title: Incidence of visual impairment due to cataract, diabetic retinopathy and trachoma in indigenous Australians within central Australia: the Central Australian Ocular Health Study.
abstract: BACKGROUND
  To estimate the incidence and causes of visual impairment for the purposes of service provision among the indigenous Australian population within central Australia from its most common causes, namely cataract, diabetic retinopathy and trachoma.
  
  
  METHODS
  Clinic-based cohort study.
  
  
  METHODS
  One thousand eight hundred eighty four individuals aged ≥20 years living in one of 30 remote communities within the statistical local area of 'Central Australia'.
  
  
  METHODS
  From those initially recruited, 608 (32%) participants were reviewed again between 6 months and 3 years (median 2 years). Patients underwent Snellen visual acuity testing and subjective refraction. Following this, an assessment of their anterior and posterior segments was made. Baseline results were compared with those who were reviewed.
  
  
  METHODS
  The annual incidence rates and causes of visual impairment (vision worse than Snellen visual acuity 6/12 in at least one eye).
  
  
  RESULTS
  The incidence of visual impairment in at least one eye was 6.6%, 1.2% and 0.7% per year for cataract, diabetic retinopathy and trachoma, respectively (7.9%, 1.5% and 0.7% per year for those aged ≥40 years). Advancing age was the main risk factor common to all three.
  
  
  CONCLUSIONS
  It is important to be mindful not only of the prevalence of disease in a community but also of the rate at which new cases are occurring when allocating resources to address the ocular health needs of this region. Compared with historical data, diabetic retinopathy is emerging as a new and increasing threat to vision in this population.
authors.affiliation: Department of Ophthalmology, Flinders Medical Centre, Adelaide, South Australia. john.landers@bigpond.com
authors.forename: John
authors.initials: J
authors.lastname: Landers
authors.forename: Tim
authors.initials: T
authors.lastname: Henderson
authors.forename: Jamie E
authors.initials: JE
authors.lastname: Craig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000208:ethnology*; D015331:Cohort Studies; D003930:Diabetic Retinopathy / Q000208:ethnology*; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015876:Northern Territory / Q000453:epidemiology; D012029:Refraction, Ocular / Q000502:physiology; D012424:Rural Population; D014141:Trachoma / Q000208:ethnology*; D014786:Vision Disorders / Q000208:ethnology* / Q000209:etiology; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*; D055815:Young Adult