The prevalence and causes of vision loss in indigenous and non-indigenous Australians

Foreman, Joshua, Xie, Jing, Keel, Stuart, van Wijngaarden, Peter, Sandhu, Sukhpal S., Ang, Ghee S., Gaskin, Jennifer F., Crowston, Jonathan G., Bourne, Rupert R. A., Taylor, Hugh R. and Dirani, Mohamed (2017) The prevalence and causes of vision loss in indigenous and non-indigenous Australians. Ophthalmology: Journal of The American Academy of Ophthalmology, 124 (12). pp. 1743-1752. ISSN 1549-4713

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Abstract

Purpose: To conduct a nationwide survey on the prevalence and causes of vision impairment and blindness in Indigenous and non-Indigenous Australians. Design: Nationwide, cross-sectional, population-based field survey. Participants: Indigenous Australians aged 40 years or older and non-Indigenous Australians aged 50 years or more randomly sampled from all levels of geographic remoteness in Australia. Methods: Multistage random-cluster sampling was used to select 3098 non-Indigenous Australians and 1738 Indigenous Australians from 30 sites across 5 remoteness strata with a 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 worse than 6/12 in the better eye) were determined, and risk factor analysis was conducted. Main Outcome Measures: The prevalence and main causes of vision impairment and blindness. Results: The overall prevalence of vision loss in Australia was 6.6% (95% confidence interval [CI], 5.4e7.8). The prevalence of vision loss was 11.2% (95% CI, 9.5e13.1) in Indigenous Australians and 6.5% (95% CI, 5.3e7.9) 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, 14.5e21.0 vs. 6.4%, 95% CI, 5.2e7.6, 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; 95% CI, 1.40e2.10) and having not had an eye examination within the past year (OR, 1.61; 95% CI, 1.06e2.42) were risk factors for vision loss. Risk factors in Indigenous Australians included older age (OR, 1.61 per decade; 95% CI, 1.34e1.95), remoteness (OR, 2.02; 95% CI, 1.23e3.31), gender (OR, 0.60 for men; 95% CI, 0.42e0.84), and diabetes in combination with never having had an eye examination (OR, 14.47; 95% CI, 5.65e37.05). Conclusions: Vision 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.

Item Type:	Journal Article
Faculty:	ARCHIVED Faculty of Medical Science (until September 2018)
Depositing User:	Ian Walker
Date Deposited:	23 Jun 2017 14:15
Last Modified:	11 May 2022 14:20
URI:	https://arro.anglia.ac.uk/id/eprint/701906

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