Join Us

Name of Eye Bank:(*)

Invalid Input

Address:

Invalid Input

Country:

Invalid Input

Contact Person:

Invalid Input

Contact eMail:

Invalid Input

Eye Bank's Website (if any):

Invalid Input

DATA FIELDS FOR AEBA REGISTRY

1. Is your eye bank a :

Government eye bank

Affiliated with a General Hospital or s Specialist Eye Hospital/ Center

NGO or non-profit organization

Private enterprise

Others, specify

Invalid Input

[Other] Is your eye bank a

Invalid Input

2. What type of organ/tissue donation legislation exists in your country?
(more than 1 answer is okay)

Opt-in – pledge or consent required

Opt-out – presumed consent

Coroner’s Law

Others, specify

Invalid Input

Others, specify

Invalid Input

3. Does your country have a National Organ / Tissue donor registry?

Yes

Invalid Input

4. How many other eye banks are there in your country (excluding yours)

None

One or more

Please provide names of other eye banks :

(i)

Invalid Input

(ii)

Invalid Input

(iii)

Invalid Input

5. What are your eye bank's working hours?

Invalid Input

6. Please indicate if your eye bank has the following:

Director/s

Yes

Invalid Input

If yes, how many

Invalid Input

Technical Staff

Yes

Invalid Input

If yes, how many

Invalid Input

Administrative

Yes

Invalid Input

If yes, how many

Invalid Input

Others, specify

Invalid Input

7. Source of local donors
(more than 1 answer okay)

Invalid Input

Specify

Invalid Input

8. Eye Donations to your eye bank
(* Most recent Year please)

Invalid Input

Total Death Referrals from Source(s)

Invalid Input

Total Number of Procurement

Invalid Input

Total Number of Corneas Utilized

Invalid Input

9. What are the Causes of Death of Donors (Numbers or % OK)
(* Most recent Year please)

Invalid Input

Heart disease

Invalid Input

Cancer

Invalid Input

Trauma

Invalid Input

Cerebrovascular Accident

Invalid Input

Respiratory disease

Invalid Input

Others, please specify

Invalid Input

10. Does your eye bank import tissue from overseas?

Yes

Invalid Input

11. If yes, please specify the sources of your overseas tissue (more than 1 answer is okay)

USA

Europe

Asia

Others

Invalid Input

12. Does your eye bank maintain a local patient waiting list?

Yes

Invalid Input

13. If yes, how many patients are on the waiting list? (approximate as of to-date okay)

Invalid Input

14. What is the average waiting time for a patient to receive a cornea? (approximate is okay)

Invalid Input

15. How many cornea surgeons make use of your eye bank’s services?

Invalid Input

16. No of Cornea transplants performed in your country / or in your eyebank
(* Most recent Year please)

Invalid Input

17. No of Sclera transplants performed in your country / or in your eyebank
(* Most recent Year please)

Invalid Input

18. Does your eye bank undergo regular audits / inspection?

Yes

Invalid Input

19. If yes, who conducts the audit / inspection?

Ministry of Health or other government agency

External agency

Other Eye banks / Eye or Tissue Banking Association

Others

Invalid Input

Please specify

Invalid Input