Our Summary

This research paper is about the problem of corneal blindness in India, a condition that can often be avoided. To tackle this issue, a multi-layered approach is needed, which includes medication, optical rehabilitation and corneal transplantation. One of the main challenges is the lack of donor eyes for corneal transplantation. The Government of India is supporting eye banks with funding, but more needs to be done. This includes raising awareness and education about the issue, ensuring community involvement, and improving medical standards and training. To reach the goals set out in the ‘Vision 2020: Right to Sight- India’ initiative, India needs at least 20 eye bank training centers, 200 eye banks that can perform corneal transplants, and 2000 eye donation centers. This can be achieved by strengthening the Hospital Cornea Retrieval Programme in both private and government hospitals, ensuring all eye banks and donation centers meet high medical standards, and making the process of eye donation easier to encourage more people to donate.

FAQs

  1. What are the main challenges faced by India in tackling corneal blindness?
  2. What measures are being taken by the Government of India to address the issue of corneal blindness?
  3. What are the goals set out in the ‘Vision 2020: Right to Sight- India’ initiative?

Doctor’s Tip

One helpful tip a doctor might tell a patient about corneal transplant is to follow all post-operative instructions carefully, including taking any prescribed medications as directed, attending follow-up appointments, and avoiding rubbing or putting pressure on the eyes. It is also important to protect the eyes from injury and avoid activities that could potentially damage the new cornea. Additionally, maintaining overall eye health through regular eye exams and following a healthy lifestyle can help ensure the success of the corneal transplant.

Suitable For

Patients who are typically recommended for corneal transplant include those with:

  1. Corneal scarring or clouding due to injury or infection
  2. Keratoconus, a condition where the cornea thins and bulges outwards
  3. Fuchs’ dystrophy, a condition where the inner layer of the cornea deteriorates
  4. Corneal degeneration or thinning
  5. Corneal ulcers that do not respond to medication
  6. Corneal swelling (edema) that affects vision
  7. Previous corneal transplant failure

Corneal transplantation is usually recommended when other treatments, such as medication or contact lenses, are not effective in improving vision or reducing symptoms. The decision to undergo a corneal transplant is made on a case-by-case basis, taking into consideration the patient’s overall eye health and visual needs.

Timeline

Before corneal transplant:

  1. Patient experiences vision loss or impairment due to conditions such as keratoconus, corneal scarring, or Fuchs’ dystrophy.
  2. Patient undergoes a comprehensive eye examination to determine the extent of the corneal damage and assess their eligibility for a corneal transplant.
  3. Patient is placed on a waiting list for a corneal donor tissue, as the availability of donor corneas can be limited.
  4. Patient may undergo pre-operative tests and evaluations to ensure they are in good health and suitable for surgery.

After corneal transplant:

  1. Patient undergoes the corneal transplant surgery, which involves replacing the damaged cornea with a healthy donor cornea.
  2. Patient may experience discomfort, blurred vision, and sensitivity to light in the days following the surgery.
  3. Patient is prescribed post-operative medications to prevent infection and promote healing.
  4. Patient attends follow-up appointments with their ophthalmologist to monitor the healing process and assess the success of the transplant.
  5. Patient undergoes rehabilitation and vision therapy to adjust to the new cornea and improve their visual acuity.
  6. Patient may need to use prescription eye drops or wear glasses or contact lenses to achieve optimal vision after the transplant.

What to Ask Your Doctor

  1. What is a corneal transplant and how does it work?
  2. What are the different types of corneal transplants and which one would be most suitable for my condition?
  3. What are the risks and potential complications associated with a corneal transplant?
  4. What is the success rate of corneal transplants and what are the factors that can affect the outcome?
  5. What is the recovery process like after a corneal transplant and how long does it typically take?
  6. Will I need to take any medications or follow any specific post-operative care instructions after the transplant?
  7. How long will the transplanted cornea last and will I need any additional surgeries in the future?
  8. What are the alternatives to corneal transplant if I am not a suitable candidate for the procedure?
  9. How many corneal transplants have you performed and what is your success rate?
  10. Are there any financial assistance programs or insurance coverage options available for corneal transplant surgery?

Reference

Authors: Gupta N, Vashist P, Ganger A, Tandon R, Gupta SK. Journal: Natl Med J India. 2018 Sep-Oct;31(5):283-286. doi: 10.4103/0970-258X.261189. PMID: 31267994