The latest Indigenous eye health measures 2021 report, published by The Australian Institute for Health and Welfare (AIHW), has been welcomed by Vision 2020 Australia and by Laureate Professor Hugh Taylor AC, Melbourne School of Population and Global Health, University of Melbourne.
The report shows measurable progress has been made towards improving the eye health of Aboriginal and Torres Strait Islander people, and identifies areas where there is still more to be done.
the Government committed to ending avoidable blindness in Australia by 2025 – they now have their own data… now what we need to see is funding and implementation of a plan
“I’m really delighted that the Government is funding the AIHW report, because what it shows us is they are monitoring progress and identifying where there are gaps in eye care for Aboriginal and Torres Strait Islander communities,” said Professor Taylor. “In 2019, the Government committed to ending avoidable blindness in Australia by 2025 – they now have their own data that clearly shows the areas that need focussed attention to deliver on this commitment… now what we need to see is funding and implementation of a plan.”
The report presents data from the 2019–20 year, which included the first four months of the COVID-19 pandemic in Australia. Comparisons against previous years found improvements in service delivery, detection of sight problems and eye disease, provision of treatments and spectacle correction.
While fluctuating, the overall number of services provided under the Visiting Optometrists Scheme, for example, more than tripled between 2010–11 (around 8,300 occasions of service) and 2018–19 (around 25,850) before declining in 2019–20 (around 22,089).1
Services delivered and improvements achieved were less than anticipated due to COVID-19 and Prof Taylor says we can expect the 2022 report will reflect an even more noticeable impact from the pandemic due to the many lockdowns across the country.
KEY COMPARISONS DETAILED IN THE AIHW REPORT
Eye Examinations, Screening and Self-Reporting
- Between 2010–11 and 2019–20, the proportion of Indigenous Australians who had an eye health check as part of a health assessment increased from 11% to 28% (based on age-standardised rates).1
- Among Indigenous Australians who had a diabetes test, the age-standardised proportion who were screened for diabetic retinopathy (DR) rose from an estimated 30% in 2008–09 to 34% in 2019–20; for non-Indigenous Australians, DR screenings rose from 35% to 44% before declining to 42%.1
- 104,300 Indigenous Australians had an eye examination by an optometrist or ophthalmologist in 2019–20 compared to 100,700 in 2018–19.1
Prevalence of Eye Conditions
- Among Indigenous Australians, prevalence of vision loss was highest in outer regional (16.6%) and very remote areas (15.7%). This compared to 8.1% and 7.7% respectively for non-Indigenous people living in these regions.1
- Disparity of vision loss by Indigenous status and age (2016) was particularly noticeable from the age of 60 upward, with 17.8% prevalence among Indigenous Australians aged 60-69 compared to 4.0% among non- Indigenous. By 80 years-of-age the prevalence had increased to 56% vs 12.2 % respectively.
- The overall prevalence of active trachoma among children aged five to nine-years, in at-risk communities, fell from 15% in 2009 to 4.8% in 2012 and has since plateaued at around this level (4.5% in 2019).1
- The proportion of Indigenous Australians aged 40 and over with trichiasis fell from 2.1% in 2012 to 0.1% in 2019.1
- 38% of Aboriginal and Torres Strait Islander Australians reported long-term eye or sight problems, with the prevalence higher for females than males.1
- Adjusting for age, Indigenous Australians were more likely than non-Indigenous Australians to report blindness (2.4 times as likely) or having a cataract (1.7 times as likely) as a cause of sight problems.1
Treatments
- In 2018–19, cataract surgery hospitalisations for Indigenous Australians increased 43% over 2011–12, however the long wait for surgery continued (a median number of 124 days compared to 82 days for non-Indigenous Australians).
- In 2019, the overall treatment coverage of active trachoma cases, including children, their household contacts and other community members in at-risk communities was 89%.1
- In 2019–20, 15,436 spectacles were dispensed to Indigenous Australians under state spectacle schemes by New South Wales, Victoria, Queensland, South Australia and Tasmania (the states and territories able to provide data). Victoria came closest to dispensing the estimated requirement of 3,923 spectacles for that state, dispensing 2,490 spectacles or 41 per 1,000 population.1
While there is reason for optimism, the AIHW report clearly highlights the need for further work to achieve the goal of ending avoidable blindness by 2025
CONTINUING CHALLENGES
Vision 2020 Australia Interim CEO Maureen O’Keefe said of the AIHW report, “The positive results, despite the impact of the COVID-19 pandemic, demonstrate the progress Vision 2020 Australia members have been making for a number of years in tackling avoidable blindness and ensuring access to timely eye care services for Aboriginal and Torres Strait Islander people.
“While there is reason for optimism, the AIHW report clearly highlights the need for further work to achieve the goal of ending avoidable blindness by 2025.”
“Now is the time to renew effort and investment in this important area,” Ms O’Keefe said. “The eye health and vision care sector has developed Strong eyes, Strong Communities – A five year plan for Aboriginal and Torres Strait Islander eye health and vision to ensure all Australians have the same access to eye care.
“We are thankful for the support this plan has received so far and are keen to continue working with communities and the government to end avoidable blindness for Aboriginal and Torres Strait Islander people.”
The five year plan describes an integrated suite of activities that need to be progressed over the coming five years. In combination, Vision 2020 proposes that these will: expand service delivery, strengthen partnerships and local supports, embed eye care into community controlled and mainstream services, eliminate trachoma, and sustain the focus on monitoring progress.2
Prof Taylor joined Vision 2020 Australia in calling for Australian Government investment in public provision of priority treatments (such as cataract surgery and treatments for diabetic eye disease), supporting development of community led models and building local case management that can help Aboriginal and Torres Strait Islander people connect to, and remain engaged with, treatment are all critical.
Prof Taylor said much could have been done to progress improvements in eye health during the COVID period had funding been available to strengthen the provision of local eye care in the regions of need through the Aboriginal Medical Services, regional managers, local case management, outreach specialist eye services and National Aboriginal Community Controlled Health Organisation.
“When we breakdown data from the AIHW report, we can see particular regions that fall way short of meeting goals and that’s where the Government funding needs to come in so the commitment to end avoidable blindness in Aboriginal and Torres Strait Islander communities by 2025 can be met,” he concluded.
References
- Indigenous eye health measures 2021. www.aihw.gov. au/reports/indigenous-australians/indigenous-eye-healthmeasures- 2021
- www.vision2020australia.org.au/wp-content/ uploads/2019/03/Strong-Eyes-Strong-Communities-Summaryand- Recommendations.pdf
