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