Eyecare and glasses in urban, remote and rural Aboriginal communities

Good vision plays an important role in improving quality of life, preventing injuries, and enhancing social and economic development. Ninety per cent of vision impairment and blindness in Australia is preventable simply with glasses and timely assessment and treatment of eye diseases. The Brien Holden Foundation coordinates a program to provide outreach optometry services for Aboriginal and Torres Strait Islander people through funding from the Australian Government Department of Health’s Visiting Optometrist Scheme. This improves access to eyecare and glasses, by taking services close to people’s homes where availability is otherwise limited. During our visiting trips, we provide comprehensive eye examinations and spectacles, and refer all suspected eye disease.

The Brien Holden Foundation opened our first optometry clinic in Walgett, New South Wales (NSW), in December 1999. In 2007, at the direct request of Aboriginal eye health coordinators and their Aboriginal Community Controlled Health Services, the program was expanded to the Northern Territory (NT). We now provide services to 140 urban, rural and remote locations across NSW and the NT where eye care is traditionally limited.

We deliver low- and no-cost spectacles, support chronic disease management and offer training, upskilling and development of remote health practitioners. In the NT, ready-made glasses are given the same day and custom glasses are made at low cost, with easy payment options available, such as through Centrelink. In NSW, glasses are free of charge through the NSW Government Spectacle Scheme. Over the past six years the Foundation has provided just over 56,000 individual eye examinations and over 47,000 pairs of glasses to Aboriginal and Torres Strait Islander people, as well as referral to specialist services.

Like the inequality in general health and life expectancy between Indigenous and non-Indigenous Australians, there is also a ‘gap’ in eye and visual health. The National Indigenous Eye Health Survey 2016 showed that Indigenous Australians face six times the rate of blindness, three times the rate of low vision, 12 times the rate of blinding cataract and 14 times the rate of diabetes-related blindness, compared with other Australians. However, the most alarming statistic is that approximately 90 per cent of the blindness or vision impairment is preventable or treatable. The main cause of vision impairment according to the National Eye Health Survey 2016 report is uncorrected refractive error, that is, simply needing a pair of glasses.

Eye testing in remote communities enables poor vision to be identified, treated and prevented. Visiting services involve comprehensive retinal checks, which are highly useful for the management of chronic diseases such as diabetes and hypertension. Without immediate consequences in these conditions, it is difficult to educate patients on the importance of medical treatment and lifestyle management. With the use of retinal cameras, we can now photograph blood vessels at work inside the eye to aid in the education, monitoring and management of cardiovascular disease.

Thanks to Australian Government funding, we have rolled out retinal cameras to health clinics across Australia through the Provision of Eye Health Equipment and Training Program, in collaboration with our partners. Our visiting optometrists are available to build capacity and digital resources to support retinal photo skill development can be found at https://linktr.ee/brienholdenfoundation

Please visit our website at www.brienholdenfoundation.org for more information. If you currently do not have optometry clinics provided in your community and think there is a need, please do not hesitate to contact us at [email protected] to discuss further.