Information for patients and families in the Specialist Palliative Care unit at Harold’s Cross – Corneal Donation is not currently available in our other wards or Hospices.
The information below is designed to help you and your family understand corneal donation – what it is, what it involves, and what it means – so that any decision you make can be a fully informed one.
1. The Basics
The cornea is the clear, dome-shaped tissue at the very front of the eye – the transparent ‘window’ that allows light in and gives you sharp, focused vision. It sits in front of the coloured part of the eye (the iris). Uniquely the cornea has no direct blood supply; it is nourished by tears and the fluid inside the eye. This makes it a very safe tissue to transplant.
When a person’s cornea becomes cloudy or damaged through disease, injury or other causes, vision can become severely blurred or lost entirely. The gift of a donated cornea can restore that sight.
Corneal donation means that after a person dies, the two clear corneas at the front of their eyes are very carefully removed and donated to help someone regain their sight. Each cornea is about the size of a contact lens. Corneal donation is separate from organ donation (such as heart, kidney or liver donation) and can take place even if organ donation is not possible. It’s important to understand that only the corneas are removed, not the eyes. Each donor can potentially give sight to two people.
People whose vision has been severely affected by conditions such as keratoconus (where the cornea thins and bulges), corneal ulcers or scarring from injury or infection, chemical burns or other corneal diseases. For many recipients, a transplant is the difference between functional sight and blindness.
Yes. There is a worldwide shortage of donated corneal tissue, and Ireland is no exception. For many years, Ireland has depended on imported corneas from partner eye banks abroad to meet patient needs.
We are one of just two pilot sites working with Eye Bank Ireland, (which are part of The Irish Blood Transfusion Service) so that people in Ireland have the option to donate their corneas locally. The goal is to become self‑sufficient and ensure a steady, reliable supply of safe tissue for patients in Ireland who need sight‑restoring surgery.
2. Who Can Donate
Often yes and this is exactly why we have launched this pilot programme with Eye Bank Ireland in the palliative care in-patient unit in Harold’s Cross. We know that many people in palliative care units are suitable corneal donors. Corneal donation does not require a person to be on life support and it does not conflict with the natural dying process. It happens after death and is carried out with dignity and care.
Unfortunately, yes. This is a pilot project and because only a small number of trained specialists from the Eye Bank can carry out the surgery, there are times, particularly at weekends, when donations cannot be accepted. We hope to expand the project soon such that donations could be accepted at any time, but this is not the case yet.
There are some medical conditions that mean donation may not be possible. These include specific neurological conditions (e.g. Parkinson’s disease, dementia, MND), blood cancers and any active infection or disease of the eye. Previous laser eye surgery is also a contra-indication. Importantly, most cancers do NOT exclude someone from corneal donation.
A blood sample will also be taken from the donor at the time of the cornea collection which will be tested for the presence of infectious diseases.
In addition to obtaining consent, the Eye Bank staff will work with a donor’s loved ones and their medical team to complete questions about a donor’s medical and social history. This ensures the safety and suitability of the corneas for transplant. If they confirm the presence of a contra-indication to donation at that stage, they will not go ahead with the surgical procedure.
If, following assessment, donation is not medically possible, we will tell you clearly and kindly. This is not unusual, and it does not in any way reflect on your loved one or your family.
The donated corneas are microscopically examined in the Eye Bank and the results of this, as well as of the blood tests taken, form a final quality check before the corneas are released and transported to a hospital for use in a transplantation. Sometimes it will be found that the donated corneas are not suitable for transplantation. When this happens, if consent has been given, the corneas may instead be used for surgical training or disposed of safely, respectfully and in accordance with all regulatory and ethical guidelines.
Corneas from donors of a very wide age range can be used. Older donors may still have corneas suitable for transplant. Age alone is not a reason to assume donation is not possible. Our clinical team will clarify this for your individual situation.
No. While it is wonderful if someone has registered their wishes in advance and very much assists their family in knowing their wishes, you do not need to be on the organ donor register to donate corneas. A patient can express their wish directly to our team, and families can also give consent on behalf of a loved one who has died. What matters most is that the wish is expressed clearly and that consent is given. (more details below)
3. The Process
Corneal donation takes place after death at the palliative care in-patient unit in Harold’s Cross. The corneas need to be recovered and blood samples taken within 15 hours of death to be viable for transplant. This is one reason why it helps to have a conversation about it in advance, so that if someone wishes to donate, arrangements can be made promptly and without unnecessary pressure on the family at a very difficult moment.
