Design, setting and participants: A national, stratified, random cluster sample was drawn from 30 communities across Australia that each included about 300 Indigenous people of all ages. A sample of non-Indigenous adults aged ≥ 40 years was also tested at several remote sites for comparison. Participants were examined using a standardised protocol that included a questionnaire (self-administered or completed with the help of field staff), visual acuity (VA) testing on presentation and after correction, visual field testing, trachoma grading, and fundus and lens photography. The data were collected in 2008.
Results: 1694 Indigenous children and 1189 Indigenous adults were examined, representing recruitment rates of 84% for children aged 5–15 years and 72% for adults aged ≥ 40 years. Rates of low vision (VA < 6/12 to ≥ 6/60) were 1.5% (95% CI, 0.9%–2.1%) in children and 9.4% (95% CI, 7.8%–11.1%) in adults. Rates of blindness (VA < 6/60) were 0.2% (95% CI, 0.04%–0.5%) in children and 1.9% (95% CI, 1.1%–2.6%) in adults. The principal cause of low vision in both adults and children was refractive error. The principal causes of blindness in adults were cataract, refractive error and optic atrophy. Relative risks (RRs) of vision loss and blindness in Indigenous adults compared with adults in the mainstream Australian population were 2.8 and 6.2, respectively. By contrast, RRs of vision loss and blindness in Indigenous children compared with mainstream children were 0.2 and 0.6, respectively.
- 1. Royal Australian College of Ophthalmologists. The National Trachoma and Eye Health Program of the Royal Australian College of Ophthalmologists. Sydney: Royal Australian College of Ophthalmologists, 1980.
- 2. Taylor HR. Racial variations in vision. Am J Epidemiol 1981; 113: 62-80.
- 3. Taylor HR. Prevalence and causes of blindness in Australian Aborigines. Med J Aust 1980; 1: 71-76.
- 4. Taylor V, Ewald D, Liddle H, Warchiver I. Review of the implementation of the National Aboriginal and Torres Strait Islander Eye Health Program. Canberra: Commonwealth of Australia, 2004.
- 5. Taylor HR. Eye health in Aboriginal and Torres Strait Islander Communities. Canberra: Commonwealth of Australia, 1997.
- 6. Mayers N. Report to the Royal Australian College of Ophthalmologists. Sydney: RACO, 1982.
- 7. Stocks NP, Hiller JE, Newland H, McGilchrist CA. Trends in the prevalence of trachoma, South Australia, 1976 to 1990. Aust N Z J Public Health 1996; 20: 375-381.
- 8. Mak DB, O’Neill LM, Herceg A, McFarlane H. Prevalence and control of trachoma in Australia, 1997–2004. Commun Dis Intell 2006; 30: 236-247.
- 9. Jaross N, Ryan P, Newland H. Prevalence of diabetic retinopathy in an Aboriginal Australian population: results from the Katherine Region Diabetic Retinopathy Study (KRDRS). Report no. 1. Clin Experiment Ophthalmol 2003; 31: 32-39.
- 10. Jaross N, Ryan P, Newland H. Incidence and progression of diabetic retinopathy in an Aboriginal Australian population: results from the Katherine Region Diabetic Retinopathy Study (KRDRS). Report no. 2. Clin Experiment Ophthalmol 2005; 33: 26-33.
- 11. Lansingh VC, Weih LM, Keeffe JE, Taylor HR. Assessment of trachoma prevalence in a mobile population in Central Australia. Ophthalmic Epidemiol 2001; 8: 97-108.
- 12. Wright HR, Taylor HR. Clinical examination and laboratory tests for estimation of trachoma prevalence in a remote setting: what are they really telling us? Lancet Infect Dis 2005; 5: 313-320.
- 13. McAllister IL. Screening for diabetic retinopathy in rural and remote areas of Australia. Aust N Z J Ophthalmol 1998; 26: 105-106.
- 14. Australian Bureau of Statistics. 2006 census. Experimental estimates of Aboriginal and Torres Strait Islander Australians, Jun 2006. (ABS Cat. No. 3238.0.55.001.) http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3238.0.55.001Main+Features1Jun%202006? (accessed Feb 2010).
