ORCID Profile
0000-0002-3685-4054
Current Organisation
Centre for Eye Research Australia
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Publisher: BMJ
Date: 26-04-2018
DOI: 10.1136/BJOPHTHALMOL-2017-311786
Abstract: To estimate the prevalence of glaucoma in Australia. This was a population-based study of 3098 non-Indigenous Australians (50–98 years) and 1738 Indigenous Australians (40–92 years) stratified by remoteness. Each participant underwent a standard examination that included visual field assessment, tonometry and non-mydriatic fundus photography. Two fellowship-trained glaucoma specialists independently assessed relevant case notes (past ocular history, best-corrected visual acuity, frequency doubling technology visual fields, Van Herick grade, intraocular pressure and optic disc-centred photographs) and assigned a diagnosis ranked on a scale of certainty: none, possible, probable or definite glaucoma. A total of 4792 (99.1%, 3062 non-Indigenous and 1730 Indigenous) participants had retinal photographs in at least one eye that were gradable for glaucoma. The weighted prevalence of glaucoma (definite) in non-Indigenous Australians and Indigenous Australians was 1.5% (95% CI 1.0 to 2.2) and 0.6% (95% CI 0.4 to 1.1), respectively. When definite and probable cases of glaucoma were combined, rates were 3.4% (95% CI 2.7 to 4.3) among non-Indigenous and 1.6% (95% CI 1.1 to 2.3) in Indigenous Australians. Only 52.4% of non-Indigenous Australians and 28.0% of Indigenous Australians with glaucoma self-reported a known history of glaucoma. We estimate that 198 923 non-Indigenous Australians aged 50 years and over and 2139 Indigenous Australians aged 40 years and over have glaucoma. Given the high rates of undiagnosed glaucoma coupled with a significant ageing of the Australian population, improvements in case detection and access to low vision rehabilitation services may be required to cope with the growing burden of glaucoma.
Publisher: American Medical Association (AMA)
Date: 11-2017
Publisher: Wiley
Date: 29-06-2017
DOI: 10.1111/AOS.13386
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.JSTROKECEREBROVASDIS.2017.03.018
Abstract: The study aimed to determine the prevalence of and risk factors for self-reported stroke in Indigenous and non-Indigenous Australians. In this national eye study, 1738 Indigenous Australians (41.1% male) aged 40-92 years and 3098 non-Indigenous Australians (46.4% male) aged 50-98 years from 30 randomly selected sites, stratified by remoteness, were recruited and examined. Sociodemographic information and a history of stroke, diabetes, and ocular health were obtained using an interviewer-administered questionnaire. The crude prevalence of self-reported stroke was 5.04% (156 of 3098, 95% confidence interval: 4.29%-5.87%) for non-Indigenous Australians and 8.75% (152 of 1738, 95% confidence interval: 7.46%-10.17%) for Indigenous Australians (P < .0001). The age-adjusted prevalence of self-reported stroke for non-Indigenous and Indigenous Australians was 4.23% and 12.72%, respectively. The prevalence of stroke increased significantly with age for both Indigenous (odds ratio = 1.06 per year, P ≤ .001) and non-Indigenous Australians (odds ratio = 1.04 per year, P ≤ .001), with the Indigenous prevalence being higher than that of the non-Indigenous group at every age. The prevalence of self-reported stroke was 3 times higher in Indigenous Australians than in non-Indigenous Australians. This disparity is consistent with previous reports, highlighting the need for intensified prevention and support services to reduce the burden of stroke on Indigenous Australians.
