World Sight Day – Thursday14 October
The Department of Health and Ageing has compiled a series of case studies to
highlight preventable blindness among Australians, including Aboriginal and Torres
Strait Islander people.
Preventable or avoidable blindness is a significant health concern. According to the
2004-05 National Health Survey, more than half (52%) of Australians suffer from
eye health problems.
The following eight items will help your readers better understand the issues that
preventable blindness raise, and we encourage you to place them in your
newspapers, newsletters and on your websites.
The case studies focus on the four key eye diseases: cataracts; macular
degeneration; glaucoma and diabetic retinopathy. These articles highlight:
•
the importance of eye health and the need for regular eye examinations for
early detection
•
the serious but often preventable nature of eye disease
•
the importance of good management of eye health to prevent disease and
improve quality of life
•
the risk factors of eye disease
•
the types of eye health care services available to detect, prevent and treat
vision loss.
With World Sight Day on Thursday 14 October, these articles are timely, but their
relevance to community health makes them useful at almost any times.
High-quality photos are available on request from the department (contact details
below) to illustrate the items, if required.
Department of Health and Ageing contact:
Helene Towers
Tel: 02 6289 4447
e-mail: helene.towers@health.gov.au
Case Study | Macular Degeneration | Albert Edwards | Melbourne
A chance to see the places and games he loves
Albert Edwards has three great loves in his life - family, travel and sport.
His travels have taken him and his wife, Kerry, to exotic beaches throughout the world –
from the remote coast of northern Australia through to Hawaii.
In sport, Albert has played Aussie Rules and basketball at the elite level, and has been a self-
confessed one-eyed Richmond supporter for as long as he can remember.
But nowadays 55-year-old Albert is seeing a lot less of the world and sport than he would
like. Albert is living with macular degeneration.
Macular degeneration is a disease that slowly destroys the retina and macula. Albert is
getting treatment for the disease and has slowed the progress of the sight loss. But the
grandfather of two says if he had had his eyes tested earlier, he might have been able to save
more of his sight.
Macular degeneration progressively eats away at central vision – the ability to see fine detail
such as faces, print, or in Albert’s case, the ability to see a ball or drive at night.
Unlike refractive error, which is when the eyes cannot focus and glasses are needed to correct
vision, macular degeneration is like mud splatters in the centre of sight. Dark shadows block
out detail.
“My message for people is simple. Get your eyes tested. If you’ve got macular degeneration
you just might be able to delay it or stop it getting any worse,” Albert said.
Albert played top-level basketball until he reached his mid 40s, but his eyesight started to
deteriorate to the point that he couldn’t find the ball in his vision.
“I was playing in a basketball tournament and I just noticed on this particular day I couldn’t
focus on the ball – I could still see it but it wasn’t as clean as it had been,” Albert said.
“I kept playing basketball, although I didn’t quite play up to the standards that I knew I
could. I loved the sport but I knew there was something wrong with my eyesight.
“It was a little bit daunting but I battled on. But eventually I had to give basketball away.
There are still a few blokes I used to play basketball with at Dandenong stadium still playing
and I would love to, but I know with the way my eyes are I just wouldn’t be able to do it.
“Even driving at night time became difficult. I can remember driving to our holiday home in
Victoria one particular night. I was heading off down a country road and my wife said to me
you can’t see where you’re going. I said not really, I’m following the white line. She told me
to stop the car. I got out of the car and into the passenger seat.
“That was it for night driving in the country. Now when we go on a drive we leave in the
morning or early afternoon.”
Albert says it wasn’t until about four years ago, when he went to Monash University to have
his eyes tested, that he was diagnosed with macular degeneration and referred to an eye
specialist.
Albert was asked to join a macular degeneration research project at the Centre for Eye
Research Australia (CERA). While lost sight cannot be restored in some cases, treatments
such as laser may slow or stop macular degeneration’s progress. The earlier it is detected the
more can be done to save sight.
“The research program has been fantastic. I remember when I first went there I was very
apprehensive. They’ve explained things in triplicate to me.
“I had laser treatment on my right eye – which is most affected – but somehow my left eye
improved. My left eye is keeping me on the road and moving about – letting me function
normally.”
One of the critical risk factors for macular degeneration is a family history. People with a
family history of macular degeneration have a 50 per cent chance of also contracting the
disease. This genetic link was part of the reason Albert joined the CERA research project.
