Ophthalmology (Eye & Ear Hospital) - Research Publications

Permanent URI for this collection

Search Results

Now showing 1 - 10 of 88
  • Item
    Thumbnail Image
    Grand Challenges in global eye health: a global prioritisation process using Delphi method
    Ramke, J ; Evans, JR ; Habtamu, E ; Mwangi, N ; Silva, JC ; Swenor, BK ; Congdon, N ; Faal, HB ; Foster, A ; Friedman, DS ; Gichuhi, S ; Jonas, JB ; Khaw, P ; Kyari, F ; Murthy, GVS ; Wang, N ; Wong, TY ; Wormald, R ; Yusufu, M ; Taylor, H ; Resnikoff, S ; West, SK ; Burton, MJ (ELSEVIER SCI LTD, 2022-01)
    BACKGROUND: We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. METHODS: Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. FINDINGS: Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. INTERPRETATION: This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenges. FUNDING: The Queen Elizabeth Diamond Jubilee Trust, Moorfields Eye Charity, National Institute for Health Research Moorfields Biomedical Research Centre, Wellcome Trust, Sightsavers, The Fred Hollows Foundation, The Seva Foundation, British Council for the Prevention of Blindness, and Christian Blind Mission. TRANSLATIONS: For the French, Spanish, Chinese, Portuguese, Arabic and Persian translations of the abstract see Supplementary Materials section.
  • Item
    Thumbnail Image
    Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study
    Bourne, RRA ; Steinmetz, JD ; Flaxman, S ; Briant, PS ; Taylor, HR ; Resnikoff, S ; Casson, RJ ; Abdoli, A ; Abu-Gharbieh, E ; Afshin, A ; Ahmadieh, H ; Akalu, Y ; Alamneh, AA ; Alemayehu, W ; Alfaar, AS ; Alipour, V ; Anbesu, EW ; Androudi, S ; Arabloo, J ; Arditi, A ; Asaad, M ; Bagli, E ; Baig, AA ; Barnighausen, TW ; Parodi, MB ; Bhagavathula, AS ; Bhardwaj, N ; Bhardwaj, P ; Bhattacharyya, K ; Bijani, A ; Bikbov, M ; Bottone, M ; Braithwaite, T ; Bron, AM ; Butt, ZA ; Cheng, C-Y ; Chu, D-T ; Cicinelli, MV ; Coelho, JM ; Dagnew, B ; Dai, X ; Dana, R ; Dandona, L ; Dandona, R ; Del Monte, MA ; Deva, JP ; Diaz, D ; Djalalinia, S ; Dreer, LE ; Ehrlich, JR ; Ellwein, LB ; Emamian, MH ; Fernandes, AG ; Fischer, F ; Friedman, DS ; Furtado, JM ; Gaidhane, AM ; Gaidhane, S ; Gazzard, G ; Gebremichael, B ; George, R ; Ghashghaee, A ; Golechha, M ; Hamidi, S ; Hammond, BR ; Hartnett, MER ; Hartono, RK ; Hay, S ; Heidari, G ; Ho, HC ; Chi, LH ; Househ, M ; Ibitoye, SE ; Ilic, IM ; Ilic, MD ; Ingram, AD ; Irvani, SSN ; Jha, RP ; Kahloun, R ; Kandel, H ; Kasa, AS ; Kempen, JH ; Keramati, M ; Khairallah, M ; Khan, EA ; Khanna, RC ; Khatib, MN ; Kim, JE ; Kim, YJ ; Kisa, A ; Kisa, S ; Koyanagi, A ; Kurmi, OP ; Lansingh, VC ; Leasher, JL ; Leveziel, N ; Limburg, H ; Majdan, M ; Manafi, N ; Mansouri, K ; McAlinden, C ; Mohammadi, SF ; Mohammadian-Hafshejani, A ; Mohammadpourhodki, R ; Mokdad, AH ; Moosavi, D ; Morse, AR ; Naderi, M ; Naidoo, KS ; Nangia, V ; Cuong, TN ; Huong, LTN ; Ogundimu, K ; Olagunju, AT ; Ostroff, SM ; Panda-Jonas, S ; Pesudovs, K ; Peto, T ; Syed, ZQ ; Rahman, MHU ; Ramulu, PY ; Rawaf, DL ; Rawaf, S ; Reinig, N ; Robin, AL ; Rossetti, L ; Safi, S ; Sahebkar, A ; Samy, AM ; Saxena, D ; Serle, JB ; Shaikh, MA ; Shen, TT ; Shibuya, K ; Shin, JI ; Silva, JC ; Silvester, A ; Singh, JA ; Singhal, D ; Sitorus, RS ; Skiadaresi, E ; Skirbekk, V ; Soheili, A ; Sousa, RARC ; Spurlock, EE ; Stambolian, D ; Taddele, BW ; Tadesse, EG ; Tahhan, N ; Tareque, MI ; Topouzis, F ; Bach, XT ; Travillian, RS ; Tsilimbaris, MK ; Varma, R ; Virgili, G ; Wang, N ; Wang, YX ; West, SK ; Wong, TY ; Zaidi, Z ; Zewdie, KA ; Jonas, JB ; Vos, T (ELSEVIER SCI LTD, 2021-02)
