Share on Facebook Share on Twitter Share on LinkedIn Share on Google+ Share by Email

Skip to content

Key resources

  • Bibliography
    Bibliography
  • Health promotion
    Health promotion
  • Health practice
    Health practice
  • Programs
    Programs
  • Conferences
    Conferences
  • Courses
    Courses
  • Funding
    Funding
  • Jobs
    Jobs
  • Organisations
    Organisations
  • Health Services MapHealth Services Map
Australian Indigenous HealthBulletin Alcohol and other drugs knowledge centre Yarning Places
 

Eye health

Please select category from the dropdown list below.

Eye health

Eye health can be affected by a number of factors, including genetics, ageing, premature birth, diseases (such as diabetes), injuries, ultraviolet (UV) exposure, nutrition and tobacco use [1][2]. Poor vision can limit opportunities in education, employment and social engagement; it can also increase the risk of injury and be a reason for dependence on services and other people [3][4]. Even partial loss of vision can reduce an individual’s ability to live independently and increase the risk of mortality [3][5].

In 2011, hearing and vision disorders together contributed to 1.2% of the total burden of disease experienced by Aboriginal and Torres Strait Islander people [6]. The burden of vision loss (VI)34 was estimated to be three times greater for Aboriginal and Torres Strait Islander people than for non-Indigenous people. However, evidence suggests that Indigenous children, particularly those living in remote areas, experience generally better vision than non-Indigenous children [7]

It is estimated that 90% of VI and blindness35 among both Indigenous and non-Indigenous people is preventable or treatable [8]. The Roadmap to close the gap for vision is currently guiding national efforts to increase the accessibility and uptake of culturally appropriate eye care services among Indigenous people [9].

Extent of eye health problems among Aboriginal and Torres Strait Islander people

Estimates of the prevalence of eye health problems among Aboriginal and Torres Strait Islander people have been obtained from surveys36 and surveillance activities that rely on eye examinations or self-report37.

Prevalence estimates of eye health problems based on data from eye examinations

The National Eye Health Survey (NEHS) was conducted between March 2015 and April 2016 [8]. It provides the latest evidence about the prevalence, causes and treatment of VI38 and blindness39 among Indigenous adults in Australia. The NEHS examined the eyes of 1,738 Indigenous people aged 40 years or older and 3,098 non-Indigenous people aged 50 years or older. After age-adjustment, it found that the prevalence of both bilateral VI and bilateral blindness were significantly higher among Indigenous participants (14% and 0.4% respectively) than among non-Indigenous participants (4.6% and 0.1% respectively). There was no significant difference in the prevalence of VI or blindness between males and females among either Indigenous or non-Indigenous participants. After age-adjustment, VI and blindness in Indigenous adults were both three times higher than in non-Indigenous adults. It was estimated that in 2016 up to 18,300 Indigenous people aged 40 years or older were living with VI or blindness.

There has been a reduction in the prevalence of blindness in Indigenous adults, from six times higher than that experienced by non-Indigenous adults in 2008 [7] to three times higher in 2016 [8].

According to the NEHS, the main causes of VI in Indigenous and non-Indigenous adults were uncorrected refractive error (63% and 62% respectively) and cataract (20% and 14% respectively) [8]. Diabetic retinopathy was the third most common cause of VI in Indigenous adults, but it contributed to a smaller proportion of cases among non-Indigenous adults (5.5% and 1.5% respectively). VI increased with age in both groups. The prevalence of VI among Indigenous adults was significantly higher in outer regional areas than in other areas, but remoteness did not affect the prevalence of VI among non-Indigenous adults.

The NEHS identified five Indigenous participants with bilateral blindness, the main causes of which were cataract (two people), diabetic retinopathy (one person), optic atrophy (one person) and a combination of mechanisms (one person) [8]. In comparison, the main cause of bilateral blindness in non-Indigenous people was age-related macular degeneration (5 out of 7 people).

Prevalence estimates of eye health problems based on self-reported data

Eye and sight problems40 (also referred to as diseases of the eye and associated structures such as the eyelids, eyebrows and tear ducts known as adnexa) [10]) were reported in the 2012-2013 AATSIHS by one-third (33%) of Aboriginal and Torres Strait Islander people (33% of Aboriginal people and 34% of Torres Strait Islander people) [11], making it the most commonly reported long-term health condition [12]. Eye and sight problems were reported by 38% of females and by 29% of males [13]. After age-adjustment, Aboriginal and Torres Strait Islander people were slightly less likely to report eye and sight problems than non-Indigenous people (ratios of 0.9 for: males; females; and total persons) [14].