- 15. Fox SS, Arnold A-L, Keeffe JE, Taylor HR. Sampling and recruitment methodology for a national eye health survey of Indigenous Australians. Aust N Z J Public Health 2010. In press.
- 16. Taylor HR, Keeffe JE, Vu HT, et al. Vision loss in Australia. Med J Aust 2005; 182: 565-568. <MJA full text>
- 17. Robaei D, Huynh SC, Kifley A, Mitchell P. Correctable and non-correctable visual impairment in a population-based sample of 12-year-old Australian children. Am J Ophthalmol 2006; 142: 112-118.
- 18. Ferraro JG, Mazzoni LL, Keeffe JK, et al. Evaluation of an eye health program: the Vision Initiative. Ophthalmic Epidemiol 2006; 13: 127-135.
- 19. Mueller A, Vu HT, Ferraro JG, et al. Rapid and cost-effective method to assess vision disorders in a population. Clin Experiment Ophthalmol 2006; 34: 521-525.
- 20. Burnett AM. Development and validation of a rapid assessment methodology for avoidable blindness in Aboriginal and Torres Strait Islander populations [PhD thesis]. Sydney: University of New South Wales, 2009.
- 21. Keeffe JE, Lovie-Kitchin JE, Maclean H, Taylor HR. A simplified screening test for identifying people with low vision in developing countries. Bull World Health Organ 1996; 74: 525-532.
- 22. Thylefors B, Dawson CR, Jones BR, et al. A simple system for the assessment of trachoma and its complications. Bull World Health Organ 1987; 65: 477-483.
- 23. Taylor HR, Fox SS, Xie J, et al. The prevalence of trachoma in Australia: the National Indigenous Eye Health Survey. Med J Aust 2009; 192: 248-253. <MJA full text>
- 24. Ferraro JG, Pollard T, Müller A, et al. Detecting cataract causing visual impairment using a nonmydriatic fundus camera. Am J Ophthalmol 2005; 139: 725-726.
- 25. Wilkinson CP, Ferris FL, Klein RE; Global Diabetic Retinopathy Project Group. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 2003; 110: 1677-1682.
- 26. Bird AC, Bressler NM, Bressler SB, et al. An international classification and grading system for age-related maculopathy and age-related macular degeneration. Surv Ophthalmol 1995; 39: 367-374.
- 27. Constantinou M, Ferraro JG, Lamoureux EL, Taylor HR. Assessment of optic disc cupping with digital fundus photographs. Am J Ophthalmol 2005; 140: 529-531.
- 28. Robin TA, Müller A, Rait J, et al. Performance of community-based glaucoma screening using frequency doubling technology and Heidelberg retinal tomography. Ophthalmic Epidemiol 2005; 12: 167-178.
- 29. Foster PJ, Buhrmann R, Quigley HA, Johnson GJ. The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol 2002; 86: 238-242.
- 30. Robaei D, Rose K, Ojaimi E, et al. Visual acuity and the causes of visual loss in a population-based sample of 6-year-old Australian children. Ophthalmology 2005; 112: 1275-1282.
- 31. Robaei D, Kifley A, Rose KA, Mitchell P. Refractive error and patterns of spectacle use in 12-year-old Australian children. Ophthalmology 2006; 113: 1567-1573.
- 32. Broman AT, Quigley HA, West SK, et al. Estimating the rate of progressive visual field damage in those with open-angle glaucoma, from cross-sectional data. Invest Ophthalmol Vis Sci 2008; 49: 66-76.
- 33. Taylor HR, Robin TA, Lansingh VC, et al. A myopic shift in Australian Aboriginals: 1977–2000. Trans Am Ophthalmol Soc 2003; 101: 107-112.
- 34. Daniel M, Rowley KG, McDermott R, O’Dea K. Diabetes and impaired glucose tolerance in Aboriginal Australians: prevalence and risk. Diabetes Res Clin Pract 2002; 57: 23-33.
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