Publisher: Wiley
Date: 06-09-2017
DOI: 10.1111/CEO.13035
Abstract: National data on eye health-care service utilization will inform Australia's eye health policy. To investigate the utilization of eye health-care services by Australians. Cross-sectional survey. Indigenous Australians aged 40 years and older and non-Indigenous Australians aged 50 years and older. One thousand seven hundred thirty-eight Indigenous Australians and 3098 non-Indigenous Australians were recruited from 30 randomly selected sites, stratified by remoteness. Sociodemographic, ocular history and eye health-care service utilization data were collected, and an eye examination was conducted. Recentness of eye examinations, types of providers used and associated risk factors. Approximately 67.0% of Indigenous Australians and 82.5% of non-Indigenous Australians underwent an eye examination within the previous 2 years. Indigenous status (P < 0.001), male gender (P < 0.001), Outer Regional (P < 0.001) and Very Remote (P self-reported eye disease or diabetes were most likely to have been examined within the past year (P < 0.001). For Indigenous Australians, older age was associated with recent eye testing (P = 0.001). Those with retinal disease and cataract were more likely to see an ophthalmologist (P < 0.001), and those with refractive error were more likely to see an optometrist (P < 0.001). In Regional Australia, non-Indigenouspeople were more likely to see optometrists (P < 0.001), and Indigenous Australians were more likely to utilize other, non-specialistservices (P < 0.001). Eye examination frequency has improved in Indigenous and non-Indigenous Australians compared with previous population-based research. Further improvements are required in risk groups including Indigenous Australians and those living in Regional and Remote areas.
Publisher: JMIR Publications Inc.
Date: 08-04-2020
Abstract: he COVID-19 pandemic has evolved into one of the most impactful health crises in modern history. The rapid onset and evolution of the pandemic has compelled researchers to explore innovative ways to efficiently collect public health data in a timely manner. Social media platforms, such as Facebook, have been explored as a recruitment tool for research in other settings however, their feasibility for collecting data on population beliefs and practices during infectious disease epidemics, such as COVID-19, and their capacity to yield nationally representative s les in these contexts remain unexplored. his study has two aims 1) describe the methodology used to recruit a nationwide s le of adults residing in the United States to participate in a survey on COVID-19 knowledge, beliefs, and practices, and 2) outline the preliminary findings related to recruitment, challenges using social media as a recruitment platform, and strategies used to address these challenges. Facebook advertisement c aign was used to disseminate the link to an online Qualtrics survey between March 20-30, 2020. Two supplementary male-only and racial minority- targeted advertisements with otherwise identical characteristics to the original advertisement were created on the sixth and tenth day of recruitment, respectively, to address issues of disproportionate female- and White-oriented gender- and ethnic-skewing observed in the advertisement’s reach and response trends. he advertisements cumulatively reached 236,017 in iduals and resulted in 9,609 clicks (4.07% reach). In total, 6,602 participant responses were recorded (68.7% of those who clicked on the advertisement). Total cost of the advertisement was $906, resulting in costs of $0.09 per click, $0.14 per response (all surveys), and $0.18 per full response (completed surveys). Implementation of the supplementary male-only advertisement successfully improved the cumulative percentage of male respondents from approximately 20% to 40%. he social media advertisement c aign was an effective and efficient strategy to collect large scale, nationwide data on COVID-19 within a short time period. However, significant limitations included gender and racial skewing, which may have resulted from Facebook’s cost optimization algorithms, and advertisement review challenges. Future research should attempt to address such challenges. These findings can inform future research on the use of social media recruitment for the rapid collection of survey data on knowledge, beliefs and practices related to significant public health problems, including rapidly evolving pandemics such as COVID-19.
Publisher: AMPCo
Date: 05-2017
DOI: 10.5694/MJA16.00989
Abstract: To determine adherence to NHMRC eye examination guidelines for Indigenous and non-Indigenous Australian people with diabetes. Cross-sectional survey using multistage, random cluster s ling. Thirty randomly selected geographic sites in the five mainland Australian states and the Northern Territory, stratified by remoteness. 1738 Indigenous Australians aged 40-92 years and 3098 non-Indigenous Australians aged 50-98 years were recruited and examined between March 2015 and April 2016 according to a standardised protocol that included a questionnaire (administered by an interviewer) and a series of standard eye tests. Adherence rates to NHMRC eye examination guidelines factors influencing adherence. Adherence to screening recommendations was significantly greater among non-Indigenous Australians (biennial screening 77.5%) than Indigenous Australians (annual screening 52.7% P < 0.001). Greater adherence by non-Indigenous Australians was associated with longer duration of diabetes (adjusted odds ratio [aOR], 1.19 per 5 years P = 0.018), while increasing age was associated with poorer adherence in non-Indigenous Australians (aOR, 0.70 per decade P = 0.011). For Indigenous Australians, residing in inner regional areas (aOR, 1.66 P = 0.007) and being male (aOR, 1.46 P = 0.018) were significant factors positively associated with adherence. More than three-quarters of non-Indigenous Australians with diabetes and more than half of Indigenous Australians with diabetes adhere to the NHMRC eye examination guidelines. The discrepancy between the adherence rates may point to gaps in the provision or uptake of screening services in Indigenous communities, or a lack of awareness of the guidelines. A carefully integrated diabetic retinopathy screening service is needed, particularly in remote areas, to improve adherence rates.
