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Dear Readers,
This issue of Site news features a very important aspect of eye care which is eye banking. Diseases affecting the cornea are a major cause of blindness worldwide, second only to cataract in overall importance. Thought this condition is potentially treatable it is a sad fact that due to non availability of healthy cornea tissue many people continue to live in a world of darkness. We need to understand how as eye care providers we can link between the community, the eye hospital and the patient.

This issue provides an overview of the magnitude of corneal blindness and the potential need for eye banking services. We then delve into understanding about eye banking in different dimensions and the current scenario regarding eye banking. Resources related to maintaining standards in eye banking whether it is medical standards in eye banking or corneal preservation methods are also discussed. An issue closely connected to eye banking is that related to eye donation. E-links to eye banks are also provided.

This month we feature International Federation of Eye and Tissue Banks in the Organsiation Featured section.

Hope this issue will impart the resources which are worth to be read. Looking forward to come up with more resources in future.

We wish you an experience of learning that is very practical. Your feedback will let us know how we can imsprove. Please write in your feedback at eyesite@aravind.org. We look forward to your feedback.

We wish our readers an informative reading!

Happy Reading!

Regards,

Vision 2020 e-resource team
The Issue Features...
Eye Banking
Vol. 4 No. 8 August 2007
•   Magnitude of Corneal Blindness
•   Eye Banking
•   Global Eye Banking Scenario - In India
•   Medical Standards in Eye Banking
•  Corneal Preservation Methods
•   Eye Donations
•   List of Eye Bank
•   Weblinks
•   Featured Website
•   Talk To Us

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Diseases affecting the cornea are a major cause of blindness worldwide, second only to cataract in overall importance. The epidemiology of corneal blindness is complicated and encompasses a wide variety of infectious and inflammatory eye diseases that cause corneal scarring, which ultimately leads to functional blindness. In addition, the prevalence of corneal disease varies from country to country and even from one population to another.
     Ocular trauma and corneal ulceration are significant causes of corneal blindness that are often underreported but may be responsible for 1.52.0 million new cases of monocular blindness every year. Causes of childhood blindness (about 1.5 million worldwide with 5 million visually disabled) include xerophthalmia (350 000 cases annually), ophthalmia neonatorum, and less frequently seen ocular diseases such as herpes simplex virus infections and vernal keratoconjunctivitis. Because of the difficulty of treating corneal blindness once it has occurred, public health prevention programmes are the most cost-effective means of decreasing the global burden of corneal blindness.

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Eye banking in developing country is in its budding stage. Awareness regarding eye donation has gained momentum only during the last decade. Statistics of the overall collection of corneal tissues by them reveals only a marginally increasing trend in the collection. The challenge is to not only create eye donation awareness but to also dispel myths and misconceptions associated with it. If the myths are dispelled then it becomes easy to create awareness.
  • WHAT IS EYE BANKING?

  • Abstract:
    This article describes about the Eye bank, its operations, and functionalities and how the eye banks are operated as a network.

  • EYE BANKING - AN OVERVIEW

  • Abstract
    This presentation gives an overview about the eye banking service in India. It also lists out the infrastructure and Human Resource requirements in planning the International Eye bank. It also pasteurizes the international eye banking set up at Aravind Eye Care System.

  • NEED & FUNCTIONS OF EYE BANKS

  • Abstract
    This article lists out the need for eye banking in India, current eye Collection statistics of India, accreditation and legislation policies for setting up the eye banks at the local, national and the international level. It also suggests some strategies that could be followed for promoting the eye Banks.

  • EYE BANKING - NEED AND CHALLENGES

  • Abstract
    The purpose of this article is to provide an overview of the requirements for setting up an eye Bank in order to provide safe, high quality tissue that can be utilized for sight restoration as well as to review the basic strategies that have been employed for increasing eye donation. The eye bank set up by the Aravind Eye Hospital is used as a model to explain the various steps involved. Further, it also attempts to look at the major challenges, which is impeding the implementation of a successful eye-banking Programme in the developing world.

  • PERSPECTIVES IN EYE BANKING

  • Abstract
    This article summary describes about the work issues related to constraints in collection of donor eyes and strategies to overcome them, structure of eye banks and safe tissue retrieval techniques. It also tells in detail about the strategies that may be useful in overcoming these constrains is helpful.

  • REALISTIC TARGETS AND STRATEGIES IN EYE BANKING

  • Abstract
    This article tells in detail the current corneal blindness estimates by NPCB. This article also speaks about socioeconomic factors that cause the backlog of cataract blindness and some eminent plans that could follow to prevent it.

