Visual impairment among Aboriginal and Torres Strait Islander patients attending an Australian Indigenous primary health service: a cross-sectional study
Prabha Lakhan A E , Uchechukwu L. Osuagwu B , Deborah Askew A C , Noel Hayman A D and Geoffrey Spurling A CA Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Healthcare, PO Box 52, Inala, Qld 4077, Australia.
B Diabetes, Obesity and Metabolism Translational Research Unit (DOMTRU), School of Medicine, Western Sydney University, Level 2, Macarthur Clinical School Building, Parkside Crescent, Campbelltown, NSW 2560, Australia.
C Primary Care Clinical Unit, The University of Queensland, Level 8, Health Sciences Building, Building 16/910, Royal Brisbane and Women’s Hospital, Herston, Qld 4029, Australia.
D School of Medicine, Griffith University, Parklands Drive, Southport, Qld 4222, Australia.
E Corresponding author. Email: prabha.lakhan@health.qld.gov.au
Australian Journal of Primary Health 26(4) 287-292 https://doi.org/10.1071/PY19119
Submitted: 11 June 2019 Accepted: 17 April 2020 Published: 13 July 2020
Journal Compilation © La Trobe University 2020 Open Access CC BY-NC-ND
Abstract
This cross-sectional study aimed to identify the period prevalence of visual impairment (VI) and blindness among Aboriginal and Torres Strait Islander people attending an Indigenous urban primary healthcare service, eye care practitioner referrals for those with VI and any opportunities to improve care delivery. Visual acuity (VA) examinations, using a Snellen chart, are performed as part of routine annual health assessments offered to children and adults. This study included patients aged ≥5 years (n = 1442) who had a health assessment conducted between 1 January 2015 and 31 December 2016 and provided consent for the use of their health assessment information for research. Of patients with available data, 2.4% (33/1374) experienced VI, defined as presenting VA worse than 6/12 to 6/60 in the better-seeing eye. VI was more common in those aged ≥60 years (14/136; 10.3%) and was significantly associated with increasing age (P < 0.001). No patients experienced blindness, defined as presenting VA worse than 6/60 in the better-seeing eye. All patients with VI were aged ≥16 years. Nine (27%) of the 33 patients with VI in the better-seeing eye were referred to an optometrist or an ophthalmologist. The low period prevalence of VI and no blindness in this study are positive findings. The findings also indicate that routine VA testing of older adults, especially those aged ≥60 years, should be conducted to avoid missing those not having an annual health assessment.
Additional keywords: health promotion, Indigenous health services, primary health care.
References
Abouzeid M, Anjou MD, Taylor HR (2015) Equity in vision in Australia is in sight. Medical Journal of Australia 203, 21–23.| Equity in vision in Australia is in sight.Crossref | GoogleScholarGoogle Scholar | 26126562PubMed |
Australian Government Department of Health (2014) Medicare health assessment for Aboriginal and Torres Strait Islander people (MBS ITEM 715). (Department of Health: Canberra, ACT, Australia) Available at www.health.gov.au/internet/main/publishing.nsf/content/mbsprimarycare_ATSI_MBSitem715 [Verified 25 July 2018]
Australian Institute of Health and Welfare (AIHW) (2011) ‘Eye health in Aboriginal and Torres Strait Islander people.’ Catalogue no. IHW 49. (AIHW: Canberra, ACT, Australia)
Australian Institute of Health and Welfare (AIHW) (2018) ‘Indigenous eye health measures 2017.’ Catalogue no. IHW 192. Available at https://www.aihw.gov.au/reports/indigenous-australians/indigenous-eye-health-measures-2017/contents/prevalence [Verified 11 July 2018]
Benchimol EI, Smeeth L, Guttmann A, Harron K, Moher D, Petersen I, Sorensen HT, von Elm E, Langan SM (2015) The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. PLoS Medicine 12, e1001885
| The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement.Crossref | GoogleScholarGoogle Scholar | 26440803PubMed |
Bond C, Foley W, Askew D (2016) ‘It puts a human face on the researched’ – a qualitative evaluation of an Indigenous health research governance model. Australian and New Zealand Journal of Public Health 40, S89–S95.
| ‘It puts a human face on the researched’ – a qualitative evaluation of an Indigenous health research governance model.Crossref | GoogleScholarGoogle Scholar | 26260982PubMed |
Burnett AM, Morse A, Naduvilath T, Boudville A, Taylor HR, Bailie R (2016) Delivery of eye and vision services in Aboriginal and Torres Strait Islander primary healthcare centers. Frontiers in Public Health 4, 276
| Delivery of eye and vision services in Aboriginal and Torres Strait Islander primary healthcare centers.Crossref | GoogleScholarGoogle Scholar | 28066755PubMed |
Foreman J, Keel S, Xie J, Wijngaarden P, Crowston J, Taylor H, Dirani M (2016) National Eye Health Survey 2016. Report prepared by the Centre for Eye Research Australia and Vision 2020 Australia. Available at https://www.vision2020australia.org.au/wp-content/uploads/2019/06/National-Eye-Health-Survey_Full-Report_FINAL.pdf [Verified 26 May 2020]
Foreman J, Xie J, Keel S, van Wijngaarden P, Sandhu SS, Ang GS, Fan Gaskin J, Crowston J, Bourne R, Taylor HR, Dirani M (2017) The prevalence and causes of vision loss in Indigenous and non-Indigenous Australians: the National Eye Health Survey. Ophthalmology 124, 1743–1752.