Publisher: JMIR Publications Inc.
Date: 08-10-2020
DOI: 10.2196/21071
Abstract: During the COVID-19 pandemic, there is a heightened need to understand health information seeking behaviors to address disparities in knowledge and beliefs about the crisis. This study assessed sociodemographic predictors of the use and trust of different COVID-19 information sources, as well as the association between information sources and knowledge and beliefs about the pandemic. An online survey was conducted among US adults in two rounds during March and April 2020 using advertisement-based recruitment on social media. Participants were asked about their use of 11 different COVID-19 information sources as well as their most trusted source of information. The selection of COVID-related knowledge and belief questions was based on past empirical literature and salient concerns at the time of survey implementation. The s le consisted of 11,242 participants. When combined, traditional media sources (television, radio, podcasts, or newspapers) were the largest sources of COVID-19 information (91.2%). Among those using mainstream media sources for COVID-19 information (n=7811, 69.5%), popular outlets included CNN (24.0%), Fox News (19.3%), and other local or national networks (35.2%). The largest in idual information source was government websites (87.6%). They were also the most trusted source of information (43.3%), although the odds of trusting government websites were lower among males (adjusted odds ratio [AOR] 0.58, 95% CI 0.53-0.63) and those aged 40-59 years and ≥60 years compared to those aged 18-39 years (AOR 0.83, 95% CI 0.74-0.92 AOR 0.62, 95% CI 0.54-0.71). Participants used an average of 6.1 sources (SD 2.3). Participants who were male, aged 40-59 years or ≥60 years not working, unemployed, or retired or Republican were likely to use fewer sources while those with children and higher educational attainment were likely to use more sources. Participants surveyed in April were markedly less likely to use (AOR 0.41, 95% CI 0.35-0.46) and trust (AOR 0.51, 95% CI 0.47-0.56) government sources. The association between information source and COVID-19 knowledge was mixed, while many COVID-19 beliefs were significantly predicted by information source similar trends were observed with reliance on different types of mainstream media outlets. COVID-19 information source was significantly determined by participant sociodemographic characteristics and was also associated with both knowledge and beliefs about the pandemic. Study findings can help inform COVID-19 health communication c aigns and highlight the impact of using a variety of different and trusted information sources.
Publisher: Wiley
Date: 25-08-2017
DOI: 10.1111/CEO.13031
Abstract: In Australia, knowledge of the epidemiology of retinal vein occlusion remains scarce because of a paucity of recent population-based data. The National Eye Health Survey (2015-2016) provides an up-to-date estimate of the prevalence of retinal vein occlusion in non-Indigenous and Indigenous Australian adults. To determine the prevalence and associations of retinal vein occlusion in a national s le of Indigenous and non-Indigenous Australian adults. Population-based cross-sectional study. A total of 3098 non-Indigenous Australians (aged 50-98 years) and 1738 Indigenous Australians (aged 40-92 years) living in 30 randomly selected sites, stratified by remoteness. Retinal vein occlusions were graded from retinal photographs using standardized protocols and recorded as central retinal vein occlusion or branch retinal vein occlusion. Prevalence of retinal vein occlusion. In the non-Indigenous population, the s ling weight adjusted prevalence of any retinal vein occlusion was 0.96% (95% confidence interval: 0.59, 1.6), with branch retinal vein occlusion observed in 0.72% (95% confidence interval: 0.41, 1.2) and central retinal vein occlusion in 0.24% (95% confidence interval: 0.13, 0.47). Any retinal vein occlusion was found in 0.91% (95% confidence interval: 0.47, 1.7) of Indigenous Australians aged 40 years and over, with branch retinal vein occlusion observed in 0.83% (95% confidence interval: 0.40, 1.7) and central retinal vein occlusion in 0.07% (95% confidence interval: 0.02, 0.32). Older age (odds ratio = 1.64 per 10 years, P = 0.006) and the presence of self-reported diabetes (odds ratio = 3.24, P = 0.006) were associated with any retinal vein occlusion after multivariable adjustments. Retinal vein occlusion was attributed as the cause of monocular vision loss (<6/12) in seven (0.25%) non-Indigenous and six (0.36%) Indigenous participants. These data suggest that retinal vein occlusion is relatively uncommon in the non-Indigenous Australians aged 50 years and over and Indigenous Australians aged 40 years and over. Similar to previous Australian and international reports, the prevalence of retinal vein occlusion rose sharply with age.