“I have grandchildren, and because macular degeneration is a degenerative thing and it gets
handed down, I want to do what I can to help researchers to hopefully find a cure.
“I’ve got a positive result from being in the research project. It has been fantastic for me and
it will be fantastic for my son; my grandchildren and their children and people in general.”
But while science is working towards a cure, Albert says regular eye tests, particularly for
people 40 years and older, is the best defence.
For more information about what you can do to protect your vision or the vision of the
Facts about Macular Degeneration
Macular degeneration affects people’s central vision – the part of the eye where we process
visual detail such as faces or text. It can happen at any time in someone’s life but the
condition is more prevalent as people get older. This is referred to as age-related macular
degeneration (AMD).
In the early stages of AMD symptoms may not be obvious. By the time symptoms appear
damage has already been done. While vision lost to AMD cannot be restored, early detection
–
even before vision loss is obvious – can slow or stop sight loss.
Some people are at more risk of getting AMD. This includes:
people with a family history of the disease;
people who smoke; and
people with low levels of carotenoids and vitamins C and E in their blood.
Regular eye checks are important to early detection and sight saving treatment.
Case Study | Fiona Steele, Community Nurse | Mt Allen
Trachoma - the long road to healing
The eyes of young people in the remote central desert community of Yuelamu are getting
better. Three years ago, 76 per cent of school age kids (5-9 years) tested had active
trachoma. Today, the infection rate is down to 24 per cent.
This dramatic turnaround is the result of a community committed to wiping out a disease that
starts in the young, but if left untreated, often leads to permanent blindness as people get
older.
Yuelamu Community’s Remote Area Nurse, Fiona Steele, says the Yuelamu community has
led the fight against trachoma, and if more communities could achieve the same dramatic
reduction, the disease’s foothold in central Australia could be broken.
Trachoma is an infection that can cause scarring on the inside of the eyelid. Over time, this
can cause the eyelashes to turn inward, rubbing against the unprotected eyeball and
ultimately causing blindness in older people. In places like Yuelamu, where it is dry and
dusty, the disease is more common. Australia is the only developed country in the world that
still has high levels of trachoma.
“As part of the Healthy School Age Children program, we screen for trachoma,” Fiona says.
“Based on the infection rates we have been doing two community-wide treatments each year
and each time we do a treatment the community flocks to the health centre. They don’t want
this disease destroying the sight of any more people.
“Eyes play an important part in the teaching and learning of Aboriginal culture. People here
communicate a lot using their hands – gestures can mean so much more than words. Losing
sight denies them the opportunity to hunt, to contribute to the learning of the young, to record
the beauty of this culture through art.
“Although trachoma starts in the young it is the older people – those who we need to teach
the young the traditional ways – who lose their sight.”
Fiona, who, with husband Barry, has been in Yuelamu for more than five years, says the
success of Yuelamu in combating trachoma is based on building a strong community
awareness of the issue and of what people can do to reduce the spread of the disease.
The health clinic is just a small part of Fiona’s health practice. Most of her work is done in
the streets, in the general store, or in people’s homes. “I don’t just wait for people to come
and see me at the clinic. Each day, as I go about my life in our community, I talk with people
about things that are happening and their health and the health of their families.”
Fiona hopes the downward trend in infections with trachoma at Yuelamu will allow her to
one day focus on targeting infected households rather than the current community-wide
treatments. But this will depend on other communities also making inroads into infection
rates.
“People here move around a lot and trachoma is easily passed from person to person. We
need every community to do its bit in getting the disease under control. Once it is back in
our community it will spread through usual contact.
“The simple message is people can reduce the chances of getting or passing on trachoma if
they follow some simple rules about keeping eyes clean, washing hands and faces as often as
possible and also getting their eyes tested regularly to see if they need treatment.
“We can’t get rid of the dust and flies but we can get rid of trachoma if the community works
together.”
The Australian Government is investing millions of dollars to address both the symptoms of
vision problems, and also the underlying social and environmental factors that contribute to
poor eye health in Indigenous communities.
It is providing more than $58 million towards the early detection and treatment of eye and ear
health conditions, which includes funding for intensive eye surgery weeks in Alice Springs
and an increase in funding for the Visiting Optometrists Scheme. It also includes $16 million
to boost services combating endemic trachoma in Indigenous communities.
