Awareness regarding eye donation among medical students: Plan to educate early
Soham S Pal1*, Zaid Nafe2, Veerendra B Atnoor3, Supriya V Chitupe4
1,3,4Department of Ophthalmology, 2Department of Community Medicine, DR. VM Government of Medical College, Solapur, Maharashtra.
Email: sohampal4@gmail.com
Abstract Background: According to WHO estimates India has 10 million blind populations. Corneal problems cause a significant proportion of blindness in India. Although effective strategies to prevent corneal blindness are likely to be more cost effective, visual rehabilitation by corneal transplantation remains the major treatment for restoring sight in those who already have corneal blindness. The requirement of donor corneas per year is at least 20 times the current procurement. Medical students can be involved in the motivation of patients and relatives to pledge their eyes and to do grief counselling for donating eyes Objective: To assess the knowledge and attitude of under graduate medical students regarding eye donation and their willingness to pledge eyes for donation. Methodology: A Cross sectional descriptive study was conducted among 400 medical students of a tertiary care hospital in Solapur. The study tool was pre tested semi structured self administered questionnaire. Results: 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. Mass media such as television, newspapers, magazines and posters were important sources of information on eye donation. 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.
Key Word: corneal blindness, eye donation, medical students
INTRODUCTION
Vision is the most important sense because it allows interacting freely with the environment and enjoying the beauty of life. Eye is sometimes called the “mirror of soul”. It twinkles with humor, sparkles with joy, softens with worry, hardens with anger, and clouds when things go wrong or one loses hope. The eye often reflects physical health. Once vision becomes significantly limited, it influences the activities of daily living. Even simple tasks become difficult to perform. So eye care is very important to maintain the eye health1. 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% is on account of corneal blindness2. Inspite of establishment of the hospital cornea recovery programme and modern eye banking models in India, the current cornea procurement rate in India is a dismal 22,000 per year. The annual requirement of corneas being 100,000 and utilization being only 40% (8800)3.85 domestic eye banks of the United States reported that there were 110,600 corneal donations and 59,271 corneal grafts. In Europe, approximately 20,000 corneal transplantation procedures are performed among 35,000 procured corneas per year. In the United Kingdom, corneal transplantation is performed for more than 3500 people per year4. Sri Lanka and USA are major donors of cornea for many countries including India because procurement of local corneas is low5.
AIM
the aim of the study was to assess the awareness regarding eye donation among medical the students.
MATERIAL AND METHODS
It is a descriptive cross-sectional study, and conducted in undergraduate medical students of DR. V. M. Government Medical College, Solapur, during period from November 2018 to February 2019. The data were collected via a structured questionnaire in English language. Socio-demographic information (age, gender, education) were taken with 21 questions about awareness regarding eye donation. We assess the level of awareness for each participant by scoring those 21 questions by giving 1 score point to each question, so the total points were 21 points. The participant were divided into 3 groups which were poor (0-11 points), satisfactory (12-16 points) and good (17-21 points). The participants were interviewed with the questionnaire after informed consent was taken.
RESULTS
Table 1: Distribution of study population according to socio-demographic characteristics.
