Observed in April each year, National Donate Life Month helps encourage Americans to register as organ, eye and tissue donors. It also honors those that have saved lives through the gift of donation. Let’s focus on eye donation….
Eye Donation and Corneal Transplants
While we use the term “eye donation,” the whole eye is not transplanted. Corneal transplants are the most common use of donated eye tissue.
The process of cornea donation starts with an individual’s decision to be an eye, tissue and organ donor, or a family’s consent to donation, and results in a cornea transplant for a patient suffering from corneal blindness. The eye bank facilitates this important process. If you choose to be an eye donor, you can be proud knowing you are helping to improve the quality of life for someone with little to no sight.
What Is the Cornea?
The cornea is the clear, dome-shaped layer of tissue on the surface of the eye that provides a window for light to pass through, and enables us to see. The cornea serves two functions:
- First, it helps protect the eye from dust, germs and other harmful matter.
- Second, it helps us focus. The cornea bends or refracts light entering the eye onto the natural lens. The lens further refocuses the light onto the retina.
Why Do People Need a Corneal Transplantation?
Corneal transplants can restore vision, reduce pain and improve the appearance of an unhealthy cornea. They restore sight to those suffering from vision loss caused by:
- Eye disease or injury that made the cornea cloudy or distorted, causing vision loss
- Scarring of the cornea, following trauma or infections such as a corneal ulcer or herpes
- Keratoconus (thinning of the cornea that causes a cone-shaped bulge to develop)
- Age or conditions that may lead to cornea blindness such as Fuch’s dystrophy, pseudophakic bullous keratopathy, or corneal degeneration
Who Can Donate Corneal Tissue?
Almost everyone is a universal donor for corneal tissue. The blood types of the donor and the recipient do not need to match. Age, eye color and eyesight are not factors either. Aside from those suffering from infections or a few highly communicable diseases, most people are potential cornea donors.
As with other tissue donations, even people who may be unable to donate their organs can usually become cornea donors. This is because not all of the restrictions that apply to organ donation are applicable to tissue donation. There is also no age restriction for donating eyes, skin or bone.
How Prevalent Is Corneal Transplantation?
The Eye Bank Association of America (EBAA) provided 66,278 corneas for transplant in 2020. Since 1961, more than 2 million men, women and children worldwide have had their sight restored through corneal transplantation.
While EBAA members are able to fulfill all of the demand for corneas in the U.S., they also provide corneas for use internationally, as there are 12 million individuals worldwide suffering from corneal blindness.
How Successful Is Corneal Transplantation?
Over 95% of all corneal transplants successfully restore the recipient’s vision.
Will the Recipient Be Told Who Donated the Corneas?
The gift of sight is made anonymously – recipients do not learn the identity of their donor. If they wish, recipients can write anonymously to their donor family, via the eye bank, to express their thanks. The eye bank will pass along such communication.
How Can a Person Ensure That Their Wishes Regarding Donation Will Be Respected?
First, they should tell their family or guardian about their donation plans. Eye banks will always ask the family if they were told about donation wishes, even if there is an advance directive (living will). Plus, next-of-kin cooperation with a medical/social history interview is required before transplantation, so it is helpful if the family and friends know how they feel about donation.
In many states, a person can sign a card at the motor vehicle bureau stating they want to be an organ donor. They can even specify whether they wish to donate their eyes, organs or other tissues.
To learn more about becoming a donor in your state, contact your area eye bank or the organ procurement organization (sometimes called OPO or OPA) in your region.
Are There Religious Objections to Eye, Organ, or Tissue Donations?
No. Eye, organ and tissue donation are consistent with the beliefs of most major religions. Donation is an opportunity to help save a life or restore someone’s sight. In fact, most faiths support these donations as the ultimate act of charity. Check with your own spiritual leader for further guidance.
Are There Any Fees for This Donation?
The donor’s family does not pay any costs associated with the recovery of tissue. Any costs associated with cornea recovery and preparation are absorbed by the eye bank.
Does Donation Cause any Delay in Funeral Arrangements?
No – recovery of the donor eye tissue takes place within hours of death. Families may proceed with funeral arrangements without any delay or interruption.
Does Eye Donation Affect the Appearance of the Donor?
Not at all. At all times, the donor is treated with dignity and respect, and great care is taken to preserve their appearance. Donation does not affect or alter the donor’s appearance, nor does it delay funeral services, including a viewing (if desired).
How Soon After a Donation Must a Cornea Be Transplanted?
Eye tissue procurement is performed within hours of death. The preservation medium used in the United States keeps the cornea’s cells alive for 14 days after recovery, but most transplants occur within a week.
What Happens if Donated Eye Tissue Is Not Suitable for Transplant?
Some medical conditions present problems for transplantation. As a result, some donated eyes are found to be unsuitable for transplantation. Whenever possible, non-transplanted tissues are used for research and educational programs to study visual impairment or to advance knowledge of surgical techniques.
Why Should Eyes Be Donated?
Restoring sight to patients suffering from corneal blindness is only made possible through cornea donation. The transplantation process depends upon the priceless gift of corneal donation from one human being to another. Donated eyes are also needed for research and education.
How Do Research and Education Benefit From Eye Donation?
Research on glaucoma, retinal disease, the eye complications of diabetes and other sight disorders can lead to new treatments and cures. In addition to the cornea, scientists use tissue from the retina, lens and other parts of the eye to discover the causes and treatments for eye disorders and diseases. This donated tissue allows researchers to develop new approaches and cures for diabetic eye disease, cataracts, macular degeneration and glaucoma.
How Does the Eye Bank Ensure Safe Corneal Tissue for Transplantation?
The donated eyes and the donor’s medical and social history are evaluated by the eye bank in accordance with the Eye Bank Association of America’s (EBAA) strict medical standards. Eye banks also follow U.S. Food and Drug Administration (FDA) regulations.
The EBAA also issues standards for eye banks to use in training personnel to evaluate donor eyes. With a recipient’s safety in mind, only corneas that meet these strict evaluation guidelines set forth by the EBAA and FDA are distributed for transplantation.
Fast Facts About Cornea Transplantation
- Receiving a cornea transplant will NOT change the color of the recipient’s eye! The cornea is clear, not to be confused with the colorful iris.
- Whenever possible, eye banks try to place the cornea with a recipient who is close in age to the donor. Especially for younger recipients, this helps ensure that the cornea will last throughout their lifetime.
- More than 80 nonprofit eye banks in the U.S. coordinate the distribution of donated corneas for transplantation. Thanks to generous donors, there is no national waiting list of patients needing corneal transplants.
- The whole eye is never transplanted. However, with a donor’s family permission, the eye may be removed for education and research.
- Donated corneas must be processed and placed in a preservation solution within 8–12 hours after the donor’s death. To maximize chances for success, the transplant must occur within two weeks.
- One cornea donor can restore sight to 1–2 people.