By Dr Neeraj Jain, MBBS, MD (ophthalmology), DNB, MNAMS
What is eye donation?
The most transparent part of the eye which is in front of the eye is called the cornea. If this becomes opaque (due to diseases such as an ulcer, infection or injury) it stops or reduces light transmission into the eye. This condition is called corneal blindness. To treat corneal blindness, the diseased cornea is replaced with a new transparent cornea. The only source of a transparent cornea is donated corneal tissue from the human race. The most important fact that makes donation possible is that the cornea is alive even after death, and can be used successfully if retrieved soon after the death of a person.
When a person decides to donate his/her eyes after death, the eye will be collected by a team from the eye bank and that is why it is called eye donation. We will discuss this procedure in detail later.
What is corneal transplant?
The donor eye provides the functional transparent cornea and this is used to replace the opaque and non functional cornea. So this whole procedure is called an eye donation (for the donor) and corneal transplant (for the recipient).
Why is eye donation needed?
The only substitute for a human cornea is another human cornea donated after death by someone. Corneal blindness is a curable type of blindness, and only donated corneas can help these blind people see again.
Importantly, patients who have complications after cataract surgery suffer from loss of transparency of the cornea. A cornea transplant helps to restore sight to such patients.
Can all blindness be cured by eye donation?
No, only the cornea (clear, front part of the eye) is used for corneal transplants. Only persons with corneal blindness can be cured with a corneal transplant. Other reasons for loss of sight (glaucoma, diabetic retinopathy, etc) cannot be treated by cornea transplant. The sclera (white part) can sometimes be used for sight-saving surgery as well.
Who can donate eyes?
Almost everyone can donate his or her eyes. Eye donation can be done at any age.
Can I donate my eyes if I wear glasses?
Yes, you can! People who have poor vision and wear glasses, or have had previous eye diseases or surgery can still donate, since these conditions may not affect the cornea. Eyes donated to the Eye-Bank that are not medically suitable for transplant may be used for medical research and education. For example if you have had LASIK surgery you can donate for certain kinds of transplant surgery (endothelial graft).
How can I be an eye donor?
One would need to be willing for eye donation, as it is a voluntary act. When you are alive you can inform your family members and relatives about your desire. Another way to express your desire is to get an eye donation card and keep it in a visible place. Making a will is not enough, as, usually by the time the will is read; it’s too late to utilize the cornea.
The best way is to express your desire to all your family members and ask them to fulfil this wish after your death. It is possible to make a donation even without making a written pledge by informing your family of your intentions. They can then make the donation on your behalf.
What is the procedure of eye donation?
After death, someone would need to inform the nearest eye bank. The eye bank team asks the family to sign a consent for the donation. If that is done, both the eye balls will be removed by eye surgeons and the whole procedure takes 20-25 minutes.
After death the person in possession of your body is the sole authority on the donation. He can refuse on any ground. So it is always advisable to inform your family members about your wish.
Will we be able to have an open-casket funeral?
Yes. No one will know there has been an eye donation unless you tell them. Very rarely there may be a bit of swelling, but otherwise there should be no visible signs following donation. After death, lids are closed so people would rarely be aware of the change. If desired by relatives, artificial eyes are put in place for better cosmetic results after removal of the donor eyes.
What is the time limit after death for the donation?
The earlier the better. After death the body deteriorates very fast. The rate of deteriorations depends on environmental temperature and cause of death as well. Guyana has a hot climate, so the passage of every hour after death will reduce the quality of the cornea. A poor quality cornea, can be used only for research purposes.
It will help to remember the following points:
* Close the eyes after death, drying of the cornea leads to faster decay.
* Put a cold, moist, cloth over the eyes. It helps keep the cornea usable for a longer period.
* Place a pillow under the head of the body.
* Inform the eye bank as soon as possible, so that the donor tissue can be procured and
processed to maintain its quality.
* Discuss the issue with the family so a quick decision can be made and time can be saved. * We all know it’s usually tough to talk about these matters, and consensus is sometimes dif-
ficult.
Next week we will discuss the issue of an Eye Bank, cornea transplant and some more questions about the procedure and eye donation.
