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   Table of Contents      
COMMUNITY EYE CARE
Year : 2007  |  Volume : 55  |  Issue : 1  |  Page : 49-52

Medical students' perception on eye donation in Delhi


Department of Community Medicine, Maulana Azad Medical College, New Delhi - 110 002, India

Date of Submission30-Jun-2005
Date of Acceptance26-Oct-2006

Correspondence Address:
Meghachandra M Singh
71A/ J and K Pocket, Dilshad Garden, Delhi - 110 095
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.29495

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  Abstract 

Corneal transplantation remains a major treatment option for restoring sight among those suffering from corneal blindness. The number of corneal transplants done is far less than the actual requirement in India. This is largely due to the inadequate numbers of corneas collected. Medical students can be involved in the motivation of patients and relatives to pledge their eyes and to do grief counseling for donating eyes. The aim of the study was to assess the perception and willingness of 180 first-year medical students towards eye donation in Delhi. They were administered a pretested semi-structured questionnaire on eye donation. Data were analyzed using Epi-Info software package 6.04 version. The majority (99.4%) of students knew that eyes can be donated after death but only 41.1% knew that the ideal time of donation was within six hours of death. Most participants (87.2%) were willing to donate eyes. Nobility in the act of eye donation was the main motivational force for eye donation according to 85.5% of students. Perceived reasons for not pledging eyes by the people were: lack of awareness (32.7%), objection by family members (27.7%), unsuitability to donate because of health problem (17.7%) and the unacceptable idea to separate the eye from the body (15.5%). Mass media such as television, newspapers, magazines and posters were important sources of information on eye donation. Perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community.

Keywords: Blindness, corneal transplantation, eye donation.


How to cite this article:
Singh MM, Rahi M, Pagare D, Ingle G K. Medical students' perception on eye donation in Delhi. Indian J Ophthalmol 2007;55:49-52

How to cite this URL:
Singh MM, Rahi M, Pagare D, Ingle G K. Medical students' perception on eye donation in Delhi. Indian J Ophthalmol [serial online] 2007 [cited 2019 Mar 22];55:49-52. Available from: http://www.ijo.in/text.asp?2007/55/1/49/29495

Source of information on eye donation

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Source of information on eye donation

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Distribution of perceived reasons for not donating eyes*

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Distribution of perceived reasons for not donating eyes*

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Distribution of perceived reasons for donating eyes by donors*

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Distribution of perceived reasons for donating eyes by donors*

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Responses to questionnaire on eye donation

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Responses to questionnaire on eye donation

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Corneal diseases constitute a significant cause of visual impairment and blindness in the developing world. The major causes of corneal blindness include trachoma, corneal ulceration following xerophthalmia due to vitamin A deficiency, ophthalmia neonatorum, use of harmful traditional medicines, onchocerciasis, leprosy and ocular trauma.[1],[2],[3]

The Andhra Pradesh Eye disease study (APEDS)[4] reported the prevalence of corneal blindness at 0.13% (95% CI: 0.06-0.24), constituting 9% of all blindness. APEDS also suggested a significant burden of corneal blindness in the rural population of Andhra Pradesh, of which 95% was avoidable. Although strategies to prevent corneal blindness are likely to be more cost-effective, visual rehabilitation by corneal transplantation remains a major treatment option for restoring sight in those who already have corneal blindness.[4]

Approximately 18.7 million people are blind in India[5] and 1,90,000 are blind from bilateral corneal disease. Every year another 20,000 join the list. This problem is compounded by a low level of annual procurement of donor eyes which is 18,000 annually as per a report of the National Programme for Control of Blindness and Eye Awareness.[6] The late Dr. Muthiah started the very first eye bank in India and he performed the first corneal transplant successfully in 1948.[7] Even after more than 50 years, patients waiting for corneal transplants constitute a considerable backlog which is growing. The need, therefore, is to educate the masses about eye donation in an effort to increase the procurement of corneas.[8]

Well-informed medical students could be expected to influence eye donation rates.[8] Education of physicians early in their courses may lead to better procurement rates for donor organs.[9] This study was designed to assess the perception of first-year medical students towards eye donation and their willingness to pledge eyes.


