TanZanEye strengthens eye care in the remote west of Tanzania

On the occasion of Glaucoma Awareness Month, we want to highlight a remarkable project that the association TanZanEye — registered both in Germany and Tanzania — runs together with local and international partners in the remote west of Tanzania. The TanZanEye project builds infrastructure: it constructs and equips eye clinics, trains local specialists and supports their continuing education. Thanks to TanZanEye, thousands of patients have already been treated; the long-term goal is robust, sustainable structures for eye care in this underserved region — and, of course, raising awareness of glaucoma as one of the leading causes of blindness in the area.

Glaucoma, often diagnosed only at an end stage, presents an enormous challenge: very few patients have access to eye drops, which are either hard to obtain or prohibitively expensive — continuous therapy is therefore rarely feasible. Access to surgical or invasive treatment options is missing entirely.

Faced with the large number of patients with advanced-stage glaucoma, local ophthalmologists began applying the gentle, low-risk treatment method of transscleral cyclophotocoagulation in microsecond pulse application (µCPC). The method has proven ideal for local conditions: it is easy to perform, requires little aftercare and delivers promising results.

Karsten Paust: "Thanks to µCPC we can lower intraocular pressure efficiently and achieve a marked improvement in patients' quality of life. In the end, we can save many patients from going blind."

Between October 2020 and October 2021, 200 glaucomatous eyes were treated and a retrospective analysis was carried out. The mean intraocular pressure (IOP) before treatment was 34 mmHg. After one year, the mean IOP among patients who returned for follow-up was 17 mmHg (note: there is a data gap in follow-up due to the long and arduous journey to the Eye Center). Typical complications were short-term post-operative inflammation and occasionally a somewhat prolonged dilation of the pupil. The treatment parameters used were a total energy of 80 J at a power of 1600 mW.

The diode laser used for the treatment, the FOX 810 (A.R.C. Laser GmbH, Nuremberg), is particularly well suited to local conditions. The device is easy to operate, the procedure is quick to learn and — after appropriate training — the application can be delegated. It does not require an external power supply because it runs on a battery — a significant advantage in a region where the power grid is often unreliable. Weighing less than 1.5 kg, the FOX 810 is also portable, which matters greatly in remote areas.

On-site screening by eye-care staff is performed with the Arclight Ophthalmoscope, a lightweight, low-cost, solar-powered ophthalmoscope purpose-built for field work. Once a diagnosis is made, patients are referred to ophthalmologists who, after confirming the indication, perform µCPC. The procedure has already established itself as a standard method for glaucoma treatment (POAG and PEX). Trained local specialists thereby provide affected patients with high-quality care close to home.

TanZanEye works hand in hand with local specialists and partners and aligns with local conditions to ensure high-quality eye care across western Tanzania. Karsten Paust: "As a development partner, our role is not to prescribe solutions, but to listen, learn and support locally led initiatives. Local expertise is what matters."

It is a matter close to our hearts — and Glaucoma Awareness Month is the perfect occasion to draw attention to this comprehensive project and to raise awareness of glaucoma and the challenges of eye care. Sustainable improvements in healthcare for remote regions can only come from sustainable, local initiatives.

"Success in global development isn't about what we think communities need, it's about understanding what they actually need."