However, the only cornea surgeon being on EoL is an issue that the eye bank faces currently 

Eye Bank: Despite the opening of an eye bank at the Thimphu referral hospital about two years ago, no cornea transplants could take place so far with the only cornea surgeon gone on extraordinary leave.

Although the hospital’s ophthalmology department is well equipped to conduct cornea transplants, hospital authorities said that cornea transplant could not take place without the surgeon who is on a two-year extraordinary leave. The surgeon is on extraordinary leave until July next year.

However, only 91 people have pledged to donate their corneas so far since October 2014 when the eye bank opened, which health officials attribute to strong religious beliefs.

Ophthalmologist Dr Ngawang Tenzin said there are about 230 patients registered for cornea transplants so far this year and the figures are increasing every year.

Dr Ngawang Tenzin said that one of the leading causes of blindness in Bhutan is corneal infection as a result of trauma to the eyes such as from agricultural works, among others. “Cornea infection is caused by any minor infection to the eye which if not treated immediately leads to corneal blindness,” he said.

Corneal blindness occurs from infections and injuries that scar the cornea, the glassy, transparent, dome shaped membrane, which covers the black part of the eye. To treat corneal blindness, corneas are required for which the demand for corneas was expected to be met at home with the opening of the eye bank.

Themed “No more corneal blindness,” the opening of eye banking services coincided with World Sight Day and marked the start of eye donations in the country. The eye banking service was required to collect and store corneas safely. A 2009 study has found that there are 10,000 people, who are completely visually impaired from corneal blindness while 15,000 are visually impaired in one of their eyes. There are 27,000 people with shrunken eye globes in the country.

Eye bank officials said that the 91 people who have pledged to donate their corneas are all aged below 50 years.

Singye Namgyel, 25, from Lhuentse is among the 91 donors who have pledged to donate their eyes.

Singye Namgyel said he decided to donate his eye to help someone regain his or her eyesight. “When I leave, I want to be remembered for something,” he said, adding that he heard of the eye bank through a friend who had also pledged to donate his eyes.

Kinley Wangmo, 42, a housewife also pledged to donate her eyes last year as soon as she heard of it on national television. “Not many people are aware on how it’s done which is why people hesitate,” she said, agreeing that more awareness was required. “There is no clear information on the procedures from health officials which also adds to the issue.”

Officials said that as people still hesitate given strong religious beliefs that bodies not be touched after death, more awareness is needed for people to come forward. They said religious personnel should talk about eye bank and  lead  as example by donating to encourage donation of corneas.

Since 2008, 34 patients have received cornea transplants. Although donors should be free from HIV/AIDs infection and have no past history of injury or trauma to their eyes, eye bank officials said that for now they are just accepting donors without considering such criterion to encourage more donors. Corneas need to be harvested within six hours after death, as after six hours the cornea would become opaque.  The process of harvesting the cornea would not disfigure the eye.

Anyone willing to donate their eyes after death can walk into the hospital with a kin as witness to pledge to donate their eyes. Forms are also available on the hospital website.

Meanwhile, although the Tilganga institute of ophthalmology has also promised to support the hospital with at least two corneas a month since 2014, the hospital is yet to receive it.

Dr Ngawang Tenzin said that the eye bank still receives corneas from Nepal as and when the institute can spare based on goodwill as no memorandum of understanding has been signed.

Health officials said that cornea donations are not organ donations and that the cornea, which is avascular, is immune privilege.  This means, it has no immune cells and, unlike kidneys, which can be rejected by the body, the cornea tissue does not get rejected.

Kinga Dema