Ms RESHMA BANU NAIK

Ms RESHMA BANU NAIK

I YEAR M. Sc NURSING

MEDICAL SURGICAL NURSING

YEAR 2011-2012

TULZA BHAVANI COLLEGE OF NURSING

NO, 899/3, NEAR HAJRAT JUNEEDI DARGA, GYANG BAWADI,

BIJAPUR - 586101.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

6. BRIEF RESUME OF THE INTENDED WORK

6.1 INTRODUCTION

“The eye is the window to the world and the window of the Soule’’

-William Shakespeare

‘It is a terrible thing to see and have no vision ‘said Helen Keller about people who have the gift of sight but see little with those eyes for the sighted. The colorful flowers ,butterflies ,raindrops are no wonder but for some one has had a corneal transplants, the sight of the worlds beauty is nothing less than a miracle.1

The human eye is organ of vision. A vital organ of vision it plays a very important role not only in life but also the human body. The human eye is organ which gives us sense of sight allowing us to learn more about the surrounding world. Then we do with any other four senses the eye allows us to see and interpret the shapes, colour and dimension of the objects in the world by processing the light they reflect or emit. The eye is able to see in bright light or in dim light, but it can not see object when there is no light, we use our eyes in almost every activity we perform, whether reading, watching television , and in other countless ways now a days good vision is critical at essential to conducting activities of daily living activities easily.2

Blindness is a devastating physical condition with deep emotional and economic implications. The consequences affect not only the individual but also the family and the community. A blind person loses his or her independence and is prone to experience a sense of profound loss and depression arising from being economic emotional burden and indirectly so childhood has unique problems. Thus, much time and resources are spent to reduce this burden of blindness with an aim to prevent it as far as possible.3

Eye donation is noble act, which enables a visually impaired person to gain eye sight through another person’s donated corner. The donor actually pledges to donate his or her eyes before their death. There are approximately 35 million people in the world who are blind or going blind and most are curable if they had a corner donor. Curable people comprise of almost 3 million people of which 60% are children aged below 12. There are approximately 1.2 cores blind people in India of these around 20 lakh carnally blind are in need of corneal transplantation. As against annual requirements of 75,000 to 1, 00,000 corneas are donated in India at present.4

Blindness is the condition of lacking visual perception due to physiological or neurological factors. It may also refer to a loss vision that cannot be corrected with glasses or contact lenses. Various scales have been developed to describe the extent of vision loss and define blindness total blindness is clinically recorded as NLP an abbreviation for ‘No light perception’, no vision is defined as visual acuity of less than 6/18(20/60) but equal to or better than 3/60(20/400) or corresponding visual field loss to less than 10 degrees. In the better eye with best possible correction. Partial blindness means you have very limited vision, complete blindness means you cannot see anything and do not see light. Cornea transplantation is not a life saving produce but it has great potential for enhancing quality of life most of visual impairment is resulting from corneal damage defective cornea causes blindness. The leading causes of corneal damage requiring transplant are keratinous, Fuchs dystrophy, herpes simplex keratins, and chemical burns patients considering cornea transplant must be evaluated for other ocular conditions that can affective visual acuity after transplant. This condition includes strabismus, amblyopic, retinal disease, glaucoma and previous cataract surgery. A complete examination of all ocular structures is performed to determine existing conditions that can effect graft survival. The eye is carefully assessed for infection because corneal transplantation cannot be performed in presence of inflation.5

6.2 NEED FOR THE STUDY.

"Alone we can do so little, together we can do so much”

-HELEN KELLER

Need for the study means scientific method which refers to a body of technique for investigation phenomena, ace scientific method of enquiry must be based on gathering empirical and measurable evidence subject to specific principles of reasoning.

