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R. Husain, S. Saw, M. Farook, G. Gazzard, D. Widjaja, D. Tan; Prevalence and Causes of Visual Impairment in Sumatra, Indonesia . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1268.
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Purpose: To determine the prevalence rates and causes of blindness and low vision in a rural setting in Sumatra, Indonesia Methods: A population-based visual impairment survey of adults 21 years and older was conducted in six villages in Sumatra, Indonesia. A one-stage cluster sampling procedure was conducted whereby 100 households were randomly selected from a sampling frame of 3447. Presenting distance visual acuity and refractive error was measured for each eye separately. Bilateral low vision was defined as habitual visual acuity in the better eye between 6/18 and 3/60. Bilateral blindness is defined as habitual visual acuity worse than 3/60 in the better eye. Subjects (n=66) with low vision or blindness had further examination of their anterior segments and fundi using a portable slit lamp, direct and indirect ophthalmoscope by an ophthalmologist to determine the possible causes of visual impairment. Results: The overall primary participation rate was 83.4% and the secondary participation rate was 73.3 %. The age-adjusted prevalence rates for Bilateral Low Vision and Blindness were 5.8% (95% Confidence Interval [CI]: 4.2,7.4) and 2.2% (95% CI: 1.1,3.2) respectively. Age and low income were significantly associated with increased prevalence of Blindness. There was no association with gender. There were 20 adults with unilateral visual impairment and 39 with bilateral visual impairment. The rates of low vision in both eyes was highest (n=40; 4.0%), followed by low vision in 1 eye and normal vision in the other (n=32; 3.2%), blindness in both eyes (n=15; 1.5%), blindness in 1 eye and low vision in the other (n=3; 0.3%) and blindness in 1 eye and normal vision in the other (n=2; 0.2%). The rates of unilateral and bilateral visual impairment were significantly higher in adults above 50 years of age compared with adults aged 50 years and below (p=0.001). Cataract and uncorrected refractive error accounted for 74.2%, 62.5% and 60% of cases of Bilateral Low Vision, Bilateral Blindness and Unilateral Low Vision respectively. Other causes included Amblyopia, Age-related Macular Degeneration, Macular Hole, Optic Atrophy and Trauma. Conclusions: The main causes of Low Vision and Blindness in Indonesia are un-corrected refractive error and cataract. Strategies to implement appropriate low cost and accessible eye care services are needed.
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