Eye transplants hit by Covid-19 storm

Fear of Covid-19 infection being passed on to recipients through transplanted eyes, the safety of retrieval and transplant teams, as well as reluctance of recipients to undergo surgery has practically shut down eye transplants in city

When officials at Nagri Eye Bank got a call that a family wished to donate the eyes of a deceased kin, they kept their fingers crossed. Fear of contracting coronavirus had ensured that the eye hospital, which had carried out 527 eye transplants in the past three years, was unable to carry out even one operation this year. But their prayers were answered: the deceased had got a Covid-19 test done just a day before his death. The RT-PCR result was negative, enabling transplants to restore colour and light in the lives of two patients who had suffered from corneal blindness.

The hospital receives at least 3-4 calls every week from people wanting to donate eyes. However, this is the first and only eye donation accepted by the hospital this year since lockdown was instituted at the end of March.

Currently, there are about 70 patients in need of eye transplants on the waiting lists of two major ophthalmology hospitals in Ahmedabad.

These patients, however, will have to wait for a while longer in order to be able to see clearly again as many hospitals are being forced to decline eye donations even from willing donors due to fear of spreading Covid infection.



Fear of Covid

Attending one such call for donation, doctors of M&J Western Regional Institute of Ophthalmology at BJ Medical College, which hosts DE Anklesaria Eye Bank – the largest in Gujarat, found out that the prospective donor had contracted Covid-19 a month earlier and had died of complications.


In another instance, a home retrieval call showed no cause of death and so the donation had to be declined. The fear of Covid-19 infection being passed on to the recipients, safety of retrieval and transplant teams, as well as reluctance of recipients themselves due to fear of Covid-19 has practically shut down eye transplants in the biggest city of Gujarat.

Dr Tejas Desai, Medical Superintendent of Nagri Hospital said, “We usually get 15-17 pairs of eyes per month and carry out 34 transplants. However, since lockdown, we have been able to retrieve only one pair of eyes. This has led to a complete shutdown of the transplant programme this year.”

Currently, there are more than 20 patients on the waiting list at Nagri Eye Hospital.

Similarly, against more than 135 eye transplantations that take place at M&J institute each year, only two were carried out this year as doctors could only accept one pair of donated eyes.

Dr Jagruti Jadeja, professor of Ophthalmology at M&J institute said, “There were already a number of restrictions on eye donations including the inability to accept eyes from those who had septicaemia, infectious diseases, HIV, hepatitis or other venereal diseases, or those who have been on ventilator for a long time. The onset of Covid-19 came as a big blow, not only for the few willing to donate but also for possible recipients.” There are about 50-70 patients on the waiting list for eye transplants at any given time at the hospital, said Dr Jadeja.

Home retrieval stopped

Home retrieval of donated eyes, which used to be a major plus point for eye donations, have also been stopped as per national Covid guidelines, said doctors. Apart from suspect Covid deaths, the safety of these retrieval teams was also kept in mind while framing these regulations.


The scope and spread of the pandemic has also affected the acceptance of patients in the waiting list for eye transplants, who are now actively refusing to get surgery done for fear of contracting Covid-19. The two transplants carried out and M&J Institute were also done on patients lower down the waiting list after several patients at the top of the list refused to get them done, said Dr Jadeja.


Eye diseases worsened during lockdown
There has been an influx of patients coming with late presentations of various eye conditions as they were unable to do so, first due to lockdown then due to fear of Covid-19 infections at public hospitals. Private ophthalmologist Dr Tejal Dalal said, “While there was a lot of confusion till June about which patients to see and who could be operated upon, most of the patients are still scared to seek medical help, thus reporting late.

They need to know that 80% of eye diseases can be prevented if detected in time. While cataract is well-known, people don’t realize they have glaucoma or diabetic retinopathy. More than one-third of patients lose their sight to this ailment.”

Dr Priti Kapadia, HoD of Ophthalmology and Additional Superintendent of Surat NCH, said, “Patients with mature cataracts are at risk as it can cause lens-induced glaucoma and lead to worse prognosis and post-operative results for patients. Of the 15 recent patients with mature cataracts, Dr Kapadia said five also had lens-induced glaucoma.”

Dr Hansa Thakkar HOD of Ophthalmology at Ahmedabad Civil Hospital said that patients often need change of medicines in 7-15 days but that had stopped during lockdown. There are only about 100 patients in OPD against 200 before lockdown.