Enhancing access to eye care accessibility in the Goldfields region of Western Australia

Access to ophthalmic care in the remote Goldfields region in Western Australia is constrained by distance and limited specialist provision. Lions Outback Vision (LOV) has been providing ophthalmology services in the Goldfields region from 2017 to 2023. We aimed to audit the LOV service provision from 2017 to 2023 by evaluating the type and number of ophthalmology services provided, changes in cataract surgery rate over time, engagement by Aboriginal and Torres Strait Islander patients, and specialist workforce provision.

A retrospective, observational audit was conducted by examining de-identified records extracted from LOV's electronic records system. Chi-squared tests were used for bivariable analysis. Cataract surgery rate and full-time equivalent ophthalmology national comparisons were calculated using recent population census data.

There was an increase in total occasions of service, number of cataract surgeries and intravitreal injections (a greater than sixfold increase in occasions of service and a 16-fold increase in intravitreal injections between 2017 and 2023). The cataract surgery rate was lower than the Australian national rate across all years. The number of services provided to Aboriginal and Torres Strait Islander people increased. The full-time equivalent rate of consultant ophthalmologists increased in the region over the 7-year period.

Ophthalmology services in the region have expanded annually but remain well below the national average in workforce specialist provision. Full-time equivalent rate in the region peaked in 2023 but remains 11 times lower than the national average. This audit provides a compelling case for the establishment of a permanent and sustainable ophthalmology service in the area.