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are more likely to delay the examination and appear as complex RD2, 3). This is similar to other findings that suggest that later and severe RD cases appear to emerge from more deprived regions. This pattern has significant effects on the final visual prognosis6). Retinal detachment can be estimated at 17,500 to 25,000 new cases annually in Indonesia. However, the national annual report for the number of RD surgeries is not provided1). In Indonesia, approxi-mately 1,600-2,800 vitreoretinal doctors are expected to serve 230 million people. Given the small number of VR surgeons in Indonesia, especially now that the population has reached 270 million, treating VR diseases requires not only timely intervention but also easier access to referral healthcare centers and affordability1). Healthcare access is also impacted by transportation, especially in rural regions where travel distances are long and alternative forms of transportation are few7, 8).While retinal detachment has added to the burden of blindness in Indonesia, few studies have directly discussed their epidemiology and effects on the scale of retinal diseases. In this paper, we will study what has been learned about RD in developing countries with limited facilities and uneven vitreo-retinal surgeon distribution. We would like to iden-tify the situation particularly at Dr. Soetomo General Academic Hospital (DSGAH) as one of the national referral hospital in Indonesia that located in East Java. East Java has two other hospitals that are equivalent to DSGAH, however comprehensive vitreoretinal facilities are inadequate. The purpose of this research was to study discrepancies between travel distance to the referral hospital (TDH) as one of the socioeconomic factors that impact the referral pathway. We hypothesized that patients living far from the referral hospital will be more likely to seek treatment late, which would lead to more severity and having unfavorable compliance in completing follow-up treatment. As such, late referral, the longer period from symptom onset to consultation (SO-C), and severe retinal prolifera-tion occurrence might impact the final visual acuity (VA). These findings will hopefully provide the data to enhance access to eye care, lead to better screening programs in peripheral areas, and raise awareness not only for health workers but also the people at risk so that early identification and diag-nosis can be achieved as timing is a critical factor in RD management. Material and MethodsA retrospective medical chart review was conducted at the Ophthalmology Out Patient Department (OPD) of Dr. Soetomo General Academic Hospital (DSGAH), Surabaya, East Java, Indonesia from 2013-2017. DSGAH is one of two other national referral hospital in East Java that serves as a teaching hospital and a referral center for the east part of Indonesia. The review was performed on all cases diagnosed with RD by the consultant in the vitreoretinal unit. Approval to review the medical record was obtained from DSGAH Institutional Review Board (IRB) under the number 0977/ KEPK/ II/ 2019. All the proce-dures performed in this study were in accordance with the ethical standards of the Declaration of Helsinki and the IRB. The IRB committee has been informed of the objective of the study and how the data will be used. As this study presented no risk to the participants and did not violate individual rights, thus access to medical records has been granted without informed consent needed. Demographic details including age, sex, travel distance to the referral hospital (TDH), the period from symptom onset to consultation (SO-C), Prolif-erative vitreoretinopathy (PVR) severity, and 6 months follow-up attendance (6mo-FA) were obtained. The TDH was determined by the distance between the place of origin (where the patient lives) and DSGAH Surabaya in kilometer (km) using an online distance calculator. The SO-C was determined by patients’ subjective reports in the medical record, which defines the period between the first onset of retinal detachment symptoms such as floaters, photopsia, visual field defect or vision disturbances, and the first examination at OPD.The presenting BCVA and 6 months post-opera-tive BCVA from the affected eye were recorded from Snellen’s charts examination and converted to LogMAR for analysis. Proliferative vitreoretinop-athy (PVR) type according to the Updated Retina Society Classification (1991)9) and macula condition (macula-on or macula-off) were retrieved. Addi-tionally, 6mo-FA was obtained from the availability of the data in the medical records, including anatom-37Methods