Macular Degeneration and Depression

“Anxiety and depression in patients with advanced macular degeneration: current perspectives”         Clinical Ophthalmology, January 2016

   The authors of this article discuss the strong connection between macular degeneration and mental health problems.   Citing 75 sources they state that increased functional disability puts AMD patients at risk of developing depression and anxiety.  The incidence of clinically significant sub threshold symptoms of depression can be found in one-third of visually impaired older adults.  That is twice as high as in normally sighted older adults where depressive symptoms affect about 15%.

   They list the mechanisms for development of depression and anxiety among those with AMD as loss of functional capacity, a basic deficit in problem solving skills and a poor future outlook. 

   A new set of control strategies must be developed including: putting extra energy into high priority skills like reading, giving up activities like reading for more feasible options like books on tape, obtaining visual aids to help with reading and giving up on the unattainable goal of reading.

    “Low vision rehabilitation aims to reduce vision-related disability by maximizing residual vision through training in the use of optical and assistive devices, orientation and mobility skills, and general compensatory strategies.”

   The authors further state that:   “In the absence of available practice models that specifically address depression and anxiety, traditional low vision rehabilitation (which includes care provided by low vision optometrists, occupational therapists, low vision specialists, and other professionals with training in low vision rehabilitation) presents the best current treatment option to address these mental health problems in a rehabilitation context.”

The take home message seems to be that by providing low vision care to AMD patients and helping them continue to   function and maintain their independence we may be helping them avoid or delay clinical depression.

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