Prevalence and causes of blindness and low vision among adults in Fiji


  • Competing/conflicts of interest: No stated conflict of interest.

  • Funding sources: The design, implementation and analysis of the Fiji Eye Health Survey 2009 were financially supported by the New Zealand Agency for International Development (NZAID) and the Australian Agency for International Development (AusAID). These organizations had no role in the design or conduct of this research.

Ms Jacqueline Ramke, The Fred Hollows Foundation New Zealand, Private Bag 99909 Newmarket Auckland 1023, New Zealand. Email:


Background:  To estimate the prevalence and causes of blindness and low vision among adults aged ≥40 years in Fiji.

Design:  Population-based cross-sectional study.

Participants:  Adults aged ≥40 years in Viti Levu, Fiji.

Method:  A population-based cross-sectional survey used multistage cluster random sampling to identify 34 clusters of 40 people. A cause of vision loss was determined for each eye with presenting vision worse than 6/18.

Main Outcome Measures:  Blindness (better eye presenting vision worse than 6/60), low vision (better eye presenting vision worse than 6/18, but 6/60 or better).

Results:  Of 1892 people enumerated, 1381 participated (73.0%). Adjusting sample data for ethnicity, gender, age and domicile, the prevalence of blindness was 2.6% (95% confidence interval 1.7, 3.4) and low vision was 7.2% (95% confidence interval 5.9, 8.6) among adults aged ≥40 years. On multivariate analysis, being ≥70 years was a risk factor for blindness, but ethnicity, gender and urban/rural domicile were not. Being Indo-Fijian, female and older were risk factors for vision impairment (better eye presenting vision worse than 6/18). Cataract was the most common cause of bilateral blindness (71.1%). Among participants with low vision, uncorrected refractive error caused 63.3% and cataract was responsible for 25.0%.

Conclusion:  Strategies that provide accessible cataract and refractive error services producing good quality outcomes will likely have the greatest impact on reducing vision impairment.