Beyond vision: The overlooked burden of depression in glaucoma patients

Core Tip

Core Tip: Depression is common in people with glaucoma and still too often missed. The slow loss of vision, the fear of blindness, reduced social participation, and the day-to-day burden of complex treatment plans all take a psychological toll and erode quality of life. When depressive symptoms are present, patients are less likely to adhere to medications, sustain self-care, or keep follow-up appointments - behaviors that, in turn, can worsen visual outcomes. Emerging evidence also points to shared biology between glaucoma and depression. Neuroinflammation, mitochondrial dysfunction, and dysregulation of the hypothalamic-pituitary-adrenal axis recurs across both conditions and may help explain their clinical co-occurrence. For these reasons, routine identification and management of depression should be part of glaucoma care: Addressing mental health is not ancillary - it is integral to protecting vision.