• Number of people at risk for or with glaucoma examined in rural districts
• Knowledge of glaucoma among patients and relatives
• Rate of attendance at follow-up appointments
   

• Baseline studies of eye health units in Kilimanjaro Region.
• Training and equipping staff in eye health centres and developing a glaucoma care network 
• Evaluating impact of training, of equipment and of glaucoma care network
• Baseline study to develop the most effective way for patients and relatives to understand and apply knowledge about glaucoma
• Developing and using information and teaching material for patients and relatives about glaucoma
• Evaluating impact of education material and methods
• Disseminating research results
   

The project will be conducted at KCMC Eye Department which has an established partnership with CBM, International Centre for Eye Health (London School of Hygiene & Tropical Medicine) and the Eye Centre of the University Hospital Freiburg. KCMC has also the capacity to implement the results and share the insights across its networks in Africa and beyond. Staff salaries at the eye units which will receive additional training and equipment are not included in the budget so they will therefore also continue to operate after the project has finished. The project also aims to implement self-sustaining information and counselling methods for patients. We expect to implement a sustainable improvement of glaucoma services and prevention of blindness locally and an additional impact through peer-reviewed publications and presentations at conferences which will provide opportunities to apply the results in other eye care settings across Africa.
Training of local PhD holders is a key component of capacity building for training and research institutions and aims to contribute to a long-term increase of context-specific research to solve region-specific challenges. Furthermore, KCMC conducts a MMed training programme for ophthalmologists from different African countries which also includes a research project and requires local academic capacity to supervise the research projects of the residents. These academic capacities will be significantly expanded in the funded project.

The project builds on research results of the ongoing programme of glaucoma research based at KCMC. The Kilimanjaro Glaucoma Intervention Programme (KiGIP) started in 2014 and aims to understand and improve various aspects of glaucoma care, encompassing care-seeking behaviour, clinical treatment, training, and research. For example, the KiGIP team conducted a randomized controlled treatment trial which compared the regional standard treatment of timolol eye drops with selective laser trabeculoplasty (SLT) and was published in the Lancet Global Health journal. The laser treatment was significantly more effective than eye drops in managing glaucoma in this African population, a landmark finding which will help to inform the long-term treatment strategy in this region. 
A comparison of a low-cost direct ophthalmoscope with the standard model was also performed by the KiGIP team. These devices are used to assess the optic disc for glaucomatous damage and the results suggested that the low-cost device is a reliable alternative to costly standard direct ophthalmoscopes. 
The collaboration between the KCMC Eye Department, CBM, International Centre for Eye Health and the Department of Ophthalmology at the University Medical Centre Freiburg offers a broad spectrum of experience and expertise.