Eye Donation: Challenges & Remedies


Dr. Vinayak Bhatia,
 ICARE Eye Hospital and Post Graduate Institute, NOIDA, U.P., India

Dr. Smriti Sharma Bhatia
Assistant Professor, Department of Chemistry, Miranda House, University of Delhi-07

The measure of life is not its duration, but its donation’ : Peter Marshall

Life is, too precious, to be lost to an organ failure. Body or Organ donation is a gracious act; it reaffirms our faith in humanity. Organ transplantation has been one of the greatest advances of modern science that has resulted in many patients getting a renewed lease of life. It was included in the top five medical miracles of the last century. The impact of visual loss on the personal, economic, and social life of an individual is profound, and when the prevalence of blindness in communities is high, the consequences become a significant public issue.  However, it is not easy to convince the general public for eye donation.

Some of the challenges faced and proposed solutions in this field are:

  • Consent Required

As health is a State subject, some of the states have passed Corneal Grafting Acts governing the removal of corneas and other related matters. Recently, the Central Government has enacted the “Transplantation of Human Organs Act, 1994”, which governs, the removal of eyes for therapeutic purposes and other related matters. The said Act applies, in the first instance, to the States of Maharashtra, Goa and Himachal Pradesh and to all the Union territories. The Acts passed by the States including the aforesaid Act passed by the Central Government permit the removal of corneas after the death of the person either with the written consent of the donor (while he is alive) or after obtaining the necessary authority of the person lawfully in possession of the donor. The identity of the donor ids generally not revealed and to avoid any commercial misuse of corneas, they are provided free of cost for transplantation.

  • Time Limit

As it is essential to remove eyes as soon as possible after the death, the decision to donate eyes should be taken preferably before death and the nearest eye bank should be contacted immediately after death. Unless the matter is decided beforehand, the emotionally- charged atmosphere in the family prevailing after the death makes it difficult to arrive at a quick decision in favour of donating the eyes. Precious time can be saved if the death takes place in a hospital where facilities for removal of corneas are available. However, if the death takes place elsewhere, then organizing the removal of eyes (enucleatuion) takes a lot more time and effort. Since the cornea detoriates with the passage of time after death and as the possibility of corneas getting affected also increases, the early removal and preservation of cornea is a must. It is also essential to prevent the cornea from drying up after death to prevent it from detoriation. It is, therefore, necessary that the eyes of the deceased are closed and should not be exposed to the breeze or wind, fan or any direct air flow from air conditioners.

  • Motivation- A Difficult Task

The task of motivating and actually procuring the eye donation in adequate numbers require a lot more effort and dedication than other similar mission like, say, collecting the blood donation. In a single blood – donation camp, it may be possible to collect a large number of blood bottles but such is not the case with eye donations. The instances of voluntary organizations starting an eye bank with enthusiasm and then becoming defunct are common. Thus, while we have over 150 eye banks established formally, many have become non- existent over a period of time and currently the active eye banks may number just between 30 and 40.

  • Collecting Pledge Cards- A limited Impact on Actual Procurement

Many voluntary organizations organize drives to collect pledge cards in large numbers. While such cards may be helpful in creating awareness in favour of eye donation, their effectiveness in getting the actual eye donations is generally quite limited. Usually so much time elapses between the filling up of such a card and the occurrence of actual death of the pledger that in due course many people even forget having ever filled up such a card. A pledge for eye donation from a young person of say 25 years of age may not have any significant meaning for the eye bank if his/ her death were to take place 40- 50 years later. The cards have to be stored in the eye banks for a long time and as the contact is lost over a period of time, the pledge may not be of any practical value. It may be mentioned that even to store the large quantity of pledge cards collected over a period of time becomes a vexed problem for many eye banks owing to the paucity of storage space. The wish to donate eyes can be incorporated in the will itself in which case it is likely to serve the intended person more effectively. A more result oriented approach for procurement of eye donations would be to concentrate on motivational campaigns for eye donations in major hospitals where a large number of deaths take place.

