Eye Department KCMC
Newsletter
Issue 1 Volume 1 Serial 1 30th September 2011
A
note of Introduction
W. Makupa
After attending
the annual scientific conference of OSEA in Dar es Salaam
it became evident that eye care cadres in Tanzania will need to have a forum
of their own. This would mean an annual meeting and also a newsletter for
sharing information. It was in this spirit that “MACHO” developed as an idea on
12th September 2010. It is only now that this is coming to fruition.
For a while it was thought that it may be possible to have it strictly as
internet group mailing list, but most of primary eye care cadres and some of
mid level eye care cadres do not have regular access to the internet. This
means that we will have to produce a few hard copies for those who do not have
access to the internet.
The aim of this
newsletter is to share information on best practices, eye care updates and eye
care services rendered at the Eye Department KCMC.
White
Pupil
I. Makupa
The normal
appearance of the pupil of the human eye is black. In flash photographs the pupil may appear red, called the
"red eye/red
reflex", and is entirely normal. The
appearance of a white pupil is never a normal condition and requires immediate
evaluation by specialists trained in ophthalmology. Pre-referral treatment is not recommended for
abnormal red reflex or white pupil. White pupil in an infant or child may occur
in a number of eye diseases. Most commonly occurs in congenital cataract and
retinoblastoma (Rb- a malignancy of the retina). It can also be caused by other
rare eye conditions. Both Congenital Cataract and Retinoblastoma
are eye diseases with grave consequences on the child’s vision or even life
(Rb).
Early presentation and immediate referral to an eye
care professional are essential for good outcomes.
Awareness & Education: public and healthcare professionals
Increased
awareness and education about the white pupil (leukocoria), may lead to earlier
diagnosis, and consequently, a higher likelihood of cure and better vision
potential for affected eyes.
Parents,
rather than healthcare professionals, are usually the first to notice the white
pupil. It is very important to inform and empower parents by public education
about white pupil. As the time frame available for observation is much greater
for parents, focusing on educating parents rather than increasing professional
screening may be the most effective way to increase early detection of
leukocoria. Educating the public on white pupil could also empower parents to
persuade a reluctant primary healthcare professional to refer to a specialist.
Educational resources for
parents:
- Internet resources
- Public awareness campaigns Awareness materials include: posters and flyers, television and radio advertisements.
Education
for healthcare professionals
Once parents notice the white
pupil, their healthcare practitioners must know to respond with prompt
referral. Children with white pupil need immediate
referral to an ophthalmologist. This is essential for timely diagnosis and
good treatment outcomes. The referral lag has serious consequences both in
congenital cataract and retinoblastoma. To increase awareness of leukocoria
among healthcare professionals, posters and educational leaflets (e.g.
describing the correct method for how and when to administer the red reflex
test) can be provided to healthcare professionals throughout Tanzania.
Public & healthcare awareness
& education: recommendations
We recommend that:
- Information on white pupil be included in public healthcare packages given to new parents.
- Major pediatric and vision screening provide information on white pupil in their print and online public information materials.
- Information on leukocoria, information about the proper performance of the red reflex test be provided to healthcare professionals who see young children and pregnant women in their clinics.
- White pupil education be included in the healthcare curricula.
Eye
Health Care Services available at KCMC are:
- Optical services, complete with refraction, prescription and making of eye glasses for both adults and children
- Complete ophthalmolgical consult, with paraclinical diagnostic tools such as: autorefractor, ophthalmic ultrasound, automated perimetry, fundus flourescein angiography and optical coherence tomography.
- Comprehensive ocular surgical services, biometry is performed in each cataract patient to calculate the power of intraocular lens to be implanted with the aim of achieving best possible outcome.
- Ocular pharmacy stocked to cater for basic and necessary ocular therapeutics
- Rehabilitative services for the visually impaired are available with a range of low vision devices.
- The Eye Department in collaboration with its partners (KCCO and EACO), conducts Day Eye Diseases Screening Outreaches (Direct Referral Site) within Kilimanjaro Region twice every week to screen the population for sight threatening conditions and transports to hospital all those who need intervention. Also Week Eye Surgery Outreaches are conducted to places too far from KCMC but the need for care exists.
Editor:
W. Makupa, Eye Department KCMC, P.O.Box
3010 Moshi – Tanzania
Tel:
+255 27 275 4890 Fax: +255 27 275 4381 Email: makupauw@yahoo.com
