Summary

Vision loss has a profound impact on a person’s quality of life and ability to perform everyday activities, for example, by limiting opportunities for physical mobility, work, education and social engagement (Razavi et al. 2018). Eye diseases and vision problems are the most common long-term health conditions reported by Aboriginal and Torres Strait Islander (First Nations) Australians, with over one-third of First Nations people self-reporting eye or sight problems (ABS 2018-19).

This report presents data for both First Nations and non-Indigenous Australians for a range of eye health measures across prevalence, diagnosis and screening, treatment services and workforce and outreach programs. Data are presented over time, by age and sex, by state and territory, remoteness areas and lower level geographies.

Prevalence

Trachoma is a highly infectious disease of the eye. Repeated trachoma infections can result in scarring, in-turned eyelashes (trichiasis) and blindness. The overall prevalence of active trachoma among children aged 5–9 in at-risk communities fell from 15% in 2009 to 2.2% in 2022.

Diagnosis and screening

  • Between 2011–12 and 2021–22, the proportion of First Nations Australians who had an annual First Nations specific health assessment increased from 14.5% to 24.4% (based on age-standardised rates).
  • In 2021–22, 12.9% of First Nations people (around 114,000) had an eye examination by an optometrist or ophthalmologist.
  • Diabetic retinopathy is a complication of diabetes which can result in vision loss if not detected and treated early. Among First Nations people who had a diabetes test, the age-standardised proportion who were screened for diabetic retinopathy rose from an estimated 33% in 2010–11 to 40% in 2021–22.

Treatment

  • In 2020–21, the age-standardised cataract surgery rate for First Nations people was about 8,691 hospitalisations per 1,000,000 population – an increase of more than 25% since 2013–14.
  • In 2022, the overall treatment coverage of active trachoma cases in at-risk communities was 96%, that is, 829 community members identified as having trachoma received treatment. This included children with active trachoma, along with their household contacts and other community members.
  • In 2021–22, 17,547 spectacles were dispensed to First Nations people under state spectacle schemes by New South Wales, Victoria, Queensland, South Australia and Tasmania (the states and territories able to provide data). Of these, Victoria (2,496 spectacles, 39 per 1,000 population) came closest to meeting the estimated number of spectacles needed (4230) – 59% of the population-based need met.

Workforce and outreach

The number of occasions of service provided under the Visiting Optometrists Scheme – which provides specialist eye health services to First Nations people in mainly regional and remote areas – have fluctuated, but overall services have tripled between 2010–11 (around 8, 300 occasions of service) and 2021–22 (around 25,000 occasions of service).

Comparison with non-Indigenous Australians

  • Between 2010–11 to 2020–21, the total age-standardised proportion of First Nations people tested for diabetes who had an eye examination increased from 33% to 43% before decreasing to 40% in 2021–22, while for non-Indigenous Australians it rose from 37% to 48% before declining to 46%.
  • In 2020–21, age-standardised hospitalisation rates for First Nations people for cataract surgery (8,691 per 1,000,000) were lower than for non-Indigenous Australians (8,944 per 1,000,000).