  • TRAINING GENERAL PHYSICIANS IN ENUCLEATION OF DONOR EYE

  • Abstract
    This article highlights the importance of having Eye Donation Centre, Need for training General Physicians in enucleating, Legislative aspect, Cornea Retrieval training programme for Physicians and about training curriculum.

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  • EYE BANKING FOR DEVELOPING COUNTRIES IN THE NEW MILLENNIUM

  • Abstract
    This article tells in detail about the current status of eye banking in the developing countries. It also tells about the need for organizations, and individuals to come forward and work towards promotion of eye donations, and procurement of eyes, in a country where home deaths are common, so as to try and address this need in the next millennium.
Eye Banking Scenario in India
In developing countries such as India, one has to develop a system that is effective, efficient and at once financially relevant. A 3-tier structure encompassing all activities of eye banking will address this issue rather well. The determinants will be the infrastructure and manpower available with a profile of functions covered. This system proposed the three tiers of eye donation centers, eye ban and eye banking training centre. These should be integrated and will not be effective in isolation.

Eye Bank
  • Eye bank is an institution that should provide a round-the-clock public response system over the telephone and conduct public awareness programmes on eye donation.
  • Co-ordinate with donor families and hospitals to motivate eye donation.
  • To harvest corneal tissue.
  • To process and evaluate the collected tissue.
  • To distribute tissue in an equitable manner.
  • To ensure safe transportation of tissue.
Hospital Eye Bank:
A Hospital Eye Bank in an institution that fulfills all the requirements and functions of eye bank except that it restricts collection of tissue within the hospital where the eye bank is located. Eye Bank Training Center (EBTC): All of the eye bank mission plus training for all levels of personnel in eye banking and research.

Eye Donation Center (EDC):
Eye Donation Center is affiliated to a registered eye bank, which should provide: (1) public and professional awareness of eye donation (2) co-ordinate with donor families and hospitals to motivate eye donation (3) to harvest corneal tissue and collect blood for serology (4) to ensure safe transportation of tissue to the parent eye bank.

Eye Bank Association of India (EBAI) Statistics

Institutional Life Members 467
Individual Life Members 478
Institutional Annual Members 63
Individual Annual Members 137
Corporate Members 19
Foreign Members 12
Total Members Registered with EBAI 1176
Total Eye Banks Registered with EBAI 505

Institutional Life Member  
South Zone 177
North Zone 77
East Zone 40
West Zone 114
Central Zone 59
Total 467

Institutional Life Member  
South Zone 125
North Zone 92
East Zone 67
West Zone 123
Central Zone 71
Total 478
  • EYE BANKING IN INDIA

  • Abstract
    This article tells in detail about the Current status of eye banking in India. It also tells in detail about how the donor eyes are collected through the NGOs and also suggests how this can be improved by creating awareness among the people for eye donation.

  • EYE BANKING--ARE WE REALLY UP TO IT IN INDIA?

  • Abstract
    This article tells in detail about the need for the Eye Banking in India. It also tells about the plan for setting up eye banks according to the population and how to effectively operate for collecting Donor eyes etc.

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Quality consciousness is fundamental to success of corneal transplantation. The practice of quality control in eye banking is possible only by institution of medical standards to be followed uniformly by every eye banking organization throughout the country.
     Medical standards have been developed to assure consistent and acceptable levels of quality, proficiency and ethics in dealing with eye tissue for transplantation. Also to define the minimum standards of practice in the procurement, preservation, storage and distribution on eye tissue for transplantation and research.
     Across the world, medical standards for eye banking are constantly being updated. The Eye bank association of America first adopted the medical standards document in 1980. These have formed the basis for eye banking standards in most countries with adaptations to suit regional influences. We have provided you with some articles which deal with medical standards in eye banking.

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Apart from the suitability of the donor tissue, the survival of the tissue after enucleation from a donor till the time of transplantation greatly depends on the preservation methods used. Unlike tissues such as bone or heart valves that may be extensively processed and altered from their natural state, corneas must be transplanted as a viable living tissue. Thus the aim of any current corneal storage technique is simply to maintain this living viable state while holding the cornea for the period between donation and transplantation. To enable us to achieve this aim various techniques have evolved over the past 30 years and are still evolving. Storage techniques are being used not only to store corneal tissue but also for preservation of sclera tissue. We have provided you with some of the resources which orient about corneal preservation methods.
  • CHANGES IN THE CORNEAL NA-K ATPASE LEVELS IN EYES STORED IN MOIST CHAMBER AT 4C

  • Abstract:
    This report deals with a chronological measurement of Na-K ATPase enzyme activity in human and bovine corneas stored in a moist chamber at 4C. It also tells about the preservation procedure of the Donor eyes.

