Establishing eye screening services to prevent avoidable blindness in remote Northern Australian communities

Summary

In July 2018, CSIRO along with its project partners Queensland Health, Laynhapuy Homelands Aboriginal Corporation, Marthakal Homeland and Resource Centre Aboriginal Corporation, Gidgee Healing and NT Eye Specialists commenced a multi-year project to establish telehealth-based eye screening services to prevent avoidable blindness in remote northern Australian communities.

The primary outcome sought from this project was a working sustainable teleophthalmology service, to continue serving the communities after project completion. This outcome has been achieved, and a secure telehealth service now connects metropolitan-based ophthalmologists to patients in several regional and remote communities in Northern Territory and Queensland. The telehealth platform incorporates AI-based image quality and disease detection algorithms to complement and support decisions of eye health assessment teams. This service helps in closing the gap in access to eye care services for people living in under-served rural and remote communities, preventing needless blindness.

A valuable screening service has been established in the target areas, evidenced by the following outcomes realised by the project:

improved access to ophthalmic health services for residents of the project screening locations, thereby closing the gap in providing specialist eye care to the rural and remote communities;

demonstration that routine eye examination (instead of opportunistic eye examination) is feasible for early detection of some eye diseases for remote and rural patients;

cost savings relating to reduced patient travel to metropolitan areas and/or prioritising patients by need for a consultant’s visit to their locality, hence increasing efficiency and maximising resource use;

improved health outcomes by earlier identification of diseases, enabling not only vision saving treatment but reduced consumption of scarce health resources;

capacity building of Northern Australian healthcare workers to perform eye screening and obtain new knowledge about eye diseases; and

improved patient health awareness where the retinal camera is used as an educational tool.

This project established an innovative eye screening and telehealth service that is improving access to specialist eye care in remote communities across northern Australia. Led by CSIRO and partners, the project combined portable retinal imaging technology, artificial intelligence (AI) and telehealth to enable local health workers to screen patients for eye disease and connect them with specialist ophthalmologists for rapid assessment and treatment. The project responded to the significant burden of vision impairment among Indigenous Australians, who experience blindness and vision loss at three times the rate of non-Indigenous Australians. By allowing retinal images to be securely captured in remote communities and assessed remotely using AI-supported diagnostic tools, the model improved access to early detection and treatment of diabetic retinopathy and other vision-threatening conditions. The project screened more than 1,000 patients across remote Queensland regions in 2022–23, identifying over 220 serious eye disease cases in a single year. It trained 40 healthcare workers in eye screening techniques, strengthened local health service capability and improved the adoption of telehealth technologies by clinicians. The benefits have been substantial. Earlier detection and treatment have reduced avoidable blindness, improved quality of life and generated significant economic savings through reduced patient travel and lower health system costs. The project has also created a scalable model for AI-enabled healthcare delivery that can be adapted to detect other eye conditions and support a wider range of telehealth services across remote northern Australia. By combining technology, specialist expertise and community-based healthcare delivery, the project has demonstrated a practical pathway to closing the gap in eye health outcomes and preventing avoidable blindness in remote and Indigenous communities.