Vision Impact Fund
Where Ideas Meet Impact.
- Complete the expression of interest form below.
- We review all submissions.
- Applications close at 5pm AWST, March 13.
- Select EOIs will receive an invitation to proceed with a full application.
- Invitations announced on March 26.
- Upon invitation, you'll be able to submit your detailed proposal via email.
- Full applications close on April 23.
- Successful projects will be announced in mid-May, ready to make a tangible impact.
Expression of Interest Form
Supporting impactful projects that align with our priority areas.
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About the Vision Impact Fund (VIF)
Advancing Eye Health
The Vision Impact Fund (VIF), an initiative by the Perth Eye Foundation, seeks to address the salient challenges in the eye health sector. Our goal is to provide substantial support to organisations and individuals dedicated to improving eye health outcomes.
Prioritising Real Needs
Our commitment to eye health is rooted in the insights from our Vision Health Report. This research provides a comprehensive overview of the vision health sector, examining demographic trends, prevalent eye conditions, and the current state of research and funding mechanisms. Through this analysis, we've identified a series of key priority areas that we believe need our collective attention. The Vision Impact Fund is our direct response to these findings, ensuring our funding is directed to the genuine needs of the sector.
Our Priority Areas
- The prevalence of eye conditions increases with age. Ninety-three (93) % of people >65 years are affected by an eye condition in comparison to 12% of children aged 0-14 years (NHS).
- The Australian population is ageing due to low fertility and increasing life expectancy. The median age of the Australicrease by 128% between 2007 to 2036 with the proportion provided to patients aged over 85 tripling.
- Given Australia’s aging population, the burden of eye disease is likely to increase in the future.
- The prevalence of cataract increases with age. An Ontario, Canada study with a similar aging population to Australia projected the number of cataract operations to increase by 128% between 2007 to 2036 with the proportion provided to patients aged over 85 tripling.
- Cataract was the leading cause of blindness (40%) in Indigenous participants of the NEHS. Blinding cataract is 12 times more common among Aboriginal and Torres Strait Islander adults than in non-Indigenous Australians.
- Cataracts are reversible; therefore, this is a potentially addressable burden of blindness.
- Cataract wait lists are increasing, suggesting the system is at capacity.
- Over 50% of all eye conditions diagnosed in the NEHS were new diagnoses suggesting a significant burden of undiagnosed eye conditions in the community.
- The rate of undiagnosed eye conditions in the NEHS was 5.58% of all Indigenous participants and 3.03% of all non-Indigenous participants. In addition, three of the top 4 causes of blindness, AMD (54.6%), glaucoma (8.1%) and DR (5.4%) in WA, have better outcomes for patients when identified early.
- This suggests the need for increased regular eye examinations.
- WA has the second highest rate of hospitalisations for Indigenous people with eye injuries (1.8 per 1000 population). The rates are highest in remote and very remote areas.
- The Kimberley has the highest rate (3.2 per 1000 population) and Perth has the lowest rate (0.6 per 1000 population).
- The overall prevalence of active trachoma in WA in children aged 5-9 years was 6.4% in 2019. These figures have increased since 2017, when the prevalence was 4.1%.
- The highest prevalence was 12.3% in the Goldfields. In the 2019 NTSRU, 551 children were examined in 36 of the 38 communities at risk; 66% of them had clean face.
- Twenty-four percent of families of children registered on the Australian Childhood Vision Impairment Register reported they received no low-vision support from a non-government agency.
- The Raine Study reports that WA has one of the highest prevalence of keratoconus in the world (1.2%, 95% CI 0.7% ─ 1.9%).
- There is currently no state-wide public funding for hard contact lenses, one of the treatment options for this condition. This is a major gap, as it can leave patients significantly out of pocket.
- There is a growing incidence of early onset type 2 diabetes in Western Australian Children that disproportionately affects Aboriginal and Torres Strait Islander children.
- Early onset T2DM patients are at risk of developing premature retinopathy
- The proportion of female ophthalmologists in Western Australia has steadily risen from 15% in 2016 to 20% in 2021.
- This is below the national average of 24% female ophthalmologists in 2020, according to the AIHW NHWD.
- In 2020, 76% of the workforce was locally trained, 4% trained in New Zealand, and 20% trained overseas. These proportions have remained relatively stable since 2016 where 74% of the workforce was locally trained.
- There does not appear to be recognition or support of this workforce in line with their importance.
- There are no current or past Aboriginal and/or Torres Strait Islander ophthalmologists in Western Australia.
- There is currently one nationally.
- 4-5% of the optometry workforce remains dormant at any given time.
- This represents a significant and valuable workforce that can be activated to contribute towards other existing WA eye health issues.
- There is limited publicly available data on the size and demographics of the ophthalmic nursing workforce.
- Ophthalmic nurses play an important role in eye health care and there is little insight into the structure and mechanics of the workforce.
