Public attitudes to corneal tissue donation in an urban South African population

Abstract

Background: Corneal pathology is the second leading cause of preventable blindness in Sub-Saharan Africa. Corneal disease is the cause of visual loss in 11% of blind or severely visually impaired children and 4% of blind adults in South Africa. In majority of cases, a corneal transplant or keratoplasty can restore or significantly improve vision. South Africa has an immense shortage of donor corneas, causing the burden of corneal disease requiring transplantation to continually rise. Aim: The aim of this study was to determine the public attitude towards corneal tissue donation in an urban South African population. Setting: The study was conducted at St John’s Eye Hospital, Soweto, South Africa. Method and Design: This was an observational, cross-sectional quantitative study of the current attitude of an urban South African population towards corneal tissue donation. A self-designed questionnaire was developed. The participants were asked about reasons for both willingness and unwillingness to donate their corneas. The study population included patients or escorts attending the out-patients clinic at Saint John’s Eye Hospital. Results: A total of 100 participants (60 females and 40 males) completed the questionnaire. The mean age (±SD) of the study participants was 41.26 (±14.7) years. Seventy-six percent of participants did not know about corneal donation. Sixty four percent of participants were willing to donate their corneas, whereas 25% were not willing to do so. The main reason for unwillingness to donate their corneas was cultural reasons. In this study there was no statistically significant correlation between the willingness to donate corneal tissue and age, gender, level of education and employment status. There was a statistically significant difference between the willingness to donate one’s solid organs as compared to the willingness to donate one’s cornea (p-value 0.029). Participants were more willing to donate their solid organs than they were willing to donate their corneas. Conclusion: There is a decreased level of awareness of corneal tissue donation in this urban South African population. However, many of the participants had a positive attitude towards corneal donations. Increasing the awareness of donation and its benefits may help increase the supply of corneal tissue.