Summary

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This report includes the latest available data for each measure where possible. The 2016, 2017 and 2018 editions of the report presented data for 23 measures, however, data stopped being collected for one measure. Of the 22 measures with ongoing data collections, 11 have sub-measures. In total, this 2024 edition of the report contains 37 measures and sub-measures, 27 of which have been updated. Of the 27 measures that have been updated, trend data for 20 of these measures and sub-measures are presented in Table 2 (within the PDF version).

  • 7 measures or sub-measures appear to be improving.
  • 4 measures or sub-measures appear to be worsening.
  • 6 measures or sub-measures have updated data but show no change or no clear trend over time.
  • 3 measures have updated data, but it is not possible to determine if changes represent an improvement or not. For example, an increase in hospitalisations for eye diseases could be interpreted as an increase in disease rates or an increase in treatment rates.

The following sections provide a summary of key findings. The latest findings for each measure are presented in Table 1 (within the PDF version), while trends data for selected measures together with an assessment of each trend are presented in Table 2 (within the PDF version).

Prevalence

One of the 3 prevalence measures has updated data. One sub-measure of this measure – trachoma (1.3.1) – appears to have improved over the reporting years. Time trend data is not presented for the other sub-measure, trichiasis prevalence (1.3.2) due to changes in how the sub-measure is assessed over time.

  • 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%). Cataract is the leading cause of blindness for First Nations adults (NACCHO, 2019).
  • 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 trachoma among children aged 5–9 fell from 14% in 2007 to 1.8% in 2023. 

Diagnosis and screening

Four of the 5 diagnosis and screening measures have updated data. Of these, both sub-measures of measure 2.1 (annual health assessments for First Nations people), and 2 of the 3 sub-measures of measure 2.3 (screening for diabetic retinopathy) appear to have improved over the reporting years. Data for measure 2.2 (eye examinations by an eye care specialist) do not show change or a clear trend over time. Time trend data for both sub-measures of measure 2.4 (trachoma and trichiasis screening) is not presented due to changes in how the sub-measures have been assessed over time.

  • In 2022–23, 27% (246,707) of First Nations people had an annual health assessment that should have included an eye health check. The age-specific proportion of First Nations people who had a health assessment increased from around 11%–14% in 2011–12 for all age groups up to age 44 years to around 25%–28% in 2022–23.
  • In 2022–23, 14% of First Nations people (126,898) had an initial 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. An estimated 28,762 First Nations people had a diabetes test in the previous 2 years. Of these,14,351 (50%) also had an eye examination in 2022–23.

Treatment

Eight of the 10 treatment measures have updated data. Of these, measure 3.4 (cataract surgery) appears to have improved over the reporting years, while all 4 sub-measures of measure 3.6 (waiting times for elective cataract surgery) appear to have worsened. Data for both sub-measures of measure 3.7 (treated for diabetic retinopathy) show no change or no clear trend over time. It is not possible to determine if changes are improvements or not for measures 3.1 (diseases), 3.2 (injuries) and 3.3 (procedures). Time trend data for both sub-measures of measure 3.8 (trachoma and trichiasis treatment) are not presented due to changes in how the sub-measures have been assessed over time.

  • In 2021–23, among First Nations people, there were 8,008 (4,467 per 1,000,000 population) hospitalisations for cataract surgery. Between 2015–16 and 2022–23, the age‑standardised rate for cataract surgery for First Nations people rose from 7,504 to 9,297 per 1,000,000.
  • In 2020–22, among First Nations people, there were 13,329 (7.4 per 1,000 population) hospitalisations for diseases of the eye and around 12,874 (7.2 per 1,000) hospitalisations for eye procedures.
  • In 2023, trachoma treatment coverage was 82% – that is, 1,677 active cases, household and community contacts received treatment. Treatment coverage for active cases detected in screening activities was 99%.
  • In 2022–23, 21,921 pairs of 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 among First Nations people (4,339) – with 65% of the population-based need met.

Workforce and outreach

Three of the 4 workforce and outreach measures have updated data. Of these, measure 4.1 (optometrists) appears to have improved over the reporting years. Data for measures 4.2 (ophthalmologists), 4.3 (allied ophthalmic personnel) and 4.4 (outreach and other programs) show no change or no clear trend over time. Data for the 5 sub-measures of measure 4.4 are mixed. Some sub-measures appear to show improvement over time while others seem to be worsening. Trends should be interpreted with caution, however, as jurisdictions may elect to use different outreach programs for eye services depending on their needs.

  • 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 Optometrist Scheme – which provides specialist eye health services to First Nations people in mainly regional and remote areas – has fluctuated; however, overall, First Nations services more than quadrupled between 2009–10 (6,975 occasions of service) and 2022–23 (32,001 occasions of service).

Comparison with non-Indigenous Australians

  • Between 2012–13 and 2022–23, the total age-standardised proportion of the First Nations population who had an eye examination was relatively stable, around 20%, while the equivalent proportion for non-Indigenous Australians rose from 22%–27%.
  • Between 2012–13 and 2022–23, the total age-standardised proportion of First Nations people tested for diabetes who had an eye examination rose from 30%–43%, while for non-Indigenous Australians it rose from 34%–47%
  • In 2022–23, the age-standardised hospitalisation rate for First Nations people for cataract surgery (9,297 per 1,000,000 population) was higher than that for non-Indigenous Australians (9,062 per 1,000,000).
  • In 2022–23, the proportion of First Nations people who had elective cataract surgery and were treated within 90 days (37%) was less than the proportion of non-Indigenous Australians who were treated within this time (43%).
  • In 2022–23, the average days waited by First Nations people before receiving cataract surgery was 182 days, while the average for non-Indigenous Australians was 175 days.