Publisher: Public Library of Science (PLoS)
Date: 03-01-2017
Publisher: Public Library of Science (PLoS)
Date: 04-04-2017
Publisher: Wiley
Date: 09-2017
DOI: 10.1111/CEO.13036
Publisher: Informa UK Limited
Date: 27-03-2017
DOI: 10.1080/09286586.2017.1296166
Abstract: To present the recruitment and testing methodology of the National Eye Health Survey (NEHS), a population-based study that aimed to determine the prevalence and causes of vision impairment and blindness in Australia. Non-Indigenous Australians aged 50 years and older and Indigenous Australians aged 40 years and older were recruited using a door-to-door approach from 30 randomly selected geographical areas, stratified by remoteness. Participants underwent a vision examination, anterior segment assessment, intraocular pressure testing, perimetry, and fundus photography. In total, recruiters approached 23,235 residences, and 11,883 residents were successfully contacted (51.1%). Of these, 6760 (56.9%) were deemed eligible and 5764 agreed to participate (positive response rate = 85.3%). Of those who agreed, 4836 residents attended the examination (4836/6760 = 71.5%). This included 1738 Indigenous Australians (41.1% male) aged 40-92 years (mean ± standard deviation = 55.0 ± 10.0 years) and 3098 non-Indigenous Australians (46.4% male), aged 50-98 years (mean ± standard deviation = 66.6 ± 9.7 years). The NEHS achieved an excellent positive response rate, and the data collected from 4836 Australians will provide the first population-based national estimate of the prevalence of vision impairment and blindness. This data will guide future economic analysis, policy formulation, and eye health service delivery in Australia.
Publisher: Wiley
Date: 18-05-2020
DOI: 10.1111/CEO.13776
Publisher: JMIR Publications Inc.
Date: 04-06-2020
Abstract: uring the COVID-19 pandemic, there is a heightened need to understand health information seeking behaviors to address disparities in knowledge and beliefs about the crisis. his study assessed sociodemographic predictors of the use and trust of different COVID-19 information sources, as well as the association between information sources and knowledge and beliefs about the pandemic. n online survey was conducted among US adults in two rounds during March and April 2020 using advertisement-based recruitment on social media. Participants were asked about their use of 11 different COVID-19 information sources as well as their most trusted source of information. The selection of COVID-related knowledge and belief questions was based on past empirical literature and salient concerns at the time of survey implementation. he s le consisted of 11,242 participants. When combined, traditional media sources (television, radio, podcasts, or newspapers) were the largest sources of COVID-19 information (91.2%). Among those using mainstream media sources for COVID-19 information (n=7811, 69.5%), popular outlets included CNN (24.0%), Fox News (19.3%), and other local or national networks (35.2%). The largest in idual information source was government websites (87.6%). They were also the most trusted source of information (43.3%), although the odds of trusting government websites were lower among males (adjusted odds ratio [AOR] 0.58, 95% CI 0.53-0.63) and those aged 40-59 years and ≥60 years compared to those aged 18-39 years (AOR 0.83, 95% CI 0.74-0.92 AOR 0.62, 95% CI 0.54-0.71). Participants used an average of 6.1 sources (SD 2.3). Participants who were male, aged 40-59 years or ≥60 years not working, unemployed, or retired or Republican were likely to use fewer sources while those with children and higher educational attainment were likely to use more sources. Participants surveyed in April were markedly less likely to use (AOR 0.41, 95% CI 0.35-0.46) and trust (AOR 0.51, 95% CI 0.47-0.56) government sources. The association between information source and COVID-19 knowledge was mixed, while many COVID-19 beliefs were significantly predicted by information source similar trends were observed with reliance on different types of mainstream media outlets. OVID-19 information source was significantly determined by participant sociodemographic characteristics and was also associated with both knowledge and beliefs about the pandemic. Study findings can help inform COVID-19 health communication c aigns and highlight the impact of using a variety of different and trusted information sources.
