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Joshua Foreman, Stuart Keel, Jing Xie, Peter Van Wijngaarden, Hugh Taylor, Mohamed Dirani; The prevalence and main causes of vision loss in Indigenous and non-Indigenous Australians: The Australian National Eye Health Survey. Invest. Ophthalmol. Vis. Sci. 2017;58(8):834.
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© ARVO (1962-2015); The Authors (2016-present)
Australia currently has no national data on the prevalence of vision loss. The National Eye Health Survey aimed to determine the prevalence and causes of vision loss in Indigenous and non-Indigenous Australians.
A cross-sectional population survey was conducted between March 2015 and April 2016. Multistage random-cluster sampling was used to select 3098 non-Indigenous Australians aged 50 years and older and 1738 Indigenous Australians aged 40 years and older from 30 sites across all remoteness strata. Participants were recruited using a door-to-door approach. Sociodemographic information, diabetes and stroke history and ocular health data were collected using an interviewer-administered questionnaire. Trained examiners conducted a standardised eye examination, including vision and perimetry testing, anterior segment and intraocular pressure assessment, and fundus photography. The prevalence and main causes of vision loss (bilateral presenting visual acuity <6/12) were determined and multivariable risk factor analysis was conducted.
The weighted prevalence of vision loss of 11.2% (95% CI 9.5-13.1) in Indigenous Australian adults was 1.7 times higher than in non-Indigenous Australian adults (6.5%, 95% CI 5.3-7.9) (p<0.001). The leading causes of vision loss in Indigenous and non-Indigenous Australians were uncorrected refractive error (60.8% and 61.3%, respectively) and cataract (20.1% and 13.2%, respectively), followed by diabetic retinopathy in Indigenous Australians (5.2%) and age-related macular degeneration in non-Indigenous Australians (10.3%). Increasing age (OR 1.72 per 10 years, 95% CI 1.40-2.10) and not having undergone an eye examination within the past year (OR 1.61, 95% CI 1.06-2.42) were significant risk factors for vision loss in non-Indigenous Australians. In Indigenous Australians, older age (OR 1.61 per 10 years, 95% CI 1.34-1.95), greater geographic remoteness (2.02, 95% CI 1.23-3.31), female gender (OR 0.60 for males, 95% CI 0.42-0.84) and having diabetes in combination with a history of never having had an eye examination (OR 14.47, 95% CI 5.65-37.05) were risk factors for vision loss.
The prevalence of vision loss in Indigenous Australians is almost double that of non-Indigenous Australians. Older Indigenous Australians with diabetes living in regional and remote areas are at the highest risk for vision loss.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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