The investment by the Australian Government is critical to supporting people like Fiona
Steele, who are working at the coalface of Indigenous eye health.
For more information about what you can do to protect your vision or the vision of the
Facts about Trachoma
Trachoma is an eye disease that mainly infects the young but can lead to permanent blindness
in older people.
Trachoma is easily treated with the antibiotic azithromycin.
There are other ways to stop trachoma besides medicine, such as:
washing face and hands at least morning and night;
keeping the number of flies down by proper and frequent rubbish disposal;
avoiding exposure to dust as much as possible; and
having an annual eye check, such as the Healthy School Aged Kids (HSAK) screening.
Eye Health Case Study | Gary Fehlberg | Diabetic Retinopathy/Oedema | Melb
Eyes on the long road
Veteran truck driver Gary Fehlberg reckons anyone driving for a living who is over 40 years
of age should have regular eye checks – before little problems turn into big problems.
After more than 25 years behind the wheel and more than two million kilometres on long
hauls across Australia, 55-year-old Gary knows how important good sight is to the safety of
drivers and how sight can change without warning.
Five years ago Gary, who has Type 1 diabetes, noticed a slight blurring in the central part of
vision in his right eye. Over months it got progressively worse. Gary went to see his
optometrist only to find out that he had diabetic retinopathy, one of the world’s leading
causes of vision loss in people aged 20 to 65 years. It causes damage to the small blood
vessels in the retina on the back of the eye.
“For a long time you don’t take any notice of it but then it starts annoying you and you can’t
read street directories and things like that,” Gary said. “I thought I had better do something
about it.
“I’d been driving interstate for over 20 years and I had tremendous eyesight. I never needed
glasses or anything. So when my sight started to get worse I just assumed it was a symptom
of age. But in my case it was a bit more than that.”
Current treatments for diabetic retinopathy can prevent further vision loss but cannot restore
lost sight.
Gary was also diagnosed with macular oedema, a swelling of the macula caused by the
leakage of fluid from the damaged blood vessels. The macula is the critical area of the retina
that converts light into signals for the brain. Macular oedema can also cause permanent
damage to central vision.
Gary started laser treatment, which is commonly used to prevent further sight loss. But with
some of the damaged blood vessels very close to the centre of his macula, the risk of further
damage to his vision by the laser was too great.
Gary’s doctor referred him to the Royal Victorian Eye and Ear Hospital in the hope that Gary
might be considered for a groundbreaking study into a new treatment that didn’t use laser and
was being conducted by the Centre for Eye Research Australia (CERA).
Gary was selected to join the CERA study and started getting injections of a new drug into
the white of the eye, rather than laser directly onto the damaged blood vessels. After three
years in the study he is positive about his future prospects.
“My eyesight doesn’t bother me greatly as it is now but I thought I’d better go and get
something done about it before it did deteriorate and get beyond repair. The trial looks
promising.”
Gary now pays particular attention to his eyes and his vision. “I’m very mindful now. I’m
always tallying up how my sight’s going – whether it’s deteriorating or not; what I can see
and what I can’t see with each eye; how my reading’s going.
“I think anyone who drives for a living should have their eyes looked at regularly. It’s like a
maintenance program to help you stay on the road. You wouldn’t let a problem with your
truck get out of control – that just wastes time and money.
“Our eyes are our living and our safety. Getting your eyes tested to find out if you have a
problem before you have sight loss is just smart. It doesn’t cost anything and its going to save
you in the long run.”
For more information about what you can do to protect your vision or the vision of the
Facts about Diabetic Retinopathy
Anyone with diabetes is at risk of getting diabetic retinopathy. The risk increases if:
you’ve had diabetes for a long time;
your diabetes is poorly controlled;
you have kidney damage; or
you have high blood pressure or high blood cholesterol.
Early detection and starting treatment before your eyesight becomes too bad can prevent
significant damage to the eyes and vision. Laser treatment can prevent further sight loss but
cannot restore lost vision.
Talk to your doctor or optician about making regular eye checks part of your diabetes
management plan.
Case Study | Lilly Stafford, Artist | Diabetic Retinopathy-cataracts | Central Desert
The saving of gentle eyes
In the harsh sun-drenched Central Desert of Australia, Aboriginal artist Lilly Stafford sees
life in delicate shades. The colours of the spinifex, the richness of a tree’s bark and the depth
and change in the dusty earth, these are the colours of her life.
