Get access

Diabetic retinopathy and the major causes of vision loss in Aboriginals from remote Western Australia

Authors

  • Antony Clark MBBS(Hons),

    1. Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University of Technology,
    2. Centre for Health Services Research, School of Population Health, The University of Western Australia,
    3. Eye and Vision Epidemiology Research Group,
    Search for more papers by this author
  • William H Morgan FRANZCO PhD,

    Corresponding author
    1. Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University of Technology,
    2. Eye and Vision Epidemiology Research Group,
    3. Centre for Ophthalmology and Visual Science, University of Western Australia,
    4. Department of Ophthalmology, Royal Perth Hospital, Perth, and
    Search for more papers by this author
  • Sam Kain FRANZCO,

    1. Department of Ophthalmology, Royal Perth Hospital, Perth, and
    Search for more papers by this author
  • Hussein Farah MBBS,

    1. Population Health, WA Country Health Service – Goldfields, Kalgoorlie, Western Australia, Australia
    Search for more papers by this author
  • Kiele Armstrong MIH GradDipPH,

    1. Population Health, WA Country Health Service – Goldfields, Kalgoorlie, Western Australia, Australia
    Search for more papers by this author
  • David Preen BSc(Hons) PhD,

    1. Centre for Health Services Research, School of Population Health, The University of Western Australia,
    2. Eye and Vision Epidemiology Research Group,
    Search for more papers by this author
  • James B Semmens MSc PhD,

    1. Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University of Technology,
    2. Eye and Vision Epidemiology Research Group,
    Search for more papers by this author
  • Dao-Yi Yu MD PhD

    1. Centre for Ophthalmology and Visual Science, University of Western Australia,
    Search for more papers by this author

Professor William H Morgan, Centre for Ophthalmology and Vision Science, 2 Verdun Street, Nedlands, WA 6007, Australia. Email: whmorgan@cyllene.uwa.edu.au

Abstract

Purpose:  To report on diabetic retinopathy (DR) and the major causes of vision loss and blindness in Aboriginals in the Eastern Goldfields region of Western Australia between 1995 and 2007.

Methods:  Aboriginals (>16 years old) diagnosed with diabetes or eye problems from 11 communities in the Eastern Goldfields region of Western Australia were examined annually from 1995 to 2007. Data collected from prospective clinical examination included; visual acuity (VA), causes of vision loss, and whether DR was present. Severity of DR was graded according to the Early Treatment of Diabetic Retinopathy Study modified Airlie House grading system.

Results:  A total of 920 Aboriginals underwent 1331 examinations over the study period. There were 246 eyes with vision loss (best-corrected VA < 6/12) in 159 Aboriginals, of whom five were bilaterally blind. The four major known causes of vision loss were cataract (n = 53, 30.1%), DR (n = 44, 25.0%), uncorrected refractive error (n = 31, 17.6%) and trauma (n = 19, 10.8%). Aboriginals who had diabetes were far more likely to have vision loss (odds ratio = 8.5, 95% confidence interval 5.7–12.6, P < 0.0001). Of the 329 Aboriginals with diabetes, 82 (24.9%) had DR, and 32 (9.7%) had vision-threatening retinopathy. Of those with diabetes, 94 (42.5%) returned for follow-up examination on an average of 3.2 visits with a median time between visits of 2 years.

Conclusion:  The four major causes of vision loss in Aboriginals from the Eastern Goldfields are largely preventable and/or readily treated. DR and other diabetes-related eye conditions are a major cause of vision loss in Aboriginals, representing a significant health challenge for health services and clinicians into the future.

Ancillary