by Lucy Goodman | 12 Aug, 2024 | Pacific Islands, Resources
Key messages
Delivering eye health services in the Pacific Islands is challenging due to the remote location, susceptibility to the impacts of climate change, and economic instability. To direct future eye health research, we have reviewed all available evidence describing eye health in the Pacific Islands since 1980. The report illustrates that not enough research is available describing the prevalence of common eye conditions or service coverage in the Pacific islands, which makes it difficult to plan new eye care services.
Read the published report here.
Below is a Q&A with co-authors Dr Lisa Hamm, Dr Iris Wainiqolo, and A/Prof Jacqueline Ramke on their recently published report.
What was the question you were hoping to answer?
Our aim was to summarise all the research about eye health in the Pacific Islands since 1980. We wanted to know what research topics have been investigated, where they were conducted, and who was involved in funding. We were also interested in whether any of these variables have changed over time. Fundamentally, we hoped that this review would highlight the gaps and guide the future direction of the research.
What is the most important finding from this research?
Our review speaks to the wider issues faced by eye care providers and policy makers who are attempting to strengthen research capacity in the Pacific Islands. We observed that previous research about eye health in this region is influenced by external funders and researchers and does not correlate well with the eye conditions that are most important for people living in the Pacific Islands.
Why was it important to do this research?
Good eye health has many benefits for the well-being of individuals and society and underlies many of the United Nation’s Sustainable Development Goals. To support these goals, individual countries need as much information as possible describing the eye health needs of their population so that they can plan and deliver better eye care services.
Unfortunately, delivering eye health services in the Pacific Islands is challenging due to the remote location, susceptibility to the impacts of climate change, and economic instability. Without the infrastructure in place, the direction of future eye health research remains unclear. By identifying the gaps in our knowledge, we see this review as the first step towards improving eye health in the Pacific islands.
What research did you find describing eye health in the Pacific Islands?
Unfortunately, there is limited up-to-date research describing the prevalence of common eye conditions or service coverage in the Pacific islands, which makes it difficult to plan new eye care services. The lack of high-quality data (e.g. population-based prevalence studies) was notable.
The research we identified was mainly concentrated on Papua New Guinea, Fiji, and Vanuatu, although reported funding sources were most often from New Zealand, Australia, or the United States, illustrating the need to expand research infrastructure in the Pacific Islands.
What does this research say about the future of eye health in the Pacific?
Research in the Pacific Islands has evolved over the past ~40 years from small prevalence studies to larger externally funded research on specific eye conditions (that may not reflect local research priorities). Considering the economic challenges that limit financial investment into research, future research should be chosen strategically to fill the knowledge gaps identified from this report. Importantly, improving eye health in the Pacific islands will rely on first strengthening research leadership in the region so that Pacific Peoples can set their own research priorities.
Citation: Hamm LM, Wainiqolo I, Pant N, et al. Research about eye health and eye health services in Pacific Island Countries and Territories: a scoping review. The Lancet Regional Health – Western Pacific. 2024; 50:101152. doi: 10.1016/j.lanwpc.2024.101152
by Lucy Goodman | 10 Jul, 2024 | Children
New Zealand children are offered publicly funded vision screening services when they begin school (via the nationwide
B4 School Check service) and again in Year 7 (ages 11-12, as part of the Well Child Tamariki Ora Programme). While these screening services are good at identifying children with certain types of eye problems, we know that many children pass these screening tests and go attend school with undiagnosed vision problems. Some children also do not receive vision screening. We are addressing this problem within our teaching and research, by
providing additional screening services to schools, and
conducting research to identify how the current school screening services could be improved
Our school screening services
The School of Optometry and Vision Science provides an ongoing vision screening service for primary school children at participating schools in the Auckland region. The service provides a valuable training opportunity for Bachelor of Optometry students, who visit schools and conduct vision screening assessments on children aged 5-19. Approximately
4,000 children are screened via this service every year. One of the most common vision problems detected is refractive error, which can be corrected with spectacles or contact lenses. The School of Optometry and Vision Science’s school screening service operates alongside the
Vision Bus Aotearoa and the
Community Spectacles Scheme, so that children who are identified with a vision problem can receive the follow-up eye care that they need, through donation.
by Lucy Goodman | 24 Jun, 2024 | Community engagement, News
Members of the Community Eye Health Team on the first day of the Whakaaturanga Rangahau Wiki Hauora (Health Week Research Expo) at Kia Aroha Campus: Left to right: Joanna Black, Jaymie Rodgers, Sachi Rathod, Jacqui Ramke, Telusila Vea
In May 2024, the Community Eye Health team took part in the Whakaaturanga Rangahau Wiki Hauora (Health Week Research Expo) at Kia Aroha Campus in South Auckland.
Kia Aroha school offers a learning approach that encourages Year 1 to 13 students’ Māori and Pacific cultural identify. As an initiative of Iwi United Engaged—an organisation committed to advancing Maori health and wellbeing—the Health Research Expo aims to bring together health research with tamariki and their whanau within the wider community.
