11 states, Union Territories have no functional eye banks, reveals RTI

According to the response to an RTI application filed by Madhya Pradesh-based activist, there are a total of 320 functional eye banks in the country

Eleven states and Union Territories, including Goa and Jammu and Kashmir, have no functional eye banks, according to official data.

Doctors, however, underlined that such banks alone don't serve the purpose as there is an increased demand for eye donors especially in view of the Covid-19 pandemic which exacerbated the situation.

According to the response to an RTI application filed by Madhya Pradesh-based activist Chandra Shekhar Gaur, there are a total of 320 functional eye banks in the country.

Eleven states and Union Territories -- Andaman and Nicobar Islands, Arunachal Pradesh, Dadra and Nagar Haveli, Daman and Diu, Goa, Jammu and Kashmir, Lakshadweep, Manipur, Meghalaya, Nagaland and Sikkim -- have no functional eye banks, it said.

Dr Manisha Acharya, the medical director of eye bank at Dr Shroff's Charity Eye Hospital, said there are a total of 750 eye banks in India, but only some of them are fully functional, well-equipped, and responsible for 80 per cent of cornea collections in the country.

"A nationwide eye banking network is the need of the hour, with one well-equipped eye bank having trained professionals/counsellors affiliated with eye collection and retrieval centres to ensure better utilisation. This could be a solution because establishing an eye bank requires large investments and approval from numerous government regulatory bodies," Acharya told PTI.

States such as Tripura, Uttarakhand and Mizoram have just one functional eye bank, according to the data.

Maharashtra has the highest number of functional eye banks at 74 followed by Uttar Pradesh at 41, Karnataka at 32 and Gujarat at 25.

Dr Anita Sethi, Director, Ophthalmology, Fortis Memorial Research Institute, Gurgaon said the issue is the lack of awareness around eye donation.

"People are not aware of what an eye donation entails. And unless we have more eye donations, more people coming forward to donate their eyes, we can have hundreds and hundreds of eye banks. So, we should be spreading awareness of eye donation more than about an eye bank because an eye bank is just a place where the donated eyes are processed," she said.

Sethi said focus must be on increasing the awareness and number of eye banks in more populated states and Union Territories so there could be a match between where we can get the tissue from and where it needs processing.

"So, if you talk about very remote places like Andaman and Nicobar Islands, Daman & Diu, the population there is so less now. So, having an eye bank installed there would not really be a significant idea as to run an eye bank we do need specific equipment like specular microscope etc and technology as well. Also, there must be enough population so you can have a decent number of donations to make it viable to have an eye bank over there," she added.

Dr Parul Sharma, director -Ophthalmology, Max Hospitals, Delhi, also said that just setting up the eye bank for the corneal tissue processing is not enough till people don't actually make the calls and step up for the donation voluntarily.

According to the National Blindness and Visually Impaired Survey (2019), there are about 48 lakh people suffering from blindness and corneal blindness is the second most common type of blindness after cataract that impacts around 25,000 people every year, Acharya said.

Only corneal blind people are benefitted from donated eyes. Corneal blindness is the loss of sight due to damage in the tissue covering the front of eye called cornea.

According to the reply to the RTI query, 3,35,940 cornea collections have taken place since 2016-17, while 1,56,419 corneal transplantations have taken place since 2016-17.

Acharya said if the infection is severe and progresses to the advanced stage, scar formation occurs, which can obliterate vision, and the person may require a transplant to regain vision.

The challenge in treatment of corneal blindness is in providing follow-up care to patients who live in remote areas, she said.

People from remote areas found it difficult to return for follow-up appointments after their surgery. These challenges necessitate increasing donation drives and establishing well-equipped eye clinics in remote locations that may not perform critical surgeries but can consult patients for follow-up care, she said.

Sethi stressed the need for increasing the number of eye donations.

"We have far more corneal people waiting for corneal laminar. We are adding almost the same amount that we are able to do, we are adding those many each year. So, we have much less tissue, and we are unable to do as many transplants as we should be doing because of the lack of tissue," she said.

Sethi added that the 'other problem that we faced was Covid-19' as during this phase, the eye donations and our eye utilizations went down drastically.

"Owing to Covid-19, we were not able to even collect the tissues and the banks got depleted further. So, Covid also has added to an increase in the waiting list. Now, we are trying to get more donations and be able to fulfil the waiting list that is around," she said.

Sharma said in India, there is a wide gap between the need and availability of the corneal tissue which has increased many folds after the pandemic situation.

Given the situation of the pandemic and the risk of the virus transmission in the Covid bodies, obviously Covid and other deaths, "we didn't know whether they host Covid and are not suitable enough for further transplant situations", she said.

So, the gap between the need and the availability of corneal tissue just became wider in the pandemic, Dr Sharma said.