• Joshua Foreman, Jing Xie, Stuart Keel, Peter van Wijngaarden, Sukhpal Singh Sandhu, Ghee Soon Ang, Jennifer Fan Gaskin, Jonathan Crowston, Rupert Bourne, Hugh R Taylor, and Mohamed Dirani.
• Centre for Eye Research Australia, The Royal Victorian Eye & Ear Hospital, Melbourne, Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia. Electronic address: foreman.j@unimelb.edu.au.
• Ophthalmology. 2017 Dec 1; 124 (12): 1743-1752.

PurposeTo conduct a nationwide survey on the prevalence and causes of vision loss in Indigenous and non-Indigenous Australians.DesignNationwide, cross-sectional, population-based survey.ParticipantsIndigenous Australians aged 40 years or older and non-Indigenous Australians aged 50 years and older.MethodsMultistage random-cluster sampling was used to select 3098 non-Indigenous Australians and 1738 Indigenous Australians from 30 sites across 5 remoteness strata (response rate of 71.5%). Sociodemographic and health data were collected using an interviewer-administered questionnaire. Trained examiners conducted standardized eye examinations, including visual acuity, perimetry, slit-lamp examination, intraocular pressure, and fundus photography. The prevalence and main causes of bilateral presenting vision loss (visual acuity <6/12 in the better eye) were determined, and risk factors were identified.Main Outcome MeasuresPrevalence and main causes of vision loss.ResultsThe overall prevalence of vision loss in Australia was 6.6% (95% confidence interval [CI], 5.4-7.8). The prevalence of vision loss was 11.2% (95% CI, 9.5-13.1) in Indigenous Australians and 6.5% (95% CI, 5.3-7.9) in non-Indigenous Australians. Vision loss was 2.8 times more prevalent in Indigenous Australians than in non-Indigenous Australians after age and gender adjustment (17.7%, 95% CI, 14.5-21.0 vs. 6.4%, 95% CI, 5.2-7.6, P < 0.001). In non-Indigenous Australians, the leading causes of vision loss were uncorrected refractive error (61.3%), cataract (13.2%), and age-related macular degeneration (10.3%). In Indigenous Australians, the leading causes of vision loss were uncorrected refractive error (60.8%), cataract (20.1%), and diabetic retinopathy (5.2%). In non-Indigenous Australians, increasing age (odds ratio [OR], 1.72 per decade) and having not had an eye examination within the past year (OR, 1.61) were risk factors for vision loss. Risk factors in Indigenous Australians included older age (OR, 1.61 per decade), remoteness (OR, 2.02), gender (OR, 0.60 for men), and diabetes in combination with never having had an eye examination (OR, 14.47).ConclusionsVision loss is more prevalent in Indigenous Australians than in non-Indigenous Australians, highlighting that improvements in eye healthcare in Indigenous communities are required. The leading causes of vision loss were uncorrected refractive error and cataract, which are readily treatable. Other countries with Indigenous communities may benefit from conducting similar surveys of Indigenous and non-Indigenous populations.Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

36 keywords...

hide…