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Jose Javier Estevez, Natasha J Howard, Jamie E Craig, Alex Brown; Prevalence and Treatment Coverage Rates of Refractive Error among Indigenous Australians.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4000.
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© ARVO (1962-2015); The Authors (2016-present)
Uncorrected refractive error (RE) is the largest contributor to vision impairment among Indigenous Australians, yet epidemiological data is scarce. This study determines the prevalence, socio-demographic profile and treatment coverage rates (TCR) of RE among a population-based cohort of Indigenous Australians.
Indigenous Australians were recruited from 17 geographical clusters spanning urban to remote regions. Participants underwent a standardised clinical and ocular examination, and interviewer-led questionnaires for detailed characterisation. Significant RE was determined through subjective refractions and using the spherical equivalence (SE) categorised into; myopia (<-0.50 dioptres (D)) and hyperopia (≥+1.00D). The TCR of RE were calculated based on the proportion of participants without glasses, in comparison to the total number needing glasses when a significant RE was present. Refraction data were analysed for phakic right eyes only.
The study recruited 1220 participants and after excluding pseudophakic eyes 1166 participants remained for analysis. Participants self-reported vision difficulties in 71.5% of cases and 57.5% reported currently having spectacles. The prevalence of myopia and hyperopia was 12.3% (n=143) and 26.8% (n=312), respectively (mean SE 0.375 ± 1.49D). The SE was normally distributed around low hyperopia, which was the most common RE sub-type (24.5%). Myopia prevalence peaked in the 33-45 age group and hyperopia in the 65-74 group. Females had a higher burden of RE, with 62.2% of all myopia and 60.9% of all hyperopia. By geography, myopia was least prevalent in very remote areas (8.2%), where hyperopia was most prevalent (33.2%) (p=0.005). The overall RE TCR was 80.5%, with higher TCR observed in urban (84.1%) and regional (84.6%) areas, compared to remote regions (73.2%), albeit non-significantly (p=0.059).
In comparison to other global populations, myopia is relatively uncommon among Indigenous Australians, whereby low levels of hyperopia predominate. Differences in RE phenotypes may represent variations in environmental, socioeconomic and genetic exposures. However, despite the high rates of self-reported vision-related difficulties, there was a large proportion of individuals with uncorrected RE, especially in remote regions. Coordinated, affordable and accessible RE correction initiatives are required within this priority population group.
This is a 2020 ARVO Annual Meeting abstract.
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