Nejatian Marcel M, Dawkins Rosie, Al-Yasery Ebrar, Razavi Hessom
Lions Eye Institute, Nedlands, Australia.
Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Australia.
Clin Exp Ophthalmol. 2025 Jul;53(5):457-469. doi: 10.1111/ceo.14508. Epub 2025 Apr 9.
In the last two decades, over 250 000 refugees and asylum seekers have arrived in Australia, many of whom experience significant health problems. Information about their eye health is scarce, particularly for those detained offshore. This is the first study to explore the eye health and services available to this population, helping inform future service planning.
A mixed-methods design was employed, incorporating a multicentre audit of an ophthalmology service in Nauru and Manus Island detention centres (2015-2016) and a comparative analysis of this service against established standards of public eye care in mainland Australia. Outcomes included prevalence and causes of vision impairment, management required, and service performance using the Australian Health Performance Framework.
Eighty patients from 14 countries were included (3-57 years, 84% male). There were high rates of bilateral and unilateral vision impairment (19% and 25%, respectively) and bilateral and unilateral blindness (1% and 12%). Bilateral vision impairment was mostly avoidable (80%), with the commonest causes being refractive error and cataract. Ocular trauma accounted for 67% of unilateral blindness. Compared to mainland services, offshore eye care was sub-standard across all performance domains, including governance, information, workforce, safety, and effectiveness.
Refugees and asylum seekers held in Australia's offshore detention centres had a high burden of eye disease and inadequate access to services. Ceasing offshore detention in favour of onshore processing, as recommended by numerous medical colleges, may help ensure people seeking asylum have access to appropriate eye care in Australia.
在过去二十年里，超过25万难民和寻求庇护者抵达澳大利亚，其中许多人面临严重的健康问题。关于他们眼部健康的信息匮乏，尤其是那些被拘留在境外的人。这是第一项探索该人群眼部健康状况及可获得的服务的研究，有助于为未来的服务规划提供参考。
采用混合方法设计，纳入对瑙鲁和马努斯岛拘留中心眼科服务的多中心审计（2015 - 2016年），并将该服务与澳大利亚大陆公共眼科护理的既定标准进行比较分析。结果包括视力损害的患病率和原因、所需的治疗以及使用澳大利亚健康绩效框架评估的服务表现。
纳入了来自14个国家的80名患者（年龄3 - 57岁，84%为男性）。双眼和单眼视力损害发生率较高（分别为19%和25%），双眼和单眼失明发生率分别为1%和12%。双眼视力损害大多是可避免的（80%），最常见的原因是屈光不正和白内障。眼外伤占单眼失明的67%。与澳大利亚大陆的服务相比，境外眼科护理在所有绩效领域均未达标准，包括治理、信息、人力、安全和有效性。
被关押在澳大利亚境外拘留中心的难民和寻求庇护者眼部疾病负担沉重，获得的服务不足。按照众多医学院校的建议，停止境外拘留并改为境内处理，可能有助于确保寻求庇护者在澳大利亚能够获得适当的眼科护理。
