1. RACGP Conference GP15
22 September 2015
Melbourne
Diabetic eye disease in Indigenous Australians: what GPs can do to help close the gap
Kelly Jones, Mitchell Anjou, Peggy Chiang, Carol Wynne and Hugh Taylor
The University of Melbourne

2. to Close the Gap for Vision for Indigenous Australians
established in 2008
led by Professor Hugh Taylor
total 12 staff
funded by Harold Mitchell Foundation, Ian
Potter Foundation, Greg Poche, other private
donors and now Commonwealth Government
our goal…
to Close the Gap for Vision for Indigenous Australians

3. National Indigenous Eye Health Survey 2008
Vision Loss in Children
One fifth as common as in mainstream
Vision Loss in Adults
Blindness is 6 times more common
Low Vision is nearly 3 times more common
Causes of Blindness in Adults
32% Cataract
14% Refractive Error and Optic Atrophy
9% Trachoma and Diabetic Eye Disease
Overall 94% of Vision Impairment is avoidable
…and 35% have never had an eye exam

4. We know what we need to do…
Implement the SAFE Strategy
If VA is <6/12 or impaired function refer for assessment
Ensure provision of surgery
Retinal assessment for those with diabetes (every 12 months)
Ensure provision of laser treatment
Screening for VA (near and distance vision)
Ensure provision of spectacles
Trachoma Cataract Diabetes Refractive Error

5. 42 Roadmap recommendations
The Roadmap Launched 23 February 2012
42 Roadmap recommendations
Cataract – 35/42 recommendations
Refractive error – 34/42
Diabetic retinopathy – 35/42
Trachoma – 37/42

6. 2025
34,000
2010
- No coherent plans
- Incomplete programs
- Status quo
- Commitment and leadership
- Roadmap fully implemented
- Coherent, sustainable
2,000
15,000
Number of Blind and Visually Impaired Indigenous Australians ✗ ✔

7. The Importance of Diabetes in Eye Care

8. adults and older people
MBS mandatory eye checks in Health Assessments for Aboriginal and Torres Strait Islander
adults and older people
history to include ‘vision’
examination/assessment
to include ‘eye examination’

9. What to check
…Vision and eye examinations in MBS Aboriginal and Torres Strait Islander health assessments…
Problem with vision or eyes?
Visual acuity (near and distance)
People with diabetes require
annual retinal exam
Trichiasis

10. Diabetes Retinal Examination
At diagnosis of diabetes
Every 12 months for people with diabetes
Ophthalmoscopy (dilated fundoscopy, retinal photography)
Refer to optometrist or ophthalmologist
Not more than one year without examination

11. Essential elements in regional implementation
Implementation resources
Essential elements in regional implementation
Establish regional stakeholder group
Assess existing services (data sharing) and estimate gap
Develop regional service directory
Establish and confirm clinical pathways
Identify coordination roles
Stakeholders determine regional action plan and priorities
Regular data collection and reporting

13. Draft Health Promotion Material
Grampians
Need to promote annual eye exams for those with diabetes
Community knowledge, clinic staff knowledge
Need to build through community involvement and ownership
Develop appropriate materials and strategies
Consultations underway –
Grampians, Kimberley, Western Sydney.
National workshop in June 2015

14. …and so close the gap for vision
We now have the evidence, strategy and capacity to eliminate unnecessary vision loss for Indigenous Australians… We are looking for the support of primary care to identify and manage eye health… We need concerted government commitment to implement the Roadmap across Australia…
…and so close the gap for vision