Aravind Eye Care Systems

Training Schedule for Eye Donation Counsellors

Day I
Introduction and o rientation to Aravind Eye Hospital
Tour of p aying and f ree hospital, LAICO and Aurolab
Orientation to Rotary Aravind International Eye Bank – staff, overall functions

• Corneal blindness – magnitude
• Eye b anking scenario in India
• Objectives of the e ye bank
• Functions and Procedures

Job description of the Grief Counselor

Day II
Anatomy and p hysiology of the e ye
Cornea and its functions

• Diseases of the cornea
• Other associated conditions of the eye
• Cornea clinic observation (out- patients)
  • patient conditions
  • surgery and other conditions for corneal blind
  • Observation and i nterview with corneal transplant recipients (cornea ward).

Day III
Hospital Cornea Retrieval Programme – Introduction

Process involved in HCRP
Success stories of HCRP
Role of the e ye d onation counselor
Expectations from the e ye d onation counselor

Day IV
Introduction to g eneral counselling

• Counselling techniques
• Difference between g eneral counselling and g rief counselling
• Methods to approach and motivate a donor family
• Obtaining consent

Observation at counselling department – Aravind Eye Hospital

Day V
Documentation in HCRP
Introduction to various forms used in HCR process

• Daily report
• Motivation approach <if this is not a form, to be placed as a separate point after monthly report
• Case summary
• Monthly Report

Discussion on some of the general articles on obtaining consent from families.

Day VI
Feedback and d iscussion – clarification of doubts

Frequently asked questions about eye donation

1. What is an eye bank?
The eye bank is a nonprofit organization and obtains, medically evaluates and distributes eye which are donated by humanitarian minded citizens for use in cornea transplants, sclera reconstruction, research and education. To ensure patient safety, the donated eyes and the donor’s medical history are evaluated by the eye bank staff in accordance with the Eye Bank A ssociation of America’s (EBAA) strict medical standards.

2 . Why should eyes be donated?
Donated human eyes and corneal tissue are necessary for the preservation and restoration of sight and are used for transplantation, research and education. Over 90% of more than 41,300 cornea transplant operations performed each year successfully restore vision to persons suffering from corneal blindness.

3. Who can be an eye donor?
Practically anyone. Cataracts, poor eyesight and age do not prohibit you from becoming a donor. Prospective donors should indicate their intention on donor cards and driver’s licenses. Perhaps the most important single thing you can do is make your next of kin aware of your wishes to make sure they are carried out.

4. How can I become a donor?
The most important action you can take to ensure you will be a donor is to tell your family and legal representative. Most states now require that families be offered the option of donation when a loved one dies. Families may give consent for donation. It is most helpful if they know how you feel in advance. A donor card can serve as an indication to your family, your legal representative and hospitals of your intention to be an eye donor.

5. What is the cornea?
The cornea is the clear surface at the front of the eye and is the main focusing element. Should the cornea become cloudy from disease, injury, infection or any other cause, vision will be drastically reduced.

6. What is a corneal transplant?
The corneal transplant is a surgical procedure which replaces a disc-shaped segment of an impaired cornea with a similarly shaped piece of a healthy donor cornea. More than 90% of corneal transplant operations successfully restore the recipien's vision.

7. Can the whole eye be transplanted?
No. Only the cornea and the sclera (white part of the eye) can be transplanted. The whole eye can be used for valuable research into eye diseases, treatment and education.

8 . How prevalent is corneal transplantation?
Corneal transplants is one of the most frequently performed human transplant procedure. In 1991 there were more corneal transplants than all other organ transplants put together . In the last 30 years, more than 500,000 corneal transplants have been performed, restoring sight to men, women, and children ranging in age from nine days to 103 years.

9 . How soon after donation must a cornea be transplanted?
Corneal transplant is usually performed within four days after donation, depending upon the method of cornea preservation.

10 . When does the donation take place?
The surgical removal of the eye tissue is performed soon after the time of death, thus ensuring that the tissue is in the best possible condition for transplant. This also makes sure that the funeral arrangements are not delayed in any way. Because the removal causes no disfiguration, an open casket is still an option for the donor family.

11. Will the quality of medical care be affected if one is known to be a donor?

Strict laws protect the potential donor. Legal guidelines are to be followed before death can be certified. A physician certifying a patient’s death cannot be in any way involved with eye procurement or with the transplant.

12 . How is the donor suitability determined?
Potential donors are carefully screened for medical suitability and high risk factors. HIV, hepatitis B and syphilis tests are run before any tissue is released for surgery. Should any tissue be deemed unsuitable for transplant, the information is then scrutinized for the possibility of use for research. Our primary concern is for the safety of the potential recipients, eye bank staff and researchers.

13 . How does research and education benefit from eye donation?
In addition to corneas used for surgical procedures, more than 35,000 eyes are used annually for research and education. Research into glaucoma, retinal disease, complications of diabetes and other sight disorders benefit from donations because many eye problems cannot be simulated only human eyes can be used. These studies advance the discovery of the causes and effects of specific eye conditions and lead to new treatments and cures.

14 . Are there religious conflicts to eye, organ or tissue donation?
No. Donation is a gift of life or sight to others. As such, eye, organ and tissue donations are consistent with the beliefs and attitudes of major religions.

15 . Is there any delay in funeral arrangements?
No. Eye tissue is procured within hours of death, so families may proceed as planned with funeral arrangements.

16 . Will eye donation affect the appearance of the donor?
No. Great care is taken to preserve the appearance of the donor. . Families may even hold a viewing and have an open casket ceremony.

17 . Will the donor’s family pay or receive any fees?
No. It is illegal to buy and sell human eyes, organs and tissues. Any costs associated with eye procurement are absorbed by the eye bank.

18 . Are the recipients informed of the identity of the donor?
No. Donor anonymity is strictly preserved by law.

19 .What are the benefits to a donor family?
In addition to fulfilling a loved one’s wishes, donation can offer a comfort feeling to the grieving family. Just the knowledge that, a small part of their beloved is going to help someone to see the world, becomes a matter of great consolation to the Donor family

20. What is the role of the grief counselor?
A grief counselor is the liaison between the donor family and the eye bank. The counselor’s role is to make the family members aware of eye donation, motivate them and get their consent for eye donation.