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Corneal and other external eye diseases are very common in rural areas of southern Africa. A corneal survey was undertaken in Calvinia in the northwestern Cape to establish the incidence and nature of these disorders. Corneal diseases were found in 20,2% of the population and a further 8,4% had other external eye diseases, giving an overall incidence of 28,6%. However, many of the diseases were degenerative, their incidence rising rapidly with increasing age. Pterygium and climatic droplet keratopathy, both of which are related to actinic damage, were particularly common. The aetiology and management of the most frequently encountered diseases are discussed.

Almost all ophthalmic services in southern Africa are located in large urban centres beyond the reach of many patients in isolated rural areas. The Bureau for the Prevention of Blindness organizes mobile eye-care teams which tour these areas to provide free ophthalmic therapy and surgery. The structure and aims of the mobile teams, with reference to a specific tour, are described; the problems encountered in providing rural ophthalmological services are discussed and some possible solutions proposed.

A survey of external eye diseases was undertaken in Transkei; a total of 1,519 people were examined. A high incidence of climatic droplet keratopathy was found in the population, and this was a common cause of blindness in elderly men. Only 7 people had pterygia - all women. Both climatic droplet keratopathy and pterygia are believed to result from actinic damage, therefore the discrepancy noted in the prevalence of these two degenerative disorders was unexpected. Xerophthalmia was observed in 5 children, all of whom had mild forms of vitamin A deficiency eye disease. Although the number of children with overt vitamin A deficiency was small (0.58% of children aged less than 15 years), the importance of this finding lies in the possible pool of children without clinical disease but with low levels of vitamin A and therefore more likely to develop and to succumb to infections of the respiratory and alimentary systems. A further 20 people had corneal changes similar to those found in xerophthalmia; but since associated conjunctival signs were absent it is improbable that these changes were secondary to vitamin A deficiency.