SIGNIFICANCE This study is the first to report high rates of uncorrected vision conditions among Australian secondary schoolchildren living in a rural area and to comment on the rate of eye examinations undertaken on Australian Indigenous children. Uncorrected vision problems that continue throughout the school years have significant implications for children's quality of life and education. PURPOSE This study aimed to investigate the prevalence of uncorrected vision conditions among Australian schoolchildren. METHODS Participants included 280 students from rural primary and secondary schools (aged 4 to 18 years), of whom 40% identified as being of Aboriginal and/or Torres Strait Islander descent (Indigenous). All participants underwent an eye examination including measurements of monocular distance and near visual acuity, assessment of accommodative and vergence function, stereoacuity, color vision, and cycloplegic autorefraction. A parental questionnaire was used to determine whether the child had previously had his/her eyes examined. RESULTS The overall prevalence of uncorrected vision conditions in this population was 35%. The odds of previously having had an eye examination were 2.3× higher for non-Indigenous compared with Indigenous children despite both groups exhibiting high rates of uncorrected vision conditions (Indigenous, 31 [29%]; non-Indigenous, 66 [40%]; χ2 1 = 3.24, P = .07). Of the children who had significant refractive error (Indigenous, 23 [21%]; non-Indigenous, 49 [30%]; χ2 1 = 2.70, P = .10), 82% were uncorrected, and only 39% of Indigenous children and 54% of non-Indigenous children had previously had an eye examination. CONCLUSIONS These findings suggest that high rates of uncorrected vision conditions are present among Australian primary and secondary schoolchildren from a rural area and highlight that Indigenous children are much less likely to have had an eye examination. Understanding factors that affect the rate of eye examinations and compliance with spectacle correction must be addressed given the potential impact of these vision conditions.

This study aimed to examine the choroidal thickness profiles in visually normal Australian Indigenous children, given the important role of the choroid in refractive error and a range of ocular diseases. Methods: Choroidal thickness was assessed across the central 5 mm macular region using enhanced depth imaging spectral domain optical coherence tomography, in 250 children enrolled in an elementary school and a secondary school in rural Queensland, Australia. One hundred (40%) of these children identified as Indigenous Australians. Results: The subfoveal choroid was significantly thicker in Indigenous children (mean 369 ± 75 μm), compared to non-Indigenous children (355 ± 73 μm; P = 0.03). Subfoveal choroidal thickness was also significantly associated with age (β = +7.6, r 2 = 0.105, P = 0.003), and axial length (β = −19.9, r 2 = 0.030, P < 0.001). A significantly thicker choroid in Indigenous children was also found in analyses across the central 5 mm macular region (P = 0.008). A significant interaction between Indigenous status and meridian was observed (P = 0.007) with the largest differences between Indigenous and non-Indigenous children being in the nasal and inferonasal meridians. Conclusions: This study establishes the normative characteristics of macular choroidal thickness in Indigenous Australian children and demonstrates a significantly thicker choroid compared to non-Indigenous children from the same geographic region. These results may have implications for our understanding of factors predisposing or protecting Australian Indigenous people from a range of conditions associated with choroidal thickness. Translational Relevance: The significantly thicker choroid in Australian Indigenous children should be considered in clinical diagnoses and management of conditions associated with choroidal changes.

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Objective: To develop a tool for assessing intentions to continue or change activities for recovery following mild traumatic brain injury (mTBI) and determine if they are dependent on injury context or activity type. Method: Adult volunteers with no (or no recent) history of mTBI were randomly allocated to one of two vignette conditions, each with a different injury context. The vignette described an mTBI due to a motor vehicle accident (MVA, n = 76) or sport (SPORT, n = 89). Volunteers reported their rest or activity plans for 39 behaviours comprising three behaviour types (cognitive, physical, and restful). Results: Compared to a cut-score representing no change, on average there was a significant (p <= .001) planned decrease in physical and cognitive behaviours (MVAphysicalt(53) = 7.373; SPORTphysicalt(41) = 9.281; MVAcognitivet(41) = 9.367; SPORTcognitivet(51) = −3.521) and a significant planned increase in restful behaviours, such as sleep (MVArestfult(72) = 10.006; SPORTrestfult(86) = 9.566). An overall within-group effect for behaviour-type was not identified and there was no effect of condition (MVA vs. SPORT). Conclusion: The acute rest and activity plans for a simulated mTBI are behaviour specific and not dependent on context. An expectation for blanket-rest was not was observed but rest was planned for specific behaviours. This tool could be used to guide discussions with mTBI patients about their recovery so that their plans align with advice, and it could aid further research into the relation between intended and actual rest and activity and the effect on eventual outcomes.