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If you have a passion for advancing and promoting culturally safe healthcare among Indigenous communities, optometry might be your ideal profession.
Prior to settler colonialism, Indigenous Australians had arguably better vision than non-Indigenous people. Research suggests Indigenous Australians now experience a higher burden of disease in almost every facet of life and, in particular, poorer eye health in adulthood. Through a variety of programs and services, optometrists are working in partnership with Indigenous communities to close the gap in Indigenous eye health.
‘We’re working collaboratively with our Indigenous health team and community to provide education, research and services that are evidence-based, culturally safe and accessible,’ says optometrist Professor James Armitage from Deakin University’s Faculty of Health.
‘It’s about providing services that the community feels are culturally safe and relevant to its needs, and an educational framework so people are able to make informed choices to improve their own eye health.’
Here’s how becoming an optometrist can support you in making a difference to the lives of Indigenous Australians.
According to a 2018 report by the Australian Institute of Health and Welfare, Indigenous Australians are affected by vision loss at almost three times the rate of non-Indigenous Australians. Indigenous people are less likely to have an eye examination and much more likely to be hospitalised for eye injuries.
For cataract surgery – the most common elective surgical procedure in Australia – the median waiting time for Indigenous people is 141 days, compared to 89 days for non-Indigenous people. Less than 60% of Indigenous people with cataracts had cataract surgery, while about 90% of non-Indigenous people with cataracts underwent the procedure.
Typically, and as evidence suggests, ‘Indigenous Australians’ experience of and with the healthcare system is inherently complex and perpetuated across the lifespan by physical proximity to services, affordability and, in particular, cultural barriers,’ says Joleen Ryan, a lecturer in Indigenous health at Deakin University.
‘It should be acknowledged that more than half of the Australian Indigenous population live in metropolitan areas; however, Indigenous Australians still find it difficult to access services that are Indigenous specific and, for many, that provide comprehensive primary healthcare specific to their needs.’
The good news is optometrists – who are trained to treat a range of eye conditions and prescribe glasses and contact lenses – are working to improve the eye health of Indigenous Australians. Between 2007-08 and 2017-18, the number of Indigenous Australians who underwent a professional eye care exam increased from 13% to 16%.
'We’re working collaboratively with our Indigenous health team and community to provide education, research and services that are evidence-based, culturally safe and accessible.'
Professor James Armitage,
Faculty of Health, Deakin University
Outreach programs like the Rural Health Outreach Fund (RHOF) support specialists to provide services in regional and remote areas. The Visiting Optometrists Scheme works to improve the eye health of people in these areas by increasing access to eye health services.
‘In 2017-18, around 30,000 people were seen through the Visiting Optometrists Scheme,’ Professor Armitage says. ‘There are also a number of other screening and mobile facilities.
‘We aim to build culturally respectful relationships with Indigenous communities to improve health literacy education around good eye health and help clients to feel comfortable accessing the services that are available.
‘In summary, it’s about community education, which starts with community engagement. Rather than making patients “fit” into the healthcare system, good care is about making sure the healthcare system is fit for purpose to suit the needs of the Indigenous communities it services.’
Professor Armitage says it’s not surprising optometrists are making such a difference in Indigenous communities given the breadth of the profession. ‘Optometry is a really dynamic career,’ he says. ‘The job is very much around managing eye health and maximising eye health. It’s about preventative and interventional care.
‘Optometrists will initiate a range of therapies where appropriate. These might be physical therapies like binocular vision training or glasses or contact lenses, or prescribing certain therapeutic drugs.
‘We know Indigenous people have poorer eye health than non-Indigenous people and it’s immensely rewarding to be able to work with a diverse range of dedicated groups to help improve access to eye care for Indigenous Australians.
Sold on this career path – and life as a rural practitioner – and keen to become an optometrist? You’ll need a Bachelor or Masters degree in optometry from one of six accredited universities in Australia, including Deakin, which will allow you to apply for registration with the Australian Health Practitioner Regulation Agency (AHPRA) and the Optometry Board of Australia.
Professor Armitage says the profession is particularly appealing to people with an interest in preventative care and helping people across the lifespan.
‘If the retail side of optometry doesn’t appeal, you can develop your practising patterns so this is a minor part of your clinical day,’ he says. ‘There are also opportunities to work in other areas like policy development.’
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