This is a pilot programme and there are a limited number of suitably trained Eye Bank clinical staff available, so unfortunately there are times when retrieval is not feasible.
The corneas are retrieved by a trained specialist from the Eye Bank in a procedure that takes around 60 minutes. Only the cornea is retrieved, the eye itself is not removed. The procedure is performed with great care and respect. After donation, the eyes are gently closed, and the person’s appearance remains unchanged. This allows families to continue with their preferred funeral traditions without impact.
No, it should not cause delay. The procedure is carried out as quickly and efficiently as possible out of respect for the family’s wishes and practical needs. The team will work with you and the relevant services to ensure that the process does not interfere with funeral arrangements.
The identities of both donors and recipients are always kept private. Some families find comfort in knowing that their loved one’s donation helped someone else, and you can choose to receive an update if a transplant takes place. The Eye Bank will send a thank you card, and in many cases a short letter confirming that the corneas were used. Recipients may also choose to write an anonymous note of thanks, which can be passed on to you through the Eye Bank.
4. Decisions and Consent
If a patient has capacity and chooses to share their wish about donation — whether they want to donate or not — we record this as an expression of their wishes. Any person’s wish not to be a corneal donor will always be respected. While an individual’s stated wish to be a cornea donor is given great weight, consent is only fully obtained when the family is also in agreement and has confirmed this after the donor’s death. Consent is normally then given by what is called the ‘Designated Family Person’. This could be a spouse, civil partner, son or daughter, parent or other relevant person to a donor. We will never proceed if the family objects, and we will support whatever decision they make, without pressure or judgment.
For many reasons this is often or even usually the case. If the Designated Family Person (see above) feels the person would have wanted to be a donor, then consent can be given and corneal donation considered.
Yes. A patient or family can change their mind at any time, even after first agreeing to donate. There is never any pressure, and you are free to decide what feels right for you at any stage.
Absolutely. Corneal donation is entirely voluntary. Choosing not to donate is a completely valid and respected decision. Our care for you or your loved one will be exactly the same, regardless of any decision about donation.
5. Emotional and Practical Concerns
Having this conversation in advance means that if you choose to donate, everything can be arranged sensitively and without rush at a very difficult time. Research consistently shows that patients in palliative care settings are often very open to these conversations, and many find it meaningful to consider leaving a legacy that helps others see.
No. Corneal donation takes place after death. There is no pain. The procedure is carried out by trained specialists with the same dignity and care that we give to every patient in our unit. The body is treated with the utmost respect throughout.
Most major religions, including Catholicism, Islam, Judaism, and many others, permit or even encourage organ and tissue donation as an act of compassion and giving. However, faith is personal, and we respect that individuals and families may hold specific views. If you have any concerns about how donation relates to your faith or cultural traditions, we encourage you to speak with your religious leader. We will always support and respect your position.
No, there will be no cost incurred by the family.
Grief and loss are complex, and it is natural to revisit decisions. Many families who choose donation find it a source of consolation, knowing that their loved one’s final gift restored sight to someone else. Some families, however, find these feelings take time to arrive.
Our bereavement support team is here for you at any point after bereavement, whatever your feelings.
6. Donation and Palliative Care
No. The care, comfort and dignity of every patient in our unit is our first and only priority. The decision about donation is entirely separate from the care provided. No treatment will be given or withheld based on a donation decision, and no aspect of care will be altered. The two are completely independent.
This was a programme we previously ran successfully with the Irish Eye Bank until all Irish corneal donations had to cease in 2004 due to concerns around vCJD. Since then, Ireland has been entirely dependent on imported corneas for donation. From our experience and international research, we know that people who die in palliative care units are often genuinely interested in corneal donation. We believe that patients and families deserve to know this option exists, and to have the choice offered to them with honesty and care.
By doing so thoughtfully and compassionately, we hope to both honour individual wishes and contribute to reducing the shortage of donor corneas that affects people waiting for sight-restoring surgery across Ireland.