[Global ophthalmology : Update].

The aim of global ophthalmology is to maximize vision, ocular health and functional ability, thereby contributing to overall health and well-being, social inclusion and quality of life of every individual worldwide. Currently, an estimated 1.1 billion people live with visual impairment, 90% of which can be prevented or cured through largely cost-effective interventions.

Artificial intelligence-supported diabetic retinopathy screening in Tanzania: rationale and design of a randomised controlled trial.

Introduction: Globally, diabetic retinopathy (DR) is a major cause of blindness. Sub-Saharan Africa is projected to see the largest proportionate increase in the number of people living with diabetes over the next two decades. Screening for DR is recommended to prevent sight loss; however, in many low and middle-income countries, because of a lack of specialist eye care staff, current screening services for DR are not optimal.

XEN-45 implantation for refractory uveitic glaucoma.

Purpose: To evaluate the efficacy of XEN-45 gel stent ab interno implantation for medically uncontrolled uveitic glaucoma.

Methods: Retrospective analysis of 25 eyes receiving XEN gel stent for medically uncontrolled uveitic glaucoma from February 2019 to February 2023 with recording of intraocular pressure (IOP) values, ocular hypotensive medication, requirement for revision or secondary surgery and complications. Prerequisites for XEN implantation were a clear cornea, an open iridocorneal angle and an unscarred, mobile conjunctiva at the implantation site.

XEN-63 Compared to XEN-45 Gel Stents to Reduce Intraocular Pressure in Glaucoma.

The XEN gel stent reduces intraocular pressure (IOP) in glaucoma. XEN-45 is widely used; the newer XEN-63 has a larger lumen targeting potentially lower IOP outcomes. We retrospectively compared the first 15 XEN-63 cases to 15 matched XEN-45 controls.

Differentiating stages of functional vision loss from glaucoma using the Disc Damage Likelihood Scale and cup:disc ratio.

Background: Glaucoma staging is critical for treatment planning but has rarely been tested in severe/end-stage disease. We compared the performance of the Disc Damage Likelihood Scale (DDLS) and cup:disc ratio (CDR) using a functional glaucoma staging system (GSS) as the reference standard.

Methods: Post hoc analysis of a randomised controlled trial at the Eye Department of Kilimanjaro Christian Medical Centre, Tanzania.

The Impact of Simulation-Based Trabeculectomy Training on Resident Core Surgical Skill Competency.

Prcis: Simulation-based surgical education shows a positive, immediate, and sustained impact on core surgical skill competency in trabeculectomy among resident ophthalmologists in training.

Purpose: To measure the impact of trabeculectomy, surgical simulation training on core surgical skill competency in resident ophthalmologists.

Materials And Methods: This is a post hoc analysis of the GLAucoma Simulated Surgery trial, which is a multicenter, multinational randomized controlled trial.

Gender bias within a diabetic retinopathy screening programme in Tanzania.

Background: The Kilimanjaro Diabetic Programme has been running since 2010 and screens persons with diabetes for diabetic retinopathy (DR). It was noted that women were less likely to attend follow-up appointments compared to men. The aim of this study was to explore gender biases amongst persons registered with the screening programme.

Selective laser trabeculoplasty versus 0·5% timolol eye drops for the treatment of glaucoma in Tanzania: a randomised controlled trial.

Background: Glaucoma is a major cause of sight loss worldwide, with the highest regional prevalence and incidence reported in Africa. The most common low-cost treatment used to control glaucoma is long-term timolol eye drops. However, low adherence is a major challenge.

Simulation-based surgical education for glaucoma versus conventional training alone: the GLAucoma Simulated Surgery (GLASS) trial. A multicentre, multicountry, randomised controlled, investigator-masked educational intervention efficacy trial in Kenya, South Africa, Tanzania, Uganda and Zimbabwe.

Background/aim: Glaucoma accounts for 8% of global blindness and surgery remains an important treatment. We aimed to determine the impact of adding simulation-based surgical education for glaucoma.

Methods: We designed a randomised controlled, parallel-group trial.

Referral patterns of children with glaucoma and their caretakers in Northern Tanzania.

Aim: To describe the referral patterns of children with primary childhood glaucoma (PCG) or secondary childhood glaucoma (SCG) and their presenting symptoms in Northern Tanzania.

