A new study published in the Journal of Primary Health Care suggests that introducing publicly funded community eye care in Aotearoa New Zealand, modelled on Australia’s Medicare system, could substantially improve access to eye examinations and spectacles, particularly for underserved groups including Māori and Pacific peoples.
Unlike Australia, where Medicare-funded optometry examinations are widely available and spectacle subsidies support priority groups, New Zealand has very limited public funding for primary eye care. The authors argue that cost remains a major barrier preventing many people from accessing services, contributing to avoidable vision impairment and widening health inequities.
Using publicly available Australian data on uptake of Medicare-funded optometry services and spectacle subsidy schemes, researchers estimated what a similar system could look like in New Zealand. They applied Australian service uptake rates to New Zealand’s 2024 population and modelled costs under different funding approaches.
The analysis, including authors from the International Centre for Eye Health, estimated that a universal publicly funded eye examination programme could deliver approximately 2.4 million eye examinations annually in New Zealand. Depending on the reimbursement model used, the annual cost was estimated at between NZ$143 million using Australia’s current Medicare rebate rates and NZ$349 million using Optometry Australia’s recommended consultation fees, which are intended to better reflect the true cost of delivering care.
The study also estimated that around 60,500 pairs of spectacles could be subsidised annually at a cost of approximately NZ$13 million.
Importantly, the paper explored more targeted approaches focused on equity and financial hardship. Restricting subsidised eye examinations and spectacles to Community Services Card holders would cost an estimated NZ$50–102 million annually, while targeting Māori and Pacific peoples specifically would fund around 760,000 examinations at a cost of NZ$45–111 million per year.
The authors note that uncorrected refractive error remains the leading cause of vision impairment globally and that spectacles are considered one of the most cost-effective health interventions, with previous estimates suggesting a 36:1 benefit-to-cost ratio. They argue that greater investment in preventative eye care could improve educational and employment outcomes, reduce pressure on hospitals and disability services, and help address longstanding inequities in access to care.
The study also highlights that even in Australia, inequities in access to eye care persist, particularly among First Nations communities. The authors therefore caution that simply replicating Australia’s system may not be sufficient to achieve equitable outcomes in New Zealand without additional targeted approaches and community partnerships.
Rather than presenting a final policy recommendation, the paper is intended as a starting point for discussion about how eye care could be funded in the future. The authors conclude that New Zealand has an opportunity to rethink how preventative eye care is delivered and financed, particularly as the country seeks to reduce avoidable vision impairment and improve equity in health services.
Publication
Goodman L, Silwal P, Taylor N, Zou E, Ramke J. Funding community eye care in Aotearoa: a preliminary cost
estimate based on the Australian approach. Journal of Primary Health Care. April 2026. https://doi.org/10.1071/HC25218