Correcting Indigenous Australians' refractive error and presbyopia

摘要

Background This paper aims to identify the barriers and solutions for refractive error and presbyopia vision correction for Indigenous Australians. Design A qualitative study, using semistructured interviews, focus groups, stakeholder workshops and consultation, conducted in community, private practice, hospital, non-government organization and government settings. Participants Five hundred and thirty-one people participated in consultations. Methods Data were collected at 21 sites across Australia. Semistructured interviews were conducted with 289 people working in Indigenous health and eye care sectors; focus group discussions with 81 community members; stakeholder workshops involving 86 individuals; and separate meetings with 75 people. Barriers were identified through thematic analysis and policy solutions developed through iterative consultation. Main Outcome Measures Barriers and solutions to remedy Indigenous Australians' uncorrected refractive error and presbyopia. Results Indigenous Australians' uncorrected refractive error and presbyopia can be eliminated through improvement of primary care identification and referral of people with poor vision, increased availability of optometry services in Aboriginal Health Services, introduction of a nationally consistent Indigenous subsidized spectacle scheme and proper coordination, promotion and monitoring of these services. Conclusions The refractive error and presbyopia correction needs of Indigenous Australians are immediately treatable by the simple provision of glasses. The workforce capacity exists to provide the eye exams to prescribe glasses and the cost is modest. What is required is identification of patients with refractive needs within community, referral to accessible optometry services, a good supply system for appropriate and affordable glasses and the coordination and integration of this service within a broader eye care system.