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Evaluation of junior doctors’ knowledge of corneal donation and the new opt-out system in England
  1. Bhavesh P. Gopal1,
  2. Owuraku Asiedu Titi-Lartey2,
  3. Princeton Fernandes3,
  4. Nur-Emel Noubani1,
  5. Elizabeth Blatherwick4,
  6. Dalia Said5,6,
  7. Harminder Singh Dua5,6,
  8. Darren S J Ting5,6
  1. 1 Ophthalmology, Pilgrim Hospital, Boston, Lincolnshire, UK
  2. 2 Medicine, Lincoln County Hospital, Lincoln, Lincolnshire, UK
  3. 3 ENT, Hull Royal Infirmary, Hull, Kingston upon Hull, UK
  4. 4 Nottingham Tissue and Eye Donation Partners, Queen's Medical Centre Nottingham University Hospital NHS Trust, Nottingham, UK
  5. 5 Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK
  6. 6 Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, UK
  1. Correspondence to Dr Darren S J Ting, Academic Ophthalmology, University of Nottingham University Park Campus, Nottingham, Nottingham, UK; ting.darren{at}

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Corneal opacity represents the fifth leading cause of blindness and visual impairment globally, affecting around 6 million of the population.1 Corneal transplantation serves as the mainstay of treatment in restoring vision in patients affected by corneal opacity.2 It is the most commonly performed transplantation worldwide, though the success has been persistently challenged by the global shortage of donor cornea.2

To date, a wide range of initiatives and advancement, including public campaigns to increase awareness, introduction of telephone consent, refinement in the donation–transplantation pathway and improvement in surgical techniques,3–6 have been implemented to improve corneal donation and utility of donor corneal tissues. On 20 May 2020, England has implemented an opt-out system, also known as the Max and Keira’s Law, with an aim to improve the rate of organ/tissue donation, joining countries such as Spain, France and Italy and many others. Under the new, soft opt-out system, all adults in England are assumed to be willing organ/tissue donors unless they have registered their intent otherwise. However, the process of eye donation remains largely unchanged as consent from the family members is still required before retrieval can proceed.

Junior doctors at frontline services, particularly those who work in intensive care, oncology and palliative care units may serve as valuable members to the multidisciplinary team in contributing to the process of organ/tissue donations. Nonetheless, the knowledge of corneal donation and the new opt-out system among junior doctors in the UK has not been explored. Our study aimed to evaluate the knowledge of corneal donation and the opt-out system among the junior doctors in East Midlands, UK.

This was a cross-sectional study performed between 28 June 2020 and 29 September 2020. A 26-item questionnaire-based online survey was distributed to the junior doctors/house officers (<3 years of medical practice) who were …

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  • Collaborators Rachel Byrne; Eleanor Green; Laura Sandland-Taylor; Laura Weir; Shahid Mohammed; Basal Atwi; Yara Hreish; Zara Faizi; Natalie Mok; Thomas Poundall; Sahana Bala; Sudha Bhagwansingh Hayne; Mohamad Ali Mortada.

  • Contributors Study conceptualisation and design: BG and DSJT. Data collection: BG, OAT-L, PF, N-EN, and all collaborators. Data interpretation: BG, EB, DS, HSD and DSJT. Manuscript drafting: BG and DSJT. Critical revision of the manuscript: OAT-L, PF, N-EN, EB, DS and HSD. Final approval of the manuscript: all authors. Overall supervision of the study: DSJT.

  • Funding D.S.J.T. acknowledges support from the Medical Research Council / Fight for Sight Clinical Research Fellowship (MR/T001674/1), and the Fight for Sight / John Lee, Royal College of Ophthalmologists Primer Fellowship (24CO4).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.