Prevalence of Anterior Segment Diseases on Timor-Leste: A Telemedicine Based Study Using the Smart Eye Camera

To estimate the prevalence of anterior segment diseases in Timor-Leste using a smartphone-based slit-lamp (Smart Eye Camera, SEC) within a telemedicine workflow and assess age-related differences and cataract severity.

Methods: A community-based study (March–June 2025) recruited adults (≥18 years) across Timor-Leste. Visual acuity (VA) was measured using logMAR charts, and anterior segment images were captured with the SEC by trained clinicians and remotely graded.

Results: Among 82 participants (164 eyes; mean age 58.9 ± 14.0 years), mean uncorrected VA was 0.55 ± 0.65 logMAR, improving to 0.42 ± 0.66 with pinhole. Disease prevalence: blepharitis 7.4%, conjunctivitis 25.9%, pterygium 12.3%, cataract 37.1%. Cataract was significantly more common in those ≥50 years (44.7% vs 0%, p<0.01). Nuclear grade correlated strongly with VA (r=0.79, p<0.01).

Conclusions: Smartphone-based teleophthalmology is feasible and effective for screening in Timor-Leste, revealing a high burden of cataract and UV-related ocular surface disease.