Methods: A retrospective observational study of children <17y with PCG or SCG who were referred to Kilimanjaro Christian Medical Centre (KCMC) Eye Department between 2000 and 2013 was conducted. Presenting symptoms, age at presentation, place of origin, distance to hospital, type of glaucoma, visual acuity, optic disc appearance (vertical cup-to-disc ratio) and type of referral were described.

Severity of Visual Field Loss at First Presentation to Glaucoma Clinics in England and Tanzania.

: To compare severity of visual field (VF) loss at first presentation in glaucoma clinics in England and Tanzania.: Large archives of VF records from automated perimetry were used to retrospectively examine vision loss at first presentation in glaucoma clinics in Tanzania (N = 1,502) and England (N = 9,264). Mean deviation (MD) of the worse eye at the first hospital visit was used as an estimate of detectable VF loss severity.

Retinal imaging to identify target organ damage in older Africans: A pilot study.

By 2030, sub-Saharan Africa is forecast to see the steepest rise in the number of people with hypertension of any world region. Hypertensive retinopathy is known to be a common complication of hypertension in developed countries and some studies suggest it is associated with the presence of other hypertension-related end-organ damage (EOD) such as stroke and cardiovascular disease. In Tanzania hypertension is relatively more common than in other parts of sub-Saharan Africa, especially in the older population; however, the prevalence of hypertensive retinopathy and its association with EOD remain unknown.

[Emigration-an option for African resident physicians? : Opinions from Tanzania and Ethiopia].

Background: Globally, the majority of visually impaired persons live in low- and middle-income countries. One of the reasons is a lack of ophthalmologists in the respective countries. Migration of qualified personnel would be an additional strain on ophthalmological patient care.

Trabeculectomy or Transscleral Cyclophotocoagulation as Initial Treatment of Secondary Childhood Glaucoma in Northern Tanzania.

Purpose: The purpose is to describe the outcome of trabeculectomy with transscleral cyclophotocoagulation (TSCPC) as an initial intervention for secondary childhood glaucoma in Northern Tanzania.

Methods: A retrospective, consecutive case series was analyzed of all children with secondary childhood glaucoma who underwent initial trabeculectomy or TSCPC between 2000 and 2013 at a referral eye unit in Northern Tanzania. Retrospective data were collected on causes of glaucoma, intraocular pressure (IOP), visual acuity, complications, and subsequent interventions.

Prevalence, Risk Factors, and Complications of Diabetes in the Kilimanjaro Region: A Population-Based Study from Tanzania.

Background: In sub-Saharan Africa, diabetes is a growing burden, yet little is known about its prevalence, risk factors, and complications. To address these gaps and help inform public health efforts aimed at prevention and treatment, we conducted a community-based study assessing diabetes epidemiology.

Methods And Findings: We conducted a stratified, cluster-designed, serial cross-sectional household study from 2014-2015 in the Kilimanjaro Region, Tanzania.

Reasons for poor follow-up of diabetic retinopathy patients after screening in Tanzania: a cross-sectional study.

Background: Diabetes is an emerging public health problem in sub-Saharan Africa. Diabetic retinopathy is the commonest microvascular complication of diabetes and is a leading cause of blindness, mainly in adults of working age. Follow-up is crucial to the effective management of diabetic retinopathy, however, follow-up rates are often poor in sub-Saharan Africa.

Outcomes of surgical interventions for primary childhood glaucoma in Northern Tanzania.

Aim: To evaluate goniotomy, trabeculotomy, transscleral cyclophotocoagulation (TSCPC) and trabeculectomy as initial procedures in children with primary childhood glaucoma from Northern Tanzania.

Methods: A retrospective analysis of consecutive interventions for primary childhood glaucoma from 2000 to 2013 was conducted at the Kilimanjaro Christian Medical Centre. Success was defined as postoperative intraocular pressure (IOP) below 22 mmHg.

Severe ocular trauma-The hidden danger of plastic bottles when throwing out the rubbish.

This is the first reported case of ocular trauma caused by a plastic bottle cap occurring accidentally without misuse. The mechanism involved an un-emptied plastic bottle containing orange juice being thrown away with other rubbish. The combination of this minor impact and the pressure built up within the bottle through fermentation caused expulsion of the cap at high velocity.