Many need gift of sight

Reg­is­tered organ donors of­ten avoid ticking box for eyes

The Prince George Citizen - - Health - Sh­eryl UBELACKER

It should have been a rel­a­tively un­com­pli­cated surgery – re­mov­ing a cataract in Alvin Hal­lett’s right eye. But some­how the sur­geon ac­ci­den­tally struck his cornea, ren­der­ing him blind in that eye.

“I had no vi­sion what­so­ever,” the 82-year-old from Burk’s Falls, Ont., south of North Bay, said of the April 2017 in­ci­dent. “I couldn’t see to drive. My wife had to do all the driv­ing. I couldn’t see to boat on the lake. I couldn’t plant my lit­tle gar­den. All I could do was ride my rid­ing lawn mower and cut all my grass.”

But a year later, Hal­lett’s vi­sion was re­stored with a corneal trans­plant, thanks to one of the 2,300 de­ceased On­tar­i­ans who each year do­nate eye tis­sue to give oth­ers the gift of sight.

Of those 2,300 pairs of eyes, tis­sue from about 1,700 are used for corneal trans­plants, said Chris­tine Humphreys, di­rec­tor of the Eye Bank of Canada. “And also in ad­di­tion to the cornea, we have over 600 other oc­u­lar surg­eries take place.”

How do­nated eye tis­sue is re­moved and stored de­pends on the needs of re­cip­i­ents, she said.

“We get the whole globes, but we also get just the corneas,” Humphreys said. “We don’t have to take the whole eye.”

The cornea is the trans­par­ent layer cov­er­ing the front of the eye, which lies over the iris and pupil. Do­nated corneas are stored in a re­frig­er­ated cham­ber, bathed in a medium con­tain­ing nu­tri­ents and an­tibi­otics, and re­main vi­able for trans­plant for about 10 days.

The sclera, the white part of the eye sur­round­ing the cornea, is used for a num­ber of sur­gi­cal pro­ce­dures, in­clud­ing as a graft or patch in glau­coma surgery. Sclera tis­sue is stored at room tem­per­a­ture in al­co­hol and also has a rel­a­tively short shelf life.

The Eye Bank of Canada, which de­spite since with the 1955, has organizati­on its non-profit been name and stor­ing is serves now com­mu­ni­ty­based Kens­ing­ton eye af­fil­i­ated only tis­sue On­tario, Health. their own Other eye banks. prov­inces op­er­ate

Humphreys said that like other tis­sues and or­gans from de­ceased donors, the de­mand for eye tis­sue lags sup­ply: for in­stance, the av­er­age wait time for a cornea trans­plant in On­tario is 252 days – or more of Of the the than prov­ince 12.4 eight mil­lion who months. are res­i­dents el­i­gi­ble to be­come donors, just over four mil­lion have reg­is­tered to do­nate their or­gans and other tis­sues. And of those, about 400,000 elected not to tick the box for eye tis­sue, rep­re­sent­ing the high­est ex­clu­sion rate of all or­gans and tis­sues that can be do­nated after death. Humphreys ad­mit­ted there are bar­ri­ers to peo­ple agree­ing to do­nate their eye tis­sue, of­ten for re­li­gious or cul­tural rea­sons, but some­times be­cause of com­mon mis­con­cep­tions about el­i­gi­bil­ity or the process.

“One rea­son we hear all the time is ‘I don’t see very well,’ ‘I’ve had eye surgery’ or ‘I’m too old’ or ‘I’ve had can­cer,”’ she said. “And the fact is there are very few things that can re­sult in not be­ing a donor,” in­clud­ing hav­ing had a form of oc­u­lar surgery or can­cer.

Some fam­i­lies worry that re­cov­ery of a loved one’s eye tis­sue would de­lay their funeral, which for re­li­gious rea­sons may need to be sched­uled within 24 hours of death.

“But of­ten we can meet that need, make the do­na­tion hap­pen more quickly,” Humphreys said.

There can also be psy­cho­log­i­cal bar­ri­ers for some po­ten­tial donors and their fam­i­lies, given such be­liefs as the eyes be­ing the “win­dows of the soul.”

“Some fam­i­lies, they have trou­bles with eyes for some rea­son,” con­ceded Humphreys. “Some peo­ple think (their loved one) might be dis­fig­ured.

“A lot of peo­ple don’t know we can re­cover just the corneas, leave be­hind the rest of the eye if they want.”

As well, funeral homes can use pros­thet­ics to ob­scure the fact that eye tis­sue has been re­moved.

“Ob­vi­ously, if you’re look­ing to hav­ing a view­ing or an open-cas­ket funeral, the funeral home will work with the fam­ily to re­store their nor­mal ap­pear­ance,” she said, not­ing that there is no cost for the process to bank eye tis­sue and any ex­tra fees charged by a funeral home are cov­ered by the Eye Bank.

“A lot of peo­ple aren’t com­fort­able talk­ing about death and what hap­pens to us after dy­ing. And I think if we nor­mal­ize the dis­cus­sion and we start to talk about it, a lot of (the dis­com­fort) can be over­come by ed­u­ca­tion.”

For Barbara Edwards, the de­ci­sion to do­nate her fa­ther Dick Halver­son’s eye tis­sue after he had a sud­den fa­tal heart at­tack al­most two years ago wasn’t dif­fi­cult.

“We had talked about his wishes and he didn’t think he could do­nate – he thought he could do­nate, but not his eyes – be­cause he had such thick glasses,” said Edwards, a hos­pi­tal de­vel­op­ment co-or­di­na­tor at Tril­lium Gift of Life Net­work, On­tario’s organ and tis­sue do­na­tion and trans­plan­ta­tion ser­vice.

“But when we heard from Tril­lium that that wasn’t true, that your vi­sion didn’t af­fect your abil­ity to do­nate, we knew right away it was yes... be­cause we knew what he wanted.”

As it turned out, the 69-year-old wasn’t reg­is­tered as a donor. He had planned to sign up on his next birth­day, but died be­fore, so his fam­ily made the de­ci­sion.

“It was so spe­cial for us to be able to hon­our his legacy and be able to give the gift of sight to oth­ers,” Edwards said. “I didn’t re­al­ize how much after the fact that it would help in our griev­ing process, know­ing that other peo­ple can be helped.”

Hal­lett, who re­tired in 2000 after sell­ing his ma­rina on a lake near his home, said his corneal trans­plant and sub­se­quent cataract op­er­a­tion by a Toronto sur­geon ear­lier this year has given him back his life.

“I’ve got good vi­sion, very good. I can do any­thing I want,” he said, adding that he is so grate­ful to the anony­mous donor that “I can’t even ex­press what I feel.”

“I was to­tally grounded. It was a won­der­ful ex­pe­ri­ence for me to get my sight back.”

A lot of peo­ple don’t know we can re­cover just the corneas, leave be­hind the rest of the eye if they want. — Chris­tine Humphreys

CP PHOTO

Alvin Hal­lett, 82, was blinded in his right eye when a sur­geon ac­ci­den­tally struck his cornea. But, he now has his sight back.

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