Indigenous Australians Face Lack of Access to Cataract Surgery

Indigenous Australians face a 30 per cent lower cataract surgery coverage rate than non-Indigenous Australians, according to findings from a recent national eye health survey.

The survey looked at close to 2,000 Indigenous Australians aged 40 years and older and more than 3,000 non-Indigenous Australians aged 50 years and older, from 30 randomly selected sites.

It found that while eye examination frequency had improved across the board compared to previous population-based research, further improvements were required for Indigenous Australians, as well as those living in regional and remote areas.

The research paper said: “A considerable proportion of Indigenous Australians, particularly those of older age and those living in non-metropolitan areas, may be at higher risk for undiagnosed eye disease and vision loss due to the infrequency of eye health service utilisation.

“Considering the rapid progression of blinding eye diseases in Indigenous Australians, particularly in those of older age, waiting more than one year between eye examinations may be sufficient time for some diseases to cause irreversible damage.”

Dr Stuart Keel, the project manager of the survey from the Centre for Eye Research Australia, told Pro Bono News that these findings highlighted the lack of resources available for the Indigenous community.

“Cataracts was a leading cause of visual impairment and blindness in Indigenous Australians and also the cataracts surgery coverage rates were 30 per cent lower among the Indigenous population compared to the non-Indigenous population,” Keel said.

“These findings suggest that the Indigenous population are underserved in terms of access to cataract surgery. And there remains a large number of Indigenous Australians who require cataract surgery.”

Keel said there were “likely multiple factors” leading to these findings, but the number of Indigenous people living in rural communities further entrenched this disadvantage.

“We know a large proportion of the Indigenous population are residing in regional and remote areas of Australia [where there is] lower access to cataract surgery services,” he said.

“So quite often, if we think of the large states such as Northern Territory, Western Australia, and Queensland… the Indigenous population in these areas have to travel significant distances to get their cataract surgery performed.”

Previous studies have identified a lack of availability and utilisation of eye health services in Australia.

The research paper found that not only Indigenous Australians were under-serviced, but also “those with diabetes, those of lower socioeconomic status, men, those for whom English is not their main spoken language and individuals with eye disease”.

The consequence, according to Keel, was “needless vision loss”.

“This is reversible vision loss these people have… which can be [fixed] via cataract surgery, a very simple operation performed by an ophthalmologist. And these people basically needlessly have vision loss and it could be corrected overnight through cataract surgery,” he said.

“It’s an ongoing issue, and while there’s some fantastic interventions currently in place around Australia, I think the main message previously and from this survey is that there is an unmet need for cataract surgery in the Indigenous population.”

The Australian government has worked to remedy this, developing the National Framework Implementation Plan (NFIP) in 2014, which aimed to build on existing eye health care services and improve access for all Australians.  

The NFIP emphasised a need for up-to-date population-based data on the prevalence of vision loss, and the utilisation of eye health services, which was one of the key aims of the National Eye Health Survey.

With the survey data now available, Keel said there were a number of things that could be done to reduce the number Indigenous Australians with vision loss.  

“It’s very important in the future to build more sustainable, ongoing cataract surgery services, and postoperative services within communities to increase access for the Indigenous population,” he said.

“Promoting regular eye examinations is the key, but also promoting equitable access to general eye examinations… at a regular interval, such as every year.

“Disease can be detected quite early, and therefore we can treat it quickly and have no one going needlessly blind in our communities.”