The Observatory

Australia needs nationally consistent subsidised spectacle schemes

Spectacles or glasses, as they are more commonly known, are the easiest cost effective solution to fix uncorrected refractive error, enabling hundreds of thousands of Australians to see clearly. For many Australians, particularly in remote and regional areas, spectacles can be costly and difficult to access. In Australia, subsidised schemes exist however; they are not uniform across the country. 
Laget from Timber Creek (pictured below) has glaucoma and is short-sighted. Vision 2020 Australia met Laget when he was visiting an outreach optometry clinic facilitated by the Brien Holden Vision Institute. The clinic is three and a half hours south-west of Katherine, in the Northern Territory. Laget was visiting the clinic to get a new pair of glasses, after his grandchildren accidentally broke the last pair. He was also hoping to pick up a prescription for some more eye drops to help manage the pressure in his eyes caused by glaucoma.
Laget from Timber Creek tries on his new glasses  
The visiting optometrist ran through a comprehensive eye examination with Laget, ultimately determining that his short-distance vision was okay but that he needed glasses for both reading and long-distance. Laget was able to obtain his new glasses through the Northern Territory’s subsidised spectacle scheme, paying only a fixed cost either over a period of time or upfront. Laget was determined to pay upfront and leave with glasses that day – he didn’t want to wait at all!
Laget’s experience is not uncommon. In October, Vision 2020 Australia and the Centre for Eye Research Australia launched the National Eye Health Survey (NEHS), the first comprehensive national survey of the prevalence of vision loss in both Indigenous and non-Indigenous Australians. While the NEHS found that there are signs of progress in reducing the prevalence of major eye conditions, the data showed that the prevalence of vision impairment and blindness among Indigenous Australians is three times that of non-Indigenous Australians. What’s more, almost two thirds of this vision impairment is caused by uncorrected refractive error which could be corrected immediately with the right pair of glasses. 
Schemes which enable access to a pair of subsidised spectacles are operational in all Australian states and territories, although variations across the country mean that they offer different approaches to eligibility, entitlement, product range, cost and payment systems options. There are also different levels of impact in overcoming access barriers for Aboriginal and Torres Strait Islander people, particularly those living in rural and remote areas. This can, in itself, create a barrier to participating in some schemes through confusion amongst patients, optometrists, ophthalmologists and optical dispensers about what subsidised support may be available. It also means access to affordable spectacles is not currently equitable across all regions of Australia.  
Developed in consultation with and endorsed by the National Aboriginal Community Controlled Health Organisation (NACCHO) and its state affiliate organisations, the Principles for nationally consistent subsidised spectacle schemes for Aboriginal and Torres Strait Islander people: Recommended implementation standards detail the key elements of subsidised spectacle schemes to meet the needs of Aboriginal and Torres Strait Islander people regardless of their location. 
Further, the implementation of nationally consistent subsidised spectacle schemes that provide low-cost, quality-assured, cost-certain, product-certain spectacles to Aboriginal and Torres Strait Islander people is also a key recommendation of The Roadmap to Close the Gap for Vision (The Roadmap).
To address this issue, the Vision 2020 Australia Aboriginal and Torres Strait Islander Committee has developed a position statement calling for all schemes to be aligned with a set of nationally consistent principles and recommended standards for the provision of subsidised spectacles for Aboriginal and Torres Strait Islander people. The position statement supports the efforts of the Roadmap and Optometry Australia Aboriginal and Torres Strait Islander Eye Health Working Group in advocacy to the Australian and jurisdictional governments. 
Ultimately, a nationally consistent approach to providing subsidised spectacles to Aboriginal and Torres Strait Islander people would ensure equitable access across the country – making a dramatic and positive impact in eye health and vision care outcomes for Aboriginal and Torres Strait Islander people everywhere and ultimately, moving towards closing the gap in eye health and vision care in Australia.