Pituitary tumours and blindness: continuation of the pre-Harvey-Cushing era in developing countries

Of the 11 patients with pituitary or suprasellar tumours seen at Muhimbili Medical Centre, Dar es Salaam, from January, 1980, until July, 1982, 6 (54.5%) were totally blind, 3 (27.3%) were blind in one eye and had severe visual impairment in the other, and 2 (18.2%) had marked visual field abnormalities but normal visual acuity in one eye. Blindness in most of these patients highlights the absence of neurosurgical services in many developing countries. In addition there is little prospect of countries like Tanzania establishing neurosurgical services in the foreseeable future. The only help for patients with neurosurgical problems is from referral overseas. This, however, is possible for only a limited number because of costs, unless neurosurgical units in developed countries offer their services at nominal cost. Such an offer would not only benefit patients who would otherwise die but would also help to further the interests of neurosurgery in the helper country.