One of the biggest avoidable tragedies of , in the world, is one out of every third blind men is an Indian? Hence, has the largest burden of all the countries of the world, combating global blindness. Most Indians also suffer from a significant impairment of vision, due to various reasons and the cumulative loss to the nation is in the vicinity of USD Eleven billion.
According to statistics available with the Ministry of Health, some 27 million Indians, are suffering from moderate sight impairment; 9 million, are classified as bilateral blind, and 2, 60,000 children are blind. About 4.6 million Indians are corneal blind. Of these, 90 per cent are below the age of 45 years. They include 60 per cent who are below the age of 12 years.
An enquiry at the root cause reveals that 66 per cent of the cases are preventable or curable. And out of the 4.6 million, at least three million, can benefit from corneal transplantation.
Donated human eyes can help preserve and restore sight through corneal transplantation. And the experience in the world is that more than 90 per cent of corneal transplant operations are successful worldwide, and restore vision in people suffering from blindness due to corneal problems. Even infants born with cloudy corneas can gain vision through a corneal transplant.
The cornea is the clear, transparent dome in front of the “black portion” of the eye. It is also the main focusing surface, which converges light rays as they enter the eye to focus on the retina. It is thus the most important part of the optical apparatus of the eye. Loss of transparency directly results in loss of vision.
A corneal transplant is an operation that replaces the opaque cornea with a clear cornea obtained from a human donor eye. A cornea may become opaque owing to infection, injuries, iatrogenic causes such as malpractice and improper post-operative care, malnutrition, or congenital-hereditary reasons.
Practically anybody from the age of one can be an eye donor. There is no maximum age limit. Poor eyesight and age make no difference. Those who wear spectacles, those who have had cataract surgery, diabetics and those who are hypertensive can donate eyes. Even a person who is blind from retinal or optic nerve disease can donate eyes, provided the cornea is clear.
One can bequeath eyes by taking a pledge, resolving to donate them after death. But it requires the help of relatives or friends to carry out the pledge and desire. The next-of-kin can give consent for a donation even if the deceased family member has not signed a pledge form.
The eyes need to be collected within six hours and the eye bank has to be called as early as possible. After making the call, both eyes will need to be closed and covered with moist cotton. Any overhead fans should be turned off. If possible, antibiotic eye drops may be periodically instilled in the eyes in order to reduce chances of infection. The head end of the body should be kept raised by about 6 inches in order to reduce any bleeding during eye removal.
The removal will leave no visible signs that would interfere with common funeral arrangements and practices. There is no religious conflict involved. The donation actually gives a gift of life or sight to others. As such, it is consistent with the beliefs and attitudes of all major religious and ethical traditions.
The whole eye cannot be transplanted, only the cornea can be. The rest of the eye is used for therapeutic use, research and education. The ultimate decision about usage for transplantation will be made after evaluation.
A living person cannot donate eyes. A recipient is not told who donated the eye: the gift of sight is made anonymously. The following steps will aid the noble cause. Dial the eye bank soon after the unfortunate death of a near and dear one. Give your consent to donate the eyes of your close relatives and friends. Motivate the family members of anyone who has died in your area. Spread information about eye care and eye donation.
Over 38,500 Indians who died in 2007 helped blind people see through their eyes, representing a growth of nearly 30 per cent from 2006. The figure is still woefully short for a country that inhabitates the most number of blinds of the world, over 10 million. According to the Health Ministry statistics, 38,596 corneas were collected during the financial year ending March 2008.
Among the states, Tamil Nadu with 8,502 cornea collections is number one is terms of eye donation, followed by Gujarat, Andhra Pradesh and . On the other hand there was not a single case of eye donation in , Himachal Pradesh and most of the north-eastern states.
“There is a huge gap between the need and availability of eyes. But the good part of it is cornea collection has registered a good growth, (30 per cent growth in eye donations)” said G Ganesh, Executive Director of the Eye Banking Association of India. “The major problem is lack of awareness. Look at the states of Tamil Nadu, , Andhra Pradesh - the cornea collection is comparatively high,” Ganesh explains.
