Objective: To assess the prevalence and
causes of blindness and visual impairment (VI)
in older adults in Suriname.
Design: Population-based cross-sectional
survey.
Participants: A total of 2,998 non-institutional
residents aged ≥50 years.
Methods: Fifty clusters of 60 people were
randomly selected with a probability proportional
to the size of the population unit. Eligible
persons were randomly selected through
compact segment sampling and examined in
their own house using the standard Rapid Assessment
of Avoidable Blindness (RAAB) protocol.
Presenting distance visual acuity (PVA)
was tested and the primary cause of blindness
and VI was assessed by an ophthalmologist
in people with a visual acuity (VA) <20/60 in
either eye.
Main Outcome Measures: Prevalence
and causes of blindness (PVA <3/60), severe VI
(SVI: PVA <6/60 – 3/60), and moderate VI (MVI:
PVA <6/18 – 6/60) were assessed. Cataract
surgical coverage (CSC), main barriers to the
uptake of cataract surgery, and outcomes after
cataract surgery were evaluated.
Results: A total of 2,806 individuals were
examined (response 93.6%). The standardized
prevalence of blindness was 1.9% (95% CI: 1.0-
2.8). Prevalence’s of SVI and MVI were 1.1%
(95% CI: 0.6-1.6) and 5.6% (95% CI: 4.1-7.0),
respectively. Untreated cataract was the most
common cause of bilateral blindness (54.0%),
followed by glaucoma (23.8%). Cataract also
accounted for most cases of bilateral SVI
(57.9%). The main causes of MVI were uncorrected
refractive errors (48.6%) and untreated
cataract (33.7%). The CSC for VA <3/60 was
88.1% when calculated by eye and 94.3% by
individual. ‘Cannot access treatment’ was the
most common barrier (28.9%) for cataract
surgery. Of the eyes that received surgery,
80.5% had a good outcome (PVA >6/18) and
9.8% had a poor outcome (< 6/60).
Conclusions: The prevalence of blindness
in Suriname is comparable to other South
American and Caribbean countries. Of all
bilaterally blind cases, 87.3% is considered
avoidable. Although the CSC is already high for
all VA levels, the main intervention strategies
to reduce avoidable blindness are cataract surgery,
followed by the development of optical
and special glaucoma services, as these are the
most cost-effective interventions.