Prevalence of visually significant cataract and cataract surgical coverage in Indigenous and non-Indigenous Australians: a systematic review and meta-analysis
Aims Compare the prevalence of age-related cataract and the cataract surgical coverage rate between Indigenous and non-Indigenous Australians and explore differences in these estimates across location and time.Methods The Joanna Briggs Institute guidance for systematic reviews of prevalence studies...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open Ophthalmology |
| Online Access: | https://bmjophth.bmj.com/content/10/1/e001847.full |
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| author | Angus W Turner Mark A Chia Hessom Razavi Marcel M Nejatian Saiuj Bhat Amy Kalantary Joshua R Taylor |
| author_facet | Angus W Turner Mark A Chia Hessom Razavi Marcel M Nejatian Saiuj Bhat Amy Kalantary Joshua R Taylor |
| author_sort | Angus W Turner |
| collection | DOAJ |
| description | Aims Compare the prevalence of age-related cataract and the cataract surgical coverage rate between Indigenous and non-Indigenous Australians and explore differences in these estimates across location and time.Methods The Joanna Briggs Institute guidance for systematic reviews of prevalence studies was followed. A systematic search of Medline, Embase, Web of Science and grey literature from database inception to June 2022 was performed. All studies reporting cataract prevalence in Australian populations were included. Pooled prevalence estimates were derived using meta-analyses with a random-effects model. Nine studies enrolling 36 302 participants were included. Most studies only reported the prevalence of cataract causing vision loss (visual acuity<6/12) or blindness (visual acuity<6/60), restricting our meta-analysis to these definitions.Results Cataract causing unilateral vision loss was common in both Indigenous and non-Indigenous adults (3.5% and 3.6%, p=0.891). Indigenous adults had a higher prevalence of bilateral vision loss (3.6% vs 1.1%, p=0.011) and bilateral blindness (0.385% vs 0.001%, p=0.002) than non-Indigenous adults. Cataract surgical coverage was lower in Indigenous (68.0%; 95% CI, 55.9 to 79.0) than non-Indigenous (88.4%; 95% CI, 79.9 to 94.8) adults (p=0.004). No differences in bilateral vision loss, blindness or surgical coverage were found between rural and urban subgroups or between studies conducted before and after the year 2000.Conclusions Cataract causes vision loss in a substantial number of adults living in urban and rural Australia. Policies to improve diagnosis and surgery rates should be prioritised, particularly for Indigenous Australians who experience a disproportionate burden of advanced cataract and reduced access to surgery.PROSPERO registration number CRD42022340197. |
| format | Article |
| id | doaj-art-0e95b46526b74ea9b15e39babf6d892d |
| institution | Kabale University |
| issn | 2397-3269 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Ophthalmology |
| spelling | doaj-art-0e95b46526b74ea9b15e39babf6d892d2025-01-15T01:00:09ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692025-01-0110110.1136/bmjophth-2024-001847Prevalence of visually significant cataract and cataract surgical coverage in Indigenous and non-Indigenous Australians: a systematic review and meta-analysisAngus W Turner0Mark A Chia1Hessom Razavi2Marcel M Nejatian3Saiuj Bhat4Amy Kalantary5Joshua R Taylor6University of Western Australia, Perth, Western Australia, AustraliaInstitute of Ophthalmology, University College London, London, UKLions Outback Vision, Lions Eye Institute, Perth, Western Australia, AustraliaLions Eye Institute, Nedlands, Western Australia, AustraliaSchool of Medicine, The University of Western Australia, Perth, Western Australia, AustraliaLions Outback Vision, Lions Eye Institute, Perth, Western Australia, AustraliaLions Outback Vision, Lions Eye Institute, Perth, Western Australia, AustraliaAims Compare the prevalence of age-related cataract and the cataract surgical coverage rate between Indigenous and non-Indigenous Australians and explore differences in these estimates across location and time.Methods The Joanna Briggs Institute guidance for systematic reviews of prevalence studies was followed. A systematic search of Medline, Embase, Web of Science and grey literature from database inception to June 2022 was performed. All studies reporting cataract prevalence in Australian populations were included. Pooled prevalence estimates were derived using meta-analyses with a random-effects model. Nine studies enrolling 36 302 participants were included. Most studies only reported the prevalence of cataract causing vision loss (visual acuity<6/12) or blindness (visual acuity<6/60), restricting our meta-analysis to these definitions.Results Cataract causing unilateral vision loss was common in both Indigenous and non-Indigenous adults (3.5% and 3.6%, p=0.891). Indigenous adults had a higher prevalence of bilateral vision loss (3.6% vs 1.1%, p=0.011) and bilateral blindness (0.385% vs 0.001%, p=0.002) than non-Indigenous adults. Cataract surgical coverage was lower in Indigenous (68.0%; 95% CI, 55.9 to 79.0) than non-Indigenous (88.4%; 95% CI, 79.9 to 94.8) adults (p=0.004). No differences in bilateral vision loss, blindness or surgical coverage were found between rural and urban subgroups or between studies conducted before and after the year 2000.Conclusions Cataract causes vision loss in a substantial number of adults living in urban and rural Australia. Policies to improve diagnosis and surgery rates should be prioritised, particularly for Indigenous Australians who experience a disproportionate burden of advanced cataract and reduced access to surgery.PROSPERO registration number CRD42022340197.https://bmjophth.bmj.com/content/10/1/e001847.full |
| spellingShingle | Angus W Turner Mark A Chia Hessom Razavi Marcel M Nejatian Saiuj Bhat Amy Kalantary Joshua R Taylor Prevalence of visually significant cataract and cataract surgical coverage in Indigenous and non-Indigenous Australians: a systematic review and meta-analysis BMJ Open Ophthalmology |
| title | Prevalence of visually significant cataract and cataract surgical coverage in Indigenous and non-Indigenous Australians: a systematic review and meta-analysis |
| title_full | Prevalence of visually significant cataract and cataract surgical coverage in Indigenous and non-Indigenous Australians: a systematic review and meta-analysis |
| title_fullStr | Prevalence of visually significant cataract and cataract surgical coverage in Indigenous and non-Indigenous Australians: a systematic review and meta-analysis |
| title_full_unstemmed | Prevalence of visually significant cataract and cataract surgical coverage in Indigenous and non-Indigenous Australians: a systematic review and meta-analysis |
| title_short | Prevalence of visually significant cataract and cataract surgical coverage in Indigenous and non-Indigenous Australians: a systematic review and meta-analysis |
| title_sort | prevalence of visually significant cataract and cataract surgical coverage in indigenous and non indigenous australians a systematic review and meta analysis |
| url | https://bmjophth.bmj.com/content/10/1/e001847.full |
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