Additional refractive services, health information needed for indigenous Australians

This article describes the self-reported vision, history of eye disease and general health of indigenous Australian participants in the National Indigenous Eye Health Survey (NIEHS). The study's results provide information to guide future planning of eye health prevention strategies for indigenous Australians and re-emphasize the importance of providing adequate and accessible refractive services. The authors conclude that eye health knowledge should be improved in communities and preventive messages renewed in appropriate sociocultural formats.

The authors used a multistage cluster-sampling methodology to select 30 geographic areas stratified by remoteness to provide a representative population of indigenous Australians aged 5 to 15 years and 40 years and older. Study participants (1694 indigenous children and 1189 adults) completed a questionnaire about their eye health and satisfaction with their vision and general health before undergoing an eye examination.

The authors found that three-quarters of adults (259/342) and 88.4 percent of children (129/146) wore the right distance glasses. However, only one-fifth of the children who had been prescribed glasses wore them appropriately. As with previous studies, the overall prevalence of refractive error was low in both indigenous children and adults (less than 10 percent and less than 30 percent, respectively) compared with other ethnic groups. Adults from remote areas were less likely to have refractive error (P = 0.002), as were males versus females (P = 0.02). Similar results were found for children. Adults wearing appropriate distance glasses were as satisfied with their vision as were people with normal vision who did not need glasses (P = 0.6). Both groups were more satisfied with their distance vision than people with poor presenting vision (P = 0.007).

Self-report of cataract, diabetic retinopathy, glaucoma and age-related macular degeneration did not match with clinical findings (P < 0.001), with participants overreporting their eye disease history. However, during this survey, some participants were diagnosed with low vision due to eye diseases of which they were not aware they had.

The authors conclude that the results of this survey indicate the importance of correcting refractive error to improve satisfaction with vision and hence improve quality of life. They say the results also raise questions about the adequacy of previous prevention messages and emphasize the necessity of developing socially and culturally adapted information about vision-related health.