Publisher: Public Library of Science (PLoS)
Date: 13-04-2017
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.INJURY.2017.09.020
Abstract: To determine the prevalence of vision loss due to ocular trauma in Australia. The National Eye Health Survey (NEHS) is a population-based cross-sectional study that examined 3098 non-Indigenous Australians (aged 50-98 years) and 1738 Indigenous Australians (aged 40-92 years) living in 30 randomly selected sites, stratified by remoteness. An eye was considered to have vision loss due to trauma if the best-corrected visual acuity was worse than 6/12 and the main cause was attributed to ocular trauma. This determination was made by two independent ophthalmologists and any disagreements were adjudicated by a third senior ophthalmologist. The s ling weight adjusted prevalence of vision loss due to ocular trauma in non-Indigenous Australians aged 50 years and older and Indigenous Australians aged 40 years and over was 0.24% (95%CI: 0.10, 0.52) and 0.79% (95%CI: 0.56, 1.13), respectively. Trauma was attributed as an underlying cause of bilateral vision loss in one Indigenous participant, with all other cases being monocular. Males displayed a higher prevalence of vision loss from ocular trauma than females in both the non-Indigenous (0.47% vs. 1.25%, p=0.03) and Indigenous populations (0.12% vs. 0.38%, p=0.02). After multivariate adjustments, residing in Very Remote geographical areas was associated with higher odds of vision loss from ocular trauma. We estimate that 2.4 per 1000 non-Indigenous and 7.9 per 1000 Indigenous Australian adults have monocular vision loss due to a previous severe ocular trauma. Our findings indicate that males, Indigenous Australians and those residing in Very Remote communities may benefit from targeted health promotion to improve awareness of trauma prevention strategies.
Publisher: Wiley
Date: 06-11-2017
DOI: 10.1111/EJN.13722
Abstract: Schizophrenia is a complex psychiatric disorder with a heterogeneous aetiology involving genetic and environmental factors. Deficiencies in both brain-derived neurotrophic factor (BDNF) and NMDA receptor function have been implicated in the disorder and may play causal and synergistic roles. Perturbations in the regulation of electrophysiological signals, including high-frequency (γ: 30-80 Hz and β: 20-30 Hz) neuronal oscillations, are also associated with the disorder. This study investigated the influence of BDNF deficiency and NMDA receptor hypofunction on electrophysiological responses to brief acoustic stimuli. Adult BDNF heterozygote (BDNF
Publisher: BMJ
Date: 04-01-2018
DOI: 10.1136/BJOPHTHALMOL-2017-311257
Abstract: To assess the visual outcomes of cataract surgery among a national s le of non-Indigenous and Indigenous Australians. This was a population-based study of 3098 non-Indigenous Australians (50–98 years) and 1738 Indigenous Australians (40–92 years), stratified by remoteness. A poor postoperative outcome in an eye that had undergone cataract surgery was defined as presenting distance visual acuity (PVA) /12–6/60, and a very poor outcome was defined as PVA /60. Effective cataract surgery coverage (eCSC operated cataract and a good outcome (PVA ≥6/12) as a proportion of operable plus operated cataract) was calculated. The s ling weight adjusted cataract surgery prevalence was 19.8% (95% CI 17.9 to 22.0) in non-Indigenous Australians and 8.2% (95% CI 6.0 to 9.6) in Indigenous Australians. Among the non-Indigenous population, poor and very poor PVA outcomes were present in 18.1% and 1.9% of eyes, respectively. For Indigenous Australians, these values were 27.8% and 6.3%, respectively. The main causes of poor vision were refractive error (non-Indigenous=41.8% Indigenous=41.9%) and coincident disease (non-Indigenous=43.3% Indigenous=40.3%). The eCSC rates in the non-Indigenous and Indigenous populations were 88.5% (95% CI 85.2 to 91.2) and 51.6% (95% CI 42.4 to 60.7), respectively. Approximately half of eyes with a poor visual outcome postcataract surgery could be readily avoided through the appropriate refractive correction. The finding of a lower eCSC rate among Indigenous Australians suggests that improvements in access and quality of cataract services may be warranted in order to reduce cataract-related vision loss in the Indigenous population.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.OPHTHA.2017.06.001
