Soo Ng1, Shyalle Kahawita1, Nicholas Andrew1, Tim Henderson2, Jamie Craig1, John Landers1

Purpose: The association of visual impairment with increased mortality rate has not yet been reported among indigenous Australians. In this prospective cohort study, we assessed the association between visual impairment and 10-year mortality risk among the remote indigenous Australian population.

Methods: 1,347 patients were recruited from a total target population number of 2,014 in remote communities of central Australia. Visual acuity, slit-lamp biomicroscopy and fundus examination were performed on all patients at recruitment. Visual impairment was defined as a visual acuity of less than 6/12 in the better eye. Mortality rate and mortality cause were obtained at 10 years and statistical analyses were performed.

Results: The total all-cause mortality was found to be 29.3% at 10 years. This varied from 21.1% among those without visual impairment to 48.5% among those with visual impairment. After adjustment for age, sex and the presence of diabetes and hypertension, those with visual impairment were 29% more likely to die (HR=1.29; P=0.009) during the 10-year follow-up period compared with those with normal vision.

Conclusion: Bilateral visual impairment among remote indigenous Australians is associated with 29% higher 10-year mortality risk compared with those who are not visually impaired. Resource allocation towards maximizing visual acuity may therefore aid in closing the gap in mortality outcomes between indigenous and non-indigenous Australians.