  • Role of a Family Physician

The family doctor can also play a very active roll in eye donation. He generally enjoys the confidence of patient and his constant touch with the family of the deceased when the actual death takes place can be of great value in strengthening the motivation in favour of eye donations. On most occasions, specially when the death takes place at home, which is very common in our country, the family physician is the first one to announce the occurrence of death.One of the most effective ways to generate the necessary motivation and create an awareness on a large scale in a matter of eye donation would be to display a well-designed poster on eye donation in every general practitioner’s dispensary. The continuous exposure of this message to the patients and the medical practitioner himself would create the necessary impact in favour of eye donation in the long run.

  • Financial Assistance

The grant of some financial assistance to the nearest relative or heir of the deceased donor, especially among the economically weaker sections of the population would also help in providing the necessary incentive in favour of eye donation. It also felt that rather than providing the assistance in cash, it could be provided in the form of defraying the burial or cremation expenses

  • Listing of Eye bank Phone Numbers

It is suggested that phone numbers of all local eye banks should be listed in the concerned telephone directories, which would make them easily contactable. An arrangement could also be worked out whereby the police or fire brigade could be contacted for eye donation by the donors concerned. The Police or Fire Brigade can, in turn, pass on the message to the nearest concerned eye bank to enable it to process the matter further.

  • Appeal through Religious Heads

An appeal by the religious heads especially in a country like ours where the religious heads have a large following can go a long way in motivating the people in favour of eye donation. A formal dialogue with these religious heads needs to be established giving them the basic information on the subject and impressing upon then them the vital needs for procuring a large number of corneas foe the benefit of the blind. This is because once these religious heads are sufficiently motivated, they can play a lead role in encouraging eye donations on a larger scale. It may be noted that even in Islamic countries where the activity of eye donation was practically non- existent, the situation is changing rapidly and the maulavis, who had preferred to remain silent on the issue in the past, have now changed their stand in favour of eye donation. In fact the religious heads in Egypt, Saudi Arabia, Jordan, Pakistan etc. have passed ‘Fatavas’ in support of eye donation. Let us hope that the maulavis in our country also would follow suit and the Muslim community, which has uptill now remained aloof in this field, would actively participate in the drive for eye donation.

  • Pledge- cards attached to Driving Licences or Identity Cards

In a country like the U.S.A., almost every adult has a driving licence and meny attach their eye donation pledge cards to this licence. In a country where every family owns a vehicleand where the automobile accidents take a heavy toll on life, such a pledge greatly facilitates eye donation. Such pledges can also be included in the identity cards to be issued to the employees by the employers of large organizations or agencies. Even the credit card can be modified so as to provide for some space for  recording the pledge for eye donation. In large metropolitan cities like Mumbai, where a substantial number of people hold season tickets for travel by suburban trains, the identity cards issued to them by railway authorities can provide for the required space for recording their pledge for eye donation.

  • Promotional Literature

The distribution of promotional literature containing the basic information on the subject with an appeal for eye donation is apt to play an important role in the motivational campaign in favour of eye donation. Such promotional literature can be distributed amongst the relative of patients in major hospitals. In fact, copies of the literature can be kept at the reception counter in the hospital and also given to the relatives at the time of registration of the patient concerned in order to generate the necessary initial tempo in favour of eye donation. Sponsorship can be obtained from voluntary charitable organizations for meeting the cost of printing such literature.

  • Appreciating the donors and their Family Members

While financial assistance might provide the necessary incentive for the members belonging to economically weaker sections of the society, the posthumous appreciation of the donor and his/her family members by the concerned eye bank and social organizations would go a long way in stimulating the eye donation activity among the middle class and the affluent sections of the society. The issuance of a certificate of appreciation and  giving due publicity concerning the noble act of eye donation on the part of the deceased donor would substantially contribute in motivating the members of the public at large.

  • Grief Counseling

The concept of Grief Counseling aimed at motivating public in favour of eye donation is gaining momentum in our country. Grief Counseling is a program whereby social workers who are called “Grief Counselors” work towards motivating the bereaved family for an eye donation.


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