World an estimated 180 million people worldwide are visually disabled, of whom nearly 45 million are blind, four out of five of them living in developing countries. About 80 pre cent of blindness is avoidable. However, a large proportion of those affected remain blind for want of access to affordable eye care. Blindness leads not only to reduce economic and social status but may also result in premature death. The major causes of blindness and their estimated prevalence are cataract (19 million); glaucoma (6.4 million); trachoma (5.6 million); childhood blindness (more than 1.5 million); onchocerciasis (0.29 million); and other causes (10 million).prevalence varies between countries, from 0.2 per cent or less in developed countries to more than 12 per cent in some sub-saharan countries. About 32 per cent of worlds blind are aged 45-59 years but the large majorities about 58 per cent are over 60 years old.6

In India blindness is one of the most significant social problems. It is estimated that there is an annual incidence of 2 million cataract induced blindness in the country. Approximately 3 million eyes need cornea transplantation. National Survey on blindness 2001-02 shows prevalence of blindness in population 50 years and above, to be about 8.5 per cent and estimated prevalence in general population to be about 1.1 per cent. About 6-7 per cent of children aged 10-14 years have problem with their eye sight. In Karnataka it was estimated that approximately 520 individuals were affected by cataract induced to blindness per year. 6

VISION 2020: “THE RIGHT TO SIGHT”, a global initiative to eliminate avoidable blindness was launched by WHO on 18th Feb 1999. One significant way in which this initiative differs from previous ones is that the concept centers around rights issues. Recognition of sight as a fundamental human right by all counties can be an important catalyst of initiatives for the prevention and control of blindness. The objective of “Vision 2020” is to assist member countries in developing sustainable systems which will enable them to eliminate avoidable blindness from major causes that is cataract, xerophthalmia and other causes of childhood blindness, refractive error and low vision, trachoma and other causes of corneal blindness by the year 2020.6

Corneal diseases are a significant cause of visual impairment and blindness in the developing world. The major causes of corneal blindness include trachoma, corneal ulceration following xeropthlmia due to vitamin A deficiency xeropthlmia neonatorm and use of harmful traditional medicines leprosy and oculus trans. In India we have a transplantation made possible by eye donation more than 90% of the corneal transplantation is carried out successfully and helps restore vision in people with corneal blindness.7

Approximately 18.7 million people are blind in India and 190,000 are blind from bilateral corneal disease. Every year another 20,000 join the list, the late Dr Muthiah started the very first eye bank in India and he successfully performed the first corneal transplant in 1948. Even after more than 50 years patients waiting for corneal transplant constitute a considerable backlog, which continues to grow the need therefore is to educate the masses about eye donation in an effort to increase the procurement of corneas.8

A study was conducted on awareness and perception regarding eye donation among nursing students. According to Eye bank association of India is 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 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. There is approximately a 20 fold increase from the donor eyes available now. A shortage of transplantable cornea 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 solicit ting for actual eye donation at the time of death is a necessary and accepted practice through the factors affecting procurement of corneas and the public attitude towards eye donation have recently received attention in the developed world.Nursing students are the future health care providers for the community. They are from different educational backgrounds with a scientific base and have an internet inclination to serve mankind with this background they were admitted into this study with objective of assessing their knowledge and attitude on eye donation well-informed nursing students could be expected to influence eye donation. 9

The 2nd year nursing students are future health care givers, it is most important group to gain the knowledge regarding eye donation. With this they will gain the knowledge and motivate others in donating eyes. Hence the investigator felt to create awareness regarding eye donation among 2nd year B.Sc nursing students.

6.3. REVIEW OF LITERATURE

“Dump your ‘I’, but don’t dump your ‘EYE’, donate it”

-‘Sarvodaya Manava Seva’

The review of literature in a research report is a summary of current knowledge about a particular problem and includes what is known and not known about the problem. The literature is reviewed to summarize knowledge for use in practice or to provide a basis for conducting a study. Review of literature section includes a description of the current knowledge of a particular problem, the gaps in this knowledge base and the contribution of the study. 10