  • DONOR CORNEAL TISSUE EVALUATION

  • Abstract
    This article provides a comprehensive review of all the aspects of donor corneal evaluation as practiced today worldwide. It also describes about the attention must be paid to the cause of death and ocular condition as several general and ocular diseases constitute contraindications for donor corneal usage.

  • A REVIEW OF METHODS FOR STORAGE OF CORNEAS FOR KERATOPLASTY

  • Abstract
    This article reviews the various methods used for the storage of the donor cornea for keratoplasty. The methods have been classified in terms of the duration of storage as (a) short term, (b) intermediate term (c) long-term and (d) very long-term.

  • RECENT ADVANCES IN CORNEAL TRANSPLANTATION

  • Abstract
    This article describes about the advanced recent technique that are followed while doing Corneal transplantation.

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The problem of corneal blindness is daunting. Several methods have been adopted by the eye bankers world wide to work towards combating corneal blindness. Despite increased public awareness about eye donation over the years, there is still an acute scarcity of donor tissues. The present supply of donor corneas falls short of the needs for sight restoring surgery. In order to reverse the situation, eye bankers have got to intensity their efforts to seek for new sources for donor tissues.

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In India
  • LIST OF EYE BANKS IN INDIA

  • Abstract
    Here is the list of eye banks in India which was developed by MedIndia.

  • LIST OF EYE BANKS - INDIA

  • Abstract
    You can view list of eye banks in India arranged as per the state and alphabetically. Click on a state you are interested in from the list, or view in alphabetical order.

  • NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS AND EYE AWARENESS


  • THE ROTARY ARAVIND INTERNATIONAL EYE BANK

  • Abstract
    The Rotary Aravind International Eye Bank seeks to provide a sustainable solution to the problem of corneal blindness, which affects 2.5 to 3.0 million persons in India. It collects, evaluates, processes and distributes viable corneal tissues to the needy. The Rotary Aravind International Eye Bank - Madurai is one of the 8 eye banks in the country affiliated to the International Federation of Eye Banks (IFEB), which stipulates stringent standards of quality for corneas used in transplants.

  • THE RAMAYAMMA INTERNATIONAL EYE BANK

  • Abstract
    Ramayamma International Eye Bank is a member of the International Federation of Eye and Tissue Banks (IFETB), USA, and the Eye Bank Association of India (EBAI). The RIEB has the infrastructure, facilities, and staff expertise to attend to the entire gamut of activities associated with eye banking, from core activities like cornea retrieval, evaluation and distribution, to wider functions such as training, research and the conducting of public awareness campaigns.
Other Countries FAQ's

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International Federation of Eye and Tissue Banks (IFETB)
TBI maintains a global outreach program, the International Federation of Eye and Tissue Banks (IFETB). Its mission is to reduce corneal blindness which afflicts more than 10 million people -- most younger than 30-- around the world.

In 1989, TBI extended its outreach globally with the founding of the International Federation of Eye and Tissue Banks (IFETB), a program designed to address the issue of corneal blindness worldwide. Corneal blindness is a major health problem in many countries outside of the U.S. In fact, 25% of all blindness is due to corneal disease, defects or trauma. Waiting lists for corneal transplants exist even in developed countries. In developing countries, millions remain blind due to lack of surgical quality corneas. The social and economic impact from this situation is profound.

The International Federation of Eye and Tissue Banks reduces corneal blindness by working in areas of the world where no effective eye or tissue banking program exists. It establishes and maintains a federation of transplant banks in cooperation with local resources. It helps distribute donor tissue for transplantation on an equitable basis without regard to race, religion, nationality or institution.

In some cases, IFETB builds transplant banks from the ground up. In other cases, it works with existing transplant banks to improve their programs. It trains personnel. It monitors medical standards, and the safety and quality of tissue and facilities. It helps distribute tissue. It serves as a conduit for information.

IFETB accredited eye banks reported 4,552 surgical quality corneas distributed for transplant in 1998. Last year, the IFETB welcomed its first tissue bank to the Federation. Since its establishment, the International Federation of Eye and Tissue Banks has returned thousands of men, women and children to fully productive lives.

Visit our website : www.tbionline.org

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