This study is concerned with the vision and eye health problems of indisenous children living in remote communities of far north Queensland in Australia.Those living in remote areas often have little or no access to the services that urban communities take for granted. There are also cultural differences which may inhibit access and further disadvantage indigenous communities. Since a screening service is the first step in determining whether treatment is required, there are strong equity reasons for undertaking a screening program in these communities.The most comprehensive screening of indigenous Australians was initiated as the National Trachoma and Eye Health Program (NTEHP) two decades ago. This program found that trachoma was endemic in some communities witkmany older persons suffering a substantial loss of vision. The relationship of eye health to climate and hv^iene was also noted in older adults. Although chemotherapy was undertaken in some areas, ongoing treatment and changes to the environment to destroy the persistence of chlamydia infections were advocated as continuing action. Despite these recommendations, there are only a few recent reports of relevant treatment and environmental changes and of these, most concern communities in the arid centre of Australia. The study reported in this thesis focussed on children in far north Queensland because there is little recent information about their vision and eye health and some of the major problems reported for adults may be prevented if screening and treatment is undertaken during childhood. Taylor (1997) compared the prevalence of follicular trachoma among Aboriginal children in the NTEHP surveys (1976)(1977)(1978)(1979) with current data (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996). Although he showed that substantial numbers of children were still affected by follicular trachoma in many areas of Australia, he could not make the comparison for Queensland as no current data were available. References • •• 174 Appendices 198 XVI LIST OF TABLES 2.1 Royal National Institute for the Blind Services 3.1 Number of Boys and Girls in Test Trials at Each Age Level 3.2 Development of Photographic Procedure 3.3 Development of Slit Lamp 4.1 Number of Children Screened in Each Community 4.2 Number of Children with Complete Assessments in Each Community 4.3 Number of Children at Different Age Levels 4.4 Distance Vision Results 4.3 Near Vision Results 4.6 Children with Strabismus 4.7 Strabismus by Age 4.8 Children with Eyelid Problems 4;9 Eyelid Problems by Age 4.10 Children with Pterygia 4.11 Pterygia by Age 4.12 Children with Other Eye Conditions 4.13 Other Eye Health Conditions by Age 133

In the more remote and isolated communities, teachers require greater self sufficiency in their knowledge base about the many factors that impact on child learning. Sensory impairment is one such factor and it is essential that teachers be alert to the possibility of undetected impairment.