Variables |
Males (%) |
Females (%) |
Total |
Age(in years)
15-20
21-25 |
98 (52.69%)
88 (47.31%) |
96 (44.86%)
118 (55.14%) |
194 (48.50%)
206 (51.50%) |
Education
First Year
Second
Third
Fourth |
56 (30.10%)
42 (22.58%)
48 (25.81%)
40 (21.51%) |
44 (20.56%)
58 (27.10%)
52 (24.30%)
60 (28.04%) |
100 (25.00%)
100 (25.00%)
100 (25.00%)
100 (25.00%) |
Socio- economic status
Upper (I)
Upper middle (II)
Lower middle (III)
Upper lower (IV)
Lower (V) |
105 (56.45%)
52 (27.96%)
29 (15.59%)
00
00 |
122 (57.01%)
68 (31.78%)
24 (11.21%)
00
00 |
227 (56.75%)
120 (30.00%)
53 (13.25%)
00
00 |
Type of family
Nuclear
Joint
Three Generation |
82 (44.09%)
57 (30.64%)
47 (25.27%) |
90 (42.06%)
68 (31.78%)
56 (26.16%) |
172 (43.00%)
125 (31.25%)
103 (25.75%) |
Religion
Hindu
Muslim
Christian
Others |
152 (81.72%)
30 (16.13%)
03 (01.61%)
01 (00.54%) |
174 (81.31%)
36 (16.82%)
03 (01.40%)
01 (00.47%) |
326 (81.50%)
66 (16.50%)
06 (01.50%)
02 (00.50%) |
It was seen from Table 1 that total 400 MBBS students participated in the study, out of which 186 (46.50%) were males and 214 (53.50%) female students. 206 (51.50%) students belonged to age group 21-25 years and 194 (48.50%) belonged to age group 15-20 years. Majority of the students belonged to upper class 227 (56.75%) followed by upper middle class with 120 (30.00%) students and 53 (13.25%) students belonged to lower middle class. There were no students who belonged to lower socio-economic status. Most of the students were from nuclear families 172 (43.00%) followed by 125 (31.25%) from joint families and 103 (25.75%) were from three generation families. Majority of the students were Hindus 326 (81.50%) followed by 66 (16.50%) were Muslims and 06 (01.50%) were Christians.
Table 2: Distribution according to AWARENESS regarding eye donation among medical students
Variables |
Males (%) |
Females (%) |
Total |
p-value |
1. Do you know eyes
can be donated after death?
Yes
No |
178 (95.70%)
08 (04.30%) |
207 (96.73%)
07 (03.27%) |
385 (96.25%)
15 (03.75%) |
The p-value is 0.7817. |
2. Source of
information about eye donation?
a. Newspaper
b. Television
c. Radio
d. Internet
e. Public hoardings
f. Friends & Relatives
g. Doctors & Hospital staff |
18 (09.67%)
21 (11.29%)
12 (06.45%)
52 (27.96%)
27 (14.51%)
25 (13.44%)
31 (16.68%) |
25 (11.68%)
27 (12.62%)
17 (07.94%)
67 (31.31%)
23 (10.74%)
21 (09.81%)
34 (15.90%) |
43 (10.75%)
48 (12.00%)
29 (07.25%)
119 (29.75%)
50 (12.50%)
46 (11.50%)
65 (16.25%) |
The p-value is 0.74317. |
3. Do you think eye
donation will be a service to mankind?
Yes
No |
174 (93.55%)
12 (06.45%) |
208 (97.20%)
06 (02.80%) |
382 (95.50%)
18 (04.50%) |
The p-value is 0.130134. |
4. Is eye donation
against your religious belief?
Yes
No |
22 (11.83%)
164 (88.17%) |
25 (11.68%)
189 (88.32%) |
47 (11.75%)
353 (88.25%) |
The p-value is 0.912001. |
5. Whether eyes can
be donated only after death?
Yes
No |
75 (40.32%)
111 (59.68%) |
90 (42.06%)
124 (57.94%) |
165 (41.25%)
235 (58.75%) |
The p-value is 0.803011. |
6. Do you know
about any eye banks in Solapur?
Yes
No |
181 (97.31%)
05 (02.69%) |
210 (98.13%)
04 (01.87%) |
391 (97.75%)
09 (02.25%) |
The p-value is 0.831385. |
7. Are you aware of
the ideal time to retrieve eyes
after death?
a. within 6 hours
b.7-12 hours
c. 13-18 hours
d. 19-24 hours
e. 25-36 hours |
142 (76.34%)
09 (04.83%)
05 (02.69%)
12 (06.45%)
18 (09.69%) |
172 (80.37%)
15 (07.01%)
08 (03.74%)
07 (03.27%)
12 (05.61%) |
314 (78.50%)
24 (06.00%)
13 (03.25%)
19 (04.75%)
30 (07.50%) |
The p-value is 0.2275 |
8. During transplantation
which part of the
donated eye is used for transplantation?
a. Only cornea
b. whole eyeball |
158 (84.95%)
28 (15.05%) |
189 (88.32%)
25 (11.68%) |
347 (86.75%)
53 (13.25%) |
The p-value is 0.3985. |
9. Does Eye donation
cause disfigurement of face of the donor?
