If you think about how much you depend on your vision for everyday tasks, it’s not surprising that being confronted with a sight-threatening eye disease can make you feel, well, a little down in the dumps. However, not only is having vision loss linked to an increased risk of mental illness, but the relationship goes in the other direction too – having a mental health issue can make you more likely to develop vision problems.

Vision Impairment Causing Mental Ill-Health

Research tells us that having an eye disease causing sight loss is associated with an increased risk of a number of mental illness and mood disorders. People with low vision or blindness are at twice the risk of developing depression compared to those with full vision. In a study conducted by the CDC, 25% of adults with vision impairment admitted to anxiety or depression. Because we’re so dependent on our sight for so many things, including participating confidently in society, vision loss has also been associated with loneliness, social isolation, fear, and overwhelming worry.

Eye diseases resulting in significant visual impairment or blindness are the most likely to be related to a mental health problem. These include:

• Age-related macular degeneration (AMD). The macula is the part of the retina responsible for your central vision. We use the macula for common tasks such as reading, recognizing faces, writing, and watching TV. Although even advanced AMD leaves your peripheral vision intact, losing the use of your macula has significant implications for your daily tasks. As America’s population ages and AMD is associated with aging, doctors expect to see rising numbers of AMD in the years to come.
• Glaucoma. Glaucoma is a disease of the optic nerve involving damage and loss of retinal nerve fibers. Vision loss tends to begin very slowly and is entirely painless, making it difficult to notice in the early stages. Mid-peripheral vision is usually the first to go; if timely treatment isn’t received, advanced glaucoma can result in blindness. Around 3 million Americans are affected by glaucoma.
• Other eye diseases with devastating consequences for vision include diabetic retinopathy and retinitis pigmentosa.

Compared to adults over the age of 65 with a vision impairment, younger adults with sight loss were found to be five times more likely to suffer from depression or severe anxiety. Experts think this may be because younger adults have not yet developed effective coping skills or emotional regulation. In children and teens, a recent study published in 2022 found significant associations between eye disease and psychiatric illnesses, including schizophrenia and bipolar disorder. Children under the age of 19 with one or more of glaucoma, cataract, congenital optic nerve disease, congenital retinal disease, or blindness/low vision had a significantly higher likelihood of a psychiatric diagnosis.

Statistically, girls are more likely to develop mental health concerns subsequent to eye disease compared to boys. The reasons for mental illness in children with vision problems can be multi-faceted, but include:

• Loneliness
• Difficulties participating in social situations
• Impaired mobility
• Lack of independence, relying particularly on adult careers

Mental Illness Causing Eye Disease?

The association between mental illness and eye disease isn’t fully understood by doctors yet, but the relationship has definitely been observed to exist. For example, those with bipolar disorder or schizophrenia have an increased risk of glaucoma, while patients with major depressive disorder seem to be more likely to develop glaucoma, dry eye disease, or AMD.

Though more research is needed to explain this link, there is a theory that these psychiatric illnesses and specific eye conditions, especially glaucoma, share similar underlying vascular or neurological causes. In order words, a circulatory system problem or central nervous system disorder contributes to both the development of the mental health problem as well as the eye disease.

Understand the Risk

Whether you currently live with low vision or a mental health disorder, it pays to understand your risk for experiencing associated health problems. If you have a vision impairment, learn to recognize the signs of common mental illness, such as anxiety and depression. These symptoms include:

• Feelings of excessive worry
• Difficulties concentrating
• Difficulties sleeping
• Unusual irritability
• Loss of interest in your usual hobbies or activities
• Feelings of sadness, helplessness, or worthlessness
• Fatigue and lethargy
• Changes to your appetite

Though mental illness carries a stigma in many communities and cultures that is hard to break through, it is important to know that you have options for getting yourself out of the rut. Friends and family are often good sources of support as are professional counselors, while medical practitioners can offer treatment options including medications or cognitive behavioral therapy.

On the flip side, if you have a disorder such as major depressive disorder, schizophrenia, or bipolar disorder, just bear in mind that you may have an increased risk of eye problems. Visit your eye doctor for a regular check-up at least once every two years. If you have other risk factors for eye disease, you may be recommended to visit more frequently.