Correction of refractive error and presbyopia in Timor-Leste.

Abstract

To investigate the aspects of spectacle correction of vision-impairing refractive error and presbyopia in those aged >or=40 years in Timor-Leste. A population-based cross-sectional survey with cluster random sampling was used to select 50 clusters of 30 people. Those who had uncorrected or undercorrected refractive error (presenting acuity worse than 6/18, but at least 6/18 with pinhole), uncorrected or undercorrected presbyopia (near vision worse than N8), and/or who were using or had used spectacles were identified. Dispensing history, willingness to wear and willingness to pay for spectacles were elicited. Of 1470 people enumerated, 1414 were examined (96.2%). The "met refractive error need" in the sample was 2.2%, and the "unmet refractive error need" was 11.7%. The "refractive error correction coverage" was 15.7%. The "met presbyopic need" was 11.5%, and the "unmet presbyopic need" was 32.3%. The "presbyopia correction coverage" was 26.2%. Lower correction coverage was associated with rural domicile, illiteracy and farming. Of the sample, 96.0% were willing to wear spectacles correcting impaired vision. Of these, 17.0% were willing to pay US$3 ( pound 1.52, euro 2.24) for spectacles, whereas 50.2% were unwilling to pay US$1 ( pound 0.51, euro 0.75). Women and rural dwellers were less likely to be willing to pay at least US$1 for spectacles. Refractive error and presbyopia correction coverage rates are low in Timor-Leste. There is a large need for spectacles, especially for elderly and illiterate people, farmers and rural dwellers: those least able to pay for them. An equitable cross-subsidisation spectacle system should be possible.