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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 28  |  Issue : 2  |  Page : 112-115

Knowledge, attitude and practice about eye donation among medical and paramedical students in tertiary eye care hospital


1 Department of Ophthalmology, Al Ameen Medical College and Hospital, Bijapur, Karnataka, India
2 Department of Medicine, BLDE University, Shri B.M. Patil Medical College Hospital and Research Centre, Bijapur, Karnataka, India

Date of Web Publication20-Mar-2017

Correspondence Address:
Hosamani Sushma
Department of Ophthalmology, Al Ameen Medical College and Hospital, Bijapur, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kjo.kjo_30_16

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  Abstract 


Background: Eye sight is very important for human life. The World Health Organization (WHO) estimates that every 5 seconds someone goes blind. Globally, 37 million people are blind, and of these nearly 10 lakh blind people are willing for corneal transplantation.
Aims: The aim of the study was to assess the knowledge, attitude, and practice regarding eye donation among the students.
Materials and Methods: The data were collected by the questionnaire method from medical and paramedical students at Al Ameen Medical College, Bijapur. Data collected from the participants were analyzed using percentage and descriptive statistics.
Results: Out of the 250 students, 60.4% were Muslim by religion. The participants were wellaware of eye donation (99.2%) quoting media as a major source of information for their knowledge. Attitude regarding eye donation in few (45.6%) was different as it was against their religious belief, although they said it was a service to the mankind (92%). Out of the 250 students, 48% were willing to pledge and 52% students did not believe in pledging their eyes.
Conclusion: The findings of the study showed that overall knowledge about eye donation among students was good, however the attitude and practice showed mixed responses.

Keywords: Attitude, eye donation, knowledge, practice


How to cite this article:
Sushma H, Warad V G, Kshetrapal M. Knowledge, attitude and practice about eye donation among medical and paramedical students in tertiary eye care hospital. Kerala J Ophthalmol 2016;28:112-5

How to cite this URL:
Sushma H, Warad V G, Kshetrapal M. Knowledge, attitude and practice about eye donation among medical and paramedical students in tertiary eye care hospital. Kerala J Ophthalmol [serial online] 2016 [cited 2019 Jan 16];28:112-5. Available from: http://www.kjophthal.com/text.asp?2016/28/2/112/202475




  Introduction Top


Eye sight is very important for human life. The World Health Organization (WHO) estimates that for every 5 seconds someone goes blind. Corneal diseases constitute a significant cause of visual impairment and blindness in the developing world. With 7.8 million blind people in India, the country accounts for 20% of the 39 million blind population across the globe, of which 1% are on account of corneal blindness (WHO visual impairment and blindness fact sheet June 2012).[1] Though there has been progress in eye donation only 53543 eyes were collected in the year 2012-2013, whereas the target was approximately 60,000 according to the National program for control of blindness 2012-2013.[2] According to the Eye Bank Association of India, the current cornea procurement rate in India is 22,000 per year. It is estimated that a significant proportion of donor corneas are unsuitable for corneal transplantation.[3] Based upon our current ratio of available safe donor eyes, we would need 277,000 donor eyes to perform 100,000 corneal transplants in a year in India.[4] This is approximately a 20-fold increase from the donor eyes available now. Shortage of transplantable corneas is common, and has been the subject of much attention. To increase procurement of corneas, raising the level of public education on eye donation is an important first step. Soliciting for actual eye donation at the time of family death is a necessary and accepted practice.[4] Though the factors affecting procurement of corneas and the public attitude towards eye donation have recently received attention in the developed world,[5] not much has been published from the developing world.[4] The purpose of this study is to spread awareness for eye donation among medical and paramedical students at a tertiary eye care centre.


  Materials and Methods Top


Awareness was defined as having heard of eye donation. Knowledge was defined as “if the participants had some understanding about the use of the donated eye like replacing a part of another eye or for replacing the cornea of another eye”. Attitudes were defined as “personal views, opinions, or feelings on eye donation/corneal transplant”. Practice was defined by “participants who had heard about eye donation were willing to pledge eyes for donation.” Two hundred fifty students were included in the study. The data were collected by questionnaire method from medical and paramedical students. We used a structured questionnaire to elicit responses. We included questions regarding awareness of eye donation, source of information, awareness of corneal transplantation, and religious beliefs. Questions were administered in the local language. We also collected demographic details from respondents including age, gender, and education.

