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Prevalence and causes of blindness and low vision in Timor-Leste
  1. Jacqueline Ramke1,
  2. Anna Palagyi1,
  3. Thomas Naduvilath2,
  4. Renee du Toit1,
  5. Garry Brian
  1. 1
    The International Centre for Eyecare Education, Sydney, New South Wales, Australia
  2. 2
    The Institute for Eye Research, Sydney, New South Wales, Australia
  1. G Brian, FRANZCO, The Fred Hollows Foundation (New Zealand), Auckland 1030, New Zealand; grbrian{at}


Aim: To estimate the prevalence and causes of blindness and low vision in people aged ⩾40 years in Timor-Leste.

Method: A population-based cross-sectional survey using multistage cluster random sampling to identify 50 clusters of 30 people. A cause of vision loss was determined for each eye presenting with visual acuity worse than 6/18.

Results: Of 1470 people enumerated, 1414 (96.2%) were examined. The age, gender and domicile-adjusted prevalence of functional blindness (presenting vision worse than 6/60 in the better eye) was 7.4% (95% CI 6.1 to 8.8), and for blindness at 3/60 was 4.1% (95% CI 3.1 to 5.1). The adjusted prevalence for low vision (better eye presenting vision of 6/60 or better, but worse than 6/18) was 17.7% (95% CI 15.7 to 19.7). Gender was not a risk factor for blindness or low vision, but increasing age, illiteracy, subsistence farming, unemployment and rural domicile were risk factors for both. Cataract was the commonest cause of blindness (72.9%) and an important cause of low vision (17.8%). Uncorrected refractive error caused 81.3% of low vision.

Conclusion: Strategies that make good-quality cataract and refractive error services available, affordable and accessible, especially in rural areas, will have the greatest impact on vision impairment.

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  • Funding: This work was, in part, financially supported by the Australian Federal Government through the Co-operative Research Centres Program (Vision CRC).

  • Competing interests: The International Centre for Eyecare Education distributes and receives financial benefit from the sale of ready-made 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.

  • Abbreviations:

    Rapid Assessment of Cataract Surgical Services