Suicide and Visual Loss: A Case Report Reflecting the Need for Recognition and Management in Ophthalmological Settings

Abstract

In the United States, 5.5 million people over the age of 40 meet criteria for visual impairment (VI). They often suffer significant psychosocial and health consequences, including reduced quality of life and depression, which can be persistent and difficult to treat. Additionally, VI may increase the risk of suicide. We report a case of a patient with age-related macular degeneration (ARMD) and suicidal ideation. While this link is reasonable, there are no prior cases of suicidality among patients with ARMD. Moreover, the literature is silent regarding proper approaches to diagnosing and managing suicidality among patients with VI, especially ARMD.

The association between suicide ideation and sensory impairment among elderly Koreans

“…This result is similar to that reported in a previous study that found that comorbidity of physical impairment and mental distress is common among elderly people with visual impairments (Li et al, 2011). In addition, lingering depression has been associated with psychosocial and health consequences, including poor quality of life and increase in the risk of suicide (Byron et al, 2008;Johnson et al, 2014). Indeed, visual impairments among the elderly increase elders' reliance on others, particularly in their ability to perform activities of daily living (ADL).…”

“…Some studies (Kim et al, 2010;Seomun & Lee, 2011) have reported that depression is the most important factor associated with elderly suicide ideation. There is also research on the association between hearing impairment and depression (Li et al, 2014), as well as a case report on the relation between vision loss in elderly individuals and suicide (Johnson, Rovner, & Haller, 2014). However, there is a relatively narrow understanding of suicide ideation among elderly persons; therefore, it seems necessary to further research the factors that influence suicide ideation, as well as the individual characteristics of elderly individuals that are associated with suicide ideation.…”

Association of Co-Existing Impairments in Cognition and Self-Rated Vision and Hearing With Health Outcomes in Older Adults

“…Cognitive impairment was only significantly associated with low SRH when it was accompanied by both visual and auditory impairments. This finding suggests that cognitive impairment may be associated with differences in insight on self-perceived illness ratings (Johnson, Rovner, & Haller, 2014; Yeung et al, 2015).…”

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

“…AMD patients (n=144) who reported poor adaptation to vision loss, especially with respect to acceptance of and compensation for vision loss, reported more depressive symptoms than those who adapted better 128. One case report highlights risk of suicide because of AMD-related vision loss;129 eye-care providers should be trained to identify patients at risk of suicidality.…”