Her inspiration, she says, is all around her. From the veranda of her home in the small
community of Yuelamu at the edge of the Tanami Desert, she points to her colours; to the
experiences and the land of her family.
Through her eyes Lilly translates the beauty of her land into paint. Her work hangs in
galleries in South Australia and Victoria, and also in private collections throughout the
world. Yet in the past seven years this masterful artist has almost lost her sight twice, once to
diabetic retinopathy and then to cataracts.
Diabetes, or sugar sickness as it is known, is a big concern for the health of Indigenous
people’s eyes. Diabetic retinopathy is one of the leading preventable causes of blindness in
Indigenous Australians. A recent survey into Indigenous health found that in the past 30
years the rate of diabetes has soared – from less than half a per cent, to more than a third of
the population. Alarmingly, most Indigenous diabetics are not getting their eyes tested to
pick up signs of early retinopathy – early treatment can prevent 98 per cent of blindness.
Cataracts are also a leading cause of preventable blindness in Indigenous people. They cause
more than a third of blindness in adults, and are responsible for about one third of low vision.
Cataracts, which can be a normal part of ageing, cause the lens inside the eye to get cloudy
and the eyes can become sensitive to light. Colours appear faded or yellowed.
Lilly’s first scare with sight loss happened in 2003. She struggled to finish a painting as the
symptoms of sight loss caused by diabetic retinopathy started to show.
Lilly had two treatments of laser surgery to stop progress of the disease. Although some
damage would be permanent, the surgery saved most of her sight. She also started to look
after her diabetes.
Unfortunately, diabetes, and sometimes even laser treatment itself, can promote the growth
of cataracts. In Lilly’s case, a cataract in her right eye started to grow and by 2008 it had
almost completely obscured vision. Lilly needed surgery again.
This time, however, she would not be making the 600 kilometre round trip to Alice Springs
alone. A new program at the Alice Springs Hospital that started in 1997 was bringing
visiting surgeons and patients together for a week of intensive surgery. Most importantly,
Lilly was able to travel with others heading to the hospital. Once in Alice Springs the local
Fred Hollows Foundation, resident hospital staff and other community organisations worked
together to support Lilly, making her stay and the prospect of surgery less daunting.
Lilly’s cataract was removed and her sight restored. She returned home able to see clearly.
“It was blind that side,” Lilly said with a hand cupping her right eye. “After the operation it is
all good. I can see far. I can paint, do everything. I’ve been able to go hunting and get bush
tucker.”
The success of the surgery week, now locally known as the ‘Eye Blitz’, has seen the program
continue, and to date more than 450 people have had vision-saving surgery through the
initiative.
The innovative approach to delivering eye surgery has been made possible through a wide-
ranging health partnership that brings together the Fred Hollows Foundation, the Eye
Foundation, the Anyinginyi Health Aboriginal Corporation, the Central Australian
Aboriginal Congress and the Australian and Northern Territory Governments. It is part of
the Central Australian Integrated Eye Health Strategy.
But for Lilly, the quietly spoken great, great grandmother of the Central Desert, the biggest
success of the initiative is the chance it has given her to teach her family the skills and
passion of her art so they can continue in her footsteps. “I am teaching all the grand children
and great grand children everything. It’s good.”
Thanks to the work of eye surgeons, governments, health workers and community-based
agencies, Lilly is able to continue to create her artworks and to build the skills of future
generations of Indigenous artists.
The Australian Government is investing millions of dollars to address both the symptoms of
vision problems, and also the underlying causes of poor eye health in Indigenous
communities.
It is providing more than $58 million towards the early detection and treatment of eye and ear
health conditions, which includes funding for the intensive eye surgery weeks in Alice
Springs and an increase in funding for the Visiting Optometrists Scheme. It also includes
$16 million to boost services combating endemic trachoma in Indigenous communities.
The investment by the Australian Government is critical to supporting people like Tim
Henderson, who are working at the coalface of Indigenous eye health.
For more information about what you can do to protect your vision or the vision of the
Eye Health Case Study | Glaucoma | Robert Chong | Melbourne
A fighting spirit sees results
When Robert Chong was leaving his native Malaysia to come to Australia, his father wanted
to show him that respect, not aggression, was a better way for Robert to prove himself in his
new country. His father simply asked Robert to land a hard blow to his father’s chest. Robert
tried but found himself flat on his back at his father’s feet.