To enable one to understand the function of an eye in the human body, I have collected some vital information, from the medical profession, which I am tabulating for your consideration.
1. Eyes are the most complex organs you possess except for your brain.
2. Eyes are composed of more than two million working parts.
3. Eyes can process 36,000 bits of information every hour.
4. Under the right conditions, the eye can discern the light of a candle at a distance of 14 miles.
5. Eyes contribute towards 85% of your total knowledge.
6. Eyes utilize 65% of all the pathways to the brain.
7. Eyes can instantaneously set in motion hundreds of muscles and organs in your body.
8. In a normal life-span, will bring you almost 24 million images of the world around you.
9. The external muscles that move the eyes are the strongest muscles in the human body for the job that they have to do. They are 100 times more powerful than they need to be.
10. The adult eyeball measures about 1 inch (2.5 cm) in diameter. Of its total surface area only one-sixth is exposed -- the front portion.
11. The eye is the only part of the human body that can function at 100% ability at any moment, day or night, without rest. Your eyelids need rest, the external muscles of your eyes need rest, the lubrication of your eyes requires replenishment, but your eyes themselves “never” need rest. But please rest them!
12. Eyes are your most precious sense... cares for them properly!
Top Ten Facts On Blindness
1. Globally, every five seconds, a person goes blind.
2. Nine out of every ten blind persons live in developing economies.
3. According to the National Health Policy document of the Government of India, 1983, “One of the basic human rights is the right to see”.
4. Despite this lofty aim, ’s blind population totals a whopping 12 million.
5. More than two thirds of ’s visually handicapped live in Andhra Pradesh, Orissa, Madhya Pradesh, , Rajasthan, Tamil Nadu and Uttar Pradesh.
6. Cataract, the leading cause of visual disability, accounts for 62.6 percent of blindness in the country.
7. Other causes are glaucoma, macular degeneration, posterior segment pathology, retinal detachment, corneal opacities, retinitis pigmentosa, and surgical complications.
8. A largely undocumented cause for blindness in is diabetic retinopathy, especially in the working middleclass. The extent of the problem, which can be prevented with good glycemic control, is yet to be estimated.
9. The National Programme for Control of Blindness, launched in 1976, aims to reduce the overall blindness prevalence rate from 14 blind persons per 1000 population to 3.
10. The programme focuses on controlling avoidable blindness; providing high quality eye care to affected persons, especially rural poor; increasing the number of cataract operations and reduction in backlog by screening all population over 50 years.
FAQ About Eye Donation
Eyes can be donated only after death.
Eyes must be removed within 4 - 6 hours after death.
Only a Registered Medical Practitioner can remove eyes from a deceased.
The eye bank team will remove the eyes from the home of the deceased or from a hospital.
Eye removal does not delay the funeral since the entire procedure takes 20-30 minutes only.
A small quantity of blood will be drawn to rule out communicable diseases.
Eye retrieval does not cause disfigurement.
Religions are for eye donation.
The identities of both the donor and the recipient are kept confidential.
To donate eyes, the relatives of the deceased should do the following procedures:
Close the eyelids of the deceased.
Switch off the fan.
Raise the head of the deceased slightly by placing a pillow underneath.
Contact the nearest eye bank as quickly as possible.
Give the correct address with specific landmarks and telephone number to enable the eye bank team locate the place easily.
If the death certificate from the physician is available, keep it ready.
Eye donation can be done only with the written consent of the next of kin in the presence of two witnesses.
What is a cornea and how do cornea transplants restore sight?
The cornea is a clear dime-sized tissue that covers the front of the eye. If the cornea becomes clouded through disease or injury, vision is impaired and sometimes lost entirely.
The only substitute for a human cornea is another human cornea donated at death by someone who thus leaves a living legacy.
Who can donate eyes?
