Blindness and Visual Impairment Situation in Indonesia Based on Rapid Assessment of Avoidable Blindness Surveys in 15 Provinces

ABSTRACT

Purpose: To report the latest data on blindness and visual impairment (VI) in Indonesia.

Methods: Rapid Assessment of Avoidable Blindness (RAAB) surveys were done in 15 provinces in Indonesia between 2013 and 2017. The population of the study was people aged 50 +. In each province, the required number of clusters was selected with a probability proportionately to size. A weighted average analysis for prevalence, causes of visual impairment, and cataract surgical coverage (CSC) estimated the values of the country.

Results: The prevalence of blindness in East Java was the highest at 4.4% (95% CI: 3.1–5.6%), followed by Nusa Tenggara Barat (NTB) at 4.0% (95% CI: 3.0–5.1%) and South Sumatra at 3.4% (95% CI: 2.4–4.4%). In number, blindness among people aged 50+ in East Java was the highest at 371,599, followed by West Java at 180,666 and Central Java at 176,977. Untreated cataract was the commonest cause of blindness in all provinces (range: 71.7% to 95.5%). CSC_person<3/60 and CSC_person<6/60 in Bali were the highest at 81.3% and 72.4%, respectively. Indonesia countrywide prevalence of blindness was 3.0%. The total number of people with VI (PVA less than 6/18 in the better eye) in Indonesia was 8,019,427, consisting of 1,654,595 of blindness and 6,364,832 of moderate and severe VI.

Conclusion: The burden of blindness in Indonesia is high, and untreated cataract contributes the most. There is an urgent need to increase cataract surgical coverage by providing better access to cataract surgery services for all people in need.

KEYWORDS:

• Prevalence
• avoidable blindness
• Indonesia
• cataract
• RAAB

Acknowledgments

We thank all elements of RAAB surveys in South Sulawesi, NTB and West Java for initiating the surveys in Indonesia. Their initiative to conduct a population-based survey triggers other RAAB surveys in Indonesia. We acknowledge the outstanding contribution of all individuals from different institutions and organisation in Indonesia who dedicated their valuable time to ensure the surveys completed. We thank The National Institute for Health Research and Development of The Indonesian Ministry of Health for organising the survey fieldworks. Our gratitude also for all The Indonesian Ophthalmologist Association (IOA) members in North Sumatra, West Sumatra, South Sumatra, South Kalimantan, DKI Jakarta, West Java, Central Java, East Java, NTB, NTT, Bali, South Sulawesi, North Sulawesi, Maluku, and West Papua who dedicated their valuable time in the surveys. Finally, we thank all fieldwork personnel for their priceless contribution in the survey, even though they had to deal with a challenging geographical situation.

Declaration of Interest

None of the authors have any proprietary interests or conflicts of interest related to this submission.

Financial supports

• RAAB survey in South Sulawesi province was financially supported by Lions Club International and Indonesian Ophthalmology Association (IOA) South Sulawesi Branch.

• RAAB survey in West Java province was financially supported by Cicendo Eye Hospital, CBM Indonesia and Indonesian Ophthalmology Association (IOA) West Java Branch.

• RAAB survey in Nusa Tenggara Barat (NTB) province was financially supported Fred Hollows Foundation (FHF) and Ministry of Health Office of NTB province.

• Other 13 RAAB surveys were financially supported by National Institute for Health Research and Development (NIHRD), The Indonesian Ministry of Health.

This manuscript has not been published anywhere previously and that it is not simultaneously being submitted and considered for any other publication.