The event was engaging for both students and the visiting kairangahau (researchers), with over twenty different interactive displays on offer. Over the three-day event, the Vision Bus Aotearoa staff and students provided free vision screening services and follow-up care to Year 9 children, alongside other wellness checks. Meanwhile, other Community Eye Health team members were busy engaging with tamariki about eyes and vision, and the students were excited to take home their own pair of 3D glasses and some information packs about “eye health”.
We thank Kia Aroha school for inviting us to participate in this event, and we hope to see you again next year.
ngā mihi nui | fa’afelai lava | malo ‘aupito
by Lucy Goodman | 16 Jun, 2024 | Pacific Islands, Resources
Key messages:
Countries concerned with eye health should consider strategies to improve access to spectacles. In Australia and New Zealand, eye health experts identified Indigenous people as the population group to be prioritized in efforts to improve access to refractive error services. Reducing out-of-pocket costs via public funding for refractive error correction was the most promising strategy identified by these experts to improve access.
Read the published paper and download the plain language summary of the findings.
About refractive error:
Throughout the world, the most common cause of impaired vision is uncorrected refractive error—a condition where the eye cannot focus light correctly, leading to blurry eyesight. Refractive error can (usually) be corrected with spectacles or contact lenses. However, even in countries where spectacles are readily available, they are often unaffordable for some people. Improving access to spectacles is one of the most effective ways that a country can reduce the number of people experiencing impaired vision.
Why did we do this research?
We conducted this research to identify different ways that countries in the Western Pacific could improve access to spectacles.
What did we do?
This study gathered opinions from eye care experts in 17 countries within the Western Pacific region. Experts provided their opinions on the population groups that faced the most barriers to refractive error services, and the strategies they believed would be more effective to provide these services. The experts provided multiple rounds of feedback to prioritise the important strategies in each region.
What did we find in Australasia?
Of the 75 experts, 15 were from Australia or New Zealand. Many of the population groups and strategies identified by these experts were unique to this region. Australasian experts identified Indigenous people as the population group to whom services were least accessible.
Reducing out-of-pocket costs by providing publicly funded services to certain population groups (e.g. elderly, low-income groups, and children) was the most promising strategy to improve access to eye examinations or spectacles.
Other strategies to improve access to eye examinations included:
- Improving cultural safety of the services so that people feel comfortable using the service.
- Establishing refractive services in regions where they are most needed, and incentivising optometrist to work there.
Other strategies to improve access to spectacles included:
- Health promotion to raise awareness and acceptance of spectacle wear.
- Using readymade spectacles where suitable (alongside messaging of the importance of regular eye checks).
- Regular screening of adults who are likely to need near vision correction (~>40 years), e.g. during medical examinations in the workplace
Citation: McCormick I, Tong K, Abdullah N, et al. Strategies to address inequity of uncorrected refractive error in the Western Pacific: A modified Delphi process. Ophthalmic and Physiological Optics. Published Online First: 16 June 2024. doi: 10.1111/opo.13348
Funding: This work was not funded by a specific grant from the public, commercial, or not-for-profit sectors.
by Lucy Goodman | 26 Mar, 2024 | Eye care services, Resources
Key messages
New Zealand has very little evidence describing vision impairment or access to eye care services. Reassuringly, recent studies often compare their findings between Māori and Pacific People and other ethnic groups. The evidence we do have consistently reports that eye care services are less accessible to Māori and Pacific People compared to other ethnic groups.
Read the published paper and download the plain language summary of the findings.
Inequities in eye health
Health inequities are common in Aotearoa New Zealand. In particular, Māori experience poorer access to services and subsequently poorer health compared to other population groups in New Zealand. However, we don’t know if this is the case for eye health services, and eye health has received little attention by policy makers. To improve eye health, policy makers need to know the number of people and the population groups who are most in need of eye health services. While further research may be needed to answer these questions, some of the information could be identified from existing evidence.
Why did we do this research?
We wanted to identify and summarise all the existing evidence of inequities in eye health between different population groups—particularly between Māori and other ethnic groups. This will help us identify what types of research is still needed.
What did we do?
We looked for all published studies about eye health in New Zealand. Studies were eligible if they reported the number of people with impaired vision, or access to an eye care service (such as the number of people attending a vision screening service). We did this in a systematic way, by searching databases for published evidence and carefully screening the results using pre-defined criteria.
What did we find?
New Zealand has very little published evidence describing the prevalence of vision impairment or access to eye health services. We found 47 relevant studies published since 1960. Almost all this evidence comes from data collected from health facilities (e.g. hospitals), which means the information is not relevant to everyone in the population. Many studies were about diabetic retinopathy (an eye condition resulting from diabetes), or cataract. Since the year 2000, studies have consistently compared their findings between Māori or Pacific People and one or more other ethnic groups. These studies reported that Māori and Pacific People experienced worse access to services compared to other groups.
What’s next?
Future eye health services need to address barriers and enablers to eye care services experienced by Māori and Pacific People. In addition, we need more evidence describing the number of people with vision impairment in the general population, and access to services for all major eye conditions.
Citation: Rogers JT, Black J, Harwood M, et al. Vision impairment and differential access to eye health services in Aotearoa New Zealand: a scoping review. BMJ Public Health. 2024;2:e000313. doi: 10.1136/BMJPH-2023-000313.
Funding: This work was not funded by a specific grant from the public, commercial, or not-for-profit sectors.
