The diagnosis of glaucoma places a significant psychological burden on the individual. A study conducted in Mexico found glaucoma patients are 10 times more likely to develop depression than the general population, new research suggests. The study, published in the Journal of Glaucoma, also found that depression prevalence and severity were directly linked to glaucoma severity and patient compliance.

Among the 111 study patients with glaucoma, researchers reported a depression prevalence of 50.4%. Additionally, statistical analysis revealed a significant association between glaucoma severity of the worse eye and depression severity. In the better eye, investigators found no statistically significant difference in depression severity across glaucoma severity categories.

After adjusting for age, sex, glaucoma type and glaucoma severity in both eyes, the study authors found a statistically significant association between the presence of depression and the level of treatment adherence. Patients with depression had a 38-times higher risk of noncompliance with their treatment compared with healthy patients.

Since depression was highly associated with lower rates of adherence, researchers suggested this might generate a pattern in which patients with severe glaucoma develop the worst symptoms of depression and are less compliant with their treatment, thereby generating a vicious cycle of more severe glaucoma progression and depression. “Patients with a decreased visual field become physically impaired due to the chronicity of their disease such as when they perform certain daily activities such as driving,” the authors wrote in their paper. “The possibility of becoming blind generates anxiety and social withdrawal and the elevated cost associated with medical and surgical treatment adds to their stress.”

Glaucoma treatment should involve a multidisciplinary team of optometrists, glaucoma specialists, psychologists and psychiatrists to achieve better outcomes, the researchers concluded.

Gamiochipi-Arjona JE, Azses-Halabe Y, Tolosa-Tort P, et al. Depression and medical treatment adherence in Mexican patients with glaucoma. J Glaucoma. November 3, 2020. [Epub ahead of print].