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Importance Epidemiological data on visually significant ocular trauma in the Top End of the Northern Territory. Background: Our main objective is to determine whether Indigenous patients are disproportionately affected by visually significant ocular trauma as compared to non‐Indigenous patients. Design This was a retrospective audit at the Royal Darwin Hospital in the Top End of the Northern Territory during January 2013 to June 2015. Participants: A total of 104 ocular trauma patients were included; 43 were Indigenous and 61 were non‐Indigenous. Methods: Medical records of patients with ocular trauma between January 2013 and June 2015 (except simple, non‐penetrating corneal foreign bodies and abrasions) were reviewed. Vision loss was defined by visual acuity: mild ≥6/18, moderate 6/18‐6/60, severe ≤6/60 following World Health Organization standards. Main Outcome Measures: The study included the incidence of ocular trauma patients by ethnicity (Indigenous vs non‐Indigenous). Our secondary outcome included vision loss, mechanism of injury, open vs closed injury, age, remoteness and alcohol involvement. Results: A total of 104 patient charts were reviewed; 43 (41%) were Indigenous and 61 (59%) were non‐Indigenous. Alleged assault was the greatest contributor to ocular trauma in both groups (74% in Indigenous vs 39% non‐Indigenous). Severe vision loss was more prevalent in the Indigenous vs non‐Indigenous patients (30% vs 16%). Conclusions and Relevance: Indigenous patients were disproportionately affected by visually significant ocular trauma compared to non‐Indigenous patients. This research provides important data on ocular trauma in the Northern Territory. Further prevention strategies are needed to reduce vision loss in this population. [ABSTRACT FROM AUTHOR]

The purpose of this review is to compare the prevalence of diabetic retinopathy ( DR) between Indigenous and non-Indigenous Australians with Diabetes Mellitus ( DM). Australian DR prevalence data from 6 Indigenous studies ( n = 2865) and 5 non-Indigenous studies ( n = 9801) conducted between 1985 and 2013 were included for analysis. Estimated prevalence of any DR among Indigenous Australians with DM was 23.4% compared with 28.9% for non-Indigenous Australians (χ2 = 26.9, P < 0.001). In studies performed after 1990, a significantly higher rate of diabetic macular edema was found in Indigenous compared with non-Indigenous Australians with DM (7.6% versus 4.9%, χ2 = 6.67, P = 0.01). Although there are limitations in comparing these studies, one explanation for the observed data could be a model in which Indigenous Australians are relatively resistant to early stage DR, but with a subset progressing to sight threatening DR due to individual genetic and environmental susceptibility factors coupled with poor glycemic control. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence and associations of blinding trachoma within the indigenous Australian population living in central Australia. Methods: A total of 1884 individuals aged 20 years or older, living among 30 remote communities within the statistical local area of ‘Central Australia’, were recruited for this study. This equated to 36% of those aged 20 years or older and 67% of those aged 40 years or older within this district. Participants were recruited as they presented to the eye clinic at each remote community. Anterior segment examination was performed and the rates of trachomatous trichiasis (TT) and trachomatous corneal opacification (CO) were documented. The prevalence of TT and CO in one or both eyes was presented. Results: There were 6.1% (95% CI 5.0–7.2) (8.3% of those aged 40 years or older) who had TT and 3.3% (95% CI 2.5–4.1) (4.4% of those aged 40 years or older) who had CO. Both TT and CO were associated with advancing age and female sex. Prevalence varied widely between communities, from 0% to 33% for TT and 0% to 27% for CO. Conclusion: Our study has shown that blinding trachoma remains endemic among indigenous Australians in central Australia. However, compared with previous estimates, the prevalence of TT and CO appears to be decreasing. [ABSTRACT FROM AUTHOR]

Background: Aboriginals and Torres Strait Islanders form a significant proportion of the population in far north Queensland and are at increased risk for many eye conditions. This study describes the pattern of fungal keratitis seen at Cairns Base Hospital, far north Queensland, Australia. Methods: A retrospective review of all cases of culture positive fungal keratitis presenting between 1998 and 2008. The records of 17 patients were reviewed for epidemiological, risk factor, microbiological, treatment and outcome data. Results: The study included 16 eyes from 16 patients. Five (31.25%) patients were of Aboriginal and Torres Strait Islander descent. Pre-disposing factors were ocular trauma ( n = 7) and contact lens wear ( n = 3). No patients were on topical steroids at presentation. All patients grew filamentous fungi with Fusarium the most common isolate (50%). Aspergillus, Curvularia and Lasiodiplodia theobromae were the next most common accounting for two cases each. Two patients developed corneal perforations, whereas two required penetrating keratoplasty and one required evisceration. Eight patients had a visual acuity of 6/18 or better at presentation and this increased to 13 patients at final follow up. Conclusions: A significant proportion of the patients presenting to Cairns Base Hospital with fungal keratitis are Indigenous. The very high percentage of cases due to filamentous fungi is similar to other tropical regions of the world. The very low rates of Candida infection and steroid use prior to presentation are in contrast to studies from temperate areas such as Melbourne and Philadelphia. [ABSTRACT FROM AUTHOR]