Knowledge of the respondents was assessed through questions regarding meanings of the terms “eye donation”, source of information for their knowledge, ideal time for retrieval of eyes, whether eye donation causes disfigurement of face, and which part of the donated eye is used for transplantation. Attitudes of the respondents regarding eye donation was determined through questions regarding opinions on issues such as the willingness to donate eye in the future and influence of religion on attitude towards eye donation. Practices were determined by, after counseling, whether the participant agreed to fill the pledge form, whether the participant agreed to motivate other family members/friends to fill the pledge form of eye donation, and whether the participant agreed to spread the knowledge regarding eye donation to others.

Questionnaire

  1. Age/gender
  2. Religion and education
  3. Heard about eye donation: yes/no
  4. If yes, source of awareness: family/doctors/friends/media
  5. Do you think eye donation will be a service to mankind? Yes/No
  6. Is eye donation against your religious belief? Yes/No
  7. Whether eyes can be donated only after death? Yes/No
  8. Are you aware of the ideal time to retrieve eyes after death? Yes/No
  9. During transplantation which part of the donated eye is used for transplantation: Only cornea (layer in front of the black portion of the eye)/whole eyeball.
  10. Eye donation causes disfigurement of face of the donor? Yes/No
  11. The eyes can be removed at donor's house itself? Yes/No
  12. Family will be charged for donating organs, tissues and eyes: Yes/no
  13. History of medical illness is contraindication for eye donation: Yes/no
  14. Is there age limit for eye donation: Yes/no
  15. Can patients using spectacles donate eyes: Yes/no
  16. Person with eye problem like cataract or glaucoma cannot donate their eyes: Yes/no
  17. Prior permission required for eye donation: Yes/no
  18. Is there an eye bank in our city? Yes/no
  19. Do you believe in myths like we will be born blind in the next life? Yes/no
  20. Are you willing to donate/pledge your eyes? Yes/No



  Results Top


Out of the 250 students, 60.4% were Muslim by religion [Table 1]. The participants were well aware regarding eye donation (99.2%) quoting media as a major source of information for their knowledge [Table 2].
Table 1: Distribution based on religion

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Table 2: Source of information

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Students were well aware that eyes could be donated only after death (82.4%), and that during transplantation only the front part of the eye or the cornea is used for replacing the recipients' cornea (93.6%). Majority were well aware of the ideal time to collect eyeballs (74%) without causing disfiguration and eyes can be collected even at house itself (57.2%). Majority knew that eye donation being a novel cause was not charged (91.6%) and systemic illnesses, such as diabetes mellitus or hypertension, were not contraindication for eye donation (64%), even persons with spectacles and the one with cataract or glaucoma without age limit (64%) can also donate the eyes [Table 3]. Attitude regarding eye donation in few (45.6%) was different because it was against their religious belief, although they said it was a service to the mankind (92%) [Table 4].
Table 3: Knowledge about eye donation

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Table 4: Attitude regarding eye donation

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Practice regarding eye donation among these students showed a mixed response. Out of 250 students, 48% (120) were willing to pledge and 52% (130) students did not believe in pledging theeyes. In India there are various myths associated with eye donation that may prevent many people from donating their eyes.


  Discussion Top


Corneal transplantation offers the potential for sight restoration to those who are blind from corneal diseases. This, however, is dependent on people willing to pledge their eyes for donation. Although 99.2% of the participants were aware of eye donation, the willingness to donate eyes was seen in only 48% of the participants. This finding of better awareness than willingness to donate eyes was well observed in the study by Yew et al. in 2005 in Singapore (awareness 80.7% and willingness 67%).[6] Furthermore, the study by Tandon et al. in 2004, showed that the prior knowledge of eye donation, literacy, and socioeconomic status had no influence on willingness for eye donation and major reasons for not donating eyes included refusal to discuss the issue, legal problems, and religious beliefs.[7] According to study by Bhandary et al.[8] awareness of eye donation was observed in 69% of the participants. In our study, 57.2% of the participants knew that eyes could be retrieved at the house of the deceased. Among those who were aware regarding eye donation, 88% knew that eyes could be donated only after death whereas according to our study 82.4% knew this fact.

