Many of us take for granted seeing and enjoying our surroundings—until they are gone. Hospitals can help give people their sight back. Registering to become a cornea donor could give someone the gift of sight after you pass away. If you are planning on becoming an eye donor, it is vital to know everything you need to know about cornea donation. The information below will explain what corneal donation means and why it is important to patients.
The cornea is the clear tissue at the front of your eye that lets in light so you can see. This small and straightforward eye part is essential for thousands of corneal transplants a year, often saving the sight of patients for many years.
What is Eye Donation?
Eye donation involves donating your corneas—not your iris. It is sometimes called a keratoplasty or a corneal graft. When you register as an organ donor, you can also choose to be a tissue donor. Donating your corneas is called a tissue donation.
Many UK hospitals facilitate the process of people donating their corneas when they have passed away by also preparing corneas for transplantation. The hospital team travels across the UK and is willing to speak to professionals and families about how to have an essential conversation about donations.
Why do people need an eye transplant?
- People can need corneal transplants for quite a few reasons, including:
- A disease or injury that has made the cornea cloudy or distorted, causing vision loss.
- Infections such as corneal ulcers cause scarring of the cornea.
- Keratoconus (thinning of the cornea that causes a cone-like bulge to develop, usually in young people)
- Age or inherited conditions that may lead to the cloudiness of the cornea in older people
- Scarring is caused by herpes (the cold sore virus).
Must an eye donor be dead?
For the most part, corneal donations come from dead people. In scarce circumstances, a donor may be living. There are no instances of donations between people who are living in other circumstances. For example, a patient who has an ocular tumour in the back of the eye may be able to donate the eye at the time the eye is removed. If an eye is blind and released but is healthy in the front, that cornea might also be used. Another circumstance where a person may donate a cornea to themselves is where one eye can still see and the other can't. That is very rare.
Are people with glaucoma candidates for this procedure?
Glaucoma is one of the factors that harm corneal transplant, so glaucoma must be controlled before or at the time of the corneal transplant. People with glaucoma have an eye condition where the optic nerve is being damaged, usually by pressure inside the eye that is too high. The cornea is not affected by glaucoma, but some patients will have both glaucoma and a corneal condition. Those patients may require surgery for glaucoma and surgery for the cornea.
Would someone with diabetic retinopathy benefit from a corneal transplant?
Diabetic retinopathy directly affects the retina, not the cornea, so a transplant would not help unless there is a problem with the cornea.
Would someone with macular degeneration benefit from a corneal transplant?
Patients with macular degeneration have a disease of the retina. The retina is like the photographic film inside a camera. It is a thin tissue that lies on the inside of the eye. Consequently, unless the cornea is also affected, corneal transplantation would not help a patient with macular degeneration. Some people have corneal dystrophies, such as Fuchs, who also has macular degeneration. They can benefit from transplantation when the cornea becomes cloudy.
Does having diabetes prevent someone from being an eye donor?
Only the advanced stages of diabetes that require insulin prevent a patient from being a donor. Patients who have diet-controlled diabetes may still be eye donors. Patients who have severe forms of diabetes may donate their eyes for research rather than for corneal transplantation. Research is a special mission and may lead to the prevention or cure of blindness for many more than one patient.
Are eye transplants done more frequently on elderly or younger patients?
Many patients who receive transplants are older, but the populations who are very old or very young are the populations that receive most transplants. Similarly, most of the donors are also older. The typical eye bank will accept donations from 2 to 70. Donors younger than two and older than 70 are helpful for research tissue but not corneal transplantation. Patients generally receive corneal tissue from donors approximately the same age or younger than themselves.
How successful are eye donations?
A corneal transplant is successful if it remains clear. The success rate is usually determined at one, two, and five years. The best success rate in one year will be 98 per cent of clear corneas, usually in patients with keratoconus or other corneal dystrophies. Over time, success rates drop, so this group would be 90 per cent clear at five years.
For all grafts, success rates are typically 80-90 per cent in one year and 70-75 per cent in five years, but that includes patients who are less than ideal candidates or have problems involving the peripheral cornea. These patients have a higher rate of corneal rejection.
What would not allow a person to become an eye donor?
The main things that disallow you to be a donor are things that would be regarded as unsafe for the people who collect the tissue. This would include clear conditions such as HIV positive status or AIDS, severe infectious problems such as sepsis or hepatitis that is active, which would be unsafe for technicians. The concern would be transmitting these diseases to the technician through a needle stick or to a transplant recipient. There are other rare conditions, such as rabies, which the eye banks and eye bank technicians will be aware of. Still, the public would probably not know about it. Every donor has their medical history screened before being accepted and having the tissue recovered.
Can I become an Eye donor?
Most people can donate their corneas when they die. As with other tissue donations, even people who may be unable to donate their organs can usually become cornea donors. There is an upper age limit of 80 years for eye donors. However, this can sometimes be increased depending on national stock levels. Corneas can be donated up to 24 hours after you die.
I am not sure if I can donate my eyes.
The cornea is the clear tissue at the front of your eye that lets in light so you can see. This part of the eye is used in sight-saving corneal transplants. Almost anyone can donate their corneas. Nationally, not enough people donate their corneas, meaning surgeons or hospitals cannot perform as many operations as needed.
I want to become an eye donor. What do I do next?
Tell your friends and family that you want to be a cornea donor—they must understand your wishes. Your family’s support is needed for donation. Dealing with the death of a loved one is a difficult time to make an important decision like this.
The NHS Organ Donor Register is a secure database that records people’s decisions about whether they want to be organ and tissue donors when they die.