Seeing the Unseen: The Power of Eye Donations

Need for routine discussions on eye donation within end-of-life care settings is re-emphasized by a new study.

Increasing eye donations is shown to be vital for sight-restoring surgeries as a study at the University of Southampton underscores the importance of regular dialogues in end-of-life care settings about eye donation, published in the Health and Social Care Delivery Research Journal, ().

Researchers from the University of Southampton and clinical partners, including NHS Blood and Transplant, carried out the study, which has been funded by the National Institute for Health and Care Research (NIHR).

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‘Regular conversations about end-of-life eye donation in clinical settings are found to boost eye donations that are crucial for restoring sight. #eyedonations, #sight-restoration, #vision ’

It found just a small fraction of eligible patients in hospice and palliative care settings are being approached to consider the option of eye donation. This is despite both healthcare professionals and patients having favorable views towards it.

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The researchers say practice needs to change so that patients who wish to donate are being offered the opportunity as a part of routine end-of-life care.

Over two million people in the UK are living with sight loss, taking a huge toll on their lives and costing the economy a reported £4.34 billion each year.

Some conditions, such as Keratoconus and Fuchs’ Corneal Dystrophy, can be treated with surgery which removes all or part of a damaged cornea and replaces it with healthy donor tissue (corneal transplant). However, there is a shortfall in the supply of donor tissue needed for operations.

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NHS Blood and Transplant aims to achieve a weekly stock of 350 eyes for use in surgery or research. But from April 2021 to March 2022, only 88 eyes on average were donated per week.

The RNIB predicts that by 2050, the number of people with sight loss will double to nearly four million (mainly due to the aging population), further increasing the demand for eye tissue. Each donor can help restore or improve the sight of up to 10 people.

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Clinical partners across England reviewed the case notes of 1,199 deceased patients in three hospice care and three hospital-based palliative care services.

Although 46 percent of patients were eligible to donate their eyes, less than 4 percent of potential donors had been approached or referred for eye donation.

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To understand attitudes and potential barriers to eye donation, the researchers interviewed over 100 healthcare professionals and over 60 patients and carers receiving palliative care. They also conducted a national survey of 156 service providers.

Dr Tracy Long-Sutehall, Associate Professor at the University of Southampton and lead author of the research says:

“Many patients and carers were not aware of eye donation being an option for themselves or their relatives. Those we spoke to generally had positive views about eye donation and were open to being asked about their preferences. This suggests there could be many potential donors in hospice and palliative care settings who are willing to donate their eyes after their death so that others might see.”

Healthcare professionals were in favor of eye donation being discussed as part of end-of-life care planning but had gaps in their knowledge around eligibility criteria and processes for referral; more than half had received no formal training regarding eye donation.

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As such, the majority had never, or hardly ever, initiated a discussion about eye donation with patients or family members.

Dr Long-Sutehall added: “Conversations around eye donation need to be sensitively managed, so it’s understandable that healthcare professionals would be reluctant to raise it if they haven’t had suitable training and education.”

The study demonstrates that there is significant potential for more patients to be allowed to donate their eyes in the future, and for eye donation to be embedded in routine end-of-life care clinical practice.

Emma Winstanley, Lead Nurse for Tissue and Eye Services at NHS Blood and Transplant who was a co-applicant in the study, says:

“This research provides crucial new insight to better understand both patient and healthcare staff views on eye donation. With more patients dying outside of traditional hospital settings, either at home or in hospices, patients must have the opportunity to donate whenever donation is possible. Eye donation is particularly special as a donation can even be possible for patients who have cancer. We know that many patients and families take great comfort and pride in donation. By working closely with hospice colleagues, we can enable more patients to donate and more life-transforming surgeries to take place.”

Reference:

Eye Donation from Palliative and Hospice care contexts: the EDiPPPP mixed Methods study - (https://eprints.soton.ac.uk/478649/)

Source-Eurekalert