Corneal Blindness
Corneal blindness is a condition where the cornea (the clear outer layer of the eye) becomes opaque, leading to loss of vision.
It can be caused by various eye disorders that affect the cornea’s transparency, leading to scarring and blindness.
Main Causes of Corneal Blindness
Infectious Causes: Bacteria, viruses, fungi, and protozoa can infect the cornea, leading to scarring and vision loss.
Injuries or accidents can damage the cornea and lead to blindness.
Contact Lenses & Steroid Use: Overuse of contact lenses or improper use of steroid medications can increase the risk of corneal blindness.
Other Diseases: Conditions like trachoma, dry eye disease, keratoconus, and non-infectious uveitis can also cause corneal damage.
Treatment Options
Corneal transplantation (also known as a corneal graft) is the most common treatment, where a damaged cornea is replaced with a healthy one from a donor.
Eye banks play a crucial role in corneal transplantation by harvesting, processing, and storing donated corneas for use in surgeries.
New techniques like lamellar keratoplasty (partial corneal transplant) and bioengineered corneas are being developed to address donor shortages and improve outcomes.
Corneal Blindness Crisis in India
Corneal blindness is a major cause of vision loss in India, affecting over 1.2 million people, with many cases being preventable or treatable through corneal transplants.
India needs around 1,00,000 corneal transplants annually, but only 30% of this demand is currently met.
India has a shortage of eye banks (only 12-14 functional) and corneal surgeons (only about 500), which hampers the availability of corneas and timely surgeries.
'Presumed Consent' Proposal
Presumed Consent policy suggests automatically treating all eligible deaths in hospitals as cornea donors unless the deceased has explicitly opted out.
It aims to streamline the donation process, reduce delays, and increase the availability of corneas.
By eliminating the need for family consent in each case, this approach could increase the number of corneas available for transplantation and help address the corneal blindness crisis.
Challenges with Presumed Consent
Critics argue that presumed consent may undermine the importance of voluntary consent
Thus create distrust in the donation process, which relies on a healthy partnership between the public, medical professionals, and policymakers.
Countries with the best organ donation rates, such as Spain and the U.S., don’t use presumed consent but employ a "Required Request" system, where families are still formally asked for consent, leading to high donation rates.
Required Request and Grief Counseling
Hospital Cornea Retrieval Program (HCRP): This model involves grief counselors approaching the families of deceased patients to gently encourage corneal donation, ensuring consent is obtained.
In regions like Andhra Pradesh, Telangana, and Odisha, there are no waiting lists for corneal transplants due to this approach.
The "Required Request" model not only increases corneal donations but also provides closure to grieving families, who often find comfort in knowing their loved one’s eyes help restore someone’s vision.
COMMENTS