JIPMER EYE BANK Department of Ophthalmology

Eye Bank (EB) is an institution that should provide a round-the-clock public response system over the telephone and conduct public awareness programmes on eye donation.

AIMS AND OBJECTIVES:

• To harvest corneal tissue
• To process, preserve and evaluate the collected tissue
• To distribute tissue in an equitable manner for Keratoplasty
• To ensure safe transportation of tissue
• Co-ordinate with donor families and hospitals to motivate eye donation
• Provide eye tissues for research and training
• Provide support and grief counselling to donor families
• Promote awareness programmes among the public
• Equip the eye bank personnel

PROCUREMENT

JIPMER Eye Bank has links with many voluntary organisations like Lions clubs, Rotary clubs and other NGOs for its outreach activities. These clubs also perform the activities of the Eye Donation centres and contribute to the Eye Bank by procuring Eyes.

GRIEF COUNSELLING

JIPMER eye bank has grief counsellor appointed to co-ordinate with the family members of the deceased who are potential donors.
Counsellors” activities include:

• Approaching the family members of the deceased at an appropriate time and counsel them in an ideal surrounding.
• Providing comfort, moral support and sympathy to the family members while attempting to motivate them for eye donation.
• Addressing the fears and queries raised by the family members.
• Following appropriate norms and regulations in Medico-legal cases.
• Alerting the eye bank team soon after obtaining consent for eye donation.

Eye Ball Collection (Enucleation)

Enucleation is removal of eye balls from a deceased donor.

JIPMER Eye Bank has a dedicated phone line for receiving enucleation call (24 Hours) 0413-2275666 Informant has to provide the ophthalmologist attending the enucleation call the following details:

1. Name, age, sex of the deceased person
2. Cause of death (if possible)
3. Time of death
4. Place of death (hospital or home)
5. Home address, phone number

A team of ophthalmologists and paramedics will then attend the enucleation call and carry out enucleation at the earliest. The eyes are removed by standard surgical procedures maintaining aseptic conditions during and after removal of the eyes. After the eyes have been removed, a ball of cotton wool is tightly packed in the empty eye socket. The eye lids are stitched using a black thread ensuring no disfigurement of the face of the donor. The enucleated eye balls are transported in a Moist Chamber to the Eye Bank for further processing and utility.

Drawing of donor blood sample

After the enucleation, the physician draws 5 ml of blood from the donor to screen for infectious diseases.

Screening of donors

Tissue from donors with the following conditions is potentially hazardous to eye bank personnel and harvesting eyes is contraindicated.

Contraindications for Retrieval:

• Active viral Hepatitis
• Acquired immunodeficiency syndrome (AIDS) of HIV
• Active viral encephalitis or encephalitis of unknown origin
• Creutzfeldt-Jakob disease
• Rabies

Contraindications for corneal utilisation for transplant:

Tissue from donors with the following conditions are potentially health threatening and also affects the surgery outcome and, thereby, not utilised for surgical purposes.

Conditions with potential risk of transmission of local or systemic communicable from donor to recipient:

• Death of unknown cause
• Death with neurologic disease of unestablished diagnosis
• Subacute sclerosing panencephalitis
• Progressive multifocal leukoencephalopathy
• Active meningitis or encephalitis
• Encephalopathy of unknown origin or progressive encephalopathy
• Active septicemia (bacteremia, fungemia, viremia, parasitemia)
• Active viral hepatitis
• Creutzfeldt-Jakob disease
• Congenital rubella
• Reye’s Syndrome
• Rabies
• Active miliary tuberculosis or tubercular meningitis
• Hepatitis B surface antigen positive donors
• HTLV-I or HTLV-II infection
• Hepatitis C Seropositive donors
• HIV seropositive donors

The eyes that are not utilised for purpose of corneal transplantation, will be used for surgical training of residents and/or purpose of research

Donor Blood Screening

HIV Screening

JIPMER Eye Bank has collaboration with microbiology department for a 24 hour operational HIV screening programme using an approved test for all donors of surgically designated tissue. A negative screening test is documented prior to use of tissue for transplantation.

Hepatitis B & C screening

JIPMER Eye Bank also has an operational hepatitis B & C screening programme using approved tests for hepatitis B & Hepatitis C antigen for all donors of surgically designated tissue. A negative screening test is documented prior to use of tissue for transplantation.

FREQUENTLY ASKED QUESTIONS ABOUT EYE DONATION

Q. What is an eye bank?

A. It is the link between donor and recipient/eye surgeon. It is an organization recognized by the government to collect and distribute human eyes to those requiring corneal transplantation.

Q. Who can be an eye donor?

A. Anyone can be a donor irrespective of age, sex or blood group.

Q. Do religious authorities approve of donating one’s eyes?

A. Yes, all religious faiths support this vital sight restoration program.

Q. Is the whole eye used for transplant?

A. No. Only the thin transparent layer in front of the iris called the cornea is used for transplant.

Q. What is a cornea?

A. Cornea is a transparent tissue without any blood vessels. A clear cornea enables one to have a good vision.

Q. What is meant by corneal transplantation?

A. It is a surgical procedure whereby an impaired cornea of the patient is replaced by a healthy cornea from a donor for gaining the lost vision.

Q How quickly should the corneas/eyes be removed after death?

A. Corneas/eyes should be removed within 6 hours of demise.

Q. Is it necessary to transport the donor to the hospital after death for donating eyes?

A. No. The eye bank personnel will go to the donor’s residence and remove the eyes. The procedure takes approximately 20 to 30 minutes.

Q. Do cataracts or the use of spectacles render the corneas unfit?

A. No. Both these conditions relate to the lens of the eye and not the cornea.

Q. Does eye donation disfigure the donor’s face?

A. No. The removal of corneas/eyes does not cause disfigurement.

Q. Is there any delay in funeral arrangements?

A. No. Tissue procurement is performed within 20 to 30 minutes. Therefore family members of the deceased may proceed as planned with funeral arrangements.

Q. What conditions render corneas unfit for donations?

A. Corneas of persons suffering from AIDS, jaundice, rabies, syphilis, tetanus, septicemia and viral diseases are considered unfit for donation.

Q. What about diabetes or hypertension?

A. Even donors with these conditions can donate their eyes.

Q. Does the human body reject the transplanted donor cornea?

A. A cornea does not have direct blood supply. Therefore the risk of rejection is very low. If rejection occurs, it can be suppressed by timely medication.

Q How will the donated eyes be used?

A. After the cornea is removed from the whole eye, it is evaluated and then supplied to the eye surgeon for use in a patient.

Q. Is there any use of corneas that are for some reason not utilised for surgery?

A. Corneas that are rejected for technical reasons may be used for research or education purposes.

Q. Will the donor or recipient family be told who donated or received the cornea?

A. No. The Donor - recipient information is maintained confidential.

Q. Will the donor family be given fees?

A. No. It is illegal to buy or sell human eyes, organs or tissues. Any cost involved with cornea retrieval is borne by the eye bank.

JIPMER Eye Bank Statistics: