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2024 Samoa Rapid Assessment of Avoidable Blindness

In July 2024, Samoa completed its first Rapid Assessment of Avoidable Blindness (RAAB) survey.

The Rapid Assessment of Avoidable Blindness (RAAB) is a simple survey method used to find out how many people have vision problems, why they have them, and if they are getting the help they need.

The 2024 Samoa RAAB survey assessed vision in adults 50+ across all the districts of the country. With diabetes rates in Samoa among the highest in the Pacific, this survey also looked at the impact of diabetes and diabetic eye disease on vision.

Over 11 weeks, a dedicated team visited 132 communities across Samoa, reaching more than 4,000 people.

The survey was locally led by Dr Lucilla Ah Ching-Sefo, with support from the Ministry of Health, The Fred Hollows Foundation NZ, and regional eye health colleagues.

What did we learn?

Prevalence of Vision Impairment
One in 10 older people in Samoa has serious vision problems that could be prevented.
Avoidable blindness
Eight in 10 cases of blindness in older people could be avoided with access to proper treatment.
Cataracts as the Leading Cause
Cataracts are the main cause of blindness and severe vision problems in Samoa.
Uncorrected Refractive Errors
Not wearing the right glasses is the main reason for less severe vision problems in Samoa.
Cataract Surgical Coverage (CSC)
Samoa has a high coverage rate for cataract blindness, with 9 out of 10 people blinded by the condition having received surgery.
Visual Outcomes After Cataract Surgery
The majority of patients in Samoa achieve good vision after cataract surgery, with only a minority experiencing limited improvement.
Barriers to Cataract Surgery
The most common barriers to cataract surgery include lack of perceived need, unaware that treatment was possible, limited access to services, and fear. Targeted awareness campaigns can help address these barriers and encourage more people to seek treatment.
Effective Cataract Surgical Coverage (eCSC)
While Samoa has very good cataract surgery results, improving the quality of surgery can help more people achieve better vision.
Distance Refractive Error Coverage (REC)
One in ten older people in Samoa need glasses to see in the distance.
Effective Refractive Error Coverage (eREC)
Fewer than one in 10 older people who need glasses to see in the distance are getting the right glasses that work for them.
Use of reading glasses
Just one in five older people in Samoa who need reading glasses have them.
Prevalence of Diabetes and Diabetic Retinopathy (DR)
More than one in five older people in the survey had suspected or known diabetes. Around four in 10 people who had diabetes also had eye problems caused by the disease.
Diabetic Retinopathy (DR) Screening
Nearly eight in 10 older adults with diabetes had never had their eyes checked before, highlighting the need to strengthen eye health services.

What can we do about it?

SURGICAL
Improve Cataract Surgery Access and Outcomes

Increase surgical services in rural facilities and initiate regular audits of surgery outcomes.

GLASSES
Expand Refractive Error Services

Ensure improved access, affordable corrective lenses and train more health care providers to manage refractive errors.

OUTREACHES
Implement Systematic DR Screening

Integrate regular DR screenings into diabetes care to detect and treat early-stage DR, with a focus on  patient education.

TRAINING MATERIALS
Increase Public Awareness

Launch campaigns to promote routine eye exams and educate on available eye care services.

STRENGTHENING LOCAL HEALTH SYSTEMS
Strengthen Eye Health Infrastructure

Build capacity in eye care through improved infrastructure, trained personnel, and stable supply chains.

EQUIPMENT
Promote Policy Support

Advocate for prioritizing eye health in national policies to secure sustainable funding and international support.

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