Almost everyone can donate his or her eyes. WEARING GLASSESS AND AGE of the person make no difference. Persons younger than 18 years must have the authorization of the parents or guardian.
How can I donate my eyes?
There are two very important steps you must take to become a donor. First, sign a donor card and carry it with you. Second, TALK TO YOUR FAMILY. You must let you family members know that you wish to be an eye donor. Unless your donor card is available at the time of death, your next of kin will be responsible for granting consent. It can be a difficult decision for them if your wishes are not known. Having a discussion about donation with your family is the first step in the effort to restore sight and save lives.
Is there a cost to donate?
There is no cost to donate. Transplant agencies pay any costs associated with recovery of organs and tissues from donors.
Would donating delay funeral arrangements?
Donating should not delay funeral arrangements. It may take additional time, usually no more than four hours, to coordinate the donation process with the funeral home, and for any extra efforts taken to prepare the body for presentation.
Does one's religion support eye, organ and tissue donation?
All major religions support donation. However, if you have concerns about your religion’s position, please get in touch with your religious leader/representative.
Is cancer a rule-out for donation?
No, cancer does not automatically prohibit eye donation.
If I wear glasses can I still donate?
Yes, you can! People who have poor vision and wear glasses, or have had previous eye diseases or surgery can still donate, since these conditions may not affect the cornea. Eyes donated to The Eye-Bank that are not medically suitable for transplant may be used for medical research and education. For example if you have had LASIK surgery you can donate for research and medical education purposes.
Are families told who will receive the donation?
It is Eye-Bank policy to keep donor and recipient identities completely confidential. However, certain information can be shared and The Eye-Bank offers to conduct correspondence between donor families and recipients as long as identities are kept anonymous. Recipients especially are encouraged to send thank-you notes to their donor families through The Eye-Bank. Click here to learn how to write your donor family.
Can the family designate a recipient?
It is possible to designate a recipient although it is fairly unlikely that a donation would occur in a timely manner to facilitate a needed transplant. However, if at the time of death a family member is in need of a cornea transplant then The Eye-Bank will make every effort to match the donor tissue with that person.
How long do recipients usually wait for a cornea?
Cornea transplant surgery is typically an elective procedure allowing the surgeon and patient to choose the most convenient day for the surgery to take place. The need for emergency tissue is met within 24 hours.
How long can a cornea be stored?
The Eye-Bank does keep a “bank” of tissue in its laboratory. Fortunately, cornea tissue can be preserved and stored for several days before it must be used for transplant. However, since the demand for ocular tissue is so great most donor tissue is distributed within a day or two after its arrival.
If you are in Chennai, the Sankara Nethralaya has a dedicated phone line available round-the-clock for eye bank and eye donation: 044-28281919 and 044-28271616. Others in different parts of , can get in touch with a reliable eye bank and make arrangements for donating their eyes after their death.
Does it make any sense to destroy an important part of our body if it can be used for the benefit of others once we have died?
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DONATE YOUR EYES! Donate your eyes to give sight. Let the blind smile with our eyes. You will have the satisfaction of seeing this world even after your death for the benefit of two blind people.
Pamphlets circulated by Sankarara Nethralaya Eye Bank. For any further information, please contact firstname.lastname@example.org
If you have specific questions, or want to know more about eye donation, you may contact Mr. Acharya, at email@example.com /firstname.lastname@example.org or call him at: 301-251-0378
All information collected from medical sources. The relevant URLs are given. Being general in approach, this article may not satisfy your needs. Kindly contact your nearest eye specialist, and he would guide you in the matter.
All photographs are from the Internet and the copyright rests with the individual photographer.
I have made adequate arrangements for donating the eyes of self and wife after our death.
Greatly indebted to Dr. S. Badrinath, Chairman, Sankara Nethralaya for the details and the motivation for donating the eyes after death.
The gift of sight: The country that exports its eyes to the world
By Associated Press Reporter
Updated: 08:29 GMT, 23 January 2012
At 10:25 a.m., a dark brown eye was removed from a man whose lids had closed for the last time.
