Poor visual acuity and anxiety disorders share an association, study finds. Photo: Getty Images.

One study published in American Psychologist outlines just how prominently mental health can be affected by eye conditions. With little currently known about the relationship between visual disabilities and anxiety disorders, the researchers of the study examined the underlying effects of modifiable risk factors.

UK Biobank participants were included in the analysis—totaling 117,252 patients—with baseline data collected from 2006 to 2010. Habitual visual acuity was measured by a standard logarithmic chart and ocular disorders were reported through questionnaires collected at the baseline. Inpatient data, lifetime anxiety disorder and current anxiety symptoms assessed by an online mental health questionnaire were identified over a 10-year follow-up to identify incident hospitalized anxiety.

What the researchers of the study found was that one-line worse visual acuity was associated with an increase in risk of incident hospitalized anxiety, lifetime anxiety disorder and current anxiety scores. Additionally, ocular disorders including cataracts, glaucoma, macular degeneration and diabetes-related eye disease were associated with poorer visual acuity and at least two anxiety outcomes. A subsequent onset of eye diseases, especially for far cataracts, and lower socioeconomic were involved in poorer visual acuity and anxiety disorder association. 

As such, the researchers recommend that “early interventions involving treatments for visual disabilities and effective psychological counseling services sensitive to socioeconomic status may help prevent anxiety in those living with poor vision.”

The authors of the study discuss that their findings suggest poorer visual acuity is an independent risk factor for anxiety seen in middle-aged and older adults. The authors give some context to the existent literature, stating that prior studies have elucidated a need to intervene with visual impairment and blindness rather than emphasizing the whole continuum of visual acuity. As well, they mention that other prior studies have been limited in generalizability due to their sample sizes, subjective vision assessments or cross-sectional design.

Other than the clear association identified between the two conditions in this population, the researchers speculate that “receiving the diagnosis of ocular disorders itself may present as a chronic stressor and threat to the person if no substantial intervention is widely available.”

Reminiscent of this possibility is the fact that with an ageing population, visual disabilities have reached the forefront of public health as a pronounced concern, with eye care burden and mental health disorder intervention expected to increase.  

The authors of the study are hopeful, though, that “this information will raise awareness among doctors of the need to address psychiatric consequences in older people and allow health governance to advocate for health policies by prioritizing targets for vision intervention to reduce the excess risk of anxiety disorders.”

Zhang X, Wang S, Du Z, et al. The associations and mediators between visual disabilities and anxiety disorders in middle-aged and older adults: a population-based study. Am Psych. February 27, 2023. [Epub ahead of print].