When Professor Hugh Ringland Taylor AC first joined Fred Hollows in the field with the National Trachoma and Eye Health Programme in 1976, he expected to return to conventional ophthalmology practice. Instead, that early exposure to Indigenous eye health challenges launched a career that would fundamentally reshape Australia’s approach to preventable blindness.

“I often say I was led astray by Fred at a tender age, and in many ways, I’ve been astray ever since,” Prof Taylor laughed.

Now, as Emeritus Professor at the University of Melbourne, Prof Taylor has documented his remarkable journey in Opening Eyes, a new book that serves as both memoir and manifesto for eye care professionals seeking broader impact beyond private practice.

SEIZING UNEXPECTED OPPORTUNITIES

Prof Taylor’s story chronicles how chance encounters and unexpected opportunities shaped his career trajectory from expected private practice to international recognition in epidemiologic work, public health initiatives, and prevention of blindness across multiple countries.

And it serves as both testament to what’s possible when clinical expertise meets public health vision, and practical guidance for eye care professionals seeking broader community impact.

His research portfolio spans continents and conditions – from trachoma and river blindness (onchocerciasis) to groundbreaking research on the effects of ultraviolet light research at Johns Hopkins University, and then the effects of smoking on the eye.

One notable example demonstrates the potential scale of his public health impact: working in Pakistan during the 1980s, Prof Taylor identified trachoma and vitamin A deficiency among Afghan refugees. Collaborating with the World Health Organization (WHO) and the United Nations Committee for Refugees (UNHCR), they prescribed treatment for over a million people.

“There’s no way that I could sit in my private practice doing a couple of cataracts and ever be able to influence the eye health of a million people,” he observed. “My work has enabled me to have a broader impact in the community.”

TRANSFORMING INDIGENOUS EYE HEALTH

Australia’s statistics tell a powerful story of the impact he and his colleagues have had since the 70s. When Prof Taylor began working in Aboriginal and Torres Strait Islander communities in the 1970s, trachoma rates averaged 30% across communities, with Indigenous Australians experiencing 10 times more blindness than the mainstream population.

Today, Australia is on the brink of WHO certification for trachoma elimination, and Indigenous blindness rates have dropped to only three times the mainstream level – though Prof Taylor notes these data are nearly a decade old, with new surveys frustratingly delayed by COVID-19 and government postponements.

“The AIHW (Australian Institute of Health and Welfare) puts out results every year on the services provided to First Nations Aboriginal and Torres Strait Islander people, and that gives us a good measure of progression. But the bottom line is really what the epidemiologic prevalence survey will show, and that’s work that Professor Paul Mitchell is doing in Sydney,” he said.

INDIGENOUS LEADERSHIP TAKING HOLD

Perhaps most significantly for Prof Taylor, the emergence of the First Nations Eye Health Alliance represents the evolution he’d long hoped to see – from externally-led initiatives to Indigenous-led advocacy.

“It’s fantastic to see First Nations people trained and interested in eye care, and being enabled to take on leadership roles,” he said.

“The First Nations Eye Health Alliance is starting to take the lead – they know what to do and they know how to do it. The trouble is they are only receiving about half the funding required to fully implement eye care services that will meet the needs. So the sector, led by the First Nations Eye Health Alliance, needs to keep pushing and lobbying with government to get those services increased and upgraded.”

NEXT CHALLENGE: DIABETIC EYE SCREENING

With trachoma almost eliminated in Australia and Indigenous blindness rates significantly reduced, Prof Taylor believes the next major challenge in Indigenous eye health is systematic diabetic eye screening.

“People with diabetes form about three-quarters of the people over the age of 40 who need an eye exam,” Prof Taylor explained.

He advocates integrating this screening into Aboriginal Community Controlled Health Organisations (ACCHOs) as part of basic primary care.

This represents what Prof Taylor calls “an opportunity for a younger person following my ambitions to step in and make the difference – or particularly, a young Indigenous advocate”.

However, noting that existing retinal cameras are ageing and underutilised owing to resource constraints, there is also a need for industry support to ensure ACCHOs are working with the latest technology.

INSPIRING BROADER PARTICIPATION

As international funding challenges mount – particularly with reduced American support for global health initiatives – Prof Taylor believes individual practitioners and organisations have increasingly important roles.

“We need to think beyond ourselves,” he stated, encouraging support for non-government organisations and foundations working in blindness prevention, or directly volunteering in developing countries. Crucially, he said meaningful contribution doesn’t require total career transformation.

“You can be busy in your private practice, but you can spend a week once a quarter to go and visit Alice Springs or Katherine or even somewhere locally to provide optometric or ophthalmology services,” he suggested.

“It doesn’t have to be a huge sacrifice, but if it’s done regularly and if people know that you’ll be there when you say you’re going to come, and you build some continuity and trust– little things like that can make a huge difference.”

GETTING INVOLVED

For practitioners interested in contributing to Indigenous eye health initiatives, Prof Taylor recommended contacting:

• First Nations Eye Health Alliance for national coordination,

• State ACCHO affiliates such as VACCHO (Victorian Aboriginal Community Controlled Health Organisation) in Victoria, and

• Local ACCHOs in specific regions where practitioners would like to contribute.

Additionally, opportunities to reach underserved communities exist through the Visiting Optometry Scheme and Rural Ophthalmology Training Hub (ROTH).

Opening Eyes by Hugh R Taylor is published by Kerr Publishing and available in paperback and as an eBook. An audiobook is available at Author’s Republic (authorsrepublic.com).