Psychiatric disorders linked to visual impairment: A review of mental health challenges and interventions across age groups

Table 1 Psychiatric and psychosocial effects of visual impairment in different age groups with suggested management strategies

Age group	Common ocular conditions	Psychiatric and psychosocial impact	Suggested management strategies
Children and adolescents	Myopia, strabismus, ROP, congenital blindness	Depression, anxiety, social withdrawal, low self-esteem, peer difficulties, identity issues	Early correction (e.g., myopia glasses, strabismus surgery), parental and school-based support, CBT, REBT, peer interaction training, recreational activity, training in adaptive skills, mobility support, and emotional counselling
Young adults	High myopia, glaucoma, retinitis pigmentosa	Social stigma, fear of disease progression, loss of autonomy, vocational stress, existential anxiety	ACT, problem-solving therapy, vocational rehabilitation, CBT (mood monitoring, cognitive restructuring), counselling, psychosocial education, peer and tele-support, identity re-framing interventions
Middle-aged adults	Diabetic retinopathy, glaucoma, uveitis, cataract	Adjustment disorders, stress, sleep disturbances, relationship strain, anticipatory grief about progressive vision loss	PST, vision rehabilitation, integrated ophthalmology-psychiatry care, emotional support groups, tele-health mental health support, education about prognosis, and promoting lifestyle modification (e.g., smoking cessation, exercise)
Older adults	ARMD, glaucoma, cataract, Charles Bonnet Syndrome	Major depression, cognitive decline, anxiety, loneliness, sleep-wake disturbances, suicidal ideation, increased dependency	Stepped care, CBT/REBT, routine screening with PHQ-9/GAD-7, vision rehabilitation with assistive devices, low vision therapy, group-based interventions, social engagement programs, home safety adaptations, caregiver training, integration of mental health in eye care

ROP: Retinopathy of prematurity; CBT: Cognitive behavioral therapy; REBT: Rational emotive behavior therapy; ACT: Acceptance and commitment therapy; ARMD: Age-related macular degeneration; PST: Problem-solving treatment; PHQ-9: Patient Health Questionnaire 9; GAD-7: Generalized Anxiety Score 7-Item Scale.