    BACKGROUND: To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990-2020, and forecasts for 2050. METHODS: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ≥6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision
  • Item
    Thumbnail Image
    Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study
    Steinmetz, JD ; Bourne, RRA ; Briant, PS ; Flaxman, S ; Taylor, HR ; Jonas, JB ; Abdoli, A ; Abrha, WA ; Abualhasan, A ; Abu-Gharbieh, E ; Adal, TG ; Afshin, A ; Ahmadieh, H ; Alemayehu, W ; Alemzadeh, SA ; Alfaar, AS ; Alipour, V ; Androudi, S ; Arabloo, J ; Arditi, A ; Aregawi, BB ; Arrigo, A ; Ashbaugh, C ; Ashrafi, E ; Atnafu, DD ; Bagli, E ; Baig, AA ; Barnighausen, TW ; Parodi, MB ; Beheshti, M ; Bhagavathula, AS ; Bhardwaj, N ; Bhardwaj, P ; Bhattacharyya, K ; Bijani, A ; Bikbov, M ; Bottone, M ; Braithwaite, T ; Bron, AM ; Nagaraja, SB ; Butt, ZA ; dos Santos, FLC ; Carneiro, VLA ; Casson, RJ ; Cheng, C-Y ; Choi, J-YJ ; Chu, D-T ; Cicinelli, MV ; Coelho, JM ; Congdon, NG ; Couto, RAS ; Cromwell, EA ; Dahlawi, SMA ; Dai, X ; Dana, R ; Dandona, L ; Dandona, R ; Del Monte, MA ; Molla, MD ; Dervenis, N ; Desta, AA ; Deva, JP ; Diaz, D ; Djalalinia, S ; Ehrlich, JR ; Elayedath, R ; Elhabashy, HR ; Ellwein, LB ; Emamian, MH ; Eskandarieh, S ; Farzadfar, F ; Fernandes, AG ; Fischer, F ; Friedman, DS ; Furtado, JM ; Gaidhane, S ; Gazzard, G ; Gebremichael, B ; George, R ; Ghashghaee, A ; Gilani, SA ; Golechha, M ; Hamidi, S ; Hammond, BR ; Hartnett, MER ; Hartono, RK ; Hashi, A ; Hay, S ; Hayat, K ; Heidari, G ; Ho, HC ; Holla, R ; Househ, M ; Huang, JJ ; Ibitoye, SE ; Ilic, IM ; Ilic, MD ; Ingram, AD ; Irvani, SSN ; Islam, SMS ; Itumalla, R ; Jayaram, S ; Jha, RP ; Kahloun, R ; Kalhor, R ; Kandel, H ; Kasa, AS ; Kavetskyy, T ; Kayode, GA ; Kempen, JH ; Khairallah, M ; Khalilov, R ; Khan, EA ; Khanna, RC ; Khatib, MN ; Khoja, TAM ; Kim, GR ; Kim, JE ; Kim, YJ ; Kisa, A ; Kisa, S ; Kosen, S ; Koyanagi, A ; Bicer, BK ; Kulkarni, V ; Kurmi, OP ; Landires, I ; Lansingh, VC ; Leasher, JL ; LeGrand, KE ; Leveziel, N ; Limburg, H ; Liu, X ; Kunjathur, SM ; Maleki, S ; Manafi, N ; Mansouri, K ; McAlinden, C ; Meles, GG ; Mersha, AM ; Michalek, IM ; Miller, TR ; Misra, S ; Mohammad, Y ; Mohammadi, SF ; Mohammed, JA ; Mokdad, AH ; Moni, MA ; Al Montasir, A ; Morse, AR ; Mulaw, GF ; Naderi, M ; Naderifar, H ; Naidoo, KS ; Naimzada, MD ; Nangia, V ; Swamy, SN ; Naveed, M ; Negash, H ; Huong, LTN ; Nunez-Samudio, V ; Ogbo, FA ; Ogundimu, K ; Olagunju, AT ; Onwujekwe, OE ; Otstavnov, N ; Owolabi, MO ; Pakshir, K ; Panda-Jonas, S ; Parekh, U ; Park, E-C ; Pasovic, M ; Pawar, S ; Pesudovs, K ; Peto, T ; Pham, HQ ; Pinheiro, M ; Podder, V ; Rahimi-Movaghar, V ; Rahman, MHU ; Ramulu, PY ; Rathi, P ; Rawaf, DL ; Rawaf, S ; Rawal, L ; Reinig, N ; Renzaho, AMN ; Rezapour, A ; Robin, AL ; Rossetti, L ; Sabour, S ; Safi, S ; Sahebkar, A ; Sahraian, MA ; Samy, AM ; Sathian, B ; Saya, GK ; Saylan, M ; Shaheen, AA ; Shaikh, MA ; Shen, TT ; Shibuya, K ; Shiferaw, WS ; Shigematsu, M ; Shin, JI ; Silva, JC ; Silvester, A ; Singh, JA ; Singhal, D ; Sitorus, RS ; Skiadaresi, E ; Skryabin, VY ; Skryabina, AA ; Soheili, A ; Sorrie, MB ; Sousa, RARC ; Sreeramareddy, CT ; Stambolian, D ; Tadesse, EG ; Tahhan, N ; Tareque, MI ; Topouzis, F ; Bach, XT ; Tsegaye, GW ; Tsilimbaris, MK ; Varma, R ; Virgili, G ; Vongpradith, A ; Vu, GT ; Wang, YX ; Wang, N ; Weldemariam, AH ; West, SK ; Wondmeneh, TG ; Wong, TY ; Yaseri, M ; Yonemoto, N ; Yu, C ; Zastrozhin, MS ; Zastrozhina, A ; Zhang, Z-J ; Zimsen, SRM ; Resnikoff, S ; Vos, T (ELSEVIER SCI LTD, 2021-02)
