Seeing big picture of eye disease

Health Sciences

Diabetes is emerging as a major health problem in Aboriginal communities, with related eye diseases causing blindness in remote indigenous populations, according to a new study involving the University of Adelaide.

The study, conducted over a five-year period between 1999 and 2004, reveals that diabetic retinopathy (diabetic disease of the retina) is endemic in many Aboriginal communities, up to four times higher than the general population.

Researchers in Ophthalmology and Visual Sciences, part of the School of Medicine at the University of Adelaide, and the South Australian Institute of Ophthalmology screened 1651 Aboriginal patients from 22 communities in remote South Australia. Support and ethics approval for the research was obtained from the Aboriginal Health Council of South Australia.

The researchers found that almost 47% had adult-onset diabetes mellitus (a condition where the body cannot maintain normal blood glucose levels), with the disease twice as prevalent in women than men. Within this group, 22% had eye-related diseases.

Dr Shane Durkin and Professor Dinesh Selva said the world faced a global epidemic of diabetes mellitus, with 5% of people in developed countries now suffering from the disease. In Australia the figure is 6% - and two to four times higher among Aborigines.

On a more positive note, the study found that the prevalence of blinding trachoma (chronic eye infection caused by bacteria) has declined in Aboriginal communities over the past 25 years.

While still prevalent in Central Australia, trachoma appears to be less common in the southern areas compared with the north.

"This decrease may be related to improvements in living standards, community awareness of risk factors and increased access to antibiotics," Professor Selva said.

The findings were recently published in a paper in the official journal of the Royal Australian and New Zealand College of Ophthalmologists, Clinical and Experimental Ophthalmology.

The public health research division of the South Australian Institute of Ophthalmology has also recently completed an extensive blindness study in rural Myanmar (formerly Burma) in South-East Asia.

The 3000-person population-based study has resulted in an improved eye health support program (Vision Myanmar) to help train local ophthalmologists, updating their skills and knowledge on a regular basis.

The Institute is currently conducting similar population-based studies to assess the causes and prevalence of blindness in central Sri Lanka and the city of Sao Paolo in Brazil.

In addition, the Institute has recently established the Ophthalmic Research Laboratories (ORL) in the Hanson Institute under the direction of Associate Professor Robert Casson. The ORL is conducting world-class research into the pathophysiology and treatment of glaucoma and age-related macular degeneration, two of the leading causes of blindness in the developed world.

Professor Selva is the Foundation Professor of Ophthalmology and Visual Sciences at the University of Adelaide and Chairman of the South Australian Institute of Ophthalmology.

Story by Candy Gibson

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