Blindness has been recognized as an important public health problem in India. In India, there are approximately 12 million bilateral visually impaired and 8 million unilateral visually impaired, which is about one fourth of the total blind population of the world. This means 14.9 out of every 1000 people in India are visually impaired compared to just 3 per 1000 in the developed countries. India has 12,000 trained Ophthalmic Surgeons (OS), which means that Ophthalmologist/Population ratio is 1 OS: 84,000 population. The private and NGO sectors in the country have made significant contributions in the control of blindness. Blindness in most cases is avoidable that is, either preventable or curable. Of the 12 million visually impaired, approximately 10.3million are curable by relatively simple operations, unfortunately, yet they remain uncured.0.7 million of India's population suffers from corneal blindness, mostly, children in their early childhood, which can be improved by corneal transplantation.
Eye Banking Scenario:
Eye banking in India is in its budding stage. Awareness regarding eye donation has gained momentum only during the last decade. Statistics of the overall collection of corneal tissues by the 404 Eye Banks registered with Eye Bank Association of India reveals only a marginally increasing trend in the collection. On an average the country needs 200,000 corneas in a year and as against it only 20,000 are collected. Out of the 20,000 corneas collected only 47%(10,000 eyes) are utilized for sight restoration as the other 50% are of too poor a quality to use in transplantations.
The current Eye Banking scenario in India reveals that only 10 eye banks out of 404 are registered and also collect more than 50% of the total collection. Of these, 146 eye banks have contributed only 7% to the total collection. The rest is contributed by Eye Banks which collect anywhere between 100 to 500 eyes. In India, the challenge is to not only create eye donation awareness but to also dispel myths and misconceptions associated with it. If the myths are dispelled then it becomes easy to create awareness. These 10 eye banks enjoy community support and confidence due to their dedicated and quality services. In the year 2004, bout 23,000 corneas were collected all over the country and only 9,500 were utilized for sight restoration. Many organizations involved in Eye Banking lack trained personnel, infrastructure and community support. If the resources of all the Eye Banks are pooled and a focused campaign for eye donation is run in collaboration with the Government, Private and International NGO’s, the targeted collection of 200,000 corneas for the whole country in a year can be achieved.
The present supply of donor tissues falls short of the needs for sight restoration surgery because of the following reasons:
1. Mushrooming of non-functional eye banks with inadequate infrastructure - Eye banks with minimal resources is setup with a partial funding from NGO's and they fail to adopt standard procedures in enucleation & preservation which in turn has an effect on the quality of the tissue retrieved.
2. Lack of trained eye bank personnel (technicians, eye donation counselors and Eye Bank Managers)
3. Lack of mobilization of resources for financial sustainability of the eye banks
Problem description:
Corneal blindness is persisting and escalating in the country, due to lack of awareness among the general public. A majority of rural population is affected by corneal blindness, because of ocular trauma arising out of agricultural activity. Rural people are not oriented to the curative aspects of the problem of corneal blindness. The solution to corneal blindness lies in the collection of corneal tissues obtained through eye donations. Eye donation has not gained momentum in the country because of various myths, misconceptions and religious beliefs surrounding it. Moreover, services for the corneal blind patients are disbursed by corneal surgeons at the tertiary eye care centers. The lack of services stems from the scarce supply of corneal tissues. Although many of the eye donation campaigns running in the country have increased the eye donation pledging, but Mere pledging is of no use because not even pledge translates into donation only one out of 100 pledges translates into donation. Improper infrastructure, untrained personnel or lack of motivation among staff or ignorance among family members of the deceased are some major causes.
To add to it, there is lack of quality eye banking setups. Eye bank call for high investments and since most of them lack the necessary resources, they are unable to collect more number of quality eyes. Surgery for corneal blindness though not very costly when compared to other surgeries for eye diseases, needs prolonged management and hence is not very rewarding. One of the strategies adopted by Eye banks to collect quality corneal tissue is through Hospital Cornea Retrieval programme; wherein an eye donation counselor employed at a multispeciality hospital motivates the family of the deceased for eye donation. This method ensures that the quality of the cornea collected meets the standards of quality eye care. Even though this is an excellent strategy, the programme per se is not sustaining as it is a cost intensive exercise and calls for tremendous effort on the part of the eye banks.
I take this opportunity to extend this appeal to all the people to take up this noble cause of eye donation in their families and support the mission...
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