Organ transplants raise difficult ethical questions about people’s right to determine what happens to their bodies. According to the WHO, 5% of the world’s 39 million blind people suffer from corneal opacity, the scarring or clouding over of the cornea, while another 4% suffer from trachoma, a bacterial infection that results in damage to the cornea. Cataracts and glaucoma are the most common causes of blindness, while trachoma is described as the main cause of preventable blindness.

The main reason for cornea damage in Pakistan are infections – sometimes including ulcers (infective keratitis) – or keratoconus, wherein the cornea becomes too thin and its shape is distorted. In the UK, the main reason for cornea damage is a condition that mainly affects older people called Fuchs’ dystrophy, which causes the cornea to swell and become cloudy. Keratoconus is also a problem, affecting mostly younger patients.

The cornea is one of the easiest tissues to transplant as it does not require donor and recipient to match. It is bloodless tissue, taking oxygen directly from the air. It is also possible to take a cornea from an elderly person, and graft it on to the eyes of a much younger one. If a donor is more than 80 years of age, there is a higher chance that the cornea will not be suitable. However, it has been reported that in one case the cornea of an 86-year-old Buddhist monk was given to a nine-year-old Jordanian boy. Harvesting of the eye must happen within a few hours of death and the cornea itself must be used on a patient within about four weeks, depending on the storage method.

The eagerness of Sri Lankans to offer their corneas to others shows how the country has long harvested more than it needs and has been able to send the surplus to other countries. On the other hand, the reluctance surrounding organ donation in the Islamic world really is an alarming situation for Islam and humanity.

In Muslim countries it is generally forbidden to damage the human body, before or after death, so Pakistan and Egypt have been major recipients of Sri Lankan corneas. Malaysia, Nigeria and Sudan also feature on the list of more than 50 receiving countries. Becoming an organ donor is an unarguable good. If you die and offer your body to medicine, you can extend the life of others with zero inconvenience—after all, you’re dead. But in actuality, the perception of organ donation isn’t quite so crystal clear and requires more attention and concern from society.


Karachi, May 4.