The prevalence and causes of vision impairment and blindness in Australia: the National Eye Health Survey

© 2018 Dr. Joshua Ross ForemanVision impairment (VI) and blindness affect 440 million people worldwide. As most cases can be avoided through evidence-based eye health care interventions, the elimination of avoidable VI and blindness is a global health priority. Nationally-representative population surveys on the prevalence and causes of VI and blindness are required to inform targeted eye health care programs. This thesis documents Australia’s first National Eye Health Survey (NEHS) that aimed to determine the prevalence and causes of vision loss and rates of utilisation of eye health care services for non-Indigenous Australians aged 50 years or older and Indigenous Australians aged 40 years or older residing in all levels of geographic remoteness in Australia. Multistage random-cluster sampling was used to select a nationally-representative sample of 3098 non-Indigenous Australians and 1738 Indigenous Australians from 30 population clusters across all five geographic remoteness strata (Major Cities, Inner Regional, Outer Regional, Remote and Very Remote). Participants underwent an interviewer-administered questionnaire and a series of standardised eye examinations, including visual acuity assessment, anterior segment assessment, perimetry, fundus photography and intraocular pressure measurement. The prevalence of bilateral vision loss was 6.5% (95% confidence interval [CI]: 5.4-7.8) in non-Indigenous Australians and 11.2% (95% CI: 9.5-13.1) in Indigenous Australians. The age- and sex-adjusted prevalence of bilateral vision loss was 2.8 times higher in Indigenous than non-Indigenous Australians (P