Standing over his prone son, Mr Chong senior offered Robert this advice; “When you get to
Australia you don’t get into any fights – fighting is not for you. It will only demean you.”
That was 48 years ago, and Robert remembers the lesson well. But while Robert has not
ignored his father’s advice, he is widely recognised as one of Melbourne’s great fighters
when it comes to building a better Australia for all people.
Nowadays Robert is also fighting a more personal fight, a battle against the threat of
blindness through glaucoma.
Five years ago during a regular eye check up with his optometrist, Shirley Loh, Robert was
diagnosed with glaucoma, a disease of the optic nerve related to the pressure in the eye. If
untreated it could lead to blindness.
Robert says the diagnosis shook him. “When I heard I had glaucoma the fear that it conjured
up was blindness. I am quite an active person. I thought if I go blind what would I do?”
But Robert is no stranger to taking on hard battles. He was elected to local government in
1997, was twice elected Mayor of the City of Whitehorse, and is still a serving Councillor.
But even before he was elected to Council, he had been instrumental in fighting for
community services in areas such as Home & Community Care, Aged Care and migrant
services. He has championed migrant groups to get government support for culturally
sensitive facilities and services. His tireless community involvement earned him an Order of
Australia award in 1991.
Robert’s treatment for glaucoma started with a course of special eye-drops, a common and
usually effective way to reduce pressure in the eyes. But after a year or so the pressure had
not stabilised and Robert was given the option of laser surgery to open small holes near
where fluid is supposed to leave the eye. This makes it easier for the eye to release pressure
naturally.
“When my specialist mentioned laser treatment I thought it might be painful or put me out of
action for weeks. It worried me. But it was nothing really. You get some eye drops to numb
the eye then it is just click, click, click. It was all over in 10 or 15 minutes and there was no
pain involved. I was quite happy because I was quite apprehensive when he mentioned laser
treatment.
“The treatment got my eye pressure down. It could go down further but as a treatment it was
quite successful.”
Optometrist Shirley Loh said because Robert was diagnosed early and started treatment, he
has minimised his sight loss. But he will need to continue using the eye drops to help reduce
the pressure and get regular eye checks to monitor any change to his eyes.
“Treatment for glaucoma cannot restore sight that is lost but it can usually prevent or slow
progress of the disease and further sight loss,” Ms Loh said.
Robert agrees. “I was lucky. I got tested and found the problem early. Everyone should get
their eyes checked to make sure they are in good condition. If you have a local optician he or
she will be able to tell you if you have signs of glaucoma.”
The ever-optimistic Robert is confident that he will win his fight against glaucoma.
“I have faced many challenges in my life, but if you believe in something and you put your
efforts toward making a difference, you can overcome the barriers.”
One of Robert’s early successes for his community is the Waverly Chinese Senior Citizens
Club, which he started in 1989. The club has grown to more than 1,650 active Chinese and
non-Chinese members who get together through the week for Tai Chi classes, music days
and social outings.
“This club is not just for Chinese people. It is about sharing this wonderful culture with
others so that we can all see that our country is a place of many cultures, of many people who
have come together as Australians.
“We are growing as a nation. Learning to respect and enjoy differences. Back in 1989,
council was working with older people but it was all focused on English speaking residents.
No one spoke Chinese. Because of this the older Chinese people could not enjoy the services
that were available because they couldn’t understand what was going on.
“I thought a new club for older Chinese would help them feel more comfortable and also
open doors for others to see how older Chinese people keep active. Today it is a place of
great harmony.”
For more information about what you can do to protect your vision or the vision of the
Facts about Glaucoma
Glaucoma is the leading cause of irreversible blindness worldwide. It affects people of
all ages, but is more common in people as they get older.
More than 300,000 Australians have glaucoma.
Although there is no cure for glaucoma it can usually be controlled and further loss of
sight either prevented or at least slowed down.
Your optometrist can test for glaucoma and provide advice or referrals to help you fight
the disease.
Case Study Diabetic Retinopathy - Sarah Mawer
Through a mother’s eyes
For Sarah Mawer, the joy and anticipation of being pregnant for the first time was short-
lived.
By the end of her first trimester, 28-year-old Sarah was living with the real fear that she
might never see her unborn child. Sarah, an insulin dependant diabetic, had suddenly started
going blind.
