Lions Outback Vision is concerned about losing traction on its ‘Close the Gap’ efforts after the COVID-19 emergency curtailed its Vision Van and Visiting Optometrist Services, leaving the organisation to treat only urgent cases through costly chartered flights.
Strict intra-regional barriers to prevent the spread of the virus to vulnerable communities have restricted the organisation’s ‘hub and spoke’ model for dealing with dispersed populations over vast geographic areas in Western Australia.
The Vision Van, a mobile outreach service that provides a range of ophthalmological eyecare to 20 communities within the state, was recently in the town of Derby, in the Kimberley region, when it was required to cease operation and return to Perth for the foreseeable future.
Outback Vision’s successful telehealth service, where many pre-assessment and post-surgery appointments are performed, has been limited after its Visiting Optometrist Services were also halted and regional optometry services closed.
Dr Angus Turner, McCusker Director of Lions Outback Vision, part of the Lions Eye Institute, said the biggest challenge now was the continuation of vision-restoring intravitreal injections for retinal diseases.
So far, he said, these have been managed with careful triage and prioritisation, and accessed via chartered flights to communities across the Kimberley and Pilbara regions. The flights are costly and require significant volumes of paperwork and clearances from the relevant authorities.
“We have to make sure these patients don’t experience any significant vision deterioration,” Turner said. “For many country patients, the injections allow them to continue driving and keep a job – they are very well-attended and patients are more compliant with this form of treatment because of the clear benefits.”
Funding issues
Turner said the chartered flights were introduced earlier this year as part of the ‘hub and spoke’ model operating out of Broome where Lions Outback Vision established a new eye health clinic.
Called the North West Hub, it not only had resident ophthalmologists based in the North West for the first time, but also enabled the team to maintain the monthly regime of injection treatments across the North West of the state through efficient use of aviation services.
Turner said ongoing funding of the charter plane was now uncertain, however it remained a crucial element of the ‘hub and spoke’ model.
For example, some flights were originally funded for specific cataract surgery activities with the Indigenous and Remote Eye Health Service (IRIS), allowing Lions Outback Vision to offer other forms of eyecare such as intravitreal injections during the visits. However, the Federal Government has suspended all non-urgent eye surgery, causing a significant funding conundrum.
Overall, Turner said, for a population that has a higher burden of vision loss and blindness, there needed to be a bolstered post-pandemic effort to ensure the sector does not lose ground on its pursuit of eye health parity.
Funding to support aviation will be a critical part in enabling the efficient provision of eyecare across a vast geographic area.
“We were already on the backfoot in many regions, trying to keep up with the burden of disease, and the maldistribution of ophthalmologists in the regions in Australia, so following this pandemic there will be a period of even greater backlog of demand for patients for eyecare, so we are concerned about losing traction with the efforts to close the gap,” he said.
“However, with the new facility we have in Broome to provide regional eyecare, I trust the benefits of this service will provide an opportunity to stand us in good stead to catch up and make an impact in the future.”
