Letter to the Editor: Bridging the visual and the visceral: Critical commentary on the scope and methodological limits of integrated psycho-ophthalmology

Table 1 Proposed conceptual framework for integrated psycho-ophthalmological assessment

Phase	Description	Focus areas
Phase 1 ophthalmic red flags	Completed by doctor during clinical exam	Somatic amplification, catastrophizing language, and treatment fatigue/non-adherence
Phase 2 quantitative screening	Administered in the waiting area	HADS-A/D ≥ 11: High priority for psychological triage; SF-12 PCS < 30: High risk for functional disability and social withdrawal
Phase 3 clinical interview	Completed by psychologist	Perceptions of prognosis (vision), changes in self-image (identity), and loss of tasks like driving (autonomy)

This model is a theoretical expansion based on the findings of Capobianco et al[1] and requires further empirical validation. HADS: Hospital Anxiety and Depression Scale; PCS: Physical component summary; SF-12: 12-item Short Form Health Survey.