A Day in the Life of an Eligibility Specialist: Meet Terri Koelling

Evaluating eye tissue for human transplant requires attention to detail.

By Rae Price - May 23, 2024

Eye tissue evaluation key to transplants.

Although the job can be emotional, working as an eye tissue eligibility specialist at Rocky Mountain Lions Eye Bank (RMLEB) can provide heart-warming rewards. Terri Koelling has worked for RMLEB for 10 years. She came to the eye bank after 16 years in funeral services, where her interest in eye banking began.

While working for a funeral home, Terri was introduced to RMLEB and able to observe eye tissue recoveries, which piqued her interest in the organization’s mission. She told herself that if she ever left the funeral business, she would explore options at the eye bank. Eventually, after 16 years, she did move on and kept an eye on RMLEB’s job board for a position that would match her skills and interests. She started as a recovery coordinator/technician, which at that time was a combined position. Terri said working at RMLEB gave her the opportunity to keep medical instruments in her hands, while doing eye tissue recoveries, “which is exactly what I wanted to do.” 

Armed with degrees in social work and mortuary science, she was well suited for a job that requires emotional maturity and attention to detail. Terri has also been an adjunct anatomy and philosophy lab professor, speaking to her strong interest in medical and science-related jobs. That knowledge, she said, was helpful, but she has also continued to learn and stay current with changes in the industry. In fact, she recently received the designation of Certified Eye Bank Technician (CEBT), a status conferred, after stringent testing, by the Eye Bank Association of America. The certification lends additional credibility to the technician and the associated eye bank.

Typical day includes eye donor medical chart review.

A typical day at the eye bank is not always typical depending on the case load but does follow a pattern. The eye tissue recovery staff works in two shifts. Terri is on the day shift, so begins her day at 8 a.m. with charting, and ends at 6 p.m. after the evening blood samples have been submitted for serology testing. In this case, charting is reviewing the tissue donor’s medical history to ensure the cornea is safe for transplant in the recipient. Processing, or preparing the eye tissue for release to a surgeon for transplant, can’t happen until thorough review of medical records, serology reports, family history, and more.

She also relies on the reports from the recovery coordinators and technicians, those who do the initial review of the donor and procure the corneas. These people, she explained, are her, “eyes and ears in the field”, looking for things that might need further review to ensure the eye tissue is eligible for transplant in another person.

Terri looking through slit lamp.

Eye tissue is reviewed using a slit lamp, a special microscope that allows the cornea to be examined for blemishes and quality, including cell counts. While higher cell counts are optimal, Terri explained there is often no rhyme or reason as to how many cells are present. Everyone is born with a certain number of cells, so as people age some cells will be lost, but she added, “Logic would tell you that a younger donor would have a higher cell count and an older donor will have a lower cell count – there is a general trend in that- but you can’t always count on that because certain disease processes will affect that and just luck of the draw will affect that. Some younger donors have a surprisingly low cell count, and some older donors have a surprisingly high cell count. So, we evaluate every single cornea for its cell count.”

Image of cells with green dots indicating counts.

Cells are counted using a computer-generated algorithm, where a specific area is chosen and cells within that area are manually counted with mouse clicks.

Teamwork and coordination is key.

Fulfilling the wishes of eye donors and their families takes a lot of teamwork and coordination. “Everybody is part of the wheel,” Terri said, “When the referrals [of potential donors] come in, if they can’t be processed, nothing happens down the road. We are doing everything we can to honor the decision of the donor and the family.”

Honoring the mission requires commitment.

Terri explained working at RMLEB requires a commitment to the mission. She said there are times when it might be snowing, and someone doesn’t want to drive through the snow, or it is late, and they want to go home. “Eye bankers can’t do that,” Terri explained, “We don’t have the flexibility of time, we have to get everything done– but the rewards are high.”

Teamwork is also important due to the emotional aspect of dealing with death and grieving families every day. She said it is important to remember you are working with others who know what you are experiencing, “It’s OK to share your feelings with co-workers, knowing you are in a supportive environment.”

One of the most rewarding things for her is seeing the corneas being released for transplant. “I really like being part of the research, but also when we get corneas ready to go to countries that have low transplant rates because of the circumstances of the countries; we are part of gathering and getting tissue ready for a team to go, that makes me very happy and just knowing that we are supporting the wish of the donor and their family.”

Terri concluded, “It’s an honor to work at the eye bank because every day you get to come to work and know that you’re going to make a difference. Whether you’re going to see the end result or not, every day you’re coming to work and what you do will impact somebody in a positive way.”
A text graphic including the blue and green logo for Donate Life. Cursive-like font under the logo read: Colorado and Wyoming Careers
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