- There is substantial growth in the AHW workforce driven by young people and females. This represents an opportunity to promote ophthalmology as a viable area of interest and increase the ophthalmic AHW capacity.
- As primary care physicians, GPs are often the first point of contact with the health system for a patient with an eye disorder.
- 1.9% of GP consultations in Australia are related to an eye disorder equating to approximately 315,239 services in WA in 2020.
- Ophthalmic anti-infectives are amongst the most common medications prescribed, accounting for 0.8% of all prescriptions.
- The epidemiology of eye diseases and standard of care is unknown for this patient cohort.
- It is important that GPs are resourced appropriately, clinically supported, and have adequate training to ensure patient safety and high standards of care for this large patient volume.
- GP’s are an integral component of the eye health care workforce and commonly refer to ophthalmologists.
- Referrals account for 6.5% of all specialist referrals, which is disproportionately higher than the proportion of the specialist workforce (1%) represented by ophthalmology. There were an estimated 99,549 referrals to ophthalmology from GPs in 2020.
- GPs are not often recognised as part of the eye health care workforce as is evident by their absence in key government and non-government reports.
- Emergency departments are overwhelmed.
- In Australia, 65.5% of eye presentations were classified as semi-urgent or and non-urgent urgent and 92% of eye conditions were not admitted in 2019.
- In 2019, 65% of eye presentations to a WA emergency department were classified as semi-urgent or non-urgent. This may represent cases, which could be redistributed to other primary health care avenues and reduce this burden.
- The relatively modest size of this issue should be recognised; in 2019, 65.5% of low acuity eye presentations representing approximately 7166 cases or 0.8% of the 929,507 total presentations to the WA emergency departments.
- 50–77% of non-Indigenous Australians and 20–44% of Indigenous Australians receive appropriate retinal screening.
- The proportion of people screened decreases with increasing remoteness of locations.
- In 2016, MBS item numbers 12325 and 12326 were introduced to support diabetic retinopathy retinal fundus photography screening in primary care.
- Between the financial years 2016 ─ 2021, the cumulative use of item numbers 12325 and 12326 nationally was 10,598. WA had the third highest total utilization and second highest per capita utilization.
- The cumulative 10,598 screening episodes over 5 years fell significantly short of the projected 400,000.
- A number of studies have assessed potential factors, which may have contributed to this significant underutilisation. These include costs of retinal cameras, time constraints, the need for dedicated staff to take the responsibility for DR screening, lack of skills to make a DR diagnosis, lack of awareness of Medicare incentives for non-mydriatic retinal photography, optometrists being perceived as ideal for DR screening, and limited referral pathways.
- The National Health Workforce Dataset is created through a survey, which is completed by AHPRA-accredited health practitioners during annual registration.
- The survey contains questions, which assess the characteristics of the workforce and aim to predict trends such as vocation, retirement, and geographical location of work intentions.
- These data inform a number of key reports such as the Eye Health Workforce In Australia report that informs the government and peak-body policy decisions around training and workforce distribution strategy.
- Data is self-reported and missing some granularity in the geographical distribution of the workforce. For example data is postcode-based and does not capture the often multiple places of work for one clinician.
- Greater detail may lead to better policy making.
- In 2018-19, age-standardised rates of cataract surgeries for Indigenous Australians (8,519 per 1,000,000) remained lower than those of non-Indigenous Australians (9,102 per 1,000,000).
- Cataract surgery coverage rates across Australia are significantly lower in Indigenous (61.47%) Australians compared to non-Indigenous (87.63%) Australians (p<0.001).12
- This suggests an ongoing gap in access to eye health care
- Results from the AIHW data indicated that across Australia, around 6,100 Indigenous Australians (around 3,655 per 1,000,000) had cataract surgery between 2017 and 2019 with the rate being highest in remote and very remote areas and lowest in major cities.
- In WA, between 2017 and 2019 the met need for cataract surgery was estimated to be 76% in NG Lands, 57% in the Wheatbelt, 53% in the Kimberley region, 49% in the Goldfields, 44% in the Great Sothern region and the Pilbara, 35% in the Mid-West, 29% in Perth, and 25% in the South-West.
- Indigenous Australians are more reliant on public hospitals for cataract surgery with approximately 80% of cataract surgeries for Aboriginal and Torres Strait Islander people and 29% for non-Indigenous people are performed in public hospitals.
- A recent report prepared for Vision2020 concluded that as Indigenous Australians have higher rates of cataracts and predominantly have surgery in public hospitals, they are disproportionately affected by the long wait times, which may be a contributing factor to lower surgery rates and coverage.
- The RANZCO InReach Ophthalmology network offers a pathway for Aboriginal and Torres Strait Islander patients to be wait listed for procedures directly on the public hospital wait list from private practices.
- Analysis of the AIHW elective surgery activity data suggests that the median wait times for cataract surgery are increasing in Western Australia (Figure 14).
