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Building an eye care program with
Aboriginal communities in Victoria –
a partnership approach
Genevieve Napper1 and Cheryl Vickery 1
Kulan Barney2, Jimi Peters2, Mitchell Anjou3, Tim Fricke1,4, Jonathan Jackson1,4,
Indigenous Allied Health Alliance Annual Conference November 2013 Adelaide
1. Australian College of Optometry, 2. Victorian Aboriginal Community Controlled Health Organisation (VACCHO), 3 Indigenous Eye Health Unit, Melbourne School
of Population Health, University of Melbourne, 4. Department of Optometry and Vision Sciences, University of Melbourne
Partners
Eye Health in Aboriginal communities
• Blindness and vision impairment are 6.2 times and 2.8 times,
respectively, more prevalent in adult Aboriginal Australians than in
the non-Aboriginal Australians
• 35% of adult Aboriginal people have never had an eye examination
• Main causes of vision loss in Aboriginal Australians are refractive
error and presbyopia, cataract, and diabetic eye disease
• 39% of Aboriginal adults can not see
normal sized print
• 94% of vision loss
is preventable or
treatable
Taylor HR et al (2009) National Indigenous Eye Health Survey, Minum Barreng (Tracking Eyes). Melbourne, Indigenous Eye Health Unit, Melbourne School of Population Health in
collaboration with CERA and Vision CRC (ISBN 978-0-7340-4109-8)
Australian Institute of Health and Welfare 2011. Eye health in Aboriginal and Torres Strait Islander people. Cat. no. IHW 49. Canberra: AIHW
Holden BA et al (2008) Global vision impairment due to uncorrected presbyopia. Archives of Ophthalmology 126(12):1731-9
Building an eye care program – strategies
Aim – to reduce avoidable blindness and vision loss for Aboriginal communities
•Reducing barriers to accessing eye care services that Aboriginal communities
experience (geographic access difficulties, lack of culturally appropriate services,
costs) – accessible, available, affordable, acceptable services
•Increasing locations and settings for optometry services for Aboriginal
communities across Victoria – urban and rural
•Increased number of eye examinations linked with the introduction of the Victorian
Aboriginal Spectacle Subsidy Scheme (VASSS)
•Partnerships with other organisations – working with Aboriginal Community
Controlled Health Organisations (ACCHOs), Government, Eye Health
Organisations, Community (Aboriginal Liaison Officer)
•Developing a workforce of optometrists – current and future
Developing an optometry workforce
17 optometrists at the ACO work regularly with Aboriginal Communities
-Victorian Aboriginal Health Service (VAHS) Fitzroy 1998 -
-outer suburban Aboriginal Health Services (Bunurong Dandenong and Western Suburbs
Indigenous Gathering Place Maidstone)
-Indigenous access programs at Braybrook, East Preston and Frankston
-Visiting Optometry Scheme in rural Victoria – 13 ACCHOs
-Community work at schools and community health promotion events
-Northern Territory work with Brien Holden Vision Institute
• clinical skills in a range of community settings, specialist skills in paediatrics,
ocular disease/therapeutics, low vision, education. Experienced and younger
optometrists
• cultural training, peer support and education, community interaction and
learning/exchange
The Victorian Aboriginal Eye Health Committee
• Victorian statewide Aboriginal eye health committee
established 2010 drawing together key government and
non-government stakeholders
• key stakeholders: Vic Govt Department of Health
Aust Govt Department of Health
VACCHO
Australian College of Optometry (ACO)
Indigenous Eye Health Unit Uni of Melb
Vision 2020 Australia
Royal Victorian Eye and Ear Hospital (RVEEH)
Victorian Aboriginal Health Service (VAHS)
RANZCO
Vision Australia
VACKH Aboriginal Eye Health Strategy
• Koolin Balit – the Victorian Government Strategic
Directions for Aboriginal Health 2012 - 2022
• 3 projects 2010 – 2013 -VACCHO Eye Health Project Officer
-Patient pathway co-ordinator Eye and Ear Hospital
-Funding to ACO to run the Victorian Aboriginal Spectacle Subsidy Scheme
(VASSS); appointment ACO ALO Nov 2012
• Eye Health initiatives within Koolin Balit 2013 – 2017-VACCHO Eye Health Project Officer
-Victorian Aboriginal Spectacle Subsidy Scheme and ACO ALO
-additional support to regions for eye health projects, including increased
support for co-ordination and patient pathway support
Planning and Projected Needs for eye care services - Victoria
Optometry days per year Victoria (all regions) 801
Glasses required per year Victoria (all regions) 2412
Also: ophthalmology services for cataract and diabetic retinopathy, hospital
services, co-ordination time (bookings, patient pathway support, transport)
IEHU September 2012
Closing the Eye Health Gap in Victoria
In 2010 the VACKH introduced a spectacle subsidy scheme, continued for 2013 –
•Victorian Aboriginal Spectacle Subsidy Scheme (VASSS) makes glasses
available for all members of Victorian Aboriginal communities for $10 (once
every two years). Includes an expanded range of frames endorsed by
Aboriginal community elders.
