Correction of refractive error and presbyopia in Timor-Leste

AIM: To investigate the aspects of spectacle correction of vision-impairing refractive error and presbyopia in those aged >or=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 US3 (pound 1. 52, euro 2. 24) for spectacles, whereas 50. 2% were unwilling to pay US1 (pound 0. 51, euro 0. 75). Women and rural dwellers were less likely to be willing to pay at least US1 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.