Eye disease hits African children

By Daniel Dickinson
In Dar es Salaam

Teddy shows signs of disease

Fifteen-year-old Teddy Kaiweni sits nervously in the clinic of the Dar es Salaam-based Comprehensive Community Based Rehabilitation in Tanzania hospital (CCBRT).

She is waiting to hear if she has an illness which may turn her blind - an illness which has been baffling doctors not just in Tanzania but also across the world for the last two decades.

The disease, called optic neuropathy, attacks the optic nerve, destroying it in the most acute cases.

The problem is nobody knows exactly what causes the condition or why it occurs in very specific parts of the world, such as Tanzania.

While doctors continue to ponder the causes of optic neuropathy, Teddy Kaiweni's major concern is how she is going to continue studying.

For the last three weeks Teddy has been experiencing pains in her eyes and blurred vision, symptoms which appear to be worsening by the day. It's beginning to seriously affect her daily life.

"At school I am having a lot of problems reading what the teacher writes on the board. I have to get up from my desk to take a closer look or ask my friends to help me.

"This is very embarrassing and disruptive. I wonder if I can continue studying but most of all I am worried about going blind."

Teddy is complaining of some of the classic symptoms of optic neuropathy.

Difficult diagnosis

Dr Fanuel Msella is searching for answers

However, according to Vincent Mhoro, the ohthalmic medical assistant who examined her, it is a condition which is notoriously difficult to diagnose.

"Apart from impaired vision, Teddy is complaining of tingling at the end of her fingers.

"This may suggest that she has optic neuropathy but we are not sure yet."

Optic neuropathy was first diagnosed in 1988 in Tanzania and since then the number of cases has grown dramatically.

Most of those cases have been young people in the coastal region.

Research published in 1988 suggests that at least 5,000 children in Dar es Salaam alone had the condition.

At present, doctors can do little to fight what has officially become an epidemic as they have no definitive answer as to what causes optic neuropathy.

CCBRT's Dr Fanuel Msella told BBC News Online that there are few clear answers.

"No-one knows exactly why the condition occurs. At the moment we are just guessing, but we think it could be something to do with nutrition.

"But this does not explain why it is occurring only on the coast and not upcountry."

Theories

There are a number of other theories about the cause of the condition.

They include the sun, poisons in food like cyanide, even mosquitoes.

The outlook for patients like Teddy remains poor as, more or less, the only treatment doctors can offer is giving vitamin supplements - a treatment which is not always successful.

The last big epidemic of optic neuropathy was in Cuba from 1991-93.

Ophthalmologists from around the world descended on the Caribbean island to find out more, but came to few conclusions.

In Tanzania, the money to research the condition has all but run out and doctors are left pondering how to deal with the increasing number of especially young people who are seeking treatment for this elusive illness.