Gratis Ocular Tissue Program

A sight-saving program providing free cornea transplant surgery and ocular tissue to individuals who cannot afford treatment. Supported by the Lions World Vision Institute Foundation (separate 501(c)(3)).

Funding Source: Lions World Vision Institute Foundation fundraising

Geographic Scope: National and international

Eligibility: Individuals who cannot afford cornea transplant surgery and related ocular tissue care

Services Provided:

• Free corneal tissue for transplant
• Sight-saving surgery facilitation
• Patient support and coordination

Participation Benefits:

• Patients may be asked to share their story of how the gift of sight has affected them and their family
• Stories used to inspire cornea donation, support fundraising, and provide hope to others needing transplants
• All story sharing requires patient consent via pre-op questionnaire and signed release form

Organization Details:

• Lions World Vision Institute (nonprofit 501(c)(3), Federal Tax ID #01-0843838)
• Headquarters: 1410 N. 21st St., Tampa, FL 33605
• Phone: (813) 289-1200
• Email: info@lwvi.org
• Also offices in Pensacola, Jacksonville, Gainesville, Melbourne, Orlando, Fort Myers, Shreveport LA, Seattle WA, Bethlehem PA, and Mexico City

Patient Application Process

1. Patient Application Form:
   • English version available: Gratis Ocular Tissue Program Patient Application – English
   • Spanish version available: Gratis Ocular Tissue Program Patient Application – Spanish
   • Application documents available as downloads on LWVI website
2. Pre-Op Questionnaire:
   • Complete pre-operative questionnaire included in application packet
   • Required to gather patient information and medical history
3. Consent for Story Sharing (Optional):
   • Sign release form to consent to LWVI contacting patient
   • Allows LWVI to share patient's story of sight restoration (optional participation)
   • Used to inspire donors and support fundraising efforts
4. Approval Process:
   • Patients are reviewed for approval to receive the gift of ocular tissue
   • Upon approval, surgery coordination begins

Required Materials:

• Completed patient application form
• Pre-op questionnaire
• Signed consent/release form (for story sharing - optional)

Contact for Application:

• Lions World Vision Institute
• 1410 N. 21st St., Tampa, FL 33605
• Phone: (813) 289-1200
• Email: info@lwvi.org
• James Rosa, Donation Program Consultant