A study was conducted on awareness and knowledge on eye donation among university students. Four hundred (400) students studying first year Medicine, Dentistry, Laboratory Technology, Pharmacy, Biomedicine and Bioengineering degree courses in the University of Malaya were assessed on their awareness and knowledge on eye donation using an open ended questionnaire. The majority of the students (344, 86%) in this study were aware about eye donation; the awareness was higher in biomedical (77.1%) and medical students (76.7%) compared to the others (55.9%-70.7%). One hundred and eight students (27%) were willing to donate their eyes. Most of the students (376, 94%) did not know about any eye bank in Malaysia. One hundred and sixty (40%) students were aware that whole eye can be removed from the donor and 101 (25.25%) were aware that the cornea can be removed separately. However, only 121 (30.25%) knew that donated eyes were used for corneal grafting. More than half of the students (231, 57.7%) did not know that the donor eye could be stored before transplantation. The results of this study indicate that there is a need to educate the young adults in our society about corneal transplantation so that they can in turn motivate other members of society and their own family members to become eye donors, thus facilitating the availability of donor corneas for corneal transplantation in Malaysia. The study was concluded that the majority of the students were not aware about eye donation. Hence the study was recommended that there is need to enhance awareness and knowledge on eye donation. 11

A study was conducted to assess the awareness of eye donation in an urban population in India. With the purpose to create awareness of eye donation and willingness to pledge eyes for donation in the urban population of Hyderabad, India. Study was selected 2522 subjects in research and interviewed. Subjects >15 years old were interviewed regarding awareness of eye donation and willingness to pledge eyes for donation. Age-gender-adjusted prevalence of awareness of eye donation was 73.8% (95% CI: 66.5-81.0%) but only 1.9% (95% CI: 0.16-3.66%) had pledged eyes. With multivariate analysis, significantly less awareness of eye donation was found in illiterate subjects (OR 0.1; 95% CI: 0.1-0.14), subjects > or =70 years old (OR 0.3; 95% CI: 0.2-0.6), subjects of lower socio-economic status (OR 0.4; 95% CI: 0.3-0.6), females (OR 0.6; 95% CI: 0.5-0.8) and Muslims (OR 0.7; 95% CI: 0.6-0.9). Media was the major source of information about eye donation. Of those aware of eye donation, 44.9% were willing to pledge eyes. Willingness to pledge eyes for donation was significantly lower in Muslims (OR 0.18; 95% CI: 0.13-0.24) than in Hindus and in subjects > or =60years old (OR 0.3; 95% CI: 0.2-0.5). Finally study was concluded only a few had pledged eyes there is enough potential in this population for obtaining many more corneas for transplantation. Hence the study was recommended that there is need to develop awareness regarding eye donation and willingness to pledge eyes for donation. 12

A study was conducted on awareness and Perception Regarding Eye Donation in Students of a Nursing College in Bangalore. Corneal diseases constitute a significant cause of visual impairment and blindness in the developing world. The number of corneal transplants done is far less than the actual requirement in India. This is largely due to the inadequate number of corneas collected. Well-informed nursing students could be expected to influence eye donation rates. To assess the awareness and perception of 188 first- and second-year nursing students towards eye donation in Bangalore. Cross-sectional study design. A pretested, semi-structured questionnaire. Data were analyzed using the Epi-Info software package, Version 6.04.The majority (96.8%) of students knew that eyes can be donated after death but only 38.2% knew that the ideal time of donation was within 6 hours of death. Most participants (85.1%) were either willing or had already donated their eyes. Nobility in the act of eye donation was the main motivational force for eye donation according to 85.6% of students. Perceived reasons for not pledging eyes by the students were: the unacceptable idea of separating the eyes from the body (67.9%), lack of awareness (42.8%), objection by family members (28.5%), and unsuitability to donate because of health problem (10.7%).This study revealed that nursing students were well aware of eye donations and most of them were inclined to sign-up for eye donation. The perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community. The nursing students could be actively involved as volunteers in eye donation campaigns and they can act as counselors for eye donors. Hence the study was recommended that there is a need in contribution by health personnel with participation in creating awareness and motivating people to become eye donors. 14