NAIDOC Week: Strengthening eye health equity for Aboriginal and Torres Strait Islander communities

Eye health: a preventable burden with systemic roots 

Eye disease remains one of the most common long-term health conditions reported by Aboriginal and Torres Strait Islander peoples. 

More than one in three people report an eye or sight problem, and the burden increases significantly with age. 

But here’s the critical point: most vision loss is preventable or treatable when care is accessible early. 

Among First Nations people aged 50 and over, the latest national data shows: 

• Around 11% experience bilateral vision impairment
• Around 0.2–0.4% experience blindness
• The leading causes of vision loss are uncorrected refractive error (38%), cataract (34%) and diabetic retinopathy (15%) 

These are conditions that are largely manageable. The gap isn’t just clinical; it’s structural. 

Where the system is breaking down 

Despite the clear need, access to routine eye care is not evenly distributed. 

In 2023–24: 

• Approximately 14% of Aboriginal and Torres Strait Islander people had an initial eye examination by an optometrist or ophthalmologist
• Around 25–27% received an annual health assessment, which may include an eye check 

At the same time, diabetic eye disease remains a major concern.  

While screening is improving, fewer than half of those tested for diabetes received recommended eye screening in earlier reporting periods, showing persistent gaps in integrated chronic disease care. 

These numbers matter because eye disease often progresses silently. By the time symptoms appear, damage can already be permanent. 

Progress is real, but uneven 

There are strong signs that targeted investment and outreach programs are working. 

Recent improvements include:

• Increased rates of cataract surgery over time
• Better access to optometry through outreach programs
• Improvements in diabetic retinopathy screening coverage
• Growth in visiting eye care services delivered to rural and remote communities 

Government-supported initiatives such as the Visiting Optometrists Scheme are helping bring services closer to the community, particularly in rural and remote areas where access has historically been limited. 

Additionally, trachoma, once a major cause of preventable blindness, was recognised by the World Health Organisation (WHO) as having reached elimination status as a public health problem in Australia earlier this year.  

While isolated cases may still occur, the milestone represents a significant achievement for the health and wellbeing of Aboriginal and Torres Strait Islander Peoples. 

Eye health equity means access, not just availability 

Improving eye health outcomes isn’t just about having services exist on paper. It’s about whether people can realistically access them safely. 

That means: 

• Services delivered closer to home
• Culturally safe and responsive care environments
• A health system free from all forms of racism
• Co-designed with community through trusted, long-term partnerships
• Integration between primary care, optometry and chronic disease services 

The Department of Health, Disability and Aging highlights outreach programs and subsidised equipment such as retinal cameras as key mechanisms to reduce inequity in access. 

But equity is not a single program. It’s a system design challenge. 

Removing cost, distance and system complexity as eye care barriers 

Access to eye care is shaped by more than geography.  

The out-of-pocket cost of appointments and glasses, travel distances, navigating the healthcare system and finding culturally safe services can all influence when and how people seek care. 

Across Australia, initiatives such as subsidised spectacle schemes are helping to remove some of these barriers by making affordable glasses more accessible for Aboriginal and Torres Strait Islander peoples.  

Alongside outreach services, community-controlled healthcare and locally led models of care, these programs are helping more people access the eye care they need, closer to home. 

Reducing barriers to care means more people can receive timely support, protect their vision and stay connected to family, culture, education and work.

Why early eye care matters 

Many eye conditions develop gradually over time and are shaped by a range of factors, including access to healthcare, the long-term impacts of colonisation and the broader social determinants of health. 

Conditions such as diabetes-related eye disease, cataract and uncorrected refractive error can lead to vision loss when barriers make it difficult for people to access timely, culturally safe care and regular eye checks. 

Early, accessible and community-led eye care can make a profound difference.  

It can help protect sight and support people to stay connected to education, employment, culture, family and community, and to continue living life on their own terms.

What good equitable eye health looks like 

A more equitable eye health system looks like: 

• Earlier detection, not later intervention
• Consistent access to optometry regardless of postcode
• Eye health initiatives led by Aboriginal Community Controlled Health Organisations
• Prevention built into routine primary care
• People not having to navigate complexity to get basic vision support 

Because no one should lose vision from something that could have been prevented or treated.