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Optic neuropathy endemic in secondary school children in Dar es Salaam, Tanzania.
  1. Richard J C Bowman, MR1,
  2. Susanne Wedner2,
  3. Ruth Bowman3,
  4. Henry Masanja4,
  5. Catey Bunce2,
  6. clare gilbert2
  1. 1 Yorkhill Hospital, United Kingdom;
  2. 2 International Centre for Eye Health, United Kingdom;
  3. 3 Tanzania Society for the Blind, Tanzania, United Republic of;
  4. 4 Ifakara Health and Development Research Centre, Tanzania, United Republic of
  1. * Corresponding author; email: richardandruthbowman{at}


Aim: To investigate the prevalence and causes of optic neuropathy, reported as epidemic in 1997, among secondary school students in Dar es Salaam, Tanzania.

Patients and methods: 10,892 first year students from 63 secondary schools within 30km from the base hospital were interviewed and had a visual acuity screening test. Students failing the 6/12 - line in either eye were defined as having ‘poor eyesight’ and referred to the base hospital where an optometrist re-tested visual acuity and refracted them. An ophthalmologist examined students with visual acuities of 6/12 or worse in either eye and visual impairment was defined as VA ofworse than 6/12 with best correction. Associations between optic neuropathy, socio-economic status and educational results were investigated.

Results: Students ages ranged from 12-22 years , mean 15.2 years and 50.6% were male. The prevalence of optic neuropathy was 0.3% (sd=0.051). The condition affected older students and was associated with the family having fewer economic possessions (car, computer,TV). Optic neuropathy accounted for 19/33 (58%) of bilateral visual impairment cases. No effect of the disease on educational performance was identified.

Conclusion: Optic neuropathy remains a significant problem in this population and can now be termed endemic rather than epidemic.

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