Australia, officially the Commonwealth of Australia is a country comprising the mainland of the Australian continent, the island of Tasmania and numerous smaller islands. It is the world’s sixth-largest country by total area. The neighbouring countries are Papua New Guinea, Indonesia and East Timor to the north; the Solomon Islands and Vanuatu to the north-east; and New Zealand to the south-east. Australia’s capital is Canberra, and its largest urban area is Sydney.
a) Population: 24,576,000
b) Live births per year: (crude birth rate) – 12.1 births / 1000 population
c) Life expectancy at birth: total population: 82.2 years (Male: 79.8 years; Female: 84.8 years)
d) Percentage of population under 15 years: 17.84%
e) Ancestry: English (36.1%), Australian (33.5%), Irish (11.0%), Scottish (9.3%), Chinese (5.6%), Italian (4.6%), German (4.5%), Indian (2.8%), Greek (1.8%), Dutch (1.6%).
a) Type: Australia has a mixed public –private health system. Approximately 40% of the population augments what is available in the free ‘public’ system by having private insurance for hospitalizations.
b) Cost to patient to see a primary care doctor / general practitioner: More than half of primary care doctor visits involve no cost to the patient. Where these consultations are not easily available the cost standard GP consultation costs $78, which will leave patients to pay $41 after a $37 Medicare rebate (according to the Australian Medical Association).
c) Cost to patient of squint surgery under general anesthesia: Many strabismus surgeries are carried out at no cost to the patient in ‘public’ hospitals. Total cost in the private sector is typically $3-4,000.
d) Number of Paediatric ophthalmologists: As of 2012 – 20 full-time paediatric ophthalmologists.
e) Number of Paediatric Optometrists: There are 5134 optometrists; however, at present, optometry does not have recognized specialization categories. That said, because optometry provides primary eye care, most Australian optometrists see children in their practices; however, not all of them examine children less than 5 years of age. There are optometrists, however, with special interest and expertise in examining and managing visual conditions in infants and young children.
Major successes encountered in Paediatric Ophthalmology:
Historically Australian doctors were internationally important in recognizing rubella embryopathy [Gregg], thalidomide embryopathy [McBride], the toxic effect of oxygen on the retina of the premature baby [Campbell], surgeries for infantile nystagmus [Anderson] and laboratory studies on early visual development in animals [Bishop]. More recently, Mackey has been famous for genetics research over the last 25 years, the Sydney Myopia study has produced high quality data, and Australian pediatric ophthalmologists have leading roles in international organizations in pediatric ophthalmology [Martin, Kowal].
Major successes encountered in Paediatric Optometry:
A recent success is the establishment of the Paediatric Optometry Alignment Program (POAP) that was established in 2016. This premise of this program, a collaborative effort between paediatric ophthalmology and optometry, is to develop a shared model of care for children with specific eye conditions; to provide continuing education in paediatric eye care to the current optometry workforce; and to improve collaboration between ophthalmologists and optometrists. The program was instituted because it was recognized that there were an unacceptably high number of children (>1500) waiting for ophthalmology outpatient appointments at Queensland’s only dedicated children’s hospital, the Lady Cilento Children’s Hospital (LCCH), and many of these children were waiting much longer than clinically recommended. The primary reasons for the access block were that few private ophthalmologists in Queensland provide paediatric eye care and a large number of children with stable, treated conditions including strabismus and amblyopia who could potentially be managed in the community by paediatric optometrists, were being followed in the hospital outpatient eye clinic. (The above mentioned information is specific to the state of Queensland.)
Major challenges faced in Paediatric Ophthalmology:
We have a shortage of pediatric ophthalmology and strabismus specialists in Australia, especially in our public hospitals and outside the large cities. The void is being incompletely filled by overseas ophthalmologists who migrate here.
Major challenges faced in Paediatric Optometry: