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Correction of refractive error and presbyopia in Timor-Leste
  1. J Ramke1,3,
  2. R du Toit2,3,
  3. A Palagyi1,3,
  4. G Brian2,
  5. T Naduvilath4
  1. 1The International Centre for Eyecare Education, Sydney, New South Wales, Australia
  2. 2The Fred Hollows Foundation (New Zealand), Auckland, New Zealand
  3. 3The Vision Cooperative Research Centre, Sydney, New South Wales, Australia
  4. 4The Institute for Eye Research, Sydney, New South Wales, Australia
  1. Correspondence to: Ms R du Toit The Fred Hollows Foundation (New Zealand), Private Bag 56908, Dominion Road, Auckland 1030, New Zealand; rdutoit{at}


Aim: To investigate the aspects of spectacle correction of vision-impairing refractive error and presbyopia in those aged ⩾40 years in Timor-Leste.

Method: 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.

Results: 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 (£1.52, €2.24) for spectacles, whereas 50.2% were unwilling to pay US$1 (£0.51, €0.75). Women and rural dwellers were less likely to be willing to pay at least US$1 for spectacles.

Conclusion: 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.

  • PCC, presbyopic correction coverage
  • RECC, refractive error correction coverage

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  • Competing interests: The International Centre for Eyecare Education, Sydney, Australia, distributes and receives financial benefit from the sale of readymade spectacles in developing countries. However, the authors, who were previously employees of this organisation, have no personal pecuniary interest in the manufacture, distribution or sale of spectacles. The authors have no pecuniary interest in any product mentioned or in the outcome of this survey. Nor has any other conflict of interest been identified.

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