Yes
No |
05 (02.69%)
181 (97.31%) |
03 (01.40%)
211 (98.60%) |
08 (02.00%)
392 (98.00%) |
The p-value is 0.576494. |
10. Can a person with
communicable disease
donate his/her eyes?
Yes
No |
25 (13.44%)
161 (86.56%) |
25 (11.68%)
189 (88.32%) |
50 (12.50%)
350 (87.50%) |
The p-value is 0.704767. |
11. The eyes can be
removed at donor’s house itself?
Yes
No |
123 (66.12%)
63 (33.88%) |
151 (70.56%)
63 (29.44%) |
274 (68.50%)
126 (31.50%) |
The p-value is 0.398778. |
12. Family is charged for donating organs, tissues and eyes
Yes
No |
05 (02.69%)
181 (97.31%) |
08 (03.74%)
206 (96.26%) |
13 (03.25%)
387 (96.75%) |
The p-value is 0.758004. |
13. Is history of medical illness is contraindication for eye donation?
Yes
No |
140 (75.27%)
46 (24.73%) |
155 (72.43%)
59 (27.57%) |
295 (73.75%)
105 (26.25%) |
The p-value is 0.596308. |
13. Is history of medical illness is contraindication for eye donation?
Yes
No |
140 (75.27%)
46 (24.73%) |
155 (72.43%)
59 (27.57%) |
295 (73.75%)
105 (26.25%) |
The p-value is 0.596308. |
14. Is there age limit for eye donation?
Yes
No |
20 (10.75%)
166 (89.25%) |
28 (13.08%)
186 (86.92%) |
48 (12.00%)
352 (88.00%) |
The p-value is 0.574495. |
15. Can patients using spectacles donate eyes?
Yes
No |
179 (96.24%)
07 (03.76%) |
211 (98.60%)
03 (01.40%) |
390 (97.50%)
10 (02.50%) |
The p-value is 0.234888. |
16. Is prior permission required for eye donation?
Yes
No |
157 (84.41%)
29 (15.59%) |
198 (92.52%)
16 (07.48%) |
355 (88.75%)
45 (11.25%) |
The p-value is 0.016253. |
17. Do you think that “CONSENT’ for donating eyes should be:
a. Mandatory and willed before death by the donor
b. Mandatory but after death by an adult family member
c. Optional at the discretion of donor alone
d. Optional at the discretion of an adult family member |
12 (06.45%)
152 (81.72%)
15 (08.06%)
07 (03.77%) |
18 (08.41%)
178 (83.18%)
16 (07.48%)
02 (00.93%) |
30 (07.50%)
330 (82.50%)
31 (07.75%)
09 (02.25%) |
The p-value is 0.2488 |
18. Do you think that eye donation can be facilitated if someone from an eye donation centre comes and asks for eye donation upon death of a person?
Yes
No |
183 (98.39%)
03 (01.61%) |
212 (99.07%)
02 (00.93%) |
395 (98.75%)
05 (01.25%) |
The p-value is 0.5424 |
19. Can donor’s eyes be stored in an eye bank?
Yes
No |
165 (88.71%)
21 (11.29%) |
192 (89.71%)
22 (10.29%) |
357 (89.25%)
43 (10.75%) |
The p-value is
0.7447 |
20. Do you believe in myths like we will be born blind in the next life after eye donation?
Yes
No |
16 (08.60%)
170 (91.40%) |
12 (05.61%)
202 (94.39%) |
28 (07.00%)
372 (93.00%) |
The p-value is
0.2416 |
Table 3: Distribution according to ATTITUDE regarding eye donation among medical students