In the 2012-2013 AATSIHS, self-reported eye and sight problems increased with age for both Aboriginal and Torres Strait Islander people and non-Indigenous people [15]. Age-specific proportions ranged from 9% for Aboriginal and Torres Strait Islander people in the 0-14 years age-group to 92% for those aged 55 years and over and 11% to 95% for non-Indigenous people in the comparable age-groups. The proportions of eye and sight problems reported by Aboriginal and Torres Strait Islander people were lower than those reported by their non-Indigenous counterparts in all age-groups, apart from those reported for the 35-44 and 45-54 years age-groups in which the proportions were slightly higher among Aboriginal and Torres Strait Islander people. The proportion of Aboriginal and Torres Strait Islander people reporting eye or sight problems was similar in non-remote areas41 and remote areas (both 35%), but lower among those living in very remote areas (25%) [16].

The most common eye conditions reported by Aboriginal and Torres Strait Islander people in the 2012-2013 AATSIHS were: hyperopia (long sightedness: 19%), myopia (short sightedness: 13%), other diseases of the eye and adnexa42 (5.6%), blindness (3.0%), and cataract (1.1%) (Table 25) [14]. After age-adjustment, Aboriginal and Torres Strait Islander people were more likely to report hyperopia, cataract and blindness than non-Indigenous people (ratios of 1.1, 1.4 and 7.4 respectively), but were less likely to report myopia (ratio: 0.8) and other diseases of the eye and adnexa (ratio: 0.5). Blindness showed the greatest disparities in Indigenous: non-Indigenous ratios, with Aboriginal and Torres Strait Islander males and females both more likely to report blindness than non-Indigenous males and females (ratios: 6.3 for males and 8.8 for females) [14].

Table 25. Proportions (%) of people reporting specific diseases of the eye and adnexa as long-term health conditions, by sex and Indigenous status, and Indigenous:non-Indigenous ratios, Australia, 2012-2013

Diseases of the eye and adnexa

Males

Females

Persons

Indigenous (%)

Non-Indigenous (%)

Ratio

Indigenous (%)

Non-Indigenous (%)

Ratio

Indigenous (%)

Non-Indigenous (%)

Ratio

Cataract

1.2

1.4

1.7

1.0

2.0

1.2

1.1

1.7

1.4

Myopia

10

21

0.8

15

27

0.8

13

24

0.8

Hyperopia

15

25

1.1

23

31

1.2

19

28

1.1

Blindness

2.7

0.6

6.3

3.2

0.5

8.8

3.0

0.6

7.4

Other

5.7

16

0.5

5.5

16

0.5

5.6

16

0.5

Notes:

  1. Proportions are not age-standardised
  2. A long-term health conditions is one that has lasted, or is expected to last, for 6 months or more
  3. Data for non-Indigenous people are for 2011-12
  4. Ratios are age-standardised with the Indigenous proportion divided by the non-Indigenous proportion and based on the 2001 Australian estimated resident population (ERP)
  5. Blindness includes complete and partial blindness
  6. Other diseases of the eye and adnexa include: glaucoma, macular degeneration, astigmatism and presbyopia

Source: ABS, 2014 [14]

Among Aboriginal and Torres Strait Islander people who reported having diabetes, 29% reported having sight problems due to this condition [17]. After age-adjustment, this proportion was 2.6 times greater than the proportion reported by non-Indigenous people with diabetes.

The 2012-2013 AATSIHS provided some age-specific data for selected eye diseases [15]. The proportions of Aboriginal and Torres Strait Islander people reporting myopia or other diseases of the eye and adnexa are less in each age-group than those reported by non-Indigenous people. Hyperopia is also less common among young Aboriginal and Torres Strait Islander people aged 0-14 and 15-24 years of age than among non-Indigenous young people, but more common among Aboriginal and Torres Strait Islander people from 25 years of age onwards. Cataract and blindness are more common among Aboriginal and Torres Strait Islander people than among non-Indigenous people in all age-groups for which data are available.

Prevalence estimates of trachoma and trichiasis based on surveillance

The National Trachoma Surveillance and Reporting Unit provides prevalence data for trachoma detected through screening [18]. Preliminary data for trachoma are available for 2015, when screening and treatment was undertaken in at-risk communities in WA, SA and the NT. The estimated prevalence of active trachoma among children aged 5-9 years (using projected data) was 4.6%. Cases that were detected included 17 in WA, 51 in SA, and 52 in the NT. If left untreated, trachoma can cause scarring and in-turned eyelashes that lead to blindness (trichiasis) [7]. The most recent data for trichiasis are from 2014, when at risk communities in WA, SA and the NT were screened and the condition was detected in 0.05% of adults aged 15 years and over and 0.9% of those aged 40 years and over [19]. A total of 50 cases of trichiasis were detected (11 in WA, 12 in SA, and 27 in the NT).