Sarah’s eyes had succumbed to complications associated with her diabetes. Overnight her
eyesight deteriorated rapidly. She woke with blurry vision, unable to read or drive.
Sarah was diagnosed with diabetic retinopathy, a condition where blood vessels at the back
of the eyes start to swell and eventually leak fluid. The disease was slowly eroding her sight.
And unfortunately for Sarah, by the time the symptoms of vision loss were obvious, the
disease was well advanced.
“My greatest fear was not being able to see Arnya when she was born. It was really scary for
me to think I was going to have this beautiful little baby and not be able to see her or watch
her grow up. It was a cause of anxiety. I was a mess, an absolute mess,” Sarah said.
“I remember my mum saying at around 20 weeks into the pregnancy that I should be glowing
but I just couldn’t. I was too worried – too scared.”
In week 12 of her pregnancy, Sarah started weekly laser treatments at Melbourne’s Royal
Victorian Eye and Ear Hospital – hundreds of individual bursts of laser beam targeting
damaged blood vessels to stop the leakage. Sarah’s eyesight was already permanently
damaged. Her fight now centred on preventing further loss.
By week 28, Sarah’s eyes were getting worse. Her ophthalmologist suggested a more
aggressive treatment – steroid injections directly into the back of her eyes to reduce the
swelling.
Between the steroid injections and the weekly laser treatments that continued throughout her
pregnancy, Sarah was able to save almost all of her vision. And at 33 weeks Sarah laid eyes
on baby Arnya.
“She was so little. They wrapped her up and brought her to me. I felt like all my vision
problems went away – I could see her nose, her hair – it was a huge burden lifted – I was
over the moon,” Sarah said.
Diabetic retinopathy is one of the leading causes of blindness in adults aged 20-60 years in
Australia, and is a real risk for anyone with diabetes, including gestational diabetes during
pregnancy.
But according to Dr Alex Harper, Ophthalmologist at Melbourne’s Royal Victorian Eye and
Ear Hospital, significant blindness is preventable if people manage their glycaemia, blood
pressure and cholesterol levels and get their eyes checked regularly for signs of retinopathy.
“If you’ve got diabetes you need to make regular eye checks a part of your diabetes
management plan. If we can pick up signs early we can act to minimise or stop sight loss,”
Dr Harper said. “We cannot bring back sight that is lost, so the earlier we can detect and
treat the condition the more sight we can save.
“Diabetes cannot be left unchecked or unmanaged. It is a condition that requires people to
take control of what they eat and their physical wellbeing.”
Sarah says her case highlights the need for people to take control of their diabetes and to get
regular eye checks to pick up signs of retinopathy early.
Although she started strictly managing blood levels and diet when she discovered she was
pregnant (at around six weeks), she says that she had not been vigilant in the past.
“I stopped properly managing my diabetes when I was a teenager. I suppose it was that
young adult mentality where I had other things to do. I was young and thought I was
invincible. I thought I could go out every week and party like everybody else.
“This whole experience with my eyes on top of the pregnancy just made life horrible. It was
truly horrible. What was worse is that I know that if I had looked after myself maybe it
wouldn’t have happened.”
Sarah said the experience refocused her resolve to stay on top of her diabetes. By the time
she fell pregnant with her second child, now-six-month-old Lila, Sarah had her diabetes well
under control.
“I did my HbA1C – this is a test that measures the amount of glycosylated hemoglobin in
your blood. It helps you look at how well your diabetes is being managed over time. I am
eating better, exercising more and generally taking better care of myself. I had my diabetes
under control when I had Lila.”
Sarah says she will be forever grateful to the people at the Eye and Ear Hospital for saving
her sight and allowing her to watch her children grow up.
For more information about what you can do to protect your vision or the vision of the
Facts about Diabetic Retinopathy
Anyone with diabetes is at risk of getting diabetic retinopathy. The risk increases if:
you’ve had diabetes for a long time;
your diabetes is poorly controlled;
you have kidney damage; or
you have high blood pressure or high blood cholesterol.
Early detection and treatment before eyesight deteriorates can prevent significant damage to
the eyes and vision. Laser treatment can prevent further sight loss but cannot restore lost
vision.
Talk to your doctor or optician about making regular eye checks part of your Diabetes
management plan.
Eye Health Case Study | Terry Raggett | Mt Liebig, Central Desert
The stockman; his eyes and a dream of sharing
When Terry Raggett talks about his years as a stockman pushing cattle across the rugged
country of the Central Desert, a smile spreads across his weathered face. His love of his
country and of a drover’s life is obvious.