    BACKGROUND: Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. METHODS: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older. FINDINGS: Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change -0·2% [95% UI -1·5 to 1·0]; 2019 prevalence 9·58 cases per 1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised prevalence of avoidable blindness decreased by -15·4% [-16·8 to -14·3], while avoidable MSVI showed no change (0·5% [-0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15·2 million cases [9% IU 12·7-18·0]), followed by glaucoma (3·6 million cases [2·8-4·4]), undercorrected refractive error (2·3 million cases [1·8-2·8]), age-related macular degeneration (1·8 million cases [1·3-2·4]), and diabetic retinopathy (0·86 million cases [0·59-1·23]). Leading causes of MSVI were undercorrected refractive error (86·1 million cases [74·2-101·0]) and cataract (78·8 million cases [67·2-91·4]). INTERPRETATION: Results suggest eye care services contributed to the observed reduction of age-standardised rates of avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached. FUNDING: Brien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.
  • Item
    Thumbnail Image
    Utilization of eye health-care services in Australia: the National Eye Health Survey
    Foreman, J ; Xie, J ; Keel, S ; Taylor, HR ; Dirani, M (WILEY, 2018-04)
    IMPORTANCE: National data on eye health-care service utilization will inform Australia's eye health policy. BACKGROUND: To investigate the utilization of eye health-care services by Australians. DESIGN: Cross-sectional survey. PARTICIPANTS: Indigenous Australians aged 40 years and older and non-Indigenous Australians aged 50 years and older. METHODS: One thousand seven hundred thirty-eight Indigenous Australians and 3098 non-Indigenous Australians were recruited from 30 randomly selected sites, stratified by remoteness. Sociodemographic, ocular history and eye health-care service utilization data were collected, and an eye examination was conducted. MAIN OUTCOME MEASURES: Recentness of eye examinations, types of providers used and associated risk factors. RESULTS: Approximately 67.0% of Indigenous Australians and 82.5% of non-Indigenous Australians underwent an eye examination within the previous 2 years. Indigenous status (P < 0.001), male gender (P < 0.001), Outer Regional (P < 0.001) and Very Remote (P < 0.001) residence were associated with less recent examinations. Participants with >self-reported eye disease or diabetes were most likely to have been examined within the past year (P < 0.001). For Indigenous Australians, older age was associated with recent eye testing (P = 0.001). Those with retinal disease and cataract were more likely to see an ophthalmologist (P < 0.001), and those with refractive error were more likely to see an optometrist (P < 0.001). In Regional Australia, non-Indigenouspeople were more likely to see optometrists (P < 0.001), and Indigenous Australians were more likely to utilize other, non-specialistservices (P < 0.001). CONCLUSIONS AND RELEVANCE: Eye examination frequency has improved in Indigenous and non-Indigenous Australians compared with previous population-based research. Further improvements are required in risk groups including Indigenous Australians and those living in Regional and Remote areas.
