her right eye at the GRH on February 1. Her medical report said she had corneal ulcer because of dust while cleaning the house and gradually the woman lost her vision.

“Now I am able to see and my life is not what it was 15 days ago,” the happy woman said after a check-up on Tuesday.

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