In the operating theatre of Katherine Hospital, the surgical team moves in perfect coordination.
Peter Mitchell, a scrub nurse, anticipates each step of the procedure, carefully assisting the surgeon as he makes an incision in a patient’s eye.
“Being in the operating room in this moment feels incredible — there’s a real flow and understanding between us,” Mitchell says.
However, these surgeries are not simple. The patient on the table has a cataract so dense it has remained untreated for a long time.
“Such hard cataracts are rare in southern areas, but they’re common in the regions we serve,” says Mitchell.
Patients have traveled from remote communities across the Big Rivers region of the Northern Territory for a week of eye surgeries, organized by the Indigenous and Remote Eye Service (IRIS).
Over two days, 27 cataract surgeries will be performed, potentially restoring the sight of many patients who were on the verge of blindness.
Restoring Vision for a Better Life
Mildred Hector, a Bilinarra woman from Nitjpurru (formerly known as Pigeon Hole), was one of the patients. She struggled with her vision in one eye due to cataracts, which made hunting and fishing difficult.
“When I go hunting, I can use my good eye, but the other one is no good,” she says.
Her friends noticed her difficulty in seeing them, too.
After her surgery, Hector can now read the smallest letters on the eye test chart. She is excited to return home and test her improved vision.
“It feels good. We’ll go fishing, catch barramundi and turtles,” Hector says.
Surgeon Susith Kulasekara notes that, while patients in larger cities may joke about seeing their wrinkles more clearly, for many Indigenous patients, the improvement in vision is tied to practical, everyday activities like hunting and fishing.
“It’s always heartwarming to see the smiles of our patients when we remove the patch,” Kulasekara says. “These surgeries can dramatically improve their quality of life, helping with things like driving and caring for their families.”
Antony King, Director of Primary Health Care for the Big Rivers region, describes cataract surgery as “immediately rewarding” for both patients and staff at Katherine Hospital.
Bridging the Cataract Gap
Cataracts are the leading cause of blindness in Indigenous adults and contribute significantly to the eye health gap in Australia.
As cataracts develop slowly, often affecting both eyes, many remote patients don’t realize the extent of their vision loss until an optometrist visits their community. Traveling hundreds of kilometers for surgery, often on poor roads, presents an additional challenge.
There are only seven ophthalmologists in the vast Northern Territory, despite Australia having 1,004 eye specialists as of 2023.
IRIS, a federally funded program, brings eye surgeons to remote areas to address the backlog of cataract cases.
Tim Gallagher, CEO of Vanguard Health, which runs the program, explains that the distribution of eye care specialists in Australia has been shrinking for decades.
“Some patients are on the waiting list for two to three years before they can be seen,” Gallagher says.
The logistics of transporting remote patients to the hospital is also a challenge, especially when many do not have access to mobile phones and frequently move between locations.
Since mid-2023, IRIS has performed more than 800 cataract surgeries and aims to complete another 800 in the next two years.
Dr. Kulasekara adds that patients often share their positive experiences with others, encouraging others to seek help.
“They become ambassadors for the procedure,” he says.
A Transformation in Vision
While most IRIS patients are Aboriginal, some are not, like 83-year-old Peter Wilson from Katherine. He describes the transformation in his vision after cataract surgery as astonishing.
“I couldn’t believe how bright everything was, how vivid the colors are,” he says.
Wilson, who does most of the cleaning in his house, used to miss spots.
“My wife would point out the bits I missed. Now, I won’t miss anything,” he laughs.
As Hector leaves for her community of Nitjpurru, she hugs one of the eye doctors.
“Thank you, my dear, enjoy your vision,” the doctor says.
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