Five hours later, the orb was staring up at the ceiling from a stainless steel tray in an operating room with two blind patients — both waiting to give it a second life.
S.P.D. Siriwardana, 63, remained still under a white sheet as the surgeon delicately replaced the cornea that had gone bad in his right eye following a cataract surgery.
Across the room, patient A.K. Premathilake, 32, waited for the sclera, the white of the eye, to provide precious stem cells and restore some vision after acid scalded his sight away on the job.
A worker at the Sri Lanka Eye Donation Society holds three corneas in bottles with preservatives, ready to be sent abroad
The lenses are then packaged and prepared to be sent overseas. In this case the sight-saving parcel is bound to help patients in Japan
'The eye from this dead person was transplanted to my son' said A.K. Admon Singho, who guided Premathilake through the hall after the surgery.
'He's dead, but he's still alive. His eye can still see the world.'
This gift of sight is so common here, it's become an unwritten symbol of pride and culture for Sri Lanka, an island of about 20million people located off the southern coast of India.
Despite recently emerging from a quarter century of civil war, the country is among the world's largest cornea providers.
It donates about 3,000 corneas a year and has provided tissue to 57 countries over nearly a half century, with Pakistan receiving the biggest share, according to the nonprofit Sri Lanka Eye Donation Society.
The organization began promoting eye donation decades ago, but has since faced allegations of mismanagement and poor quality standards.
The supply of corneas is so great in Sri Lanka that a new, state-of-the-art government eye bank opened last year, funded by Singapore donors.
It has started collecting tissue from patients at one of the country's largest hospitals, hoping to add an additional 2,000 corneas to those already shipped abroad annually.
Nearly 900,000 people have also signed up to give their eyes in death through the Eye Donation Society's longstanding eye bank.
'People ask me, "Can we donate our eyes while we are living? Because we have two eyes, can we donate one?",' said Dr. Sisira Liyanage, director of Sri Lanka's National Eye Hospital in the capital, Colombo, where the new eye bank is based.
A cataract patient is examined at the Sri Lanka Eye Donation Society. Nearly 900,000 people have also signed up to give their eyes in death through the society's longstanding eye bank
A cataract patient waits for surgery. Thanks to the donations of his countrymen he will be able to see again
Since 1964 the Sri Lanka Eye Donation Society has sent more than 70,000 corneas to 57 countries
'They are giving just because of the willingness to help others. They are not accepting anything.'
The desire to help transcends social and economic barriers. Prime ministers pass on their corneas here along with the poorest tea farmers. Many Sri Lankans, about 67 per cent of whom are Buddhist, believe that surrendering their eyes at death completes an act of 'dana', or giving, which helps them be reincarnated into a better life.
It's a concept that was first promoted a half century ago by the late Dr Hudson Silva, who was frustrated by the massive shortage of corneas in his native Sri Lanka.
Most eyes back then were harvested from the handful of prisoners hanged each year, leaving little hope for blind patients in need of transplants.
Silva wrote a newspaper piece in the late 1950s pledging to donate his own corneas and appealing to readers to also give 'Life to a Dead Eye': the response was overwhelming.
With no lab facilities or high-tech equipment, he and wife Irangani de Silva began harvesting eyes and storing them in their home refrigerator.
They started the Eye Donation Society, and in 1964, the first cornea sent abroad was hand-carried in an ice-packed tea thermos aboard a flight to Singapore. Since then, 60,000 corneas have been donated.
While the Society's eye bank was a pioneer, questions about quality emerged as international eye banking standards improved over the next 20 to 30 years. Concerns have recently been raised about less advanced screening for HIV and other diseases, and the eye bank has also faced allegations of mismanagement.
Many of its corneas are harvested from the homes of the dead in rural areas across the country, making auditing and quality assurance levels harder to maintain, said Dr. Donald Tan, medical director of Singapore National Eye Center, who helped set up the new eye bank. Once, he said, a blade of grass was found packaged with tissue requested for research.
