Emotional response and management of visually handicapped patients.

Abstract

Emotional stress is known to accompany visual problems. This fact is apparent in patients with real or threatened acute loss of vision. Patients usually respond to a loss of vision in one of three ways: by acceptance, by denial, or by depression—with or without concomitant anxiety. A progression through these three patterns of response which varies in its pace and qualitative characteristics can be—but is rarely—seen by the physician. The response of any given patient can almost be predicted by the patient's previous response pattern to emotional stress. Acceptance and denial are the two most frequently encountered patterns of response. Fortunately, they are the healthiest responses and require the least attention, usually only by the ophthalmologist and his ancillary personnel. Depression, although the least common response to partial visual loss, may be lethal. A patient who responds to visual loss with depression requires at least a psychiatric consultation to aid the ophthalmologist in the management of the patient. In severe depression, the patient will probably require some type of psychiatric therapy, such as short- or long-term psychotherapy, chemotherapy, or some combination thereof.