A male eye health survey participant is seated at a slit lamp while examined by a female optometrist

Reviewing the evidence

Improving access to eye health services in Aotearoa

Our team members are involved in a range of projects that collate and summarise the existing evidence on eye health. This type of research includes systematic reviews, evidence summaries, and policy documents, and describes evidence from health research here in Aotearoa and internationally. 

Eye care in Aotearoa New Zealand in 2022

In 2022, researchers from the Community Eye Health team were commissioned to prepare a detailed report that summarises the state of eye care services in Aotearoa New Zealand. We used the World Health Organization’s Eye Care Situation Analysis Tool (ECSAT) to assess the eye care situation in Aotearoa, and to develop recommended actions to strengthen eye care services.

The key findings of the report were: 

  • New Zealand has a solid foundation for good quality eye care services, but there is room for improvement in the way we plan and deliver eye care services to ensure all New Zealanders can access the services they need. 
  • Service delivery-quality and workforce & infrastructure are generally “strong” or only “need minor strengthening”.
  • Leadership & governance, access to services, financing, and information generally “need major strengthening”.
  • The report provides a detailed list of 81 recommended actions that may help strengthen eye care services in New Zealand.

Download the plain language summary of the report (PDF).


Silwal PWatene R, Cowan C, Cunningham W, Harwood M, Korau J, Sue W, Wilson G, Ramke J. Eye care in Aotearoa New Zealand 2022: Eye care situation analysis tool (ECSAT). Auckland: University of Auckland, 2022.

Funding: The report was prepared for Eye Health Aotearoa, with funding from Blind Low Vision New Zealand.

Research team:

Dr Jacqueline Ramke Profile photo of Renata Watene
Pushkar Silwal A/Prof Jacqueline Ramke Renata Watene

Access to eye care for Indigenous and non-dominant ethnic minority groups

We have completed two complementary reviews to scope the available evidence on improving access to eye health for Indigenous and non-dominant ethnicity groups. While we found very little local evidence, there were a range of service delivery strategies that may be relevant in our context, and we will draw on these in our Community Eye Health work.


Hamm L, Yashadhana A, Burn H, Black J, Grey C, Harwood M, Peiris-John R, Burton MJ, Evans JR, Ramke J. Interventions to promote access to eyecare for non-dominant ethnic groups in high-income countries: a scoping review BMJ Global Health 2021;6:e006188.

Burn H, Hamm L, Black J, Burnett A, Harwood M, Burton MJ, Evans JR, Ramke J. Eye care delivery models to improve access to eye care for Indigenous people in high-income countries: a scoping review. BMJ Global Health 2021;6:e004484.

Research team:

Dr Jacqueline Ramke Dr Joanna Black
Dr Lisa Hamm A/Prof Jacqueline Ramke Dr Joanna Black

Equitable eye health services for older adults

In 2020, the Government of Aotearoa New Zealand proposed free annual “eye health checks” for New Zealand’s ~700,000 SuperGold card holders aged ≥65 years. While this proposed policy did not pass into legislation following the 2020 national election, the issues that it raised remain highly relevant to New Zealand’s eye care policies.

To assess the evidence for this policy, we conducted a systematic scoping review of primary eye care services in Aotearoa New Zealand and ten similar high-income countries. We found that most of the countries included in the review provided subsidised eye examinations for older people. New Zealand was the only country that did not provide any eye care services for older people.


Goodman LBlack J, Misra S, Tousignant B, Keay L, Woodburn S, Harwood M, Evans JR, Ramke J. Primary eye health services for older adults as a component of Universal Health Coverage: a scoping review of evidence from high income countries. Lancet Regional Health – Western Pacific 2022;100560.

Funding: This work was supported by Blind Low Vision New Zealand.

Research team:


Dr Jacqueline Ramke Dr Joanna Black
Dr Lucy Goodman A/Prof Jacqueline Ramke Dr Lisa Hamm Dr Joanna Black

Equity and diversity in eye health providers

We are committed to improving the diversity of students in the optometry course so that the profession can better reflect the population of Aotearoa. We are undertaking a number of projects to understand and improve the cultural safety of the course, as well as a baseline assessment of the gender and ethnicity of optometry students, practitioners and faculty in Aotearoa and Australia.

The following publications were completed by our researchers and describe a need for diversity in eye health leaders:

Yashadhana A, Clarke N, Zhang JH, Ahmad J, Mdala S, Morjaria P, Yoshizaki M, Kyari F, Burton MJ, Ramke J. Gender and ethnic diversity in global ophthalmology and optometry association leadership: a time for changeOphthalmic & Physiological Optics 2021;41(3):623-9.

Yashadhana A, Zhang J, Yasmin S, Morjaria P, Holland P, Faal H, Burton MJ, Ramke J. Action needed to improve equity and diversity in global eye health leadership Eye 2020;34:1051-1054.