The Prevalence and Causes of Vision Loss in Indigenous and Non-Indigenous Australians

Foreman, Joshua; Xie, Jing; Keel, Stuart; Wijngaarden, Peter van; Sandhu, Sukhpal S.; Ang, Ghee Soon; Gaskin, Jennifer Fan; Crowston, Jonathan G; Bourne, Rupert; Taylor, Hugh R.; Dirani, Mohamed

doi:10.1016/j.ophtha.2017.06.001

Cited by 72 publications

(91 citation statements)

References 51 publications

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“…Subsequently, this population is twice as likely to be hospitalized for injury compared to the non‐Indigenous population, the most common injury being falls and assault . The NT has the highest proportion of Indigenous individuals in its population of any state . RDH services a population of 183 708 of which several remote and rural Indigenous communities are included.…”

Section: Discussionmentioning

confidence: 99%

“…14 The NT has the highest proportion of Indigenous individuals in its population of any state. 11,14,15 RDH services a population of 183 708 of which several remote and rural Indigenous communities are included. Wong et al, in a suburban based study, demonstrated that males were more likely than females to be affected by ocular trauma in a 5-y prevalence study.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology of ocular trauma in the Indigenous vs non‐Indigenous population in the Top End

Kennedy

Robinson

Whist

et al. 2018

Clinical Exper Ophthalmology

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Importance Epidemiological data on visually significant ocular trauma in the Top End of the Northern Territory. Background Our main objective is to determine whether Indigenous patients are disproportionately affected by visually significant ocular trauma as compared to non‐Indigenous patients. Design This was a retrospective audit at the Royal Darwin Hospital in the Top End of the Northern Territory during January 2013 to June 2015. Participants A total of 104 ocular trauma patients were included; 43 were Indigenous and 61 were non‐Indigenous. Methods Medical records of patients with ocular trauma between January 2013 and June 2015 (except simple, non‐penetrating corneal foreign bodies and abrasions) were reviewed. Vision loss was defined by visual acuity: mild ≥6/18, moderate 6/18‐6/60, severe ≤6/60 following World Health Organization standards. Main Outcome Measures The study included the incidence of ocular trauma patients by ethnicity (Indigenous vs non‐Indigenous). Our secondary outcome included vision loss, mechanism of injury, open vs closed injury, age, remoteness and alcohol involvement. Results A total of 104 patient charts were reviewed; 43 (41%) were Indigenous and 61 (59%) were non‐Indigenous. Alleged assault was the greatest contributor to ocular trauma in both groups (74% in Indigenous vs 39% non‐Indigenous). Severe vision loss was more prevalent in the Indigenous vs non‐Indigenous patients (30% vs 16%). Conclusions and Relevance Indigenous patients were disproportionately affected by visually significant ocular trauma compared to non‐Indigenous patients. This research provides important data on ocular trauma in the Northern Territory. Further prevention strategies are needed to reduce vision loss in this population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Epidemiology of ocular trauma in the Indigenous vs non‐Indigenous population in the Top End

Kennedy

Robinson

Whist

et al. 2018

Clinical Exper Ophthalmology

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“…Furthermore, the prevalence of diabetes-related vision impairment, although varying widely between 5.2% to as high as 26.5% depending on the study context, sampling methodology and region, is consistently reported to be higher among Indigenous Australians [14][15][16]. Among non-Indigenous Australians, diabetic complications contribute only 1.7% of the total burden of vision impairment and these rates have remained largely unchanged over a twenty-year timespan [12,17]. The increasing availability of highly effective but expensive sight-saving treatments (i.e., intravitreal anti-vascular endothelial growth factor or corticosteroid drugs), improved overall diabetes and risk factor control, and access to a range of DR screening programs are likely to have played a role in this stability [18].…”

Section: Diabetic Retinopathy Among Indigenous Australiansmentioning

confidence: 99%

“…For the Indigenous people of Australia, the ongoing impact of colonisation and continuing social and political oppression and dispossession have contributed to significant socio-economic and health inequities across several key health indicators [9]. T2DM is one of the most important contributors to health inequities (both mortality and morbidity) between Indigenous and non-Indigenous Australians, as it is a potent driver of premature onset cardiovascular, renal and retinal complications [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Working Towards Eye Health Equity for Indigenous Australians with Diabetes

Estevez

Howard

Craig

et al. 2019

IJERPH

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Type 2 diabetes mellitus (T2DM) poses significant challenges to individuals and broader society, much of which is borne by disadvantaged and marginalised population groups including Indigenous people. The increasing prevalence of T2DM among Indigenous people has meant that rates of diabetes-related complications such as blindness from end-stage diabetic retinopathy (DR) continue to be important health concerns. Australia, a high-income and resource-rich country, continues to struggle to adequately respond to the health needs of its Indigenous people living with T2DM. Trends among Indigenous Australians highlight that the prevalence of DR has almost doubled over two decades, and the prevalence of diabetes-related vision impairment is consistently reported to be higher among Indigenous Australians (5.2%-26.5%) compared to non-Indigenous Australians (1.7%). While Australia has collated reliable estimates of the eye health burden owing to T2DM in its Indigenous population, there is fragmentation of existing data and limited knowledge on the underlying risk factors. Taking a systems approach that investigates the social, environmental, clinical, biological and genetic risk factors, and-importantly-integrates these data, may give valuable insights into the most important determinants contributing to the development of diabetes-related blindness. This knowledge is a crucial initial step to reducing the human and societal impacts of blindness on Indigenous Australians, other priority populations and society at large.

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“…In Australia, the results of the Australian National Eye Health Survey (NEHS) reported in 2017 that the main cause of vision impairment continued to be uncorrected refractive error corresponding to 61% of the total . Notably, while the overall prevalence of vision loss in Australia was reported at 6.6%, there was a marked contrast in prevalence of vision loss between non‐Indigenous Australians at 6.5% compared to Indigenous Australians at 11.2% . The main contributing risk factors for vision loss in non‐Indigenous Australians were increasing age (odds ratio [OR], 1.72 per decade) and not having had an eye examination within the past year (OR, 1.61).…”

mentioning

confidence: 99%