  • Item
    Thumbnail Image
    Prevalence of retinal vein occlusion in the Australian National Eye Health Survey
    Keel, S ; Xie, J ; Foreman, J ; van Wijngaarden, P ; Taylor, HR ; Dirani, M (WILEY, 2018-04)
    IMPORTANCE: In Australia, knowledge of the epidemiology of retinal vein occlusion remains scarce because of a paucity of recent population-based data. The National Eye Health Survey (2015-2016) provides an up-to-date estimate of the prevalence of retinal vein occlusion in non-Indigenous and Indigenous Australian adults. BACKGROUND: To determine the prevalence and associations of retinal vein occlusion in a national sample of Indigenous and non-Indigenous Australian adults. DESIGN: Population-based cross-sectional study. PARTICIPANTS: A total of 3098 non-Indigenous Australians (aged 50-98 years) and 1738 Indigenous Australians (aged 40-92 years) living in 30 randomly selected sites, stratified by remoteness. METHODS: Retinal vein occlusions were graded from retinal photographs using standardized protocols and recorded as central retinal vein occlusion or branch retinal vein occlusion. MAIN OUTCOME MEASURE: Prevalence of retinal vein occlusion. RESULTS: In the non-Indigenous population, the sampling weight adjusted prevalence of any retinal vein occlusion was 0.96% (95% confidence interval: 0.59, 1.6), with branch retinal vein occlusion observed in 0.72% (95% confidence interval: 0.41, 1.2) and central retinal vein occlusion in 0.24% (95% confidence interval: 0.13, 0.47). Any retinal vein occlusion was found in 0.91% (95% confidence interval: 0.47, 1.7) of Indigenous Australians aged 40 years and over, with branch retinal vein occlusion observed in 0.83% (95% confidence interval: 0.40, 1.7) and central retinal vein occlusion in 0.07% (95% confidence interval: 0.02, 0.32). Older age (odds ratio = 1.64 per 10 years, P = 0.006) and the presence of self-reported diabetes (odds ratio = 3.24, P = 0.006) were associated with any retinal vein occlusion after multivariable adjustments. Retinal vein occlusion was attributed as the cause of monocular vision loss (<6/12) in seven (0.25%) non-Indigenous and six (0.36%) Indigenous participants. CONCLUSIONS AND RELEVANCE: These data suggest that retinal vein occlusion is relatively uncommon in the non-Indigenous Australians aged 50 years and over and Indigenous Australians aged 40 years and over. Similar to previous Australian and international reports, the prevalence of retinal vein occlusion rose sharply with age.
  • Item
    Thumbnail Image
    Prevalence of trachomatous trichiasis in Australia: the National Eye Health Survey
    Dirani, M ; Keel, S ; Foreman, J ; van Wijngaarden, P ; Taylor, HR (WILEY, 2018-01)
    IMPORTANCE: Australia is the only developed country to still have pockets of endemic trachoma. The research provides up-to-date, population-based prevalence data of later complications of trachoma amongst a national sample of Indigenous adults. BACKGROUND: To report the prevalence of trachomatous trichiasis (TT) in Indigenous Australians aged 40 years and older. DESIGN: Population-based cross-sectional study. PARTICIPANTS: A total of 1738 (41% male) Indigenous Australians aged 40 years or older, living amongst 30 randomly selected Australian sites, stratified by remoteness. METHODS: Anterior segment examination was performed and trachoma grading for the presence of TT and corneal opacification (CO) was conducted using the WHO (WHO) simplified grading system. MAIN OUTCOME MEASURES: Prevalence of TT. RESULTS: A total of three (0.17%) participants had TT, and there were no confirmed cases of trachomatous CO in the NEHS. All three participants with TT were female and aged 40 years or older. Although they had likely spent their childhoods in more remote areas, two of the three confirmed cases resided in an urban and outer regional area at the time of their examinations. CONCLUSIONS AND RELEVANCE: Our data are in line with ongoing national trachoma surveillance reports that suggest the prevalence of late sequences of trachoma appear to be decreasing in Australia.
