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Kathryn Powley
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The world’s indigenous populations experience significantly higher rates of avoidable vision impairment and a striking lack of support for research to address this major health issue, according to a review of eye health led by the Centre for Eye Research Australia and the University of Melbourne.

Vision impairment is recognised as one of the leading causes of disability worldwide.

For indigenous populations, vision impairment can lead to further isolation and marginalisation in communities that are already marked by poorer health outcomes and disadvantage.

While the World Health Organization has identified the “Right to Sight” through its Vision 2020 initiative, little is known about the burden of vision impairment and eye disease on those who are most vulnerable - including indigenous populations.

Researchers at the Centre for Eye Research Australia (CERA) have completed the first global review of eye health amongst Indigenous populations.

The review, published in JAMA Ophthalmology, paints a disappointing picture of just how poorly vision impairment is understood and addressed within these communities.

University of Melbourne PhD candidate Joshua Foreman, from CERA, is first author on the paper and said few research articles are available on this critical global issue.

“For many years we have worked with Indigenous Australians, who are known to suffer from higher rates of vision loss than non-Indigenous Australians, so when we embarked on this project we wanted to know whether there was a consistent disparity among indigenous peoples worldwide,” Mr Foreman said.

“Once we had finished the review, however, we were shocked at just how big the gaps are – both in the understanding and the burden of vision impairment.”

Despite there being thousands of research publications addressing vision impairment, the team’s search of the global literature found just 64 studies on eye health among indigenous communities from the past three decades.

Only 24 of the 90 countries with indigenous populations were represented in the research record, highlighting the lack of much-needed research.

The authors ascertained that rates of vision impairment and eye disease were higher in most of the indigenous populations represented, but a lack of consistency and detail in the research record meant they were unable to dissect these findings much further.

“The consequence is that we have a limited evidence-base when it comes to developing and providing interventions for indigenous peoples,” Mr Foreman said.

Senior author and lead researcher behind Australia’s first National Eye Health Survey Mohamed Dirani, also of CERA, said he hoped the review’s findings would drive major health policy change across the world.

“Sadly, these results strongly highlight that indigenous eye health has been neglected in most countries and that this inequality needs to be addressed immediately,” Dr Dirani said.

“What we need is more research and more investment into specific and effective intervention programs targeting avoidable vision loss in indigenous populations.

“It is unjustifiable that so many people are condemned to a life of disability just because they can’t access care.”

The study’s authors did identify some good news: promising effects of the “Close the Gap for Vision” initiative, led by CERA founder Professor Hugh Taylor who now heads the University of Melbourne’s Indigenous Eye Health Unit.

While Indigenous Australians still experience vision impairment at three times the rate of the non-indigenous population, this initiative has led collaborative health service programs to reduce the prevalence of eye disorders including cataracts and trachoma.

These types of interventions could help inform programs in other countries, and the review’s authors have called on the global community to prioritise the implementation of eye health programs specifically for indigenous communities.

Professor Taylor said: “If we are to provide equity in access to eye care as part of the provision of Universal Health Care, we must make sure that the needs of indigenous populations are not overlooked.”

 

ABOUT THE CENTRE FOR EYE RESEARCH AUSTRALIA

The Centre for Eye Research Australia (CERA) is an independent medical research institute established in 1996. CERA has grown into Australia’s leading eye research institute and is a leader for research output in the world. CERA conducts eye research that makes real-life impacts and is unravelling the causes of diseases, preventing blindness through earlier diagnosis and better treatments, and restoring sight.

CERA is closely affiliated with Ophthalmology at the University of Melbourne, Department of Surgery, and is co-located with the Department at the Royal Victorian Eye and Ear Hospital. This three-way partnership between CERA, the University and the Hospital, is key to the successful translation of our research from the bench to the bedside.