By choosing to donate your eye tissue after you pass away, you can give someone the precious gift of sight or help with important medical research. Here are a few things you should know.
Why become an eye donor?
A precious gift
You can choose to donate your eye or eye tissue after you pass away. If your donation is suitable, it can be used to help others - either through transplant operations or medical research.
The cornea and the sclera are the parts of the eye used for transplant operations. The cornea is the clear window at the front of the eye and the sclera is the white of the eye that surrounds the cornea.
A corneal transplant involves replacing all or part of an impaired cornea with a healthy donor cornea, restoring the person's sight. Scleral tissue is used for patch grafts, surgical reconstruction and operations to treat glaucoma.
Donated corneas that are not suitable for transplant may be used for medical research and education, if specific consent is given for these purposes.
Who can donate?
The good news is that almost everyone can donate their eyes or corneas after their death. Eye donors can have any eye colour, blood type or level of eyesight. Donor age is not as important as it is for other organs or tissues - many eye donors are in their 70's.
There a few conditions, such as HIV and hepatitis, that prevent eye donation. But most causes of death do not impact the ability to donate.
Corneal transplants can help restore vision in people who have a damaged cornea. Damage can happen through infection, injury or diseases like keratoconus.
This sight-saving procedure is only possible if there is a donated cornea to transplant. In New Zealand, around 300 corneal transplants are performed each year - all of these are from donated corneas supplied by the New Zealand Eye Bank, which is based in the Department of Ophthalmology in The University of Auckland.
Except for blood transfusion, corneal transplants are the oldest and most common form of human transplantation.
Helping with medical research
You may also choose to donate your eyes or eye tissue to medical research. Your donation can help researchers at The University of Auckland to better understand eye diseases. This can lead to new treatments and cures.
The University of Auckland is an international leader in eye research, working to achieve better treatments for eye disease.
Register as a donor
In New Zealand you can register your wish to become a donor (including eye donation) when you update your driver's license.
Talk to your loved ones
To become a donor, the most important step to take is discussing your wishes with your closest family or friends (your 'next of kin').
It's important to do this even if you are already listed as a donor on your driver's license. After your death, your next of kin will be asked to confirm your decision and provide consent for your eye tissue to be donated. Talking to them in advance will help prepare them for this process.
If you have made funeral arrangements in advance, you may wish to tell your funeral director your intention to donate.
Confirmation after death
Before recovering an eye donation, the New Zealand Eye Bank or associated donation service will confirm your wish to donate with your next of kin.
This takes place once the New Zealand Eye Bank or associated donation service is notified of your death. For this reason, it is important that your family let medical or nursing staff know your wish to donate. Donation surgery needs to be performed within hours of the donor passing away.
In many cases a donor hasn't registered their wishes. In these cases, the New Zealand Eye Bank or associated donation service will ask the next of kin to consent to the donation of their loved one's corneas.
Once consent to donate has been confirmed or established, the team will assess if your tissue is suitable to donate. This includes getting information about your medical history from your next of kin and the medical team (or your GP).
Frequently asked questions
When is the eye tissue removed?
The cornea deteriorates rapidly after someone dies. After consent for eye donation is established, the eye tissue is removed within a few hours of death. A trained professional who works with the New Zealand Eye Bank performs this procedure.
In some cases, the eye tissue is removed at a hospital. But when someone dies at home, in a nursing home or in another facility, donation recovery may take place at a morgue or funeral home.
How is it removed?
Whole eye removal (enucleation) is a surgical procedure performed under sterile conditions. It typically takes an hour or less.
How are the corneas stored?
The corneas along with the white part of the eye (sclera) are sterilised and stored in the New Zealand Eye Bank's storage facility based at The University of Auckland. Living corneas can be stored at body temperature for up to three weeks using a technique called organ culture. Sclera are usually refrigerated in glycerol for up to one year.
Once the eye tissue is removed, it is assessed to see if it's suitable for corneal transplant. The cornea is examined with a microscope for defects and signs of disease. The number of cells in the corneal layers are also counted. These cells pump excess fluid from the cornea - a major factor in producing clear vision.
The donor's blood is tested for infectious diseases that would make the donation unsuitable for transplant.
Corneas that pass these tests are offered to corneal surgeons who have patients listed with the New Zealand Eye Bank.
How will the donor look?
The donor will look the same as they did before the procedure. There are no skin incisions involved and the surgeon ensures that facial features remain intact. Open casket or viewings can occur without concern. Eye donations do not delay funeral arrangements.
Is the donor's family informed of who receives the donation?
By law, the identity of the recipients and the identity of the donor and their family must stay confidential.
The New Zealand Eye Bank will send the donor family a letter acknowledging the donation. It can also facilitate anonymous correspondence between the recipient and donor family.
Is there a cost?
There is no cost to the donor or donor family. It is illegal to buy or sell human eyes, organs and tissues. Any costs associated with eye donation are covered by the New Zealand Eye Bank.