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Ru-ik Chee, Frank Sandi, Nicole Papworth-Jones, Donald J D'Amico, Edward Lai, Charles Cole, Grace Sun; Outcomes of an international ophthalmology mission and causes of blindness in central Tanzania. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5230.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate surgical outcomes from an international ophthalmology mission and identify common causes of visual impairment in central Tanzania.
Retrospective review of medical records from patients examined during an international mission in February 2017 and subsequent local follow up examinations. Prior approval to provide eye care services to local communities was obtained from the Ministry of Health and regional health authorities in Tanzania.
1555 vision screenings, 960 eye examinations and 401 cataract surgeries were performed. 211 male (52.6%) and 190 females had cataract surgery (average age 71.7 years). 307 phacoemulsification (76.6%) and 94 manual small incision cataract surgeries were performed. 358 of 401 surgical patients (89.3%) were present for follow up examination at 1 month. 334 patients had clearly documented 1-month postop visual acuity (VA) and were included in outcomes analysis. 327 patients (97.9%) had improvement from preop VA. Median preop potential pinhole VA was CF at near (range 20/100 to LP), median uncorrected postop VA was 20/80 (range 20/20 to LP). 228 patients (68.3%) had 20/200 or worse preop VA in both eyes, of which 138 patients (60.5%) had better than 20/200 postop VA at 1 month. Most common reasons for decreased vision in patients with 20/200 or worse postop VA (n=100) were corneal scarring (n=30), corneal edema (n=23), retinal pathology (n=12), and glaucoma (n=9). The posterior lens capsule was violated in one case. One case was aborted intraoperatively due to excessive posterior pressure and successfully completed the next day. In non-surgical patients, common contributors of vision impairment worse than 20/60 distance VA in at least one eye (n=554) included cataracts (n=227), refractive error (n=164), corneal scarring (n=83), advanced glaucoma (n=38), retinal pathology (n=16), and trauma (n=11).
In the short term, international missions have the potential to increase eye screening, provide eye care and improve vision amongst locals. Over the longer term, further efforts and development of a self-sufficient local system of care is needed to address the large remaining burden of eye disease and vision loss in central Tanzania, of which a large proportion is potentially reversible. Careful follow up examinations are necessary to obtain critical outcomes information and provide a foundation for future successful interventions.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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