Abstract:

There is concern on the availability, accessibility and affordability of the health services related to age-related eye disorders in developing countries especially Tanzania. Eye disorders is becoming a serious community problem in our country due to the fact that majority of people do not have even basic knowledge about the risks and primary management of eye disorders. Most of them they end up using local traditional medicines for their treatment hence causing more harm to their eyes which may complicate further to severe loss of vision. Therefore most of the Tanzanians experience severe vision loss mainly due to preventable eye disorders. This is mainly due to poor health seeking behaviors especially lacking the tendency of doing comprehensive eye examination for the group at risk (elders more than 40 years).

For this reason by the time they present to the hospital they find that the disorders are at a very late stages because many eye disorders have no early warning signs and symptoms. My goal in this medical field attachment was to learn more on the age-related eye disorders mainly through the patients attending the outpatient clinic at the ophthalmology unit in the Bugando medical centre. The large proportion of these patients attending the clinical OPD presented mainly with cataracts, glaucoma, refractive errors and Age-related macular degeneration, though many other eye disorders were attended these include; diabetic retinopathy, herpes zoster eye infection, bacterial/acute conjunctivitis, uveitis, pterygoid, allergic conjunctivitis, herpetic keratitis and others. The important thing to note is that eye disorders and conditions may occur also in children they are not for elders only, the common eye disorders for children attending the OPD clinic at Bugando medical centre is allergic conjunctivitis which is mostly self-limiting as the child get older.

The important practical work I learnt in this field work attachment in ophthalmology unit is doing visual assessment, general inspection of the eyes, and also slit lamp microscopy together with fundoscopy to examine the inner structures of the eye, observing some bedside eye procedures, taking proper history for eye disorders also ruling out other systemic diseases which may have eye manifestations like diabetes, hypertension and thyroid disorders also management of common eye disorders. The main challenge in the specialty is the deficit of eye experts all over the country for instance at Bugando medical centre we have only one ophthalmologist and also few primary eye care givers. The greater problem is in the peripherals which results into unnecessary referral and due to low socio-economic status of majority of Tanzanians only few manage to come for the proper management of their eye disorders at Bugando medical centre.

Conclusion: In order to improve the delivery of eye health services we need the multisectoral approach, thus the government, non-governmental organizations and individual participation are potential factors.

Recommendations: Because of deficit of experts in the ophthalmology unit, we may start our own training centre in order to increase the number of both primary (nurses), secondary (ophthalmic assistants) and tertiary (ophthalmologist) care givers in the ophthalmology unit. Since most of the eye services are more costiful example an individual after refraction who is indicated to use eye glasses my not be able to buy those glasses hence there should be a cost reduction to make most of them afford the services. Also to have effective community awareness of eye conditions we may emphasize on community based outreach only for education and delivery of primary services for those in need or on the other hand we may start Bugando eye day in which people will be invited to attend in where we may give education and primary eye services free of charge to encourage them to have a good health seeking because by moment they would have the basic knowledge on eye disorders.