Abstract: To conduct a nationwide survey on the prevalence and causes of vision loss in Indigenous and non-Indigenous Australians. Nationwide, cross-sectional, population-based survey. Indigenous Australians aged 40 years or older and non-Indigenous Australians aged 50 years and older. Multistage random-cluster s ling was used to select 3098 non-Indigenous Australians and 1738 Indigenous Australians from 30 sites across 5 remoteness strata (response rate of 71.5%). Sociodemographic and health data were collected using an interviewer-administered questionnaire. Trained examiners conducted standardized eye examinations, including visual acuity, perimetry, slit-l examination, intraocular pressure, and fundus photography. The prevalence and main causes of bilateral presenting vision loss (visual acuity <6/12 in the better eye) were determined, and risk factors were identified. Prevalence and main causes of vision loss. The overall prevalence of vision loss in Australia was 6.6% (95% confidence interval [CI], 5.4-7.8). The prevalence of vision loss was 11.2% (95% CI, 9.5-13.1) in Indigenous Australians and 6.5% (95% CI, 5.3-7.9) in non-Indigenous Australians. Vision loss was 2.8 times more prevalent in Indigenous Australians than in non-Indigenous Australians after age and gender adjustment (17.7%, 95% CI, 14.5-21.0 vs. 6.4%, 95% CI, 5.2-7.6, P < 0.001). In non-Indigenous Australians, the leading causes of vision loss were uncorrected refractive error (61.3%), cataract (13.2%), and age-related macular degeneration (10.3%). In Indigenous Australians, the leading causes of vision loss were uncorrected refractive error (60.8%), cataract (20.1%), and diabetic retinopathy (5.2%). In non-Indigenous Australians, increasing age (odds ratio [OR], 1.72 per decade) and having not had an eye examination within the past year (OR, 1.61) were risk factors for vision loss. Risk factors in Indigenous Australians included older age (OR, 1.61 per decade), remoteness (OR, 2.02), gender (OR, 0.60 for men), and diabetes in combination with never having had an eye examination (OR, 14.47). Vision loss is more prevalent in Indigenous Australians than in non-Indigenous Australians, highlighting that improvements in eye healthcare in Indigenous communities are required. The leading causes of vision loss were uncorrected refractive error and cataract, which are readily treatable. Other countries with Indigenous communities may benefit from conducting similar surveys of Indigenous and non-Indigenous populations.
Publisher: AMPCo
Date: 09-2017
DOI: 10.5694/MJA17.00057
Abstract: To determine cataract surgery coverage rates for Indigenous and non-Indigenous Australians. National cross-sectional population-based survey. Thirty randomly selected Australian geographic sites, stratified by remoteness. 3098 non-Indigenous Australians aged 50 years or more and 1738 Indigenous Australians aged 40 years or more, recruited and examined in the National Eye Health Survey (NEHS) between March 2015 and April 2016. Participants underwent an interviewer-administered questionnaire that collected socio-demographic information and past ocular care history, including cataract surgery. For those with visual acuity worse than 6/12, anterior segment photography and slit l examinations were conducted. Cataract surgery coverage rates according to WHO and NEHS definitions associated risk factors. Cataract surgery coverage rates calculated with the NEHS definition 1 of vision impairment (visual acuity worse than 6/12) were lower for Indigenous than non-Indigenous participants (58.5% v 88.0% odds ratio [OR], 0.32 P < 0.001). According to the World Health Organization definition (eligibility criterion: best-corrected visual acuity worse than 6/18), coverage rates were 92.5% and 98.9% for Indigenous and non-Indigenous Australians respectively. Greater age was significantly associated with higher cataract surgery coverage in Indigenous (OR, 1.41 per 10 years P = 0.048) and non-Indigenous Australians (OR, 1.58 per 10 years P = 0.004). The cataract surgery coverage rate was higher for non-Indigenous than Indigenous Australians, indicating the need to improve cataract surgery services for Indigenous Australians. The WHO definition of the coverage rate may overestimate the cataract surgery coverage rate in developed nations and should be applied with caution.
