Essay on Eye Health Issues in Aboriginals

 Eye problems were among the most commonly reported health conditions in Aboriginal and Torres Islander people according to the 2001 National Health Survey (NHS). Indigenous people living in nonremote areas were reported to have some eye disorders as a long term health condition.  Indigenous people are more likely than non-Indigenous people to suffer from preventable eye health conditions and their eye health can be affected by genetic factors, ageing, premature birth, diseases (such as diabetes), smoking, injuries, UV exposure and nutrition. For many Indigenous people, addressing eye health problems were limited by difficulty in accessing optometrist or specialist services. The proper diagnosis, management and treatment of eye health problems for Aboriginal and Torres Islander people were affected by geographic remoteness, economic disadvantage and lack of transport. There were numerous other factors that contributed to poor eye health of Aboriginal and Torres Strait Islander people such as age, injury, ultra- violet exposure, repeated infections, high blood pressure, diabetes, low birth weight, malnutrition, alcohol and tobacco use.

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According to measures of overall burden of diseases, vision loss and blindness was the fourth largest contributor to the health gap between Aboriginal and non-indigenous people. In other words they had three times higher chance of life years being affected by vison loss as compared to the non-indigenous community. Indigenous Australians experience higher rates of cataract, diabetic retinopathy and trachoma compared with non-Indigenous Australians. The 2016 National Eye Health Survey (Foreman et al, 2016) measured eye health in Indigenous Australians aged 40 years and over and non-Indigenous Australians aged over 50 years old. This was the first nationwide Australian population based eye health survey which involved clinical examination. In 2016, 11% of Indigenous Australians aged 40 years and over had Vision Impairment (VI) and 0.3% were blind. The major cause of blindness was cataract (40%) in Indigenous Australians and age-related macular degeneration in non-Indigenous Australians (71%). In 2016, the prevalence of VI increased markedly with age in both groups and was almost 2 times higher in 50–59 year old Indigenous Australians and almost 4 times higher in 60–69 year olds compared with non-Indigenous Australians. The Indigenous rate was highest in outer regional areas (17%). For non-Indigenous Australians the rate did not differ significantly by remoteness. Half of those found to have an eye condition were previously undiagnosed (57% for Indigenous Australians and 52% for non-Indigenous Australians). Indigenous Australians with self-reported diabetes had lower rates of recommended diabetes eye checks than non-Indigenous Australians (53% compared with 78%), particularly in very remote areas (35% compared with 64% respectively).

The history of colonisation has greatly impacted on the eye health issues for Aboriginal and Torres Islander people by introducing microorganisms to which these communities had not been exposed and were susceptible.  The infections introduced by colonists seriously affected Indigenous populations. Aboriginal and Torres Strait Islander people has a hunter gatherer lifestyle until late 18th century and was affected by the arrival of the Europeans in 1788. The tradition of searching for food and other daily life resources in order to maintain their family and cultural lives was changing one time. The advance changes in daily routine and activities impacted the development of eye problems widely and, also other chronic diseases such a diabetes which is a major cause of eye health problems among Aboriginal and Torres Strait Islander people.  Colonisation had a powerful effect on Indigenous populations as it blocked the access to or destroyed traditional farming, food-gathering, or hunting and fi shining places and practices. Colonists introduced harmful substances such as tobacco and alcohol, which had serious long-term effects on health and caused severe social, psychological, and emotional damage.  All these issues affected the diet of the Aboriginal people and related to the eye health issues .Originally they lead a high quality of life which is greatly impacted by vison loss both socially and economically. Due to eye health problems the quality of life was severely impacted which also affected physical mobility, their work ability, reduction in the life expectancy leading to increased risk of death for the people who were affected. All these issues not only had after affect on the person bearing the problem but the family and community as well. Vison loss also limits individuals to have further opportunity in education, work and, also increases the risk of getting injured quickly and then of course depending upon others for various services. Eye health was affected by diseases such as diabetes as well as environmental factors linked to higher rates of infection and cross-infection, geographic isolation, economic disadvantage and barriers to health care, which limited the opportunities for detection and treatment.

Social Determinants of Indigenous Health are the several aspects including the environments which affected their health. Two major determinants of health which contributed towards the eye health problems were social and cultural determinants of health. These determinants contributed widely towards the health inequality and health disadvantages being experienced by Aboriginal and Torres Strait Islander. The historical, social and cultural context of Aboriginal and Torres Strait Islander people’s health displays a major factor in their eye health and problems related to it. These determinants affected on health of Aboriginal and Torres Islander people in a way that they could assess health care better if they had better levels of education, incomes, and were homeowners. Due to lack of education, unemployment, low income, racism, access to available services Aboriginal and Torres Strait Islander people had to suffer a lot as composed to non-indigenous people. The combination of historical influence, social and cultural determinant had contributed towards poor eye health conditions Aboriginal people were not able to teach the services of medical case, substandard living conditions and poverty all added up to the development of eye problems to the community.

 Aboriginal and Torres Strait Islander people have a good vision at the beginning of their life and with ageing the uncorrected or under corrected refractive error becomes the major cause of vision loss among Indigenous adults. The adults experienced a higher rate of eye problems which was generally three times higher than that of non-indigenous people. The 2016 National Eye Health survey (NEHS) estimated that 18,300 or 11% of Aboriginal and Torres Strait Islander adults suffered from vison impairment or blindness. Approximately 80% of loss in eyesight among Aboriginal and Torres Strait Islander adults was due to uncorrected refractive error, Cataract and Diabetic retinopathy. According to research Aboriginal and Torres Strait Islander people used very rare eye health service inspite of having higher rates of vision loss as compared to non- indigenous people. In order to access the eye care health services the facilities were not available in rural and remote areas. The patients had to travel long distances and there was no co-ordination between patient and eye specialists unaware of the advantages of treatment and even the cost of treatment.

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The implications for Aboriginal eye health are significant not only due to the expected increase in diabetic retinopathy but also due to the increase in other diabetes-related eye conditions, for example, cataract, retinal vascular disease and neovascular glaucoma. Indigenous people are more likely than non-Indigenous people to suffer from preventable eye health conditions, but there has been some progress in some areas in recent years. Eye health can be affected by genetic factors, ageing, premature birth, diseases (such as diabetes), smoking, injuries, UV exposure and nutrition. Eye problems were among the most commonly reported health conditions in the 2001 National Health Survey (NHS) . Similar proportions of Indigenous (49%) and non-Indigenous people (51%) living in nonremote areas reported having some eye disorder as a long-term health condition. The proportion was slightly less (38%) for Indigenous people in remote areas. The differences between Indigenous and non-Indigenous people were highest, with total or partial loss of vision being twice as commonly reported by Indigenous than by non-Indigenous people. For many Indigenous people, addressing eye health problems is limited by difficulty in accessing optometrist or specialist services.

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