OP4.{8,10} | Eye Donation, Eye Banking and Deceased Eye Preservation Counselling — Summary & Reflection

KEY TAKEAWAYS

Eye donation is exclusively from deceased donors — living corneal donation is ethically and surgically not performed. The eye banking process: death notification → family consent → immediate moist chamber preservation → retrieval (corneoscleral rim excision) → evaluation (specular microscopy, serology) → preservation → distribution.

Preservation media: McCarey-Kaufman (MK) medium (4°C, 48–96 hours), Optisol-GS (4°C, up to 14 days — current India standard), organ culture (31–37°C, up to 4 weeks — European standard).

Absolute contraindications: HIV, hepatitis B/C (active), rabies, CJD/prion disease, active systemic septicaemia, anterior segment melanoma. Diabetes, hypertension, age, and most systemic diseases do NOT preclude donation.

Donor family counselling: compassion first, inform don't pressure, address myths (no blindness of relatives, no disfigurement, no religious prohibition in major faiths, no funeral delay), explain moist chamber preservation for interim care.

India: ~750 registered eye banks under THOA 1994; EBAI apex body; supply gap of ~100,000+ corneas/year; National Eye Donation Fortnight August 25 – September 8.

REFLECT

You have just studied the most important public health communication skill in ophthalmology. Most ophthalmologists and physicians avoid donation conversations because they feel uncomfortable bringing it up with a grieving family. Reflect: what makes this conversation difficult for you personally? Is it the timing, the potential for refusal, the fear of seeming insensitive? Now consider: the family of a patient who has just died, in the right clinical context, can experience a donation decision as something meaningful — a way for their loved one's death to give another person sight. How does reframing the conversation — from 'asking for something' to 'offering an opportunity' — change how you would approach it?