- In 2011, the mean median wait time was 80 days, compared to 123 days in 2019.
- The large increase in average wait times between 2017 and 2019 appears to be driven by the increase in WA Country Health Service (Figure 15).
- The longest metropolitan wait time was Joondalup Health Campus, 146 days.
- Volume-weighted wait time was slightly higher in regional sites compared to metropolitan sites for cataract procedures (153.3 vs 64.2 days, P < 0.001).
- Wait times captured through the AIHW data do not capture the time from initial diagnosis by a general practitioner or optometrist and referral to an ophthalmologist. This waiting time from initial referral to a public hospital until first visit is referred to as the ‘hidden waiting list’ or the ‘wait for the wait’.
- There are no data available for the ‘hidden waiting list’ in WA.
- There is some reporting of this figure nationally; however, it is inconsistent and ranges from a median wait time of 3 months in Victoria to 10-20 months in the 90th percentile in Queensland.
- Wait times for cataract surgery have negative health consequences and increased health care costs.
- This is an issue from a patient outcome, health, economic, and transparency perspective.
- An online search did not reveal any eye health care services specific for people with CALD backgrounds in Western Australia.
- This may represent a gap, given there are services established for other areas, including cancer screening, chronic disease prevention, dental health, immunisation programs, mental health, newborn screening, sexual health, and women’s health on the WA Health Multicultural Health Services Directory.
- The Victorian Eye Health promotion website Vision Initiative provides translated eye health resources in 10 languages other than English.
- The AIHW provides an excellent breakdown of health care expenditure in Australia through the Australian National Health Account, which was produced by compiling data from over 50 sources.
- Figure 4 in the report provides a visual overview of the flow of funds through the healthcare system from source to area of expenditure; however, it was not possible to filter this database by disease sector.
- Therefore, achieving a granular analysis of the eye health sector of the Australian health care system was not possible within the constraints of the publicly available data.
- There is no local formal training available for orthoptists, ophthalmic nurses, ophthalmic theatre nurses, and ophthalmic nurse practitioners.
- There is no local training for diabetic educators in ophthalmology.
- The emergency physician curriculum standards contain ophthalmic outcomes; however, there is no ophthalmic CPD offered through the Australian Collage of Emergency Medicine (ACEM) e-learning platform.
- The Australian Collage of Rural and Remote Medicine (ACRRM) have ophthalmic outcomes in their curriculum standards; however, there is no additional CPD offered.
- There is a paucity of tailored education available for ophthalmic nurses in Western Australia.
- The burden for all vision disorders increased slightly between 2003 and 2018. AMD increased by 2%, cataract and lens disorders increased by 2.5%, glaucoma increased by 0.4%, other vision disorders increased by 0.2% and refractive errors increased by 0.7%.
- This is despite a significant reduction in the national fatal burden during the same time period.
- This suggests that the overall health of Australians is improving; however, the eye health of Australians remains unchanged or slightly worse during this period.
- Despite this, WA had a DALY rate of 3.2 for hearing/vision, which was the lowest in the country.
- 90% of vision impairment and blindness among both Indigenous and non-Indigenous Australians is preventable or treatable and approximately 50% of the causes of vision impairment are undiagnosed.
- In the NEHS 30% of non-Indigenous, and 50% of Indigenous Australians with intermediate AMD had not accessed optometry or ophthalmology services within the past 12 months. Early diagnosis is important, as presenting VA is a strong predictor of the outcome for anti-VEGF treatment in neovascular AMD.
- The NEHS reports that 52.87% of diabetic (self-reported) Indigenous participants adhered to the NHMRC diabetic eye examination guidelines (within the past 12 months) and 77.7% of non-Indigenous participants adhered to the screening guideline (within the past 2 years).
- Results from the National Eye Health Survey found that 46.6% of the non-Indigenous population and 72.5% of the Indigenous population who had probable or definite glaucoma did not have a known history of the diagnosis.
- In the NEHS, 50% of non-Indigenous and 56% of Indigenous participants with undiagnosed glaucoma had accessed optometry or ophthalmology services within the past 12 months.
- This suggests that preventative eye health could reduce the burden of eye disease significantly and there is a large burden of silent, undiagnosed eye disease in the community.
- There was limited publicly available information about eye health-promotion projects nationally or in Western Australia.
- There is no centralised organisation, which coordinates eye health promotion in Western Australia.
- According to the 2022-26 WA Health Promotion Strategic Framework, there appears to be no focus on preventative eye health in Western Australia.
- The majority of research output in Western Australia is generated by the top institutions and researchers.
- Sixty-seven (67) % of publications were authored by the top 5 researchers (0.076% of researchers).
- Sixty -six (66) % of publications were affiliated with the top institution (The Lions Eye Institute).
- There is a long tail of 220 Western Australian research institutions which were affiliated with the research.
- This suggests that there are many researchers and institutions producing once off or small volumes of work.