  Materials and Methods Top


This was a cross-sectional study, undertaken in September 2002, among 180 newly admitted first-year medical students of the Maulana Azad Medical College, New Delhi. A pretested, semi-structured questionnaire (appendix) was self-administered for collecting the necessary information after getting informed consent. The questionnaire contained questions on demographic details, their awareness on eye donation, reasons for donating and not donating eyes by people as perceived by them, their intention to donate eyes and sources of information.

The data were entered and analyzed using Epi-info software package version 6.04. Data were expressed in proportion.


  Results Top


All 180 students participated in the study. The age distribution of the students was: 18 years (39, 21.7%), 19 years (96, 53.3%), 20 years (38, 21.1%) and 21 years (7, 3.9%) with a mean of 19.07 + 0.76 SD years. There were 96 males (53.3%). The majority, 145 out of 180 (80.5%) of the students studied in public and private schools and only 35 out of 180 (19.5%) had done their schooling from government and government-aided schools. There was no significant difference in the distribution of male and female students with regard to age and schooling background.

It was observed that 179 (99.4%) out of 180 students knew that eyes can be donated after death and ideally within six hours of death was known to 74 (41.1%) of 180 students [Table - 1]. The contact place for donation was known to only 49 (27.2%) of 180 students. The majority of the participants, 157 (87.2%) of 180 students were willing to donate eyes.

The distribution of perceived reasons to the students for eye donation by the donors is shown in [Table - 2]. Nobility in the act of eye donation was the main motivational force according to 154 (85.5%) of the 180 students. Lack of awareness was cited as an important reason for people not donating their eyes among 59 (32.7%) of 180 students [Table - 3]. Twenty-three (12.8%) of 180 students each perceived objection by family members or disliking to separate the eye from the body as the single most important reason for not donating the eyes.

Nearly half of the respondents, 89 out of 180 (49.4%) opined that donors' consent should be mandatory and it should be expressed before death, whereas according to 27 out of 180 (15%), consent should be mandatory but may be given by another adult family member. According to 56 out of 180 (31.1%), consent is not necessary but can donate if the donor alone wishes and among 8 out of 180 (4.4%), consent is not necessary but can donate if the family members of the donors wish to do so.

[Table - 4] shows that television was the most common source of information on eye donation in 140 (77.8%), followed by newspaper 131 (72.8%) and magazines 98 (54.4%) of 180 students.


  Discussion Top


In the present study 99.4% were aware that eyes could be donated after death. In a study among the south Indian population, 50.7% of participants were aware of eye donation.[10] In another study among hospital staff, 97% of them had good to excellent knowledge about transplantation of various human organs.[11] Information by mass media could be related to the high level of awareness in our study participants.

A large number of students, 155 (86.1%) out of 180 knew that the donated eye is used for corneal grafting and less than 50% knew that the ideal time for donation is within six hours of death. A study on medical and nonmedical students also observed that 79.6% of medical students knew that eyes can be donated after death and 63.3% knew that it should be done within six hours.[8] Another study in the general population showed the awareness level on eye donation to be 73.8%.[1] In the present study, only 49 (27.2%) out of 180 students knew about appropriate place for eye donation. A study done on final year medical students showed that 67.4% students could name a few eye banks.[8] This could be due to their increased knowledge in this field as compared to first-year students.

Our study showed that 170 (94.4%) of 180 participants agreed that there is shortage of eye donors and 157 (87.2%) of 180 were willing to donate eyes. In a study among optometry students, 64.5% of the respondents were willing for eye donation.[12] Another study in the urban population observed that 73.8% were aware of eye donations and only 44.9% were willing to pledge their eyes.[13] Willingness to donate eyes was less (41.5%) even among relatives of post-mortem cases who were aware about eye donation.[14] High percentage of medical students willing to pledge their eyes is supported by another study done on final year medical students, where 83.7% were willing.[8] About 85 (47%) of 180 participants were aware about selling and buying of donor eyes and 9.4% agreed to such an arrangement if needed. It was observed in a study that as the waiting list of patients requiring organ transplantation grows, there is a subtle but noticeable shift in the society towards accepting organs as a commodity, which can be paid for. It is essential to instill and promote human values in medical education to discourage such unscrupulous trade strongly, which exploits the poor.

