Abstract
Purpose :
The World Health Assembly has set targets for a 40% increase in eREC by 2030 and universal coverage in countries with baseline eREC >60%. In New South Wales (NSW) optometry and ophthalmology services are subsidised by the national health insurance scheme (Medicare) and spectacles are available free of charge for people with financial disadvantage (NSW Spectacles Program). eREC, patterns in access and out of pocket costs for refractive correction are reported.
Methods :
The Australian Eye and Ear Health Survey is a national population-based survey, which aims to estimate the prevalence of hearing loss and eye conditions which cause vision-impairment, in non-Indigenous Australians aged 50, and Indigenous Australians aged 40 years and over. Residents were selected by stratified random sampling from 9 Statistical Local Areas in the state of NSW in 2022-2023. eREC was determined using habitual distance visual acuity, history of refractive surgery, uncorrected visual acuity (worse than 6/12) and visual acuity with auto- and subjective-refraction. Costs and mode of access to refractive correction were self-reported.
Results :
Of 1476 participants, 44% were male, 56% female, age was 69.8 ± 10.0 years (mean ± standard deviation, range 40-96). Participants had seen by an optometrist (84.7%, 1227/1449), ophthalmologist (14.8%, 214/1449), general practitioner, nurse or other (0.6%, 8/1449) for eyecare, a median of 12 months ago (inter-quartile range [IQR] 4-18 months). Excluding participants with other causes of vision impairment and those who could see 6/12 or better unaided, eREC was 95.2% (298/313). Distance refractive error was corrected by spectacles (97.3%, 290/298), contact lenses (1.0%, 3/298) and refractive surgery (1.6%, 5/298). In the last 12 months, 24% (46/205) used private health insurance, 3.9% (8/205) the NSW Spectacle program and 73.7% (151/205) paid out-of-pocket for refractive correction median of AU$400, IQR AU$200-700. Access to the NSW Spectacle program was higher in Aboriginal and Torres Strait Islander participants (36.7%, 36/98 vs 4.6%, 48/1052).
Conclusions :
The eREC was high in this setting, the spectacle distribution scheme was significantly utilised, particularly in Aboriginal and Torres Strait Islander participants. Weighted estimates and inclusion of remote communities in the national survey will show a more comprehensive picture of refractive error coverage in Australia.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.