Publisher: Wiley
Date: 24-03-2018
DOI: 10.1111/CEO.13188
Abstract: Choroidal nevi are a common incidental finding on fundus examination. The National Eye Health Survey (NEHS, 2015-2016) provides an up-to-date estimate of the prevalence of choroidal nevi in non-Indigenous and Indigenous Australian adults. To describe the prevalence and characteristics of choroidal nevi among non-Indigenous and Indigenous Australian adults. Population-based cross-sectional study. This study included 3098 non-Indigenous Australians (aged 50-98 years) and 1738 Indigenous Australians (aged 40-92 years) living in 30 randomly selected sites, stratified by remoteness. Choroidal nevi were graded from retinal photographs using standard protocols. Prevalence of choroidal nevi. In the non-Indigenous population aged 50 years and over, the weighted prevalence of choroidal nevi was 2.1% (95% CI: 1.4, 3.3). Among Indigenous Australians aged 40 years and over, the weighted prevalence of choroidal nevi was 0.68% (95% CI: 0.4, 1.3). The average maximum diameter, surface area and distance from the disc of the choroidal nevi was 1730 μm, 2 766 800 μm Choroidal nevi were relatively infrequent among NEHS participants, however non-Indigenous Australians had a significantly higher prevalence than Indigenous Australians. Choroidal nevi did not affect visual acuity and the majority were small.
Publisher: Wiley
Date: 30-01-2017
DOI: 10.1111/CEO.12892
Abstract: This paper presents the s ling methodology of the National Eye Health Survey that aimed to determine the prevalence of vision impairment and blindness in Australia. The National Eye Health Survey is a cross-sectional population-based survey. Indigenous Australians aged 40 years and older and non-Indigenous Australians aged 50 years and older residing in all levels of geographic remoteness in Australia. Using multistage, random-cluster s ling, 30 geographic areas were selected to provide s les of 3000 non-Indigenous Australians and 1400 Indigenous Australians. S ling involved (i) selecting Statistical Area- Level 2 sites, stratified by remoteness (ii) selecting Statistical Area- Level 1 sites within Statistical Area- Level 2 sites to provide targeted s les and (iii) grouping of contiguous Statistical Area- Level 1 sites or replacing Statistical Area- Level 1 sites to provide sufficient s les. The main outcome measures involved Sites sites selected and participants s led in the survey. Thirty sites were generated, including 12 Major City sites, 6 Inner Regional sites, 6 Outer Regional sites, 4 Remote sites and 2 Very Remote sites. Three thousand ninety-eight non-Indigenous participants and 1738 Indigenous participants were recruited. Selection of Statistical Area- Level 1 site overestimated the number of eligible residents in all sites. About 20% (6/30) of Statistical Area- Level 1 sites were situated in non-residential bushland, and 26.67% (8/30) of Statistical Area- Level 1 populations had low eligibility or accessibility, requiring replacement. Representative s les of Indigenous and non-Indigenous Australians were selected, recruited and tested, providing the first national data on the prevalence of vision impairment and blindness in Australia.
Publisher: Wiley
Date: 11-09-2020
DOI: 10.1111/CEO.13844
Publisher: Wiley
Date: 16-10-2019
DOI: 10.1111/CEO.13647
Abstract: In Australia, nationally representative data of the burden and associations of severe uncorrected refractive error are scarce. To report the prevalence and characteristics of severe uncorrected refractive error in Indigenous and non-Indigenous Australians. Population-based cross-sectional study. A total of 3098 non-Indigenous Australians aged 50 to 98 and 1738 Indigenous Australians aged 40 to 92 living in 30 randomly selected Australian sites were examined. Severe uncorrected refractive error was defined as an improvement of ≥2 lines on the logMAR chart in one or both eyes in participants with a presenting visual acuity <6/12. Severe uncorrected refractive error RESULTS: Prevalence of severe uncorrected refractive error was 11.0% (95% confidence interval 9.3-13.0) in non-Indigenous and 14.5% (12.5-16.7) in Indigenous Australians. Eighty-two percent of non-Indigenous and 77% of Indigenous participants had a spherical equivalent refraction between -2.00D and +2.00D. Indigenous Australians who were older (odds ratio [OR] for 70-79 years vs 40-49 years = 3.59), resided in outer regional areas (OR = 1.78) and did not have an eye examination in the previous 2-years (OR = 1.50) were associated with higher odds of severe uncorrected refractive error. Geographical remoteness (OR = .68 for inner regional), male gender (OR = 1.30), older age (OR for 70-79 years vs 50-59 years = 1.51) and failure to have an eye examination in the previous 2-years (OR = 2.06) were associated with severe uncorrected refractive error among non-Indigenous participants. Increased public awareness of the importance of regular optometric examinations may be required in groups at high risk of severe uncorrected refractive error.
