Eye health measures for Aboriginal and Torres Strait Islander people 2025

This is the ninth annual Eye health measures for Aboriginal and Torres Strait Islander people report. The measures in these annual reports were developed to provide an evidence base to monitor changes in eye health among Aboriginal and Torres Strait Islander (First Nations) people over time and their use of eye health services.

This report includes the latest available data for each measure where possible. The 2016, 2017 and 2018 editions of the report presented data for 23 measures; however, data stopped being collected for 1 measure. Of the 22 measures with ongoing data collections, 11 have sub-measures. In total, this 2025 edition of the report contains 37 measures and sub-measures, 35 of which have been updated. Of the 35 measures that have been updated, Trend data for 20 of these measures and sub-measures are presented in Table 2.

• 7 measures or sub-measures appear to be improving.
• 3 measures or sub-measures appear to be worsening.
• 7 measures or sub-measures have updated data but show no change or no clear trend over time.
• 3 measures have updated data but it is not possible to determine if changes represent an improvement or not. For example, an increase in hospitalisations for eye diseases could be interpreted as an increase in disease rates or an increase in treatment rates.

Prevalence

With the release of the Australian Eye and Ear Health Survey (AEEHS) results, updated data now available for all three prevalence measures.  The sub-measure for trachoma (1.3.1) shows improvement over time. However, trichiasis sub-measure (1.3.2) does not include time trend data due to changes in the way it has been assessed over time.

• The prevalence of bilateral vision impairment for First Nations people aged 50 and over was 11% and the prevalence of bilateral blindness was 0.2%, based on the latest available AEEHS data 2022–25 (combined vision impairment and blindness affected 11.2% of those First Nations participants). 
• The 3 leading causes of vision impairment and blindness (vision loss) for First Nations people aged 50 and over were uncorrected refractive error (38%), cataract (34%) and diabetic retinopathy (15%). 
• Repeated trachoma infections can result in scarring, in-turned eyelashes on the upper eyelid (trachomatous trichiasis, referred to as trichiasis in this report) and blindness. The overall prevalence of trachoma among children aged 5–9 fell from 15% in 2009 to 1.5% in 2024. 

Diagnosis and screening

• Four of the 5 diagnosis and screening measures have updated data. Of these, both sub-measures of measure 2.1 (annual health assessments for First Nations people), and 1 of the 3 sub-measures of measure 2.3 (screening for diabetic retinopathy) appear to have improved over the reporting years. Data for measure 2.2 (eye examinations by an eye care specialist) and sub-measure 2.3.3 (Screening for diabetic retinopathy with a retinal camera) do not show change or a clear trend over time. Time trend data for both sub-measures of measure 2.4 (trachoma and trichiasis screening) is not presented due to changes in how the sub-measures have been assessed over time.
• In 2023–24, 25% (259,941) of First Nations people had an annual health assessment that should have included an eye health check. The age-specific proportion of First Nations people who had a health assessment slightly increased from around 20%–24% in 2016–17 for all age groups up to age 44 years to around 20%–25% in 2023–24.
• In 2023–24, 14% of First Nations people (147,517) had an initial eye examination by an optometrist or ophthalmologist.
• Diabetic retinopathy is a complication of diabetes which can result in vision loss if not detected and treated early. An estimated 31,927 First Nations people had a diabetes test in the previous 2 years. Of these,15,937 (50%) also had an eye examination in 2023–24.

Treatment

Updated data are available for all 10 treatment measures. Of these, measure 3.4 (cataract surgery) appears to have improved over the reporting years, while all 4 sub-measures of measure 3.6 (waiting times for elective cataract surgery) appear to have worsened. Data for both sub-measures of measure 3.7 (treated for diabetic retinopathy) show no change or no clear trend over time. It is not possible to determine if changes are improvements or not for measures 3.1 (diseases), 3.2 (injuries) and 3.3 (procedures). Time trend data for both sub-measures of measure 3.8 (trachoma and trichiasis treatment) are not presented due to changes in how the sub-measures have been assessed over time.

• In 2022–24, among First Nations people, there were 9,671 (4,736 per 1,000,000 population) hospitalisations for cataract surgery. Between 2016–17 and 2023–24, the age‑standardised rate for cataract surgery for First Nations people rose from 6,530 to 8,849 per 1,000,000.
• In 2022–24, among First Nations people, there were 15,461 (7.6 per 1,000 population) hospitalisations for diseases of the eye and around 14,920 (7.3 per 1,000) hospitalisations for eye procedures.
• In 2024, trachoma treatment coverage was 54% – that is, 1,674 active cases, household and community contacts received treatment. Treatment coverage for active cases detected in screening activities was 96%. 
• In 2023–24, 21,977 pairs of spectacles were dispensed to First Nations people under state spectacle schemes by New South Wales, Victoria, Queensland, South Australia and Tasmania (the states and territories able to provide data). Of these, Victoria (3,742 spectacles, 46 per 1,000 population) came closest to meeting the estimated number of spectacles needed among First Nations people (5,302) – with 71% of the population-based need met.

Workforce and outreach

Three of the 4 workforce and outreach measures have updated data. Of these, measure 4.1 (optometrists) appears to have improved over the reporting years. Data for measures 4.2 (ophthalmologists), 4.3 (allied ophthalmic personnel) and 4.4 (outreach and other programs) show no change or no clear trend over time. Data for the 5 sub-measures of measure 4.4 are mixed. Some sub-measures appear to show improvement over time while others seem to be worsening. Trends should be interpreted with caution, however, as jurisdictions may elect to use different outreach programs for eye services depending on their needs.

• In 2023, 6,275 optometrists were employed in Australia (21 full-time equivalent [FTE] per 100,000 total Australian population). The numbers and rates of optometrists were lowest in Remote and Very remote areas.
• In 2023, 1,004 ophthalmologists were employed in Australia (3.9 FTE per 100,000 total Australian population).
• The number of occasions of service provided under the Visiting Optometrist Scheme – which provides specialist eye health services to First Nations people in mainly regional and remote areas – has fluctuated; however, overall, First Nations services increased between 2014–15 (18,890 occasions of service) and 2023–24 (31,534 occasions of service).

Comparison with non-Indigenous Australians

• Between 2016–17 and 2023–24, the total age-standardised proportion of the First Nations population who had an eye examination was relatively stable, around 19%, while the equivalent proportion for non-Indigenous Australians rose from 23%–27%.
• Between 2013–14 and 2023–24, the total age-standardised proportion of First Nations people tested for diabetes who had an eye examination rose from 35%–43%, while for non-Indigenous Australians it rose from 39%–48%.
• In 2023–24, the age-standardised hospitalisation rate for First Nations people for cataract surgery (8,849 per 1,000,000 population) was lower than that for non-Indigenous Australians (9,204 per 1,000,000). 
• In 2023–24, the proportion of First Nations people who had elective cataract surgery and were treated within 90 days (39%) was less than the proportion of non-Indigenous Australians who were treated within this time (43%).
• In 2023–24, the average days waited by First Nations people before receiving cataract surgery was 180 days, while the average for non-Indigenous Australians was 158 days.