Summary

  1. Visual impairment is an important health issue facing the present and future generations of older Australians because it can affect physical, functional, emotional and social wellbeing, and reduce quality of life.
  2. The main aim of this bulletin is to present the most reliable, robust and up-to-date estimates of the prevalence major vision problems among older Australians. The prevalence of vision problems among Aboriginal and Torres Strait Islander peoples is also reported. These estimates are important for use in planning prevention and treatment interventions. The bulletin also presents estimates from the range of Australian data sources available and reports on a number of data quality issues.
  3. The term 'older Australians' is used in this bulletin to describe people aged 55 or more. This is the age when there is a significant increase in the prevalence of a number of chronic conditions including vision impairment.
  4. About 444,400 Australians aged 55 or more are visually impaired, which represents 9.4% of the 4.7 million Australians in that age group (Table 1). The major eye diseases that cause visual impairment in Australia are age-related macular degeneration (AMD), cataract, glaucoma and diabetic retinopathy. Together with uncorrected refractive error (URE), they contribute to over 90% of visual impairment among older Australians.

Table 1: Prevalence of visual impairment by primary cause in Australians aged 55 or more, 2004

  Number Rate (%)  
Visual impairment 444,400 9.4  
Visual impairment by primary cause   Distribution (%) Distribution (%)
excl. URE
Cataract 73,000 16 40
Age-related macular degeneration 51,500 12 28
Glaucoma 14,100 3 8
Diabetic retinopathy 7,400 2 4
Other 36,000 8 20
Uncorrected refractive error (URE) 262,400 59  
Total 444,400 100 100

Notes

  1. The primary cause of visual impairment was determined where 2 or more disorders were present.

  2. Visual impairment was defined as visual acuity < 6/12 (see glossary). It included blindness.

  3. URE can be corrected by eyewear and includes presbyopia, hyperopia, myopia and astigmatism.

Source: Based on data from MVIP and BMES (see Box 1).

 

  1. Cataract is the primary cause of 40% of cases of visual impairment in older Australians and AMD the primary cause of 28%, if refractive error is excluded (Table 1).
  2. About 56,100 (1.2%) older Australians are blind, and age-related macular degeneration, glaucoma and cataract are the most common causes (Table 2).

Table 2: Prevalence of blindness by primary cause in Australians aged 55 or more, 2004

  Number Rate (%)
Blindness 56,100 1.2
Blindness by primary cause   Distribution (%)
Cataract 6,600 12
Age-related macular degeneration 28,300 50
Glaucoma 9,200 16
Other 12,000 21
Total 56,100 100

Notes

  1. The primary cause of blindness was determined where 2 or more disorders were present.
  2. Blindness was defined as visual acuity < 6/60.

Source: Based on data from MVIP and BMES (see Box 1).

 

  1. Of the eye diseases that cause visual impairment, cataract is the most prevalent in the population followed by age-related macular degeneration, diabetic retinopathy and glaucoma (Table 3).
  2. Nevertheless, a substantial number of older Australians (about 491,900) have early age-related maculopathy, which usually carries no symptoms, and are at risk of developing age-related macular degeneration and, consequently, visual impairment (Table 3).

Table 3: Most prevalent eye diseases in Australians aged 55 or more, 2004

Eye diseases Number Rate (%)
Age-related macular degeneration 3.1 147,000
Early age-related maculopathy 10.4 491,900
Total age-related maculopathy 13.5 638,900
Cataract 31.0 1,460,400
Glaucoma 2.3 109,300
Diabetic retinopathy 2.8 133,900

Source: Based on analysis of clinical data from various data sources (see 'Overview of data sources').

 

  1. Presbyopia, an age-related vision disorder that is generally considered a natural part of ageing, affects the sight of 1.3 million older Australians (based on self-report). It contributes to the prevalence of refractive error in this population.
  2. Visual impairment and its causes are strongly related to age. Prevalence rates for both visual impairment and blindness are markedly greater among older age groups as are rates of major sight-threatening eye conditions (see Figure 2). With the ageing of the population, the number of older people with vision problems will increase over future decades, if prevalence rates remain constant.
  3. The limited data on vision problems among Aboriginal and Torres Strait Islander peoples suggest that diabetic retinopathy and trichiasis (in some communities) are important vision-threatening conditions for older Indigenous Australians. There are no authoritative data for the prevalence of cataract, AMD and glaucoma among older Indigenous Australians.
  4. Although there are sufficient data on which to plan interventions, there is a need for an effective and efficient monitoring system for vision problems that uses standard methods and indicators. The system would need to take into account the particular needs for data about the eye health of Indigenous Australians.