Maro Focus P, Moodley Vanessa R
Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Department of Optometry and Rehabilitation Science, Kilimanjaro Christian Medical College, P.O. Box 2240, Moshi, Tanzania.
Int Ophthalmol. 2025 Aug 4;45(1):322. doi: 10.1007/s10792-025-03653-9.
Keratoconus (KC), is a corneal disease that causes visual impairment, which diminishes thequality of life (QoL) of affected individuals. Although most eye care practitioners in Tanzania anecdotally report a significant number of patients presenting with KC symptoms,little is known on how KC is managed at differentlevels of the healthcare system.
To conduct a survey to assess health facility capacity and optometrists' capability to diagnose and manage KC in Kilimanjaro region, Tanzania.
A mixed-method, cross-sectional study was conducted. Health facilities providing eye care services and their employed optometristswere purposivelyselected. TheWHO Service Availability and Readiness Assessment (SARA) tool was applied to obtain eye health care service delivery data and in-depth interviews were conducted to investigate optometrists' knowledge on the diagnosis and management modalities of KC at their respective facilities.
Nine multi-level health facilitieswere included in the SARA assessment.The majority of SARA respondents were female (56%) and ten optometrists participated in in-depth interviews. Only 44% of facilities were both ready to provide and had KC services available. Although all optometrists reported being aware of KC, some did not know how to comprehensively diagnose and manage KC. Barriers to optimal patient care were a lack of equipment and supplies and no practitioner training on KC.
Findings indicate a lack of KC service availability and/or inadequate service readiness in the majority of health facilities in Kilimanjaro. Recommended remedies include general KC advocacy and a health leadership intervention to remedy reported facility and human resource deficiencies towards improved KC patient care.
圆锥角膜（KC）是一种导致视力受损的角膜疾病，会降低受影响个体的生活质量（QoL）。尽管坦桑尼亚的大多数眼科护理从业者都 anecdotaly 报告有大量出现 KC 症状的患者，但对于 KC 在医疗保健系统不同层面的管理方式知之甚少。
进行一项调查，以评估坦桑尼亚乞力马扎罗地区医疗机构诊断和管理 KC 的能力以及验光师的能力。
开展了一项混合方法的横断面研究。有目的地选择了提供眼科护理服务的医疗机构及其聘用的验光师。应用世界卫生组织服务可用性和准备情况评估（SARA）工具来获取眼部保健服务提供数据，并进行深入访谈以调查验光师在各自机构对 KC 诊断和管理方式的了解情况。
九家多层次医疗机构被纳入 SARA 评估。SARA 的大多数受访者为女性（56%），十名验光师参与了深入访谈。只有 44%的机构既准备好提供又有 KC 服务。尽管所有验光师都报告了解 KC，但有些人不知道如何全面诊断和管理 KC。最佳患者护理的障碍包括缺乏设备和用品以及没有针对 KC 的从业者培训。
研究结果表明，乞力马扎罗的大多数医疗机构缺乏 KC 服务可用性和/或服务准备不足。建议的补救措施包括开展关于 KC 的总体宣传以及进行卫生领导干预，以弥补报告的设施和人力资源不足，从而改善 KC 患者护理。