General practice attendances and hospitalisation

Among Aboriginal and Torres Strait Islander patients, 1.1% of all problems that were managed by GPs in the period April 2008 to March 2013 were related to eye health [17][20]. After age-adjustment, eye health problems among Aboriginal and Torres Strait Islander patients were managed by GPs at a similar rate as that for other patients (rate ratio: 1.0). However they were 3.5 times more likely than other patients to see GPs for the management of cataracts.

In 2014-15, there were 3,373 hospital separations for diseases of the eye and adnexa among Aboriginal and Torres Strait Islander people in Australia, accounting for 1.5% of separations, excluding dialysis, identified as Indigenous derived from [21]. A more detailed analysis of hospitalisation data is available for the period 2011-12 to 2012-13. In this period, there were 5,674 hospitalisations for diseases of the eye and adnexa among Aboriginal and Torres Strait Islander people, the majority of which (58%) were for cataracts [17]. After age-adjustment, Aboriginal and Torres Strait Islander males and females were less likely to be hospitalised for diseases of the eye and adnexa than their non-Indigenous counterparts (rate ratios of 0.7 and 0.8 respectively) [20]. Aboriginal and Torres Strait Islander people were less likely to be hospitalised for these eye conditions in non-remote areas than their non-Indigenous counterparts (rate ratio 0.7), but they were more likely to be hospitalised for them in remote and very remote areas (rate ratios of 1.2 and 1.5 respectively).

