India faces a critical public health issue with corneal blindness emerging as a leading cause of vision impairment. The Health Ministry is advocating for an “opt-out” system for cornea donation, aiming to increase the number of available corneas for transplantation. This shift from the current “opt-in” model is expected to enhance donation rates , addressing the urgent need for corneal transplants in the country.
About Corneal Blindness
Corneal blindness is primarily caused by diseases, injuries, or infections that damage the cornea, the eye’s transparent front layer. Notably, around 37.5% of blindness cases in individuals under 50 are attributed to this condition. The National Rapid Assessment of Avoidable Blindness Survey indicates that 8.2% of blindness in those over 50 is also due to corneal issues. With approximately 50,000 new cases annually, the demand for corneal transplants far exceeds the current supply.
The Need for Corneal Transplants
India requires about 100,000 corneal transplants each year to meet the demand. However, only around 50% of this need is met, with 32,414 donations recorded in 2022-23, an important drop from pre-pandemic figures. This discrepancy marks the urgent need for a robust cornea donation framework to save the sight of many individuals affected by corneal blindness.
Proposed Opt-Out System
The proposed opt-out system presumes consent for organ donation unless individuals or their families explicitly refuse. This model has been adopted successfully in several countries, leading to increased donation rates. Medical experts believe that this approach preserves the autonomy of individuals while boosting the availability of corneas for transplantation.
Benefits of Cornea Donation
Corneas can be harvested without the need for blood supply, making the process less invasive and more straightforward. They can be collected up to six hours post-mortem, and the procedure does not alter the deceased’s appearance, alleviating concerns from families. Furthermore, corneas do not interfere with medico-legal investigations, making them easier to retrieve in various circumstances.
Who Benefits from Cornea Transplants?
Individuals suffering from degenerative corneal diseases, injuries, or infections that are resistant to treatment are prime candidates for cornea transplants. The procedure can restore vision and improve the quality of life for these patients.
Improving Cornea Utilisation
To maximise the potential of donated corneas, experts advocate for a nationwide network of eye banks and retrieval centres. This would facilitate the sharing of corneas between institutions, ensuring that usable corneas reach patients in need, regardless of their location. Innovative techniques, such as dividing corneas for multiple transplants, are also being explored to enhance utilisation rates.
Government Initiatives
The National Organ and Tissue Transplant Organisation (NOTTO) is working towards establishing a national registry and coordination network for cornea donations, akin to existing systems for other organs. The government is also considering developing cost-effective preservation mediums to further support cornea donation efforts.
Questions for UPSC:
- Discuss the implications of implementing an opt-out system for organ donation in India.
- What are the primary causes of corneal blindness in India, and how can they be addressed?
- Evaluate the role of eye banks in improving corneal transplant rates.
- How can public awareness be enhanced to promote cornea donation?
- Analyze the potential benefits and challenges of a national registry for organ transplantation.
