24 Hours After Death How Eye Banks Can Turn a Tragedy into a Miracle

when i was just starting out as an

optometry student

a professor asked the class to take out

a blank sheet of paper

and describe their own eyes easy enough

most of us talked about the color blue

brown green aquamarine

our sight or lack of it and some of us

got romantic and said

that eyes were the windows to the soul

he looked at all these responses and

said well nobody put the most important

descriptor

everybody here woke up today and opened

two gifts

their eyes i remember thinking to myself

well that was a pretty cheesy line but

of course

as these things go he was absolutely

right

as my career got started as a resident

at the specialty

eye institute in michigan i realized the

difference a corneal transplant

could make in a patient’s life

one of my patients was an experienced

pilot and he asked me

why would you ever become an eye doctor

because i was under some time restraints

at the moment i said the thing that was

at the top of my mind

it was just something to do of course i

had to ask him why he flew

and he said something far more profound

because i want to see the world

as i looked at his eye i noticed

something truly heartbreaking

his cornea the front part of his eye was

swelling to the point

where he would need a corneal transplant

or he would have to give up lying

his official diagnosis was fuchs

dystrophy the number one reason of many

for a corneal transplant after we

discussed his potential options i asked

him

would you like to continue with surgery

that question alone

is a privilege in itself afford it to

those

in the united states and a select number

of countries

you see at any given time there are 12

million people

waiting for a corneal transplant which

means

only one in 70 will actually receive it

so why are we so lucky how come we can

get a corneal transplant while millions

of others have to become visually

impaired

this access to sight saving tissue is

all due to the successful infrastructure

of eye banks which is what i want to go

in depth with you today

eye banks similar to blood banks for

blood obtain

and store corneal tissue however and i

may be biased

the eye is a special organ and medically

speaking

the cornea is immune privileged

this means that tissue taken from a

donor

and implanted into a recipient is less

likely

to be met with rejection practically

speaking

it means everyone is a universal donor

for corneal tissue

the donor’s blood does not have to match

with the blood of the recipient

age eye color and even eyesight are not

factors

there are over 50 eye banks in the

united states alone

accounting for 70 000 total donors per

year

these 50i banks meet 100

of the demand in the united states and

any extra tissue

is used for research purposes or shipped

overseas

this level of success is a modern marvel

and can and should be replicated

worldwide

so how does it work how do you get this

cornell tissue

well the process starts off with

something called the call

from a hospital stating that an

individual has passed

and meets a preliminary criteria for

donation

it is now that a countdown begins

24 hours 24 hours

due to the nature of the tissue within

24 hours

an ophthalmic technician must conduct a

series

of very delicate procedures in a time of

immense grief

this includes contacting the next of kin

obtaining consent

and finally recovering the tissue

indecision during this time

is the leading cause of why corneal

tissue is not passed on

so what can we do how can we make these

24 hours more worthwhile

how can we make it so millions of

corneas are not

buried in the ground when they can be

passed on to the next generation

it starts with a simple conversation

about organ donation with your loved

ones

of course there are legitimate concerns

involved where will my corneas go

will they be wasted will they go off to

the highest bidder

in 2018 the global alliance of ibank

associations came together

to form an agreement to address these

exact concerns

the document is now known as the

barcelona principles

and is designed to protect the integrity

and altruistic nature

of the donation process i would like to

highlight

principle number seven which encourages

development of local

and national self-sufficient services

you see over 50 percent of the world’s

corneal tissue

comes from just two countries the united

states and india

i’m here to tell you that this can be

changed and most countries can obtain

the necessary resources

to become self-sufficient and keep

donations within their own community

take the example of just one ophthalmic

technician

who went on a medical mission to vietnam

after only a few weeks he realized

countless people were in need of a

corneal donation

but there was a general lack of

awareness of organ donation

so in 2008 he took four corneal

transplants from the san diego eye bank

and assisted local surgeons who were

interested in the procedure

he knew he had to get government

religious leaders on board to gain

support for eye banking

so he invited a buddhist monk to observe

after realizing the positive impact that

this could have

on his community the monk pledged his

own corneas

the surgeons took an interest and gained

additional training at the san diego eye

bank

and in 2011 just three years after the

ophthalmic technician’s first trip

vietnam opened its own

first national eye bank to provide care

to the entire country

stories such as this are possible around

the world but we need forward-minded

people

who can show communities the impact that

donations can have

the thing is when someone regains

their sense of sight they may be the

ones directly affected but the entire

community

and country in a way benefits

that person can now go on and seek

gainful employment the caregiver or

spouse

can now go on and live an independent

life the family does not have to

rely on government aid

in fact the ibank association of america

conducted a cost-benefit analysis of

corneal transplantation

and it showed a six billion dollar

economic benefit in the life of these

corneal transplants

this directly translated to federal and

government savings

of 2.5 billion dollars in the health

care industry

essentially the cost benefit of

establishing an eye bank is irrefutable

and the positive impact it has on its

community is

undeniable

now back to my patient in michigan he

went ahead with

surgery and is now once again in the air

to see the world

but he’s just one story your cornea can

go to eric

a chef who needs help measuring out

ingredients or amine

a zookeeper who needs to keep track of

various animals

or david or joey or ryan

or samir your legacy lives on

through the gift of sight so

if i can take some time to make a call

to action

i would talk to government officials in

countries who do not have this

infrastructure of eye banks

this is a cost effect and proven method

to instantly improve the standard of

living in your communities

i would talk to doctors such as myself

our training gives us a super power

not only to educate and spread awareness

but also to take our skills in places

where

it may be lacking and finally

i would talk to anybody listening to

this at home the gift of sight

is truly yours to enjoy but also

yours to give away pass it on when it’s

time

thank you very much