Eye Donation Society manager Janath Matara Arachchi says the organisation sends 'only the good and healthy eyes' and has not received a complaint in 20 years.
A group of cataract patients wait in line for surgery. The society donates around 3,000 corneas a year
Arachchi said the organisation checks for HIV, hepatitis and other sexually transmitted diseases by dipping a strip into blood samples and waiting to see if it changes colour for a positive result. Sri Lanka's Health Ministry also said it has received no complaints about the eye bank from other countries.
Medical director Dr M.H.S. Cassim denied that anyone from the organisation is making money off donations sent abroad. He said they charge up to $450 – around £290 - per cornea to cover operational costs and the high price of preservatives needed to store the tissue.
The cornea is the dome-shaped transparent part of the eye that covers the iris and pupil. It helps to focus entering light, but can become cloudy from disease or other damage.
Corneas must be carefully extracted from donors to avoid damaging the thin layer of cells on the back that pump water away to keep it clear. They must be harvested within eight hours of death, and can today be preserved and stored in refrigeration for up to 14 days.
Sri Lanka has no official organ donation registry, as is provided in some countries when driver's licenses are issued. Instead, the idea is passed down from generation to generation.
Eye donation campaigns are organised at temples by Buddhist monks, but people of other faiths also give, including Hindus and Christians.
Future donors simply mail in the bottom half of a consent form distributed by Silva's Eye Donation Society. The top portion, which looks like an award certificate with a fancy scroll lacing around it, is also filled out and often proudly displayed on the wall — serving as proof to the living that the pledge comes from a generous spirit.
'Just think if we had that level of organ donation and commitment and belief system in the United States, where we have these long lists of people waiting for hearts, livers and kidneys,' said Dr. Alfred Sommer of Johns Hopkins University, who spent more than 40 years fighting blindness in the developing world.
'If we had that level of cultural investment, there would be no lists for organ transplants.'
The U.S. is the world's biggest cornea provider, sending more than 16,000 corneas to other countries in 2010, according to the Eye Bank Association of America.
A Sri Lankan man hoping to have the gift of sight restores undergoes an eye examination
The Sri Lankan people take great pride in being able to help restore sight to many thousands across the world
But Sri Lanka, which is 15 times smaller, actually donates about triple that number of corneas per capita each year.
There is no waiting list for eye tissue in Sri Lanka, and its people get first access to free corneas. About 40,000 have been transplanted locally since the beginning, but that still leaves a surplus each year.
Pakistan, an Islamic country where followers are typically required to be buried with all parts intact, has received some 20,000 corneas since overseas donations began, Cassim said. Egypt and Japan are two other major recipients, receiving 8,000 and 6,000 corneas respectively to date, he said.
But Sri Lanka cannot meet global demand on its own. An estimated 10million people — 9 out of 10 in poor countries — suffer worldwide from corneal blindness that could be helped by a transplant if tissue and trained surgeons were available, according to U.S.-based SightLife, an eye bank that partners with developing countries. It has been working with Sri Lanka's new government facility.
'Sri Lanka has long been known to be a country with an incredible heart for eye donation and a willingness to share surplus corneas to restore sight around the world,' said SightLife president Monty Montoya.
'While efforts have been made to share information with other countries, I am not aware of any one location being able to replicate Sri Lanka's success.'
Where possible, eye tissue should be transplanted within hours of death. That was done in the Colombo operating room where patients Siriwardana and Premathilake were stitched up with what looked like tiny fishing hooks, then bandaged and helped outside.
For Premathilake — whose sight was lost when an open can of acid spilled onto his face while working at a rubber factory — this is his last hope. His right eye still blinks, but there is nothing but an empty pink cavity inside. The stem cells attached to his left eye should help create a new window of sight that he hopes will allow him to go back to work, or at least carry out daily tasks without depending on his parents.
'I am extremely happy,' he said. 'I didn't know the man who died in his previous life, but I'm always going to say blessings for him during his next births.'
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