Near-vision impairment and unresolved vision problems in Indigenous Australian adults

Background:  To describe near-vision impairment, self-reported unresolved vision problems and barriers to having near-vision correction in Indigenous Australians. Design:  A nationwide population-based study designed to determine the causes and prevalence of vision loss and utilization of eye care services. Participants:  Indigenous Australians aged ≥40 years. Methods:  Using a multistage random cluster sampling methodology, 30 geographical areas stratified by remoteness were selected to obtain a representation of Indigenous Australians. Visual acuity was conducted using a standard E chart. A questionnaire collected data on eye health, eye care service utilization and vision-related quality of life. Main Outcome Measures:  Near-vision impairment defined as presenting binocular near visual acuity < N8. Self-reported unresolved vision problems defined as anything considered an eye/vision problem by the participant, including distance and/or near-vision impairments, not resolved after seeking care and quality-of-life scores. Results:  Being aged 50–59 years (reference group 40–49 years), speaking a language other than English at home and vision loss (distance vision impairment and blindness) increased the odds of near-vision impairment. Of those with near-vision impairment, 37% (175/468) reported not having near-vision correction. Being aged 60–69 years, speaking a language other than English at home and having vision loss decreased the odds of having near-vision correction. Longer time since last consultation was associated with unresolved vision problems and worse quality-of-life scores. Conclusion:  There remains a large unmet need in regard to near-vision correction. Many Indigenous adults have unresolved vision problems that could be resolved with regular consultations with eye care services.