title: Refractive error and presbyopia among adults in Fiji.
abstract: OBJECTIVE
  To characterize refractive error, presbyopia and their correction among adults aged ≥ 40 years in Fiji, and contribute to a regional overview of these conditions.
  
  
  METHODS
  A population-based cross-sectional survey using multistage cluster random sampling. Presenting distance and near vision were measured and dilated slitlamp examination performed.
  
  
  RESULTS
  The survey achieved 73.0% participation (n=1381). Presenting binocular distance vision ≥ 6/18 was achieved by 1223 participants. Another 79 had vision impaired by refractive error. Three of these were blind. At threshold 6/18, 204 participants had refractive error. Among these, 125 had spectacle-corrected presenting vision ≥ 6/18 ("met refractive error need"); 79 presented wearing no (n=74) or under-correcting (n=5) distance spectacles ("unmet refractive error need"). Presenting binocular near vision ≥ N8 was achieved by 833 participants. At threshold N8, 811 participants had presbyopia. Among these, 336 attained N8 with presenting near spectacles ("met presbyopia need"); 475 presented with no (n=402) or under-correcting (n=73) near spectacles ("unmet presbyopia need"). Rural residence was predictive of unmet refractive error (p=0.040) and presbyopia (p=0.016) need. Gender and household income source were not. Ethnicity-gender-age-domicile-adjusted to the Fiji population aged ≥ 40 years, "met refractive error need" was 10.3% (95% confidence interval [CI] 8.7-11.9%), "unmet refractive error need" was 4.8% (95%CI 3.6-5.9%), "refractive error correction coverage" was 68.3% (95%CI 54.4-82.2%),"met presbyopia need" was 24.6% (95%CI 22.4-26.9%), "unmet presbyopia need" was 33.8% (95%CI 31.3-36.3%), and "presbyopia correction coverage" was 42.2% (95%CI 37.6-46.8%).
  
  
  CONCLUSIONS
  Fiji refraction and dispensing services should encourage uptake by rural dwellers and promote presbyopia correction. Lack of comparable data from neighbouring countries prevents a regional overview.
authors.affiliation: The Fred Hollows Foundation New Zealand, Auckland, New Zealand. grbrian@tpg.com.au
authors.forename: Garry
authors.initials: G
authors.lastname: Brian
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Pearce
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Ramke
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005139:Eyeglasses / Q000706:statistics & numerical data; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011305:Presbyopia / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012030:Refractive Errors / Q000453:epidemiology* / Q000628:therapy; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology