Two years ago, sickle cell robbed him of his vision. Visual and hearing impairment followed in quick succession, and the right treatment proved elusive for 29-year-old Manish Mahadev Bhande. But Bhande has managed to get his sight back, thanks to an eye transplant at the right time.Similarly, Mohammed Jameel and Ishwardevi Mehta, both in their mid-sixties, were suffering from corneal opacity (blindness on eyes). Both can now see the world after successful eye transplants at the Indira Gandhi Medical College (IGMC), Nagpur, last month.But they are among the fortunate few. A national programme for tackling blindness notwithstanding, the numbers tell the story: 12.57 million blind in both eyes and over 8 million blind in one eye. The government hasn't met its target of bringing down blindness under its National Programme for Control of Blindness from 1.4 per cent to 0.3 per cent by 2000.In the Vidarbha region, the two biggest State government-run hospitals - the Government Medical College (GMC) and the Indira Gandhi Medical College - have all through failed to focus on eye donation. The NGOs too feared to tread in the area, seeing it as a thankless job. Doctors at government hospitals did not encourage eye donation as they thought it to be tedious. Transplantations were rare. But things started changing for the better in 1987, when the Mahatme Eye Bank and Eye Hospital (MEBEH), run by the local SMM Eye Welfare Charitable Trust, was set up.Slowly, surely, the voluntary donation movement is picking up momentum. Ten years ago, there were no transplantation facilities, no eye collection centres and calls from relatives of the dead were left unattended. Today, Bhandara, Yavatmal, Gondia, Amravati and Akola in Vidarbha have collection centres from where eyeballs are sent to Nagpur, which has about 5-7 eye banks. These eyeballs are used for keratoplasty on blind patients registered with the banks. The transplantation is, however, done only in Amravati and Nagpur.Dr Vikas Mahatme, treasurer of MEBEH, who has conducted over 60 transplants in the last two years, said government hospitals could play a role in promoting eye donation. Death certificates issued by hospitals should mention whether the eyes of the dead person are to be donated or not, he suggested.The major impediment in the eye donation movement was The Bombay Corneal Act of 1957, which had made the donor's signature on the donor card mandatory. Today, even if relatives of the dead give their consent, eyes can be retrieved.Another hurdle is the Human Organ Transplant Act, into which eye donation has been incorporated since 1994 in response to irregularities in human organ transplants. Argues Dr Mahatme: ``How can a fraud be committed when the eyes are retrieved from dead persons in the presence of their relatives?''Dr Suhas Mahurkar, medical director of Central Eye Bank, Hospital and Research Centre (CEBHRC), Nagpur, said the cause has taken a backseat due to lack of awareness and technical problems. His institute plans to launch an ophthalmic technician course for students, as well as a mobile eye donation bank. It has urged the state government to launch a federation of eye banks in Nagpur. ``This will boost eye donation in the region,'' Dr Mahurkar says. His centre has so far done over 35 eye transplants since its inception in 1992.Though the percentage of cornea collection is more than the actual eyeballs being transplanted, the gap is due to the non-matching of the tissue-typing of eyeballs. Eyeballs which fail to match or are deemed medically unfit are kept for therapeutic purposes. But they cannot be stored for more than seven days even under appropriate storage conditions.Dr P.J. Dikkar, HoD of the Eye Department, IGMC, said due to poor public response, eye donation programmes had ground to a halt. At the moment, there are over 3,400 persons who have pledged to donate eyes at IGMC.Senior eye surgeon at IGMC Dr H.N. Chhabrani said the eye donation movement has received a setback as there are technical and financial hurdles. ``Before retrieving eyes, a blood test is to be done with the help of an AIDS kit which is a costly affair, at least in government-run hospitals,'' he said. ``During 1990-97, the IGMC did over 68 keratoplasties, but the figure has now drastically fallen to just four a year,'' Dr Chhabrani said.To boost the eye donation movement in Vidarbha, ORBIS, a non-profit organisation working for the elimination of blindness, is landing in Nagpur on an eight-day tour beginning September 23. Jason Woody, executive director, Central Florida Lions Eye Bank, Tampa, and Dr Keeneth Goins, corneal surgeon from Chicago, USA, will address various seminars and workshops in the city.ORBIS and the Mahatme Eye Bank are jointly organising a public forum for volunteers, NGOs and activists engaged in eye donation. Nearly 70 eye specialists and surgeons from Vidarbha and Madhya Pradesh are expected to attend the programme. The key, though, is still in the hands of voluntary donors.