Disfigurement of the face as a result of eye donation was documented by 6.8% of the participants in our study. According to Bhandary et al., no disfigurement of the face as a result of eye donation was documented by 76.2%. They also observed that the most important source of awareness was the media (55.4%) with newspapers topping the list (36.7%). According to our results, media was the most common source of information on eye donation in 60.8% of the participants. In our study, 60.4% of the Muslim participants felt that eye donation is against their religion. Many studies have shown that ethnicity has an important role in the willingness of organ donation. Studies show that there was poor awareness about the “Fatwa” regarding organ donation passed by the Muslim law council in 1995. According to fatwa, it is permissible to benefit from another person's organ or tissue which has been excised for medical reasons such as cornea. The main condition stipulated by the fatwa is that the dead person should have given his/her consent before death; or his/her heirs give theirs after his/her death. If neither the deceased nor heirs were identifiable, then the consent of the “Guardian of the Muslims” should be obtained. This lack of awareness has led to the fear of doing something against religion by donating organs among the population. Probably, the reasons for the unwillingness could have been culture-specific issues, arguing against donation including a sense of the sacredness of the body, belief that it is important to have an intact body after passing away and fear of illegal trade in organs.[9],[10]

Thus, to realize the dream of reducing the burden of avoidable corneal blindness, the ophthalmologists, general physicians, nongovernmental organizations (NGOs), and especially religious leaders have to work in unison to educate and motivate people to donate eyes. There is also a great need to educate students in all fields, particularly those in the medical profession regarding eye donation; to enable the younger generation to act as future motivators for enhancing eye donation rates. Strategies that have worked well in other parts of the world may be useful here too. For example, in USA, the Presumed Consent Law was introduced in 1975. This concept has legal sanction, where, if the dead person has not registered any objection to donate while alive, consent is presumed and eyes can be removed as required. This legislation has led to a manifold increase in the availability of corneal tissue. In India, we do not yet have such legislation; the government may consider the concept of “presumed consent” to boost eye donations. Such legislation would emphasize the government's commitment to the cause of eye donation. Another area of legislation is the “required request law”, wherein it becomes mandatory for all health care staff, institutions coming into contact with bereaved families to make a request for eye donation. This requires legal sanction.[11]


  Conclusion Top


The findings of the study showed overall knowledge regarding eye donation among students was good; however, the attitude and practice showed mixed responses. Effective measures should be taken to educate people with relevant information with the involvement of media, doctors, and religious scholars.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
WHO, Visual impairment and blindness. Fact Sheet N°282; June 2012.  Back to cited text no. 1
    
2.
National program for control of blindness; 2012-2013.  Back to cited text no. 2
    
3.
Dandona R, Dandona L, Naduvilath TJ, McCarty CA, Rao GN. Awareness of eye donation in an urban population in India. Aust N Z J Ophthalmol 1999;27:166-9.  Back to cited text no. 3
    
4.
Saini JS. Realistic Target and Strategy in eye Banking. IJO 1997;45:141-2.  Back to cited text no. 4
    
5.
Diamond GA, Michael C, Mossoline JF, Robert AD. Obtaining consent for eye donation. AJO 1987;103:198-203.  Back to cited text no. 5
    
6.
Yew YW, Saw SM, Pan JC, Shen HM, Lwin M, Yew MS, et al. Knowledge and beliefs on corneal donation in Singapore adults. Br J Ophthalmol 2005;89:835-40.  Back to cited text no. 6
    
7.
Tandon R, Verma K, Vanathi M, Pandey RM, Vajpayee RB. Factors affecting eye donation from postmortem cases in tertiary care hospital. Cornea 2004;23:597-601.  Back to cited text no. 7
    
8.
Gupta A, Jain S, Jain T, Gupta K. Awareness and perception regarding eye donation in students of a nursing college in Bangalore. Indian J Community Med 2009;34:122-5.  Back to cited text no. 8
[PUBMED]  [Full text]  
9.
Randhawa G. An exploratory study examining the influence of religion on attitudes towards organ donation among the Asian population in Luton UK. Nephrol Dial Transplant 1998;13:1949-54.  Back to cited text no. 9
    
10.
Alam AA. Public opinion on organ donation in Saudi Arabia. Saudi J Kidney Dis Transpl 2007;18:54-9.  Back to cited text no. 10
[PUBMED]  [Full text]  
11.
Farge EJ, Silverman LM, Khan MM, Wilhelmus KR. The impact of state legislation on eye banking. Arch Ophthalmol 1994;112:180-85.  Back to cited text no. 11
    



 
 
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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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