LETTER TO THE EDITOR
Year : 2018 | Volume
: 66 | Issue : 1 | Page : 179-
Comment on “Prevalence of ocular morbidity in school going children in West Uttar Pradesh”
Regional Director Christoffel Blinden Mission, Bengaluru, Karnataka, India
Dr. Sara Varughese
No 140, “Commerce Cube”, 5th Main, Puttannachetty Road, Chamarajpet, Bengaluru - 560 018, Karnataka
|How to cite this article:|
Varughese S. Comment on “Prevalence of ocular morbidity in school going children in West Uttar Pradesh”.Indian J Ophthalmol 2018;66:179-179
|How to cite this URL:|
Varughese S. Comment on “Prevalence of ocular morbidity in school going children in West Uttar Pradesh”. Indian J Ophthalmol [serial online] 2018 [cited 2020 Aug 7 ];66:179-179
Available from: http://www.ijo.in/text.asp?2018/66/1/179/221821
Singh et al. estimated the prevalence of ophthalmic morbidity in schoolchildren in Uttar Pradesh. Children not improving to 6/6 with a pinhole underwent a dilated fundus examination after tropicamide drop instillation. Permission and informed consent were taken from principals of the schools. Consent from the children and parents was not sought. This raises ethical concerns.
Although generally safe, the product information  for Mydriacyl (tropicamide) suggests that no controlled clinical studies have been performed in children, and hence, the safety and efficacy of the drug's use in children have not been established. In rare cases, tropicamide has been known to cause central nervous system disturbances, which may be dangerous in pediatric patients. Further glare following pupillary dilatation may put a child at risk if traveling home unaccompanied.
The UNESCO guidelines  are clear that “any preventive, diagnostic, and therapeutic medical intervention is only to be carried out with the prior, free and informed consent of the person concerned based on adequate information.” If the individual is not of age to give valid consent, then permission must be sought from the parents of the child. “In appropriate cases of research carried out on a group of persons or a community, additional agreement of the legal representatives of the group or community concerned may be sought. In no case should a collective community agreement or the consent of a community leader or other authority substitute for an individual's informed consent.”
These are standards that can be achieved in India. Saxena et al. have published their school eye screening where a letter explaining the entire procedure was sent to all the parents along with an informed consent form for the procedure.
The institutional review boards have the explicit responsibility to ensure that this happens. Beyond that, scientific journals like IJO must insist on exemplary ethical standards. Only in this way can we ensure ethical research.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
|1||Singh V, Malik KP, Malik VK, Jain K. Prevalence of ocular morbidity in school going children in West Uttar Pradesh. Indian J Ophthalmol 2017;65:500-8.|
|2||Alcon Laboratories (Australia) Pty Ltd. Product Information Mydriacyl (Tropicamide) 0.5% and 1.0% Eye Drops. Available from: http://www.medsafe.govt.nz/profs/datasheet/m/Mydriacyleyedrop.pdf. [Last accessed on 2017 Sep 05].|
|3||UNESCO. Universal Declaration on Bioethics and Human Rights 19 October, 2005. Available from: http://www.unesco.org/new/en/social-and-human-sciences/themes/bioethics/bioethics-and-human-rights/. [Last accessed on 2017 Sep 01].|
|4||Saxena R, Vashist P, Tandon R, Pandey RM, Bhardawaj A, Menon V, et al. Accuracy of visual assessment by school teachers in school eye screening program in Delhi. Indian J Community Med 2015;40:38-42.|