Abstract
Purpose
To describe the prevalence of visually significant cataract in Indigenous and non-Indigenous Australians.
Methods
A total of 3098 non-Indigenous Australians aged 50 years and over and 1738 Indigenous Australians aged 40 years and over, residing in 30 randomly selected Australian sites, were examined as part of the population-based National Eye Health Survey (NEHS). For those with visual acuity worse than 6/12, photos of the anterior and posterior segment were taken with a nonmydriatic fundus camera and assessed for cataract. Visually significant cataract was assigned in eyes with best-corrected visual acuity worse than 6/12 and cataract that was determined to be the primary cause of vision loss in that eye.
Results
In total, 99.2% (4797/4836) participants had complete data for visual acuity and cataract assessment. The overall weighted prevalence of visually significant cataract was 2.7% (95% CI: 2.0, 3.5) in non-Indigenous Australians and 4.3% (95% CI: 3.1, 5.9) among Indigenous Australians. After adjusting for age and gender, the odds of visually significant cataract were almost three times higher among Indigenous participants compared to non-Indigenous participants (adjusted odds ratio (OR) 2.95, 95% CI: 2.03, 4.29). Only 54.8% of non-Indigenous Australians and 38.9% of Indigenous Australians with visually significant cataract self-reported a known history of cataract.
Conclusions
Our results suggest that continued efforts are required to build sustainable cataract surgery services within Indigenous communities. Furthermore, given the significant ageing of the Australian population, maintaining high cataract surgery rates amongst the non-Indigenous population is critical to reduce cataract-related vision loss.
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Acknowledgements
The National Eye Health Survey was funded by the Department of Health of the Australian Government, and also received financial contributions from the Peggy and Leslie Cranbourne Foundation and Novartis Australia. The funding organisations played no role in the design and conduct of the study. In-kind support was received from our industry and sector partners, OPSM, Carl Zeiss, Designs for Vision, the Royal Flying Doctor Service, Optometry Australia, and the Brien Holden Vision Institute. We would like to specifically acknowledge OPSM, who kindly donated sunglasses valued at $130 for each study participant. The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian Government. The Principal Investigator, Dr Mohamed Dirani, is supported by a NHMRC Career Development Fellowship (#1090466). The PhD student Joshua Foreman is supported by an Australian Postgraduate Award scholarship. The Centre for Eye Research Australia (CERA) and Vision 2020 Australia wish to recognise the contributions of all the NEHS project steering committee members (Professor Hugh Taylor, Dr. Peter van Wijngaarden, Jennifer Gersbeck, Dr. Jason Agostino, Anna Morse, Sharon Bentley, Robyn Weinberg, Christine Black, Genevieve Quilty, Louis Young, and Rhonda Stilling) and the core CERA research team who assisted with the survey field work (Joshua Foreman, Pei Ying Lee, Rosamond Gilden, Larissa Andersen, Benny Phanthakesone, Celestina Pham, Alison Schokman, Megan Jackson, Hiba Wehbe, John Komser, and Cayley Bush). Furthermore, we would like to acknowledge the overwhelming support from all collaborating Indigenous organisations who assisted with the implementation of the survey, and the Indigenous health workers and volunteers in each survey site who contributed to the field work.
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Keel, S., McGuiness, M.B., Foreman, J. et al. The prevalence of visually significant cataract in the Australian National Eye Health Survey. Eye 33, 957–964 (2019). https://doi.org/10.1038/s41433-019-0354-x
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DOI: https://doi.org/10.1038/s41433-019-0354-x
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