Summary

Vision loss has a profound impact on a person’s quality of life and ability to perform everyday activities, for example, by limiting opportunities for physical mobility, work, education and social engagement (Razavi et al. 2018). Eye diseases and vision problems are the most common long-term health conditions reported by Aboriginal and Torres Strait Islander (First Nations) Australians, with over one-third of First Nations people self-reporting eye or sight problems (ABS 2018–19).

This report presents data for both First Nations and non-Indigenous Australians for a range of eye health measures across prevalence, diagnosis and screening, treatment services and workforce and outreach programs. Data are presented:

  • over time
  • by age and sex
  • by state and territory
  • remoteness areas
  • lower-level geographies.

Prevalence

  • The prevalence of bilateral vision impairment for First Nations people aged 40 and over was 10% and the prevalence of bilateral blindness was 0.3%, based on the latest available National Eye Health Survey data from 2016 (combined vision impairment and blindness affected an estimated 18,300 First Nations people aged 40 and over). 
  • The 3 leading causes of vision impairment and blindness (vision loss) for First Nations people aged 40 and over in 2016 were refractive error (61%), cataract (20%) and diabetic retinopathy (5.2%).
  • Repeated trachoma infections can result in scarring, in-turned eyelashes on the upper eyelid (trachomatous trichiasis, referred to as trichiasis in this report) and blindness. The overall prevalence of active trachoma among children aged 5–9 in at-risk communities fell from 14% in 2007 to 1.8% in 2023.

Diagnosis and screening

  • Between 2011–12 and 2022–23, the proportion of First Nations Australians who had an annual First Nations health assessment increased from 15% to 29% (based on age-standardised rates).
  • In 2022–23, 14% of First Nations people (126,898) had an eye examination by an optometrist or ophthalmologist.
  • Diabetic retinopathy is a complication of diabetes which can result in vision loss if not detected and treated early. Among First Nations people who had a diabetes test, the age-standardised proportion who were screened for diabetic retinopathy rose from an estimated 30% in 2012–13 to 43% in 2022–23.

Treatment

  • In 2022–23, the age-standardised cataract surgery rate for First Nations people was 9,297 hospitalisations per 1,000,000 population – an increase of 24% since 2015–16.
  • In 2023, in communities where active trachoma was identified, a total of 1,677 cases and household and community contacts received treatment, or 82% of people requiring treatment. This included 156 people aged 0–4 years (82% of those requiring treatment), 257 aged 5–9 years (89% of those requiring treatment), 178 aged 10–14 years (83% of those requiring treatment) and 1,086 aged 15 years and over (80% of those requiring treatment).
  • In 2022–23, 21,921 spectacles were dispensed to First Nations people under state spectacle schemes by New South Wales, Victoria, Queensland and South Australia (the states and territories able to provide data). Of these, Victoria (2,819 spectacles, 42 per 1,000 population) came closest to meeting the estimated number of spectacles needed (4,339) – 65% of the population-based need met.

Workforce and outreach

  • In 2022, 6,002 optometrists were employed in Australia (21 full-time equivalent (FTE) per 100,000 total Australian population). The numbers and rates of optometrists were lowest in Remote and Very remote areas.
  • In 2023, 1,004 ophthalmologists were employed in Australia (3.9 FTE per 100,000 total Australian population).
  • The number of occasions of service provided under the Visiting Optometrists Scheme – which provides specialist eye health services to First Nations people in mainly regional and remote areas – have fluctuated. Overall services have more than tripled between 2010–11 (8, 298 occasions of service) and 2022–23 (32,001 occasions of service).

Comparison with non-Indigenous Australians

  • Between 2012–13 to 2022–23, the total age-standardised proportion of First Nations people tested for diabetes who had an eye examination increased from 30% to 43%, while for non-Indigenous Australians it rose from 34% to 47%.
  • In 2022–23, age-standardised hospitalisation rates for First Nations people for cataract surgery (9,297 per 1,000,000) was higher than for non-Indigenous Australians (9,062 per 1,000,000).
     
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