Optometrist Sasha Patel, O.D. writes that her interest in eyecare was born through her own family experience. Patel has seen firsthand the psychological impact glaucoma has had on “nana,” her grandfather. She has gained an appreciation for the mental trials he has endured as the disease has progressed.*

Research shows that, because glaucoma results in visual disability, patients can also develop anxiety and depression, which can make daily living and personal wellness more challenging. With glaucoma cases expected to rise, patient mental health is becoming more of a concern for clinicians.

Mental Health Is ‘Critical’

Patel says news of any eye disease that can cause permanent loss of vision can be devastating. Each patient absorbs the news differently depending on disease severity and other factors. The effect on their mental health is “critical,” and mustn’t be ignored by healthcare providers or by patients themselves, for whom the many steps involved in diagnosing glaucoma can lead to fear and confusion. Patients can feel stressed and overwhelmed even before their diagnosis is confirmed. 

You should be told what’s involved in the process and why it’s important. You deserve to have your questions answered, and know that you don’t need to prepare for blindness. Rather, you should know the importance of regular testing and disease management to avoid risks and reduce further vision loss.

Quality of Life Not the Same

When you have trouble with daily activities, it’s easy to lose confidence in yourself. In turn, factors like anxiety and depression may increase your risk of glaucoma progression.

Patel describes a recent study of the quality of life effects from glaucoma-related vision loss. Specifically, it looked at impacts regarding loss of visual field, or the total area you can see when focused straight ahead, and visual acuity, or clarity of vision. The study showed that distance activities, like driving, along with a person’s mental health and social function, were most affected.

Mental Health Impacts

According to Patel, glaucoma’s mental health impacts tend to happen in stages based on disease severity. Similar to the Kübler-Ross stages of grief, these stages are:

1. Shock or denial
2. Anger
3. Depression
4. Bargaining
5. Acceptance

Early-moderate glaucoma

In early-moderate disease, you may have trouble with reading, housework, and an overall ability to move around. In some people, this can cause stress, social, and psychological anxiety, and hopelessness. Psychotherapy at this stage can be an effective outlet and support.

Advanced glaucoma

If your glaucoma has already advanced, you may fear–or already be experiencing–loss of independence (giving up driving, for example), social isolation, depression, anxiety, and poor sleep. You may have lost interest in daily activities, even ones that you previously enjoyed. Patel again suggests psychological therapy as a way of coping. Low vision aids and rehabilitation are not only available, but also critical, says Patel, adding that they are most effective once you have achieved acceptance of your situation. 

Steps Toward Empowerment

Empowerment is most effective when it’s a collaborative effort between you and your healthcare providers. Patel encourages eye health professionals to help patients cope by: 

• Educating them on low vision solutions. Just a few research-based suggestions for visual aids are better lighting, anti-glare coating, and white canes for issues with peripheral vision. Increased independence can increase hope and improve quality of life.
• Assessing patient goals. Your doctor can help you set attainable goals in all areas of your life, including your home setting, job, hobbies, and social activities and interactions. Each of these areas has different visual demands, and can be challenging to your mental health if you feel frustrated in them. 
• Referring patients for low vision testing and rehabilitation. Research shows that low vision rehabilitation provides consistent quality of life improvements, and offers a safe outlet for confiding your personal challenges and concerns about vision loss.

Self-Care Tips for Glaucoma Patients

It’s even more important to pay attention to your own moods and emotions, and either establish a self-care routine or at least have tools and techniques in your stress management and self-care toolbox that you can easily use as the need arises.

Here are some ideas to try, whether or not you have your own self-care routine:

• Eat a healthy, nutritious diet high in fresh produce, and stay well-hydrated.
• Exercise regularly, even if you can no longer participate in your favorite sports.
• Engage in relaxing activities like journaling, yoga, and meditation.
• Prioritize sleep by avoiding caffeine, and limiting phone, TV, and other screen viewing before bed.
• Practice positivity by focusing on everything you can still do instead of what you can’t.
• Socialize and stay connected with your friends, family, and extended support network.

If your mood remains low, or if anxiety and/or depression are interfering with your daily activities and quality of life, reach out to a mental health professional, your primary care physician or other healthcare provider, or a religious or spiritual leader whom you trust.

*If you’re in crisis, please call the National Suicide Prevention 24-hour Lifeline at 1-800-273-TALK (8255), text TALK to 741-741, or visit http://suicidepreventionlifeline.org.

*Patel, S. (2021, June 18). A Review of the Impact of Glaucoma on Mental Health. Eyes on Eyecare. https://eyesoneyecare.com/resources/a-review-of-the-impact-of-glaucoma-on-mental-health