While the 70-year-old retired stockman no longer rides, he keeps horses at his property near
the Central Desert community of Mt Liebig. His dream is to share his lifetime of knowledge
and experiences with his young grandchildren – to teach them the stockman’s ways.
That dream was all but dashed for Terry by what he calls sugar sickness in his eyes and
cloudy eye. Diabetic retinopathy and cataracts were destroying his vision. A cataract in his
right eye was so dense that Terry could not see out of the eye. More alarmingly, doctors
could not see through the foggy lens to pinpoint laser surgery to treat Terry’s diabetic
retinopathy.
Without proper care Terry faced serious sight loss through diabetic retinopathy, one of the
world’s leading causes of vision loss in people aged 20 to 65 years. It causes damage to the
small blood vessels in the retina at the back of the eye. Once the retina is damaged, lost sight
cannot be restored.
Fortunately for Terry, and for hundreds of others in remote communities across the Northern
Territory, help was not too far away. Alice Springs Hospital’s head of eye surgery, Dr Tim
Henderson, is a regular feature in the skies above the vast territory. For the past 10 years he
has been flying into remote communities to bring eye health care to where it is needed most.
Terry met Dr Henderson a couple of years ago when the eye surgeon made one of his regular
fly-in house calls to the Mt Liebig community. Terry and Tim talked about Terry’s options
and agreed to surgery to remove the cataract in his right eye. Removing the cataract opened
the window to allow Dr Henderson to also start laser treatment to stop sight loss caused by
the diabetic retinopathy.
Thanks to the surgeries, Terry’s eyesight has stabilised. And although he knows he has a
cataract developing in his left eye, he also knows that he has time to get it fixed before the
problem gets out of hand.
“It’s good now,” says Terry touching his eyes. “I’m too old to ride now but I can show my
grandkids – teach them to ride, teach them to hunt.”
Terry is one of hundreds of people who are getting sight-saving treatments thanks to the
combined work of government and non-government agencies.
While Dr Henderson performs many of the delicate laser surgery procedures during his
community visits, more complex operations, such as the removal of cataracts, are often done
through intensive eye surgery weeks or “Eye Blitzes” as there are known locally. This
surgery is done at Alice Springs Hospital. Up to three times a year, large groups of people
from communities across the territory come to Alice Springs for a week of specialist surgery
and care, particularly for the removal of cataracts and to fix eyes damaged by trachoma.
Unlike other services where patients go to a major hospital for surgery, the eye surgery week
makes the trip less daunting by arranging family and community support for patients.
The surgery week is a health partnership that brings together the Fred Hollows Foundation,
the Eye Foundation, the Anyinginyi Health Aboriginal Corporation, the Central Australian
Aboriginal Congress and the Australian and Northern Territory Governments. It is part of the
Central Australian Integrated Eye Health Strategy.
This wide-reaching health partnership is delivering a first-class eye health service to the
people of central Australia.
The Australian Government is investing millions of dollars to address both the symptoms of
vision problems, and also the underlying social and environmental factors that contribute to
poor eye health in Indigenous communities.
It is providing more than $58 million towards the early detection and treatment of eye and ear
health conditions, which includes funding for the intensive eye surgery weeks in Alice
Springs and an increase in funding for the Visiting Optometrists Scheme. It also includes
$16 million to boost services combating endemic trachoma in Indigenous communities.
The investment by the Australian Government is critical to supporting people like Tim
Henderson, who are working at the coalface of Indigenous eye health.
For more information about what you can do to protect your vision or the vision of the
Eye Health Case Study | Tim Henderson | Eye health in Central Australia
Flying eye - taking to the skies
Tim Henderson has seen more of Australia’s outback than most. Every Monday he takes to
the skies above Central Australia – flying to some of the most remote communities in the
world.
But Tim is not a sightseer – he’s a sight saver. For the past 10 years the Alice Springs eye
surgeon has been working at the coalface of Indigenous eye health, taking his sight saving
screening and laser surgery to communities so remote that they are beyond the reach of
traditional eye health services. His practice spans more than 1.6 million square kilometres.
The recently released National Indigenous Eye Health Survey underlines the need for Dr
Henderson’s work. The rate of blindness in Indigenous adults is more than six times higher
than non-Indigenous Australians. The major causes of blindness are cataract, refractive
error, diabetic eye disease, optic atrophy and trachoma.
