PURPOSE. Australian Aboriginal people experience up to 10 times more preventable blindness than non-Aboriginal people. This is in part due to limited access to eyecare services, cultural barriers & a lack of awareness of the importance of eyehealth. Our aim was to deliver an appropriate eyehealth service to remote Aboriginal communities.
METHOD. A team approach to prevention of vision loss was used to deliver eyecare directly to remote Aboriginal communities in the Northern Territory. Aboriginal health workers (AHWs) were responsible for case histories & vision testing, the optometrist was responsible for refraction / dispensing, IOP, internal & external examination & referral, & the ophthalmologist was responsible for tertiary eyecare. The team travelled to more than 26 communities in one year, mostly by light aircraft. Appropriate, portable & lightweight technology was used.
RESULTS. Cataract was the greatest cause of preventable vision loss. Other causes included diabetic retinopathy & trachoma. The major cause of refractive error was presbyopia. Portable YAG & argon lasers facilitated onsite treatment of post-operative cataract & diabetic retinopathy. A digital fundus camera was a cost-effective method of screening diabetic retinopathy in remote locations. More than 80% of refractive error patients could be dispensed spectacles immediately.
CONCLUSIONS. The essential components for a sustainable eyehealth service in remote Aboriginal communities included appropriate technology, a team approach & the collaboration of AHWs to help overcome cultural & communication barriers.