4056 pairs of glasses prescribed under the subsidy in 2010 – 2013
• 2013 - 2017 aiming to provide 1425 pairs of glasses each year (5700 over 4 years)
Evaluation of VASSS conducted by DH Vic in 2012 indicated positive impact
Eye Health section included in Koolin Balit – Strategic Directions
for Aboriginal Health 2012 - 2022
1/ 09/ 11 2:10 PMGoogle Maps
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ACCHO locations only (GOAL IS TO HAVE NONE OF THESE)
ACCHO locations with VOS/ACO services
ACCHO locations with VOS and local practices offering scheme
ACCHO locations with local practices offering scheme
Practice offering scheme with no local ACCHO
Optometry service locations in Victoria
ACCHO locations with optometry services
In 2012 eye care services are available at 19 (of 26) ACCHO sites and via VES
practitioners offering the VASSS at 22 mainstream sites
Victorian Aboriginal Health Services (Fitzroy) – optometry clinic opened 1998
Mildura Aboriginal Health Service – local VES optometrist visits since 1998
Rumbalara (Shepparton) – local VES optometrist visits since mid 90s
Expanded metropolitan services ACO 2010
Bunurong; Western Suburbs Indigenous Gathering Place; Billabong BBQ; community
events, youth services and schools
Visiting Optometry Scheme (VOS)
2009 – Lake Tyers, Orbost
2011 – Mildura, Robinvale, Dareton (NSW), Swan Hill, Echuca
2012 – Bairnsdale, Sale, Morwell, Heywood, Framlingham/Wangoom,
Halls Gap, Wodonga
Local optometry networks
Portland, Warrnambool, Horsham
Inner regional
-Bendigo, Ballarat, Geelong
-Healesville
Eye examinations at Aboriginal Health Services showing an
increase with introduction of spectacle subsidy
0
100
200
300
400
500
600
700
800
VOS funding from July
2009VASSS funding from
July 2010
Partners
ACO has focused on developing partnerships and collaborations in building services:
•Victorian Aboriginal Community Controlled Health Organisation (VACCHO)
•Aboriginal Health Services across Melbourne and Victoria; including elders and community
members; Victorian Aboriginal Childcare Agency
•Department of Health Victoria – Aged Care and Aboriginal Health Branch
•Victorian Advisory Council on Koori Health (VACKH) Eye Health committee
•Visiting Optometry Scheme (VOS) funded by Commonwealth Department of Health
•Medicare Australia
•Royal Victorian Eye and Ear Hospital (RVEEH)
•Vision 2020 Australia Aboriginal Eye Health committee
•Participating private optometrists in rural Victoria; Victorian Eyecare Service (VES)
•Optometrists Association Australia (OAA) ATSI Eye Health and Vision Care working group
•Indigenous Eye Health Unit (IEHU) University of Melbourne; Optometry Department
•Brien Holden Vision Institute (formerly ICEE) – NT
•Memberships: Indigenous Allied Health Alliance, Weenthunga Health Network (Vic)
Continuing Challenges and Future Directions
•Identify gaps in services for metropolitan and rural Aboriginal communities and expand services to
meet population needs – address funding gaps
•Improve co-ordination of eye care services along patient pathway
•Identify and implement strategies to ensure timely attendance for surgical and laser treatment of eye
diseases
•Achieve greater integration with local ophthalmology and hospital services
•Achieve greater integration with primary health services and health workers at ACCHOs and
greater integration with diabetes/chronic disease programs; Medicare Locals and Department of
Health Regions
•Continue to diversify service sites and settings to improve access
•Increase community and health worker education about eye care
•Enhance existing partnerships and establish new partnerships
•Increase community participation in service development and service delivery
•Close the Gap for Vision
Meeting the needs of communities
Working towards more Indigenous Optometrists
