National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness and Vision Loss

Key Area for Action 4: Improving the systems and quality of care

Action Area: Service integration

In 2014, Children’s Health Queensland Hospital and Health Service successfully integrated the Eye Departments from the Mater Children’s and Royal Children’s Hospitals into one Department at the Lady Cilento Children’s Hospital.

Action Area: Workforce Development – Specialist Workforce

A number of Hospital and Health Services recruited additional ophthalmology staff. In Central West Hospital and Health Service specialists brought students and ophthalmology registrars with them on outreach trips.

Action Area: Workforce Development– Primary Healthcare Workforce

In Torres and Cape Hospital and Health Service visiting specialists provided basic instruction in eye health and post-operative care to nurses and health workers who work in the Primary Health Care Clinics.

Key Area for Action 5: Improving the evidence base

Action Area: Eye research workforce development

Children’s Health Queensland Hospital and Health Service actively encouraged registrars and fellows to publish papers

Action Area: Knowledge transfer

West Moreton Hospital and Health Service supported the University of Queensland by facilitating an Ophthalmology Workshop that is attended by Year 2 Medical Students. A Visiting Medical Officer at Ipswich Hospital mentors the students on identifying eye problems.

Jurisdictional update – South Australia

Key Area for Action 1: Reducing the risk

Action Area: Raising Public Awareness

The South Australian Institute of Ophthalmology (SAIO) is well renowned for its clinical, laboratory based and epidemiological research. This research along with both national and international research collaborations, has produced a large number of peer-reviewed publications between 2011 and 2014. These publications contribute to raising public awareness.

Action Area: Maternal and Child Health

During the reporting period, health and development checks were provided at 1-4 weeks, 6-9 months, 18-24 months for infants/children whose parents accessed the Child and Family Health Service:

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  A history was obtained of any family vision problems that may have occurred in relatives during childhood or early adolescence.
  
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  The ‘appearance of the eyes’ included an assessment of the external eye, the lids, sclera, conjunctiva, scleara, cornea and iris.
  
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  Fixation/ following and corneal light reflex examination was used to identify any strabismus.
  

For preschool children aged 4 years, a history was taken as above but extended to include information about any symptoms that may relate to vision such as headaches that come with close work and may persist at night, but are absent on weekends or on holidays.

Challenges encountered during the reporting period:

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  Not all families access health and development checks.
  
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  National promotion was required to promote eye health and inform families of signs of poor eye health that require medical attention.
  
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  Ensuring clients had access to transport to attend specialist appointments.
  

Action Area: People with Diabetes

During the reporting period, clients who had a Diabetes Care plan were scheduled to have their eyes checked regularly. The staff from the Aboriginal Family Clinic facilitated these specialist appointments and transport was available.

Challenges encountered during the reporting period:

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  Ensuring clients had access to transport to attend specialist appointments.
  

Action Area: Research

The Central and Northern Ophthalmology Network runs an investigator initiated clinical trials unit at the Royal Adelaide Hospital and the Queen Elizabeth Hospital and has run a number of clinical trials during the reporting period.

Key Area for Action 2: Increasing early detection

Action Area: Public Awareness

Sight For All, in conjunction with RANZCO, has teamed up with the Royal Society for the Blind and the Freemason’s Foundation to raise awareness in the wider South Australian communities of blinding yet avoidable eye diseases and services available for the vision impaired.
The ‘My Eye Health Program’ was formally launched in October 2010 by My Eye Health patron Mr Kevin Scarce, Governor of South Australia. The Program runs education days delivered by trained eye health educators to a range of target audiences in metropolitan and regional areas of Australia. These include high school students, retirement village residents, allied health staff and the general community. Up to 2014, 776 presentations reaching 17,705 people had been delivered. Visit www.myeyehealth.org.au for further information and to download the free booklet.

Action Area: Primary Health Care

Between 2011-2014, the Trachoma Control Program undertook trachoma screening of 5-9 year old Aboriginal and Torres Strait Islander children living in remote South Australian (SA) communities classified “at risk” of trachoma. Between 2011 and 2014, 5,003 Aboriginal children aged 0-14 years were screened for trachoma. Children with trachoma, household members and their contacts were treated with antibiotics as per the recommendations in the Guidelines for the Public Health Management of Trachoma²⁷ in Australia.
In 2013, funding was provided by the Commonwealth Government for the continuation of the Trachoma Control Program over a four year period ending in June 2017. The prevalence of trachoma is generally trending downwards but still present at rates of 10% in some remote communities. In 2013 and 2014 increased efforts were undertaken in the complementary strategy of promoting clean faces. The aim is to reduce the prevalence of trachoma to under 5% by 2020, as per the Commonwealth Government’s commitment to the World Health Organization’s Global Elimination of Trachoma strategy.
Country Health SA contracted Aboriginal Community Controlled Health Organisations in remote “at risk” communities to screen for trichiasis disease in Aboriginal and Torres Strait Islander adults aged 40+ years. During the reporting period, a total of 4,219 Aboriginal adults over 40 years of age were screened for triachiasis.
In addition to screening, health services were responsible for referring patients to an ophthalmologist and supporting them to receive treatment, which involved surgery in many cases. Tackling trachoma and trichiasis in SA is guided by the World Health Organization’s public health approach to treat and prevent trachoma, the Surgery, Antibiotics, Facial Cleanliness and Environmental improvements (SAFE) Strategy.
The health sector worked closely with the education sector to promote clean faces as a norm in school settings. Classroom resources were used which increased children’s understanding of germs and how infections are transmitted.

During the reporting period, the Aboriginal Family Clinic (AFC) offered Adult Health Checks to all eligible clients in the Southern Adelaide Local Health Network catchment. The Adult Health Checks consisted of various assessments including a visual acuity test.

Action Area: People with Diabetes

During the reporting period, clients who had a Diabetes Care plan were scheduled to have their eyes checked regularly. Staff from the AFC facilitated these specialist appointments and transport was available.

Challenges encountered during the reporting period:

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  Ensuring clients had access to transport to attend specialist appointments.
  

Action Area: Childhood Screening

During the reporting period, the pre-school community screening programme improved access to orthoptic-led primary assessments at the community level. Health and developmental checks of children were also undertaken and recorded at 1-4 weeks, 6-9 months, 18-24 months and 4 years of age for children whose parents accessed the Child and Family Health Service.
The number of pre-school health checks which included visual screening between 1 January 2011 and 31 December 2014 was 39,128. Of that figure, there were 5,977 external referrals for further management of eye issues.

Challenges encountered during the reporting period:

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  Not all families access health and development checks.
  
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  Availability of orthoptic staffing.
  
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  Community nurse support for screening, coordination, record keeping and facilities.