Diabetes is a big concern for the health of Indigenous people’s eyes. Diabetic retinopathy is
one of the leading preventable causes of blindness in Indigenous Australians. The survey
found that in the past 30 years the rate of diabetes has soared – from less than half a per cent,
to more than a third of the population.
Cataracts are also a leading cause of preventable blindness in Indigenous people. They cause
more than a third of blindness in adults, and are responsible for about one third of low vision.
Dr Henderson says most of the sight-destroying conditions can be treated or sight loss
stopped if treatment starts early enough. With early detection and treatment of diabetic eye
disease, 98 per cent of diabetic patients will keep good vision and avoid blindness. But more
than a third of Indigenous adults have never had their eyes examined. Instead they are living
with the time bomb of blindness.
“What we are doing is very unlike most outreach services anywhere else in the world,” says
Tim. “Usually an outreach service identifies problems and sends the patient back to be dealt
with centrally.
“Here, because we’ve got lots of small discrete communities logistically a long way away, it
is actually much more cost effective, once we’ve identified several patients in a community,
to go out there and do what we can.
“You have to accept that a lot of community patients don’t want to come into town (Alice
Springs) at all. It’s too far, too crowded, too foreign. By going to where they live, we are
able to target these people and also provide opportunistic care when we have someone in
front of us with a problem that needs dealing with.”
Tim says his job is made easier by the Australian Government’s Visiting Optometrists
Scheme, which funds regular visits by optometrists to remote communities, and also by the
local community health workers who get people along to see the eye doctor when he flies in.
“What we try and do is have the visiting optometrists go out a couple of weeks or even
months before we’re due to come out – their screening and testing identifies the people we
really need to see.
“We also make a summary list drawn up from some of the previous visits and work out
which patients we need to see and target those who particularly need specialist care and
attention.
“That may mean laser treatment for some people, particularly those with diabetic eye
problems, or it might be reviews of patients who have had surgery before – just to make sure
things are going well, or preparing patients still needing surgery.
“But by coming to the community we are able to promote eye health more generally and
support local community nurses who are working to promote better health. They’ll often
bring in people they want us to take a closer look at or to have a talk to about treatments for
particular conditions. Teamwork is crucial to coping with the many challenges and when we
all work together it makes it all worthwhile.”
Tim, who is also in charge of eye services at Alice Springs Hospital, believes the focus on
Indigenous eye health by governments, and by organisations such as the Fred Hollows
Foundation; the Eye Foundation; the Central Australian Aboriginal Congress; and the
Anyinginyi Health Aboriginal Corporation, is delivering innovative solutions to delivering
eye health in the rugged outback.
One such initiative is the intensive eye surgery week or “Eye Blitz” as it is known locally.
This is run out of Alice Springs Hospital. Up to three times a year big groups of people from
communities across the territory come to Alice Springs for a week of specialist surgery,
particularly for the removal of cataracts and to repair eyes damaged by trachoma.
Unlike other services where patients attend a major hospital for surgery, the eye surgery
week makes the trip less daunting by arranging family and community support for patients.
It is a week that Tim loves. He gets to focus solely on his great passion – performing intricate
sight-saving eye surgery. To date, more than 450 people have had sight-saving surgery
through the initiative.
“We’ve seen hundreds of people through the surgery weeks. Many are people I’ve met in the
community who need more complicated surgery. Our goal is to do at least 10 operations a
day.
“The difference this surgery can make to people’s lives is beyond measure. When you
remove a cataract – clouding of the lens in the eye – you are sometimes able to restore sight
to what it was when they were young. It is often the first time they have been able to see
clearly in years. It is a moment when people get their lives back.”
The Australian Government is investing millions of dollars to address both the symptoms of
vision problems, and also the underlying social and environmental factors that contribute to
poor eye health in Indigenous communities.
It is providing more than $58 million towards the early detection and treatment of eye and ear
health conditions, which includes funding for the intensive eye surgery weeks in Alice
Springs and an increase in funding for the Visiting Optometrists Scheme. It also includes
$16 million to boost services combating endemic trachoma in Indigenous communities.
The investment by the Australian Government is critical to supporting people like Tim
Henderson, who are working at the coalface of Indigenous eye health.
For more information about what you can do to protect your vision or the vision of the
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