  • Item
    Thumbnail Image
    Prevalence and associations of epiretinal membranes in the Australian National Eye Health Survey
    Keel, S ; Xie, J ; Foreman, J ; van Wijngaarden, P ; Taylor, HR ; Dirani, M (WILEY, 2017-12)
  • Item
    Thumbnail Image
    Does blindness count? Disability weights for vision loss
    Braithwaite, T ; Taylor, H ; Bourne, R ; Keeffe, J ; Pesudovs, K (WILEY, 2017-04)
  • Item
    Thumbnail Image
    Sampling methodology and site selection in the National Eye Health Survey: an Australian population-based prevalence study
    Foreman, J ; Keel, S ; Dunn, R ; van Wijngaarden, P ; Taylor, HR ; Dirani, M (WILEY, 2017-05)
    BACKGROUND: This paper presents the sampling methodology of the National Eye Health Survey that aimed to determine the prevalence of vision impairment and blindness in Australia. DESIGN: The National Eye Health Survey is a cross-sectional population-based survey. PARTICIPANTS: Indigenous Australians aged 40 years and older and non-Indigenous Australians aged 50 years and older residing in all levels of geographic remoteness in Australia. METHODS: Using multistage, random-cluster sampling, 30 geographic areas were selected to provide samples of 3000 non-Indigenous Australians and 1400 Indigenous Australians. Sampling involved (i) selecting Statistical Area- Level 2 sites, stratified by remoteness; (ii) selecting Statistical Area- Level 1 sites within Statistical Area- Level 2 sites to provide targeted samples; and (iii) grouping of contiguous Statistical Area- Level 1 sites or replacing Statistical Area- Level 1 sites to provide sufficient samples. MAIN OUTCOME MEASURES: The main outcome measures involved Sites sites selected and participants sampled in the survey. RESULTS: Thirty sites were generated, including 12 Major City sites, 6 Inner Regional sites, 6 Outer Regional sites, 4 Remote sites and 2 Very Remote sites. Three thousand ninety-eight non-Indigenous participants and 1738 Indigenous participants were recruited. Selection of Statistical Area- Level 1 site overestimated the number of eligible residents in all sites. About 20% (6/30) of Statistical Area- Level 1 sites were situated in non-residential bushland, and 26.67% (8/30) of Statistical Area- Level 1 populations had low eligibility or accessibility, requiring replacement. CONCLUSIONS: Representative samples of Indigenous and non-Indigenous Australians were selected, recruited and tested, providing the first national data on the prevalence of vision impairment and blindness in Australia.
  • Item
    Thumbnail Image
    Prevalence, associations and characteristics of severe uncorrected refractive error in the Australian National Eye Health Survey
    Keel, S ; McGuinness, MB ; Foreman, J ; Scheetz, J ; Taylor, HR ; Dirani, M (WILEY, 2020-01)
    IMPORTANCE: In Australia, nationally representative data of the burden and associations of severe uncorrected refractive error are scarce. BACKGROUND: To report the prevalence and characteristics of severe uncorrected refractive error in Indigenous and non-Indigenous Australians. DESIGN: Population-based cross-sectional study. PARTICIPANTS: A total of 3098 non-Indigenous Australians aged 50 to 98 and 1738 Indigenous Australians aged 40 to 92 living in 30 randomly selected Australian sites were examined. METHODS: Severe uncorrected refractive error was defined as an improvement of ≥2 lines on the logMAR chart in one or both eyes in participants with a presenting visual acuity <6/12. MAIN OUTCOME MEASURE: Severe uncorrected refractive error RESULTS: Prevalence of severe uncorrected refractive error was 11.0% (95% confidence interval 9.3-13.0) in non-Indigenous and 14.5% (12.5-16.7) in Indigenous Australians. Eighty-two percent of non-Indigenous and 77% of Indigenous participants had a spherical equivalent refraction between -2.00D and +2.00D. Indigenous Australians who were older (odds ratio [OR] for 70-79 years vs 40-49 years = 3.59), resided in outer regional areas (OR = 1.78) and did not have an eye examination in the previous 2-years (OR = 1.50) were associated with higher odds of severe uncorrected refractive error. Geographical remoteness (OR = .68 for inner regional), male gender (OR = 1.30), older age (OR for 70-79 years vs 50-59 years = 1.51) and failure to have an eye examination in the previous 2-years (OR = 2.06) were associated with severe uncorrected refractive error among non-Indigenous participants. CONCLUSIONS AND RELEVANCE: Increased public awareness of the importance of regular optometric examinations may be required in groups at high risk of severe uncorrected refractive error.