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.OPHTHA.2017.02.004
Abstract: To determine the prevalence of and factors associated with diabetic retinopathy (DR) among non-Indigenous and Indigenous Australian adults with self-reported diabetes. Population-based cross-sectional study. Non-Indigenous Australians (50-98 years of age) and Indigenous Australians (40-92 years of age) with known diabetes. Diabetes was determined based on self-report of previous diagnosis of the disease. Nonmydriatic fundus photographs were obtained of each eye and graded according to the modified Airlie House classification system. Any DR, vision-threatening DR (VTDR), treatment coverage rates (proportion of participants with proliferative DR [PDR], clinically significant macular edema [CSME], or both who had evidence of retinal scatter and focal laser treatment). Four hundred thirty-one non-Indigenous Australians (13.9%) and 645 Indigenous Australians (37.1%) self-reported diabetes, of whom 93% (1004/1076) had retinal images that were gradable for DR. The s ling weight-adjusted prevalence of any DR and VTDR among non-Indigenous adults with self-reported diabetes was 28.5% (95% confidence interval [CI], 22.6-35.3) and 4.5% (95% CI, 2.6-7.9), respectively. Among adults 40 years of age and older, the s ling weight-adjusted prevalence of any DR and VTDR was 39.4% (95% CI, 33.1-46.1) and 9.5% (95% CI, 6.8-13.1), respectively. Longer diabetes duration was associated significantly with VTDR in the Indigenous Australian population (odds ratio [OR], 1.08 per 1-year increase P = 0.005) and non-Indigenous Australian population (OR, 1.05 per 1-year increase P = 0.03). The treatment coverage of PDR and CSME was 75% (56/75) in Indigenous Australians and 79% (15/19) in non-Indigenous Australians. Diabetic retinopathy was attributed as the main cause of vision loss (<6/12 in the better eye) in 9% and 19% of non-Indigenous and Indigenous Australian adults with known diabetes, respectively. Three quarters of non-Indigenous and Indigenous Australian adults with PDR or CSME have received laser treatment. The prevalence of VTDR in Indigenous and non-Indigenous Australians in the present study was lower than that found in previous population-based reports, nevertheless, approximately 1 in 10 Indigenous adults with known diabetes experience VTDR. This highlights that intensified prevention strategies are required to delay or prevent avoidable vision loss resulting from DR in Indigenous Australian communities.
Publisher: Springer Science and Business Media LLC
Date: 18-08-2017
DOI: 10.1038/S41598-017-09421-9
Abstract: We assessed the validity and reliability of self-report of eye disease in participants with unilateral vision loss (presenting visual acuity worse than 6/12 in the worse eye and equal to or better than 6/12 in the better eye) or bilateral vision loss (presenting visual acuity worse than 6/12 in the better eye) in Australia’s National Eye Health Survey. In total, 1738 Indigenous Australians and 3098 non-Indigenous Australians were s led from 30 sites. Participants underwent a questionnaire and self-reported their eye disease histories. A clinical examination identified whether participants had cataract, age-related macular degeneration, diabetic retinopathy and glaucoma. For those identified as having unilateral or bilateral vision loss (438 Indigenous Australians and 709 non-Indigenous Australians), self-reports were compared with examination results using validity and reliability measures. Reliability was poor for all four diseases (Kappa 0.06 to 0.37). Measures of validity of self-report were variable, with generally high specificities (93.7% to 99.2%) in all diseases except for cataract (63.9 to 73.1%) and low sensitivities for all diseases (7.6% in Indigenous Australians with diabetic retinopathy to 44.1% of non-Indigenous Australians with cataract). This study suggests that self-report is an unreliable population-based research tool for identifying eye disease in those with vision loss.
No related grants have been discovered for Joshua Foreman.