Cataract remains major cause of vision loss in indigenous Australians

This study reports on the prevalence of vision loss due to cataract in indigenous Australians. The authors studied a national, stratified, random cluster sample of indigenous people living in 30 communities across Australia. The results confirm the high prevalence of vision-impairing cataract in this population and the need for improved cataract surgical services targeting this population.

Subjects in the study were age 40 years and older. Each completed a questionnaire and eye exam, which included assessment of visually significant cataract.

The authors report good response rates, with 1,189 indigenous individuals examined and overall recruitment of 72 percent. Low vision (less than 6/12 to 6/60) due to cataract occurred in 2.52 percent and blindness (less than 6/60) in 0.59 percent. The cataract coverage rate (proportion of those with visually significant cataract who had been operated on) was 65.3 percent. Projections suggest that there are 3,234 indigenous adults with bilateral vision loss from cataract in Australia.

The authors say the results suggest that blinding unoperated cataract is a much more important cause of blindness in indigenous adults (31 percent) than in mainstream Australia (14 percent). Age-specific rates suggest that cataract blindness in adult indigenous Australians is approximately 12 times higher. They say the results suggest that cataract is a much more common cause of low vision in indigenous than mainstream Australian adults (28 percent vs. 14 percent).

The authors conclude that although the proportion of older indigenous Australians with vision loss due to cataract is unacceptably high, the actual number of people involved and the number of additional operations required is quite small. They say projections suggest that about 4,320 operations per year would bring the cataract surgery rate amongst indigenous Australians to the same level as for the country as a whole (9,500 per million people per year).

The study found no significant regional or state differences in the prevalence of cataract or of cataract surgical coverage, suggesting that increased cataract surgery services are required across the country to address cataract in indigenous Australians. However, the authors say that better use of available facilities and resources, including ophthalmic surgical teams and coordinators, should be able to readily address this unmet need and eliminate the unnecessary vision loss from cataract in indigenous Australians.