The prime reasons cited in the study for eye donation was nobility in the work by 154 (85.5%) and pleasure to help the blind by 141 (78.3%) of the 180 participants. But lack of awareness was the reason for people not donating eyes according to 59 (32.7%) of 180 respondents. Other reasons for not donating eyes included objection by family members, dislike of disfiguring the body, delaying of religious rites and religious restrictions. Similar reasons were also reported in other studies.[9],[12],[14]

Mandatory consent for donation expressed before the death of the donor should form the basis for eye donation ideally. However, in case of unavailability of such consent, consent from adult family members of the deceased donor should be obtained for eye donation. In a study done on the responses of relatives of post-mortem cases, it was revealed that out of the potential post-mortem donors, only 44.3% of relatives of such cases gave consent for donation after intensive counseling.[14] Mass media in the form of television, newspapers, magazines and posters were important sources of information on eye donation. Other studies also found publicity campaigns and the media to be the major sources on this issue.[1],[10],[13]

The present study revealed that first-year medical students were well aware about eye donation and most of them were inclined to pledge for eye donation. The perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community. The medical students could be actively involved as volunteers in eye donation campaigns, wherein after proper training in counseling techniques, they can act as counselors for eye donors. They can also contribute by participating in creating awareness and motivating the people for eye donation during their postings in the community medicine.

 
  References Top

1.
Krishnaiah S, Kovai V, Nutheti R, Shamanna BR, Thomas R, Rao GN. Awareness of eye donation in the rural population of India. Indian J Ophthalmol 2003;52:73-8.  Back to cited text no. 1
    
2.
Dandona L, Dandona R, Naduvilath TJ, McCarty CA, Nanda A, Srinivas M, et al . Is current eye- care policy focus almost exclusively on cataract adequate to deal with blindness in India? Lancet 1998;351:1312-6.  Back to cited text no. 2
    
3.
Rekhi GS, Kulshreshtha OP. Common causes of blindness: A pilot study in Jaipur, Rajasthan. Indian J Ophthamol 1991;39:108-11.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.
Dandona L, Dandona R, Srinivas M, Giridhar P, Vilas K, Prasad MN, et al . Blindness in Indian state of Andhra Pradesh. Invest Ophthalmol Vis Sci 2001;42:908-16.   Back to cited text no. 4
    
5.
Dandona L, Dandona R, John RK. Estimation of blindness in India from 2000 through 2020: Implications for the blindness control policy. Natl Med J India 2001;14:327-34.  Back to cited text no. 5
[PUBMED]    
6.
Ministry of Health and Family Welfare, Government of India. Eye care services - eye banking. [cited on 2006 Oct 13]. Available from: http:/mohfw.nic.in.b/index.html#vision.  Back to cited text no. 6
    
7.
Bardell T, Hunter DJ, Kent WD, Jain MK. Do medical students have the knowledge needed to maximize organ donation rates? Can J Surg 2003;46:453-7.  Back to cited text no. 7
[PUBMED]  [FULLTEXT]  
8.
Kannan KA. Eye donation movement in India. J Indian Med Assoc 1999;97:318-9.  Back to cited text no. 8
[PUBMED]    
9.
Priyadarshan B, Srinivasan M, Padmavathi A, Selvam R, Nirmalan PK. Awareness of eye donation in an adult population of southern India. A pilot study. Indian J Ophthalmol 2003;51:101-4.  Back to cited text no. 9
    
10.
Singh P, Kumar A, Pandey CM, Chandra H. Level of awareness about transplantation, brain death and cadaveric organ donation in hospital staff in India. Prog Transplant 2002;12:289-92.  Back to cited text no. 10
[PUBMED]    
11.
Golchet G, Carr J, Harris MG. Why don't we have enough cornea donors? A literature review and survey. Optometry 2000;71: 318-28.  Back to cited text no. 11
    
12.
Dandona R, Dandona L, Naduvilath TJ, McCarty CA, Rao GN. Awareness of eye donation in an urban population in India. Aust NZ J Ophthalmol 1999;27:166-9.  Back to cited text no. 12
[PUBMED]  [FULLTEXT]  
13.
Tandon R, Verma K, Vanathi M, Pandey RM, Vajpayee RB. Factors affecting eye donation from post-mortem cases in a tertiary care hospital. Cornea 2004;23:597-601.  Back to cited text no. 13
[PUBMED]  [FULLTEXT]  
14.
Phadke KD, Anandh U. Ethics of paid organ donation. Pediatr Nephrol 2002;17:309-11.  Back to cited text no. 14
[PUBMED]  [FULLTEXT]  



 
 
    Tables

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


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