Pediatric vision impairment associated with increased risk of depression, anxiety

A child has an eye exam in Vietnam. A new study by Orbis International found that nearsighted children experienced higher levels of depression and anxiety than their peers without vision impairment. (Image courtesy of Orbis UK)

A study by Orbis International found that children with myopia experienced significantly higher levels of depression and anxiety than their peers without vision impairment.

In addition, findings indicated that surgery to correct strabismus significantly improved symptoms of depression and anxiety in children.

The study, which was published in the peer-reviewed journal Ophthalmology, builds our understanding of the link between vision impairment, strabismus and children's mental health. While there is an existing large body of work focused on the impact of vision impairment on depression and anxiety in adults, studies investigating mental health in children with vision impairment are few and have not previously been reviewed in this comprehensive way.

Globally, an estimated 19 million children below the age of 14 years have vision impairment or are blind. While the prevalence of eye disorders, depression and anxiety is lower among children than adults, these conditions pose a greater risk to children when not identified and corrected promptly. The lifetime burden in terms of years affected by these conditions is also much higher.

Orbis's new study posits that the mental health of children with vision impairment may be adversely affected because they tend to participate in fewer physical activities, have lower academic achievement and are more socially isolated. Further, common vision conditions like strabismus can also negatively impact children's development and maturation, affecting not just their appearance, which can in turn affect their confidence and feelings of social belonging, but also their ability to carry out certain activities and their state of mind.

"Resilient mental health is an important requirement for children to thrive. As we see in the newly published research findings, this can be negatively impacted if a child has a vision impairment," says Prof. Nathan Congdon, Director of Research at Orbis International. "With this research, Orbis has pulled together for the first time the kind of convincing evidence that can help spur governments to action on children's vision. These results are all the more compelling because the very strongest evidence we found for impact on mental health was among kids with near-sightedness, treatable with a simple pair of glasses."

This research has profound implications for health care planners when allocating resources and designing interventions to curb vision impairment. For example, in some countries, strabismus surgery is seen as a cosmetic procedure and excluded from insurance coverage, forcing families to pay out-of-pocket. These barriers could deter patients of low socioeconomic status from seeking treatment and keep the mental health benefits of corrective surgery out-of-reach. More accessible eye care treatments will improve children's mental health and overall well-being.