Eye Diseases and Mental Health are Linked in Children | AAO 2024

Introduction

A recent study presented at the American Academy of Ophthalmology annual meeting has shed light on a concerning link between serious eye conditions and mental health issues in children. The findings suggest that children with serious eye conditions, such as strabismus, cataracts, and congenital optic nerve disease, are at an increased risk of developing psychiatric disorders, including anxiety, depression, bipolar disorder, and schizophrenia. This revelation underscores the need for a comprehensive approach to eye care that includes mental health screening and support.

The Link Between Eye Diseases and Mental Health

Eye diseases in children are not just a concern for their physical vision; they can also have profound effects on their mental well-being. A study using claims data from OptumLabs Data Warehouse analyzed a large sample of children to understand the relationship between eye diseases and mental health conditions. The results were striking:

• Strabismus: Children with strabismus (crossing of eyes) were found to have a higher prevalence of anxiety, depression, bipolar disorder, and schizophrenia compared to those without eye diseases. The odds ratio for anxiety disorder was 2.01, indicating a significant increase in the risk of developing anxiety.
• Cataracts: The study also revealed a strong association between cataracts and anxiety and schizophrenia. Children with cataracts had a 57% higher risk of anxiety and a 65% higher risk of schizophrenia.
• Congenital Optic Nerve Disease: This condition was linked to anxiety and schizophrenia as well, with children being 1.83 times more likely to develop schizophrenia.

These findings highlight the need for ophthalmologists to consider the mental health implications of eye diseases when treating children. Early detection and intervention can significantly improve outcomes for these young patients.

The Psychological Impact of Eye Diseases

The psychological impact of eye diseases can be profound. Children with strabismus, for example, often face social stigma and negative bias. This can lead to increased anxiety and depression as they struggle to fit in with their peers. Furthermore, the constant need for corrective measures like patching and eyeglasses can be a source of frustration and stress.

Moreover, the physical discomfort associated with eye diseases can exacerbate mental health issues. For instance, children with cataracts may experience blurred vision or sensitivity to light, which can lead to feelings of frustration and despair.

The Importance of Comprehensive Eye Care

Given the link between eye diseases and mental health, it is crucial that eye care providers adopt a comprehensive approach to treating children. This should include:

• Mental Health Screening: Incorporating mental health screening tools into eye examinations can help identify children at risk of developing psychiatric disorders early on. This proactive approach can lead to timely interventions that improve both mental and physical health outcomes.
• Referrals for Mental Health Evaluation: Ophthalmologists should refer children with eye diseases for mental health evaluations. Collaborating with pediatric psychologists and psychiatrists can provide children with the support they need to manage their mental health while undergoing treatment for their eye conditions.
• Parental Involvement: Engaging parents in the treatment process is also essential. Educating them about the potential psychological impacts of their child’s eye disease can help them provide the necessary support and care at home.

A Multidisciplinary Approach

The relationship between eye diseases and mental health underscores the need for a multidisciplinary approach to healthcare. Ophthalmologists, pediatricians, psychologists, and other healthcare providers must work together to address the complex needs of children with eye diseases.

Stacy L. Pineles, a professor of ophthalmology, emphasized the importance of this collaboration during the AAO presentation. She noted that ophthalmologists have a unique opportunity to be part of a multidisciplinary medical team, discussing these conditions with patients and their families, and providing referrals when necessary.

Conclusion

The link between eye diseases and mental health in children is a significant concern that requires immediate attention. By adopting a comprehensive approach to eye care that includes mental health screening and referrals, healthcare providers can significantly improve the well-being of these young patients. As research continues to uncover the intricate relationships between physical health and mental wellness, it is clear that a holistic approach to healthcare is essential for addressing the complex needs of children with eye diseases.

References

1. Li, G., Schneider YH, Klawe J, et al. Incidence of Psychiatric Disorders, Fibromyalgia and Chronic Fatigue Following Dry Eye Diagnosis Among Medicare Beneficiaries. Presented at the 2024 American Academy of Ophthalmology annual meeting, Chicago, October 18-21; Session: Cornea-External Diseases – PO272.
2. Pineles, S. L., Meer, E. A., Lee, Y. H. Eye Diseases and Mental Health are Linked in Children | AAO 2024.
3. Lee, Y. H., et al. Cross-sectional review of claims data from OptumLabs Data Warehouse of children with strabismus between Jan. 1, 2007, and Dec. 31, 2017. JAMA Ophthalmology, March 2022.
4. Pineles, S. L., et al. Assessment of the OptumLabs claims of 180,297 children with serious eye diseases, including glaucoma, cataract, congenital optic nerve disease, congenital retinal disease, and blindness/low vision, for an association with mental illness. American Journal of Ophthalmology, August 2022.