The inadequacies of the distribution of corneal tissue banking in Canada have been highlighted in the media over the past couple of weeks. I would like to discuss why it is so important to have a national distribution system for corneas (the transparent front part of the eye, sometimes called “the window of the eye”).
The good news
The cornea can be transplanted by removing a cornea from a donor eye and replacing the defective cornea in the patient’s eye. Over the past few years, the techniques and technologies associated with corneal transplantation have improved dramatically to the extent that many eye diseases of the cornea that would previously have resulted in significant vision loss are now being treated successfully by corneal transplantation. Conditions that may require transplantation are opacities that arise from injury such as chemical injuries, various corneal dystrophies and certain cases of keratoconus. For more information about these conditions I would suggest you check out the National Eye Institute’s website at the following link: http://www.nei.nih.gov/health/cornealdisease/#3
The Issues: extended wait times and lack of a quality standard
How long you wait for a cornea depends to a large extent on where you live. Availability of corneas is determined by the number of corneas donated by the public in the region in which you live and the effectiveness of the distribution system for corneas in your province. The waiting time for corneal transplantation in Canada varies from 6 months to 3 years, the longest wait times being in Alberta. However, even in provinces with short average wait times, it may take a long time to get a cornea as the distribution within provinces can be rather uneven.
This problem has existed now for some years, and was recognized by provincial, territorial and federal health ministers in 2008 when they asked the Canadian Blood Services to develop a plan to fix this problem. This plan, called the Call to Action Report, was delivered to the Health Ministers in 2011. The Call to Action report proposed a national system for the distribution of corneas that would both increase the availability of corneas. The plan also aims to establish a national standard for eye banking to ensure the highest quality of corneal tissue will be available everywhere across the country.
Unfortunately, the Call to Action Report has yet to be acted upon, and until it is, people will continue to wait for corneas. At the same time, there is no guarantee that all corneas will meet the highest standards that are in place in the best eye banks both in Canada and elsewhere.
So what can an individual do to decrease the wait times for corneal transplantation? The most important thing you can do is register to donate your corneas. By doing so, you will be providing the “gift of sight” to others who need it so badly.
One other thing you can do is to encourage your provincial politicians to support the adoption of the Call to Action recommendations for a national eye banking system in Canada.
Corneal transplantation is one of the most successful, life altering surgeries there is. Let’s all do what we can to ensure that Canada has the best possible system so that no one has to live with vision loss while waiting for a corneal transplant.
Want to donate? Here’s how
This month Canadian Blood Services, CNIB, and the Canadian Ophthalmological Society are partnering to encourage people to consider becoming an eye donor.
According to recent polls by Canadian Blood Services, 96 per cent of Canadians support organ and tissue donation. But in Ontario, less than 25 per cent are registered to be donors. The ways to register or declare your intentions to donate vary from province to province.
In Ontario, even if you’ve signed your donor card, the card may not be available when the information is needed. By registering, you ensure your donation decision is recorded.
Go to www.organsandtissues.ca/donate and click on your province to find out how to register your decision to donate.
P.S. While I’ve been carrying a donor registration card for many years, I thought that was all I had to do and that I had registered at some stage. I just checked with the Province of Ontario Organ and Tissue donor registry and found this was not the case. I have now registered, and encourage all reading this blog to do the same. It took me less than 5 minutes.