Impact of diabetes on eye care service needs: the National Indigenous Eye Health Survey

BACKGROUND: To assess the proportion of Australian Indigenous adults who require eye care services (separately among those with and without diabetes) and determine implications for eye care service planning.

DESIGN: The National Indigenous Eye Health Survey (NIEHS) was a population-based study of 30 randomly selected geographical areas.

PARTICIPANTS: The NIEHS included 1189 Indigenous adults aged 40-80 years.

METHODS: A standardized eye examination was performed.

MAIN OUTCOME MEASURE: The number requiring eye care services by diabetes status.

RESULTS: Those with diabetes were older (median 53 years) than those without diabetes (median age 50 years), P < 0.001. The total estimated population-based need for annual eye care in the NIEHS population was 52% (n = 615), and of those 72% were people with diabetes. Among those with diabetes, 29% required further primary referral for diabetic retinopathy, 12% for cataract, 1% for trachomatous trichiasis and 5% for uncorrected distance refractive error. Among those without diabetes 13% required further primary referral for cataract, 0% for trachomatous trichiasis and 5% for uncorrected distance refractive error.

CONCLUSION: This study has shown that among Indigenous adults, those with diabetes form 72% of those requiring an eye examination in any year. A key strategy to close the gap for vision for Australia's Indigenous population is to ensure those with diabetes undergo annual eye screening, have clearly defined care pathways and receive timely treatment. Establishing care pathways for those who have diabetes would also improve access to eye care services for others in the community.