Profound vision loss impairs psychological well-being in young and middle-aged individuals

Abstract

PurposeThe aim of this study was to evaluate the effects of profound vision loss on psychological well-being in adolescents, young adults, and middle-aged adults with regard to mood, interpersonal interactions, and career-related goals. In addition, we assessed the significance of the resources that may be used to enhance psychological well-being in cases of profound vision loss, and in particular, examined the utility of low vision aids and the role of the ophthalmologist as a provider of emotional support.MethodsA questionnaire was issued to individuals aged 13–65 years with profound vision loss resulting from Leber’s hereditary optic neuropathy (LHON). Depression prevalence was evaluated with questions regarding major depressive disorder symptomatology. Participants appraised the effects of vision loss on their interpersonal interactions and career goals by providing an impact rating (IR) on a 21-point psychometric scale from −10 to +10. Social well-being index was defined as the average of interpersonal IR and career IR. Subjects were additionally asked about the use of low vision aids and sources of emotional support.ResultsA total of 103 participants (mean age =26.4±11.2 years at LHON diagnosis; mean ± standard deviation) completed the questionnaire. Nearly half (49.5%) met the depression criteria after vision loss. Negative impacts on interpersonal interactions (median IR = −5) and career goals (median IR = −6) were observed; both ratings were worse (P<0.001) for depressed versus nondepressed subjects. Older age at diagnosis corresponded to higher depression prevalence and increased incidence of negative interpersonal IR and career IR. Sixty-eight percent of subjects used electronic vision aids; controlling for age, social well-being index was higher among these individuals than for those who did not use electronic aids (P=0.03). Over half of the participants (52.4%) asserted that they derived emotional support from their ophthalmologist.ConclusionProfound vision loss in adolescents, young adults, and middle-aged adults is associated with significant negative psychological and psychosocial effects, which are influenced by age and use of electronic vision aids. Ophthalmologists, in addition to managing vision loss, may serve an important role in the emotional adaptation of these patients.

Visual and Hormone Outcomes in Pituitary Apoplexy: Results of a Single Surgeon, Single Institution 15-Year Retrospective Review and Pooled Data Analysis

“…The 30% risk reduction of vision impairment we identified through pooled analysis advocates for early decompression in the setting of a visual or CN deficit, as loss of vision is associated with significant morbidity and decreased quality of life. [22][23][24][25] Moreover, our series suggests that many hormonal abnormalities normalize following surgery, although panhypopituitarism commonly arises. While the prevalence of hypothyroidism is estimated at 3.7% in the United States, 26 our data showed 41% of patients with thyroid dysfunction at presentation.…”

<p>The Impact of Inherited Retinal Diseases in the Republic of Ireland (ROI) and the United Kingdom (UK) from a Cost-of-Illness Perspective</p>

“…Profound vision loss in adolescents, young and middle-aged adults is associated with significant negative psychological and psychosocial effects. 21 Interestingly, psychological wellbeing was assessed as mood, quality of an individual's interpersonal interactions, and career goals. 21 The impact of visual impairment on career and occupational goals should be of high relevance to ophthalmologists and researchers, although few studies have examined these effects.…”

“…21 Interestingly, psychological wellbeing was assessed as mood, quality of an individual's interpersonal interactions, and career goals. 21 The impact of visual impairment on career and occupational goals should be of high relevance to ophthalmologists and researchers, although few studies have examined these effects. Impaired vision-related quality of life has been shown to be associated with the inability to work and low socioeconomic status.…”

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“…5 It is well-established that vision loss leads to poorer quality of life owing to socioeconomic consequences and negative health outcomes including depression, declining cognition, falls, and injuries. [6][7][8][9][10][11] On a national scale, in 2011 the economic burden of vision loss was estimated to be $139 billion. 12 In recent years, there have been many efforts to provide technological assistance to those who have untreatable severe visual impairment.…”