Dr Nazia Anjum
The cornea is a transparent, avascular, watch-glass-like structure that forms the anterior one-sixth of the human eye. Theprimary function of the humancornea is to act as a significant refracting medium and tofocus the rays of light through the lens onto the retina. Corneal blindness is a group of conditions that changes the corneal transparency, leading to scarring.According tothe World Health Organization, corneal diseases are among the leading causes of vision loss and blindness, following cataracts and glaucoma, among children and adults. The most common causes of corneal blindness in developing nations arecorneal infectionscaused by bacteria, viruses, fungi, and protozoa, known as corneal ulcers. The other causes of corneal blindnessinclude nutritional deficiency (vitamin A deficiency), inflammation,and genetic and degenerative diseases. The most frequent risk factors are eye trauma, contact lens wear, and unsupervised, over-the-counter use of topical steroids.These conditions cause disruption and damage to the cornea’s structural integrity, eventually leading to blindness and decreased vision. Even if the diseases listed above are treated well, the residual scarring can lead to blindness. These corneal scars and opacities can be treated with corneal transplant procedures. The concept of corneal transplantation for treating blindness was first brought into vogue by Himly in 1813. The first transplantation surgery was performed by Von Hippel in the year 1886 by replacing the cornea of a rabbit.Cornealtransplants are one of the most commonly performed transplants of human tissue worldwide. These transplants have a reasonable success rate due to the avascular nature of the cornea. However, there is a significant backlog in retrieving donor corneas in our country, leading patients to suffer from blindness due to the non-availability of corneal tissue. One of the primary reasons for poor retrieval rates of donor eyes is the misconceptions and myths related to the topic. This article tries to bring about some facts related to eye donation.
Myth 1: The whole eye is donated and transplanted!
Fact 1: Only the anterior part of the eye, that is, the cornea, is retrieved during donation and transplanted to the recipient. The whole eye is not recovered from the donor, except in certain situations after obtaining the consent of the relatives.
Myth 2: Living persons can donate their eyes
Fact 2: The donation can be made only in cases of deceased people, but you can always pledge to donate while alive. Also, the eyes mustbe retrieved within 6 hours of the death of a person.
Myth 3: Persons who donate the eyes will be born with empty sockets and facial disfigurement in the next birth!
Fact 3: According to scientific publications, this is not the case. Also, none of the religious scripturesmention statements like these.
Myth 4: Corneal donation by the aged, those with cataracts, and those who wear glasses are not worth it, as they have poor vision!
Fact 4: The corneas of old-aged donors or donors who used to wear glasses and have diabetes, are as helpful as a person with perfect vision.
Myth 5: The donation process is lengthy and may delay the funeral!
Fact 5: The process of retrieval of donor cornea will take 10-15 minutes and does not delay the funeral.
Myth 6: The donation of eyes will lead to the disfigurement of the deceased face!
Fact 6: The donation will not cause any facial disfigurement. The donor is treated with utmost dignity, and the lids are sutured so no bleeding or abnormality is evident.
Myth 7: The eyes donated may remain unused!
Fact 7: The donor eyes are preserved with utmost care in an eye bank and are used within two weeks of the retrieval.Even the poorest of the donated tissue is used for research purposes.
Myth 8: The retrieved eyes may be sold!
Fact 8:The eyes are retrieved by a doctor and stored safely in an Eye Bank.
How can the eyes be donated?
The donor can pledge their eyes to an eye Bank while alive. Also, if the family decides to donate the eyes after the person has died, they should contact the nearest eye bank as soon as possible, as the retrieval must take place within six hours. Most eye banks have trained staff who can retrieve the donated eyes round the clock (24-hour call duty). No special room is required for retrieval. Anyone from the age of one year can donate the eye, and there is no maximum age limit.
Educating society about this noble act is the key to the success of any eye bank. This year, the national eye donation fortnight is being observed from 25th August to 8th September. The observance of the fortnight aims to create awareness about eye donation activities and to combat the menace of corneal blindness. To conclude, the need of the hour is to make people wiser about the eye donation protocols and motivate them to pledge to eye donation. Let us do our bit to enlighten the lives of the patients with corneal blindness, let us pledge to donate our eyes.
(The writer is Assistant Professor, Department of Ophthalmology, AIIMS, Jammu).
