The population-based National Eye Health Survey of 1738 indigenous and 3098 non-indigenous Australians has found that the age-adjusted and sex-adjusted prevalence of unilateral vision impairment and unilateral blindness were higher in indigenous Australians than in non-indigenous Australians (18.7% and 2.9% vs 14.5% and 1.3%).

Uncorrected refractive errors and cataracts were leading causes of unilateral vision impairment in both populations (70%-75%).

While unilateral vision impairment and unilateral blindness are highly prevalent in Australia, most cases are avoidable, and health care interventions that address unilateral vision loss are therefore warranted, the researchers said.

Of the 1738 indigenous Australians, mean (SD) age was 55.0 (10.0) years, and 1024 participants (58.9%) were female. Among the 3098 non-indigenous Australians, mean (SD) age was 66.6 (9.7) years, and 1661 participants (53.6%) were female.

The weighted prevalence of unilateral VI in indigenous Australians was 12.5% (95% CI, 11.0%-14.2%) and the prevalence of unilateral blindness was 2.4% (95% CI, 1.7%-3.3%), respectively.

In non-indigenous Australians, the prevalence of unilateral VI was 14.6% (95% CI, 13.1%-16.3%) and unilateral blindness was found in 1.4% (95% CI, 1.0%-1.8%).

The age-adjusted and sex-adjusted prevalence of unilateral vision loss was higher in indigenous Australians than non-indigenous Australians (VI: 18.7% vs 14.5%; P = .02; blindness: 2.9% vs 1.3%; P = .02).

Risk factors for unilateral vision loss included older age (odds ratio [OR], 1.60 for each decade of age for indigenous Australians; 95% CI, 1.39-1.86; OR, 1.65 per decade for non-indigenous Australians; 95% CI, 1.38-1.96), very remote residence (OR, 1.65; 95% CI, 1.01-2.74) and self-reported diabetes (OR, 1.52; 95% CI, 1.12-2.07) for indigenous Australians, and having not undergone an eye examination in the past 2 years for non-indigenous Australians (OR, 1.54; 95% CI, 1.04-2.27).

Uncorrected refractive error and cataract were leading causes of unilateral VI in both populations (70%-75%). Corneal pathology (16.7%) and cataract (13.9%) were leading causes of unilateral blindness in indigenous Australians, while amblyopia (18.8%), trauma (16.7%), and age-related macular degeneration (10.4%) were major causes of unilateral blindness in non-indigenous Australians.

The reseachers conclude that unilateral vision loss is prevalent in indigenous and non-indigenous Australians; however, most cases are avoidable.

As those with unilateral vision loss caused by cataract and posterior segment diseases may be at great risk of progressing to bilateral blindness, national blindness prevention programs may benefit from prioritising examination and treatment of those with unilateral vision loss, they concluded.