Frequently asked questions
What do we know about eye conditions among Indigenous people?
For more detailed information about eye conditions among Indigenous Australians view our Indigenous eye health web resource
| Please reference this document as: Australian Indigenous HealthInfoNet (2008) Frequently asked questions: what do we know about eye conditions among Indigenous people? Retrieved [access date] http://www.healthinfonet.ecu.edu.au/html/html_keyfacts/faq/faq_specific_health/eye_disease.htm |
What do we know about eye conditions among Indigenous people?
What do we know about eye conditions among Indigenous people? (August 2008)
The main eye conditions of concern among Indigenous people are refractive error, diabetic retinopathy, cataract, and trachoma [1, 2]. The 2008 report on the health and welfare of Indigenous Australians prepared by the ABS and AIHW noted that although the number of eye and vision problems was lower for Indigenous than non-Indigenous Australians (47% compared with 51% - age standardised), Indigenous people suffered from more severe eye and vision problems (cataracts and partial or complete blindness) [3].
The main refractive errors are long sighted vision (hyperopia), short sighted vision (myopia), presbyopia, and astigmatism.
- Long sighted vision (hyperopia) occurs when the eyeball is too short and light rays focus behind the retina making near images look blurred.
- Short sighted vision (myopia) occurs when the eyeball is too long and light rays focus in front of the retina making distant images look blurred.
- Presbyopia is usually noticed over the age of 40 years when the lens loses its flexibility and is less able to change shape, leading to a loss of ability to focus on close objects.
- Astigmatism is often associated with longsighted and shortsighted vision and is a focusing error causing blurred vision.
A major national survey of more than 10,000 Indigenous people in 2004-2005 found that:
- about one in six people were long sighted - needed glasses to see close objects and
- about one in ten people were short-sighted - needed glasses to see far object [4]
Refractive error is corrected by glasses, contact lenses, or surgery. The main issues Indigenous people face is access for eye testing and the cost and repair of glasses [5]. Services from eye specialists often do not meet the needs of Indigenous people with refractive error, particularly those living in rural or remote areas [1].
Indigenous people have benefitted from certain programs like VisionCare in NSW which has seen a 58% increase in the number of glasses provided to Indigenous people from 2000-2003 [5]. Similarly, in 2000-2001 the Nganampa Health Council in SA made low-cost, ready-made glasses available through community stores [5] which proved a popular way of helping with certain refractive errors.
Diabetes can cause damage to small blood vessels in the light-sensitive tissue at the back of the inside of the eye (the retina), which impairs vision. If untreated diabetic retinopathy (DR) can lead to blindness. Rates of diabetes have been shown to be three times higher in Indigenous people than non-Indigenous people [3]. People with diabetes have 25 times the rate of vision loss and blindness when compared to those without diabetes [6]. DR causes about 10% of blindness in Australia, most of which is preventable with early detection and treatment [7].
Diabetic retinopathy is detected by screening, either by a trained ophthalmologist or by use of a special retinal camera. There are a number of remote communities that are successfully using this kind of photography to detect DR [5]. Despite this, the services to deal with DR in Indigenous communities are generally poor, especially in remote areas [8].
Cataracts can cause blurred vision due to clouding of the eye’s lens (which focuses light on the retina). Cataracts may require surgery where the lens of the eye is replaced with an artificial lens. Protecting eyes with sunglasses and not smoking are two ways to help lower the risk of cataracts.
Cataracts are one-and-a-half times more common in Indigenous people than non-Indigenous people [4]. Surgery to improve vision is delayed longer in Indigenous people than non-Indigenous people due to a number of factors including limited access [1, 5]. There are specific guidelines for cataract surgery in Indigenous populations [5].
This infectious eye disease is caused by a micro-organism which is spread through contact with eye or nose discharge. After reoccurring infections, the cornea (front of the eye) can be severely scarred, eventually leading to irreversible clouding of the cornea, vision loss, and possible blindness.
In Australia, endemic trachoma is found almost exclusively among Indigenous people [9] and Australia is the only developed nation where this eye disease hasn’t been eradicated [10, 11]. Rates of trachoma vary greatly across Australia; in 2003, schools and communities in the Kimberley rates ranged from 5% to 60% [9]. There is evidence that the intensity of trachoma is decreasing in Australia, leading to fewer cases with severe results, such as blindness [9].
The World Health Organization’s ‘SAFE’ intervention strategy has been implemented in many of Australia’s affected areas [9], but the screening and treatment programs are different in each state. There is a focus on screening young children, improving hygiene in communities, administering antibiotics, and educating children on the importance of keeping their faces clean [12].
References
1 Taylor HR (1997) Eye health in Aboriginal and Torres Strait Islander communities: the report of a review commissioned by the Commonwealth Minister for Health and Family Services, the Hon. Michael Wooldridge, MP. Canberra: Commonwealth Department of Health and Family Services
2 Reddy V (2005) Epidemiology and treatment of eye disease: Cape York Regional Eye Health Programme (1999-2004). Unpublished Master of Public Health thesis, University of Queensland, Brisbane
3 Australian Bureau of Statistics, Australian Institute of Health and Welfare (2008)The health and welfare of Australia's Aboriginal and Torres Strait Islander Peoples 2008. (ABS Catalogue no. 4704.0 and AIHW Catalogue no. IHW 21) Canberra: Australian Bureau of Statistics and Australian Institute of Health and Welfare
4 Australian Bureau of Statistics (2006) National Aboriginal and Torres Strait Islander Health Survey: Australia, 2004-05. (ABS Catalogue no. 4715.0) Canberra: Australian Bureau of Statistics
5 Taylor V, Ewald D, Liddle H, Warchivker I (2004) Review of the implementation of the National Aboriginal and Torres Strait Islander Eye Health Program. Canberra: Centre for Remote Health
6 Taylor HR (2005) Diabetic retinopathy [editorial]. Clinical and Experimental Ophthalmology;33:3-4
7 Australia and New Zealand Horizon Screening Network (2004) National Horizon Scanning Unit, horizon scanning report: the detection of diabetic retinopathy utilising retinal photography in rural and remote areas in Australia. Adelaide: National Horizon Scanning Unit, Adelaide Health Technology Assessment
8 Jaross N, Ryan P, Newland H (2005) Incidence and progression of diabetic retinopathy in an Aboriginal Australian population: results from the Katherine Region Diabetic Retinopathy Study (KRDRS), report no. 2: clinical science. Clinical and Experimental Ophthalmology;33(1):26-33
9 Mak DB, O'Neill LM, Herceg A, McFarlane H (2006) Prevalence and control of trachoma in Australia, 1997-2004. Communicable Diseases Intelligence;30(2):236-247
10 Communicable Disease Network Australia (2006) Guidelines for the public health management of trachoma in Australia. Canberra: Department of Health and Ageing
11 Tellis B, Keeffe JE, Taylor HR (2007) Surveillance report for active trachoma, 2006: National Trachoma Surveillance and Reporting Unit. Communicable Disease Intelligence;31(4):366-374
12 The Chronicle (2008) The Canteen Creek Snot Campaign: an innovative approach to trachoma. The Chronicle;11(3):25-26
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