Variables |
Males (%) |
Females (%) |
Total |
p-value |
|
21. Are you willing to donate/pledge your eyes?
Yes
No |
138 (74.19%)
48 (25.81%) |
157 (73.36%)
57 (26.64%) |
295 (73.75%)
105 (26.25%) |
The p-value is
0.8515 |
|
If yes, Reasons for donating eyes. |
Noble cause |
84 (60.88%) |
110 (70.06%) |
194 (65.77%) |
The p-value
is
0.3979 |
|
Pleasure to help the blind |
23 (16.67%) |
22 (14.01%) |
45 (15.25%) |
|
inspired by article/magazine/lecture |
18 (13.04%) |
15 (09.55%) |
33 (11.18%) |
|
Influenced by knowledge in academics |
11 (07.97%) |
07 (04.46%) |
18 (06.11%) |
|
friend/relative received cornea |
01 (00.72%) |
03 (01.91%) |
04 (01.35%) |
|
friend/relative donated cornea |
01 (00.72%) |
00 |
01 (00.34%) |
|
Reasons for not donating the eyes. |
objection by family members |
12 (25.00%) |
18 (31.59%) |
30 (28.57%) |
|
|
feels that body is ill-treated by organ transplant |
03 (06.25%) |
01 (01.75%) |
04 (03.81%) |
The p-value
is 0.598493. |
|
not eligible due to health problems |
04 (08.33%) |
03 (05.26%) |
07 (06.67%) |
|
religious reasons of removing eyes after death |
22 (45.84%) |
32 (56.14%) |
54 (51.43%) |
|
Not sure of correct use of cornea after extraction |
01 (2.08%) |
00 |
01 (00.95%) |
|
signing eye donation card is like signing death certificate
|
06 (12.50%) |
03 (05.26%) |
09 (08.57%) |
|
Table 4: Level of awareness by scoring system.
Category point (N=21) |
|
Fequency |
Poor |
(0-11) |
25 (06.25%) |
Satisfactory |
(12-16) |
242 (60.50%) |
Good |
(17-21) |
133 (33.25%) |
Table 5:
Variables |
Present study
(n=400) |
Ahirwar RK
et al6 (n=467) |
Bharti MK et al7
(n=103) |
Singh MM
et al8 (n=180) |
Do you know eyes can be donated after death? |
385 (96.25%) |
380 (81.4)
|
344 (86%) |
179 (99.4%) |
Source of information about eye donation? |
119 (29.75%)
Internet |
179 (38.3)
Television |
73 (71%).
mass media/ TV/
radio/
movies |
--------- |
Whether eyes can be donated only after death? |
165 (41.25%)
|
------------------- |
34(33%) |
179 (99.4) |
Do you know about any eye banks in Solapur? |
391 (97.75%)
|
300 (64.23%)
|
98(95.1%) |
16(32.6) |
Ideal time to retrieve eyes after death? |
314 (78.50%)
within 6 hours |
143 (30.62%)
within 6 hours |
39 (37.86%)
don’t know
32 (31.06%)
Hour/few hours |
74 (41.1%) |
Cornea is used for transplantation |
347 (86.75%)
|
229 (49.03%)
|
32(31.1%) |
155 (86.1%) |
Are you willing to donate/pledge your eyes? |
295 (73.75%)
|
107 (22.91%)
|
34 (33%) |
157 (87.2%) |
If yes, Reasons for donating eyes |
194 (65.77%)
Noble cause
|
251 (86.8%)
Noble cause
|
----------------- |
154 (85.5%)
Noble cause
|
Reasons for not donating the eyes. |
54 (51.43%)
religious reasons
|
86 (48.3%)
objection by
family members
|
----------------- |
59 (32.7)
Lack of awareness
|
DISCUSSION
Medical students are the potential part of the community who shall be the role models for the general population. The level of knowledge of medical students is important in promoting eye donations as they are the future potential doctors. Public awareness about eye donation is facing precisely the same challenges and obstacles as kidney donation did a couple of decades ago. Present study found that level of awareness regarding eye donation was satisfactory 242 i.e. 60.50% followed by good 133 i.e. 33.25% in medical students which was contrast to Bugis A et al9. As they found that most have poor level of awareness regarding eye donation in a sample of local people in Saudi Arabia.
CONCLUSION
The present study concluded that the knowledge regarding eye donation among medical students was good but still few didn’t know about the details related to the eye donation. So continuous awareness programmes and camps should be held and should include not only the community population but also for the undergraduate medical students. The present study revealed that most of the students were aware regarding eye donation and most of them were willing to donate their eyes. Those who were not willing to donate their eyes have reasons of religious belief and myths which can be changed with health education among medical students and their families and general community.
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