| The prevalence and causes of vision loss in Indigenous and non-Indigenous Australians: the National Eye Health Survey.Crossref | GoogleScholarGoogle Scholar | 28689897PubMed |
Hayman NE, Askew D, Spurling G (2014) From vision to reality: a centre of excellence for Aboriginal and Torres Strait Islander primary health care. Medical Journal of Australia 200, 623–624.
| From vision to reality: a centre of excellence for Aboriginal and Torres Strait Islander primary health care.Crossref | GoogleScholarGoogle Scholar | 24938332PubMed |
Holton H, Christiansen AB, Albeck MJ, Johnsen CR (2011) The impact of light source on discrimination ability in subjects with age-related macular degeneration. Acta Ophthalmologica 89, 779–784.
| The impact of light source on discrimination ability in subjects with age-related macular degeneration.Crossref | GoogleScholarGoogle Scholar | 20015100PubMed |
Hopkins S, Sampson GP, Hendicott PL, Wood JM (2016) A visual profile of Queensland Indigenous children. Optometry and Vision Science 93, 251–258.
| A visual profile of Queensland Indigenous children.Crossref | GoogleScholarGoogle Scholar | 26771400PubMed |
Indigenous Eye Health (2017) 2017 annual update on the implementation of the Roadmap to Close the Gap for Vision. Available at https://healthinfonet.ecu.edu.au/learn/health-topics/eye-health/publications/?id=33945&title=2017+annual+update+on+the+implementation+of+the+Roadmap+to+Close+the+Gap+ for+Vision [Verified 10 July 2018]
Keel S, Lee PY, Foreman J, van Wijngaarden P, Taylor HR, Dirani M (2017) Participant referral rate in the National Eye Health Survey (NEHS). PLoS One 12, e0174867
| Participant referral rate in the National Eye Health Survey (NEHS).Crossref | GoogleScholarGoogle Scholar | 28407009PubMed |
Landers J, Henderson T, Craig J (2010) The prevalence and causes of visual impairment in indigenous Australians within central Australia: the Central Australian Ocular Health Study. British Journal of Ophthalmology 94, 1140–1144.
| The prevalence and causes of visual impairment in indigenous Australians within central Australia: the Central Australian Ocular Health Study.Crossref | GoogleScholarGoogle Scholar | 20530181PubMed |
Mayers NR, Couzos S (2004) Towards health equity through an adult health check for Aboriginal and Torres Strait Islander people: an important Australian initiative that sets an international precedent. Medical Journal of Australia 181, 531–532.
| Towards health equity through an adult health check for Aboriginal and Torres Strait Islander people: an important Australian initiative that sets an international precedent.Crossref | GoogleScholarGoogle Scholar | 15540961PubMed |
Naidoo K, Govender P (2002) Case finding in the clinic: refractive errors. Community Eye Health 15, 39–40.
Spurling GK, Hayman NE, Cooney AL (2009) Adult health checks for Indigenous Australians: the first year’s experience from the Inala Indigenous Health Service. The Medical Journal of Australia 190, 562–564.
| Adult health checks for Indigenous Australians: the first year’s experience from the Inala Indigenous Health Service.Crossref | GoogleScholarGoogle Scholar | 19450202PubMed |
Spurling GK, Askew D, Schluter P, Hayman N (2013) Implementing computerised Aboriginal and Torres Strait Islander health checks in primary care for clinical care and research: a process evaluation. BMC Medical Informatics and Decision Making 13, 108
| Implementing computerised Aboriginal and Torres Strait Islander health checks in primary care for clinical care and research: a process evaluation.Crossref | GoogleScholarGoogle Scholar | 24053425PubMed |
Taylor HR (1980) Prevalence and causes of blindness in Australian aborigines. Medical Journal of Australia 1, 71–76.
| Prevalence and causes of blindness in Australian aborigines.Crossref | GoogleScholarGoogle Scholar | 6965759PubMed |
Taylor HR, Xie J, Fox S, Dunn RA, Arnold AL, Keeffe JE (2010) The prevalence and causes of vision loss in Indigenous Australians: the National Indigenous Eye Health Survey. Medical Journal of Australia 192, 312–318.
| The prevalence and causes of vision loss in Indigenous Australians: the National Indigenous Eye Health Survey.Crossref | GoogleScholarGoogle Scholar | 20230347PubMed |
Taylor H, Anjou M, Boudville A, McNeil R (2012) The Roadmap to Close the Gap for Vision. Full report. (The Indigenous Eye Health Unit, Melbourne School of Population Health, The University of Melbourne: Melbourne, Vic., Australia) Available at https://mspgh.unimelb.edu.au/__data/assets/pdf_file/0008/1984166/roadmap_full_report.pdf [Verified 24 July 2018]
Taylor H, Jatkar U, Anjou M (2015) The Roadmap to Close the Gap for Vision. (Indigenous Eye Health, Melbourne School of Population and Global Health, The University of Melbourne: Melbourne, Vic., Australia) Available at https://mspgh.unimelb.edu.au/__data/assets/pdf_file/0006/1984173/roadmap-summary-september-2015.pdf [Verified 11 July 2018]
Vos T, Taylor HR (2013) Contribution of vision loss to the Indigenous health gap. Clinical & Experimental Ophthalmology 41, 309–310.