References

  1. Australian Bureau of Statistics (2009) National Aboriginal and Torres Strait Islander social survey, 2008. Retrieved 11 April 2011 from http://www.abs.gov.au/ausstats/abs@.nsf/mf/4714.0?OpenDocument
  2. Biotext (2008) Risk factors for eye disease and injury: literature review. Canberra: National Health and Medical Research Council, Australia
  3. Australian Health Ministers’ Advisory Council (2012) Aboriginal and Torres Strait Islander health performance framework: 2012 report. Canberra: Office for Aboriginal and Torres Strait Islander Health, Department of Health and Ageing
  4. Access Economics (2004) Clear Insight: The economic impact and cost of vision loss in Australia. : Access Economics Pty Limited
  5. Taylor HR, Boudville A, Anjou M, McNeil R (2011) The roadmap to close the gap for vision: summary report. Melbourne: Indigenous Eye Health Unit, the University of Melbourne
  6. Australian Institute of Health and Welfare (2016) Australian Burden of Disease Study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2011. Canberra: Australian Institute of Health and Welfare
  7. Taylor HR, National Indigenous Eye Health Survey Team (2009) National Indigenous eye health survey: minum barreng (tracking eyes): summary report. Melbourne: Indigenous Eye Health Unit, The University of Melbourne
  8. Foreman J, Keel S, Xie J, van Wijngaarden P, Crowston J, Taylor HR, Dirani M (2016) The National Eye Health Survey 2016 report. Melbourne: Vision 2020 Australia
  9. Abouzeid M, Anjou MD, Taylor HR (2015) Equity in vision in Australia is in sight. Medical Journal of Australia; 203(1): 21-23
  10. Australian Institute of Health and Welfare (2008) Eye health among Australian children. Canberra: Australian Institute of Health and Welfare
  11. Australian Bureau of Statistics (2014) Australian Aboriginal and Torres Strait Islander health survey: first results, Australia, 2012-13: Table 25 [data cube]. Retrieved 26 March 2014 from http://www.abs.gov.au/ausstats/subscriber.nsf/log?openagent&table%2025%20selected%20health%20characteristics%20by%20aboriginal_torres%20strait%20islander%202012-13%20-%20australia.xls&4727.0.55.001&Data%20Cubes&8759176B7100FFF0CA257CA6000E3759&0&2012-13&2
  12. Australian Bureau of Statistics (2013) Australian Aboriginal and Torres Strait Islander health survey: first results, Australia, 2012-13: Table 3 [data cube]. Retrieved 27 November 2013 from http://www.abs.gov.au/AUSSTATS/subscriber.nsf/log?openagent&table%203%20selected%20health%20characteristics,%20by%20state_territory%202012-13-australia.xls&4727.0.55.001&Data%20Cubes&D43DB1D697BED77ECA257C2F00145D04&0&2012-13&27.11.2013&Latest
  13. Australian Bureau of Statistics (2013) Australian Aboriginal and Torres Strait Islander health survey: first results, Australia, 2012-13: Table 4 [data cube]. Retrieved 27 November 2013 from http://www.abs.gov.au/AUSSTATS/subscriber.nsf/log?openagent&table%204%20selected%20health%20characteristics,%20by%20sex%202012-13-australia.xls&4727.0.55.001&Data%20Cubes&497BBEB2AFC1B23DCA257C2F00145D2E&0&2012-13&27.11.2013&Latest
  14. Australian Bureau of Statistics (2013) Australian Aboriginal and Torres Strait Islander health survey: first results, Australia, 2012-13: Table 5 [data cube]. Retrieved 27 November 2013 from http://www.abs.gov.au/AUSSTATS/subscriber.nsf/log?openagent&table%205%20long-term%20conditions%20by%20sex%20by%20indigenous%20status,%202012-13%20-%20australia.xls&4727.0.55.001&Data%20Cubes&5C97CE7DA7059C06CA257C2F00145D5A&0&2012-13&27.11.2013&Latest
  15. Australian Bureau of Statistics (2014) Australian Aboriginal and Torres Strait Islander health survey: first results, Australia, 2012-13: Table 6 [data cube]. Retrieved 26 March 2014 from
  16. Australian Bureau of Statistics (2014) Australian Aboriginal and Torres Strait Islander health survey: first results, Australia, 2012-13: Table 2 [data cube]. Retrieved 26 March 2014 from http://www.abs.gov.au/AUSSTATS/subscriber.nsf/log?openagent&table%202%20selected%20health%20characteristics,%20by%20remoteness%20area%202012-13%20-%20australia.xls&4727.0.55.001&Data%20Cubes&9F3D9B7052520B1BCA257CA6000E31B5&0&2012-13&26.03.2014&Latest
  17. Australian Institute of Health and Welfare (2015) Aboriginal and Torres Strait Islander health performance framework 2014 report: detailed analyses. Canberra: Australian Institute of Health and Welfare
  18. The Kirby Institute (2016) 2015 Australian trachoma surveillance preliminary report. Sydney: The Kirby Institute, University of New South Wales
  19. The Kirby Institute (2015) Australian trachoma surveillance report 2014. Sydney: The Kirby Institute, University of New South Wales
  20. Australian Institute of Health and Welfare (2015) Aboriginal and Torres Strait Islander health performance framework 2014: data tables. Retrieved 11 June 2015 from http://www.aihw.gov.au/indigenous-data/health-performance-framework/
  21. Australian Institute of Health and Welfare (2016) Admitted patient care 2014-15: Australian hospital statistics. Canberra: Australian Institute of Health and Welfare
  22. Australian Department of Health and Ageing, Victorian Department of Human Services (2005) Eye health in Australia: a background paper to the national framework for action to promote eye health and prevent avoidable blindness and vision loss. Canberra: Australian Government Department of Health and Ageing
  23. Australian Institute of Health and Welfare (2015) The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples 2015. Canberra: Australian Institute of Health and Welfare

Footnotes

34. Vision loss refers specifically to loss due to refractive error, cataract, glaucoma and age-related macular degeneration [6]. It does not include vision loss due to trachoma or diabetes.

35. This calculation is based on figures for age-related macular degeneration, cataract, diabetic retinopathy, glaucoma and uncorrected refractive error [8].

36. Survey findings may not be directly comparable due to differing ways of defining and assessing vision loss [22].

37. Self-reported survey data may underestimate the prevalence of health conditions because participants: may not have been diagnosed yet, may not be willing to disclose a diagnosis, may have forgotten the diagnosis or misinterpreted the survey question [23].

38. The NEHS defines vision impairment as ‘presenting distance visual acuity <6/12 in the better eye’ [8].

39. The NEHS defines blindness as ‘presenting distance visual acuity <6/60 in the better eye’ [8].

40. Eye and sight problems include: cataract; glaucoma; disorders of the choroid and retina; disorders of the ocular muscles, binocular movement, accommodation and refraction; visual disturbances and blindness; and other diseases of the eye and adnexa [11].

41. Non-remote areas include major cities and inner and outer regional areas [16].

42. Other diseases of the eye and adnexa include: glaucoma, macular degeneration, astigmatism and presbyopia [14].

 

Table of Contents

collapseCollapse
expand Expand
    Last updated: 31 March 2017
     
    Return to top
    spacing
    general box

    Contribute

    Share your information » Give us feedback » Sign our guestbook »
    spacing
    spacing