Published On : Mon, Aug 24th, 2015

Urgent need to revamp Post-Mortem exams rules, claims Dr. Ashok Madan

 

  • Let eye-donation be our nation’s tradition, says Dr.Ashok Madan ·
  • India is home to about 1/3’d or 1.5 crore of the total 4.5 crore blind people in the world.
  • Department of Ophthalmology of Government Medical College and Hospital are observing the 30th Eye Donation Fortnight from August 25, 2015 to September 8, 2015.

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Nagpur
: In what could be mentioned as sheer red-tapism and the ill-effects it has on various facets of our life, Professor and Head of the Department of Ophthalmology Dr A H Madan claimed that they are losing many freely donated eyes because of certain unwritten laws that prevail in the legal system. He claimed that in many cases, especially that of Medico Legal Cases where the patient has died in some accident and the family members have agreed to donate the eyes, the cops and the forensic department do not allow the removal of the eyes simply because the post-mortem examination is not completed. On many occasions, the post-mortem is conducted after 12 hours, which render the donated eyes useless. The donated eyes have to be removed within 6 hours from the death of the person.

While the cops’ claim that officially they can’t permit the eyes to be removed till the post-mortem is completed, the Forensic Department has its own priorities or workloads. They will not permit the removal of any organ till they finish their post-mortem examination.

Dr Madan went on to add, as, if the eyes do not have anything to do with the cause of death or where the eyes are playing any role in revealing the cause of the death, so what is the harm in removing the eyes, because this could help a blind man get his vision. The red-tapism is preventing valuable number of eyes to go to the beneficiaries.

Dr Madan claimed that on many occasions even when the person has signed the donor form and has agreed to donate his eyes, his family members refuse to allow the doctors to remove the donated eyes.

There are several other factors that are making the donated eyes unfit for use. Some of them include travel time to retrieve a donated eye, or some minor mistakes which render the eyes useless. While explaining the plight of the Ophthalmology department, Dr Madan said, they do not have a vehicle, they do not have money to pay for the diesel, they do not have proper refrigerated cases in which they can transport the eyes and there are various other factors which render many donated eyes useless. The State Government should provide a significant amount for the valuable service they render to many blind citizens.

While speaking to Nagpur Today, President of Bar Association Ashish Jaiswal said that technically there should not be any problem if the eyes are removed before conducting the post-mortem. He added, clear-cut laws and rules have to be formulated so that such valuable organs can be of use to some really deserving persons. He added that the Nagpur District Bar Association will play a pro-active role in getting the law formulated so that the blind from the state can get their eye-sight. He added that since this is a state prerogative, they can easily bring about some amendment so that it can facilitate in the Ophthalmic Department performing their role well without having to face any red-tapism.

30th Eye Donation Fortnight
The Department of Ophthalmology of Government Medical College and Hospital are observing the 30th Eye Donation Fortnight from August 25, 2015 to September 8, 2015.In a press meet organized in the Department of Ophthalmology, Professor

and Head of the Department of Ophthalmology Dr A H Madan addressed the media personnel. He said that Cataract used to be the main cause of 90% of blindness in India about 20 years ago. However the percentage has come down to 60 %.  Cases of Cataract form the highest, i.e. 62.4% of all instances of blindness worldwide. However since Cataract can be successfully treated with surgery, this percentage is slowly coming down.

Corneal blindness is another leading cause of blindness in the world, contributing to about 25% of the cases. This type of blindness which again can be prevented and treated, is still mostly neglected in India due to multiple reasons. Dr Madan claimed that in recent times, they are getting more cases of children suffering from Corneal Blindness. Corneal Blindness accounts for approximately 85 lakh cases in the world with nearly 30 Lac cases in India itself. About 25,000-30,000 new cases of Corneal Blindness are added every year to this number. A very sorry aspect about

Corneal Blindness is that of the total cases, 25.30% of the instances are in children. Prevalence of Corneal Blindness is increasing every year due to causes like deficiency of Vitamin A in diet, injuries due to chemicals / occupation / accident, infections, congenital causes and in some cases even due to improper care of post-cataract surgery. An estimated 2.5 lakh corneal transplants are required annually to clear all backlog cases. But in India the number of eye donations is just about 55,000 per year and out of this only about 60% can be used for conical transplants. Only about 10 to 15% of the 560 odd no. of eye banks in India are efficiently functioning.

There are about 75,00,000 deaths in India annually. However the no. of eyes donations is only about 23,000, i.e. only about 0.3 – 0.4% of the population is

donating eyes after death. Thus annually there are a total of about 55,000 eyes which are collected through donations and only 15,000-20,000 corneal transplants take place each year in India.

The statistics show an acute lack of awareness regarding eye donations in India. Misconceptions and preconceived notions including traditional/religious beliefs, cultural stigma, lack of motivation and lack of awareness about the facts regarding eye donations amongst the relatives of the deceased play a major role in the surprisingly low number of eye donations in India.

Though awareness about eye donations is on the rise, much needs to be done to bridge the huge gap. Some solutions which should be implemented immediately to increase the instances of eye donations and corneal transplants are:

  1. To increase awareness amongst people to donate their eyes, word of mouth dissemination of information about eye donations along with proper recognition / felicitation to the relatives of the deceased should be encouraged.
  2. There should be proper training imparted to paramedical staff to preserve the donated eyes so that they can be used successfully for the purpose of corneal transplants.
  3. Proper training for the doctors in the field of corneal transplants so that one cornea can be used for treatment of 2 to 3 persons using the latest technologies.
  4. Sufficient facilities in the institutes and the hospitals conducting corneal transplants so that the corneas can be used in the proper way.
  5. Artificial corneas for the purpose of corneal transplants are currently under the research and development phase.
  6. Eye banks should be having proper infrastructure including uninterrupted power and sufficient funds for the purpose of conducting corneal transplants.
  7. Registration of eye banks belonging to government institutions must not be mandatory.
  8. A law mandating compulsory donation of eyes in cases of accidental death may be formulated.