Vision loss and psychopathology

Abstract

Purpose: By examining associations between vision loss and various types of psychopathology within the literature, this manuscript will provide ophthalmologists, psychiatrists, and psychologists insight into the relationships between vision and psychopathology to foster cross-professional relations. Design: Retrospective narrative literature review. Methods: A narrative literature review was conducted using PubMed, Google Scholar, and Scopus searches. Study types included reviews, case studies, survey analyses, population-based studies, and twin studies, among others. Topics explored include mental health consequences of vision loss, functional neurological disorders and deception syndromes, eye specific personality changes, Charles Bonnet syndrome, and vision disorders associated with psychosis. Results: Visual impairment correlates with depression and worsened overall quality of life and mental health. Visual health clinicians should improve competencies in basic suicide risk assessments in collaboration with primary care providers and mental health colleagues. When patients with functional neurological disorders or deception syndromes present, understanding their symptoms and motivations is crucial for proper management. Patients with myopia and keratoconus are anecdotally alleged to have unique personalities; however, research shows openness is the only trait correlated with myopia, while a proposed “keratoconus personality” is unfounded. The unique vivid hallucinations of Charles Bonnet syndrome typically do not bother patients and physician reassurance is usually enough to ease the anxious patient. Finally, Usher syndrome involves congenital deafness and progressive blindness in young children with links to psychosis and schizophrenia. Conclusions: The bidirectional psychosomatic ophthalmological landscape highlights a need to improve screening, recognition, and integrated treatment coordination between visual health providers and mental health providers.