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Vision Loss Linked to Suicide

The tragic disaster of the Germanwings Flight 9525, which crashed into the French Alps on 24 March killing all 150 people on board, is a timely reminder of the need for eye health professionals and GPs to be aware of signs of depression.

Pilot Andreas Lubitz is believed to have been suffering from depression when he deliberately crashed the plane he was flying. Additionally it has been alleged that he had sought treatment for eyesight problems, which may have jeopardised his flying abilities. A sick note declaring him unfit for work was found torn up at his apartment in Dusseldorf during investigations.

A new study published in the British Journal of Ophthalmology in March, has linked vision loss with suicidal thoughts or suicide attempts.

The study included almost 30,000 adults and was led by Dr. Tyler Hyungtaek Rim of the Institute of Vision Research at the Yonsei University College of Medicine in Seoul, South Korea. Participants underwent eye exams between 2008 and 2012 and responded to questions about their mental health, including suicidal ideation, suicide attempt and depression, as well as whether or not they had sought counselling.

The study found that approximately 16 per cent of participants reported suicidal thoughts during the previous year, and 1 per cent (300 people) had attempted suicide. A doctor had diagnosed 4 per cent of participants with depression, however, only about 2 per cent had received counselling for their mental health issues.

The authors noted that, in general, quality of life decreased as vision got worse. Those with profound low vision or no light perception at all were nearly two times more likely to have had suicidal ideations and three times more likely to have attempted suicide, compared to participants with normal vision. The confidence interval for the link with suicide attempts was 0.92 to 12.79.

The study authors wrote that “People with visual impairment often suffer substantial psychosocial consequences”.

“Ophthalmologists should embrace their responsibility to help reduce suicidality and prevent suicides in patients with low visual acuity by encouraging them to seek psychiatric care, especially in those patients who perceive severe stress because of their ocular disease.”

Several papers have been written connecting vision loss with depression and suicidal tendencies. Among them is a paper entitled Blindness, Fear of Sight Loss, and Suicide written by Diego De Leo and colleagues, which noted that “Of the five senses possessed by humans, sight has always been considered
the most important”.1

The authors wrote, “When compared with a hearing-impaired control group, impaired sight alone can acutely affect otherwise psychologically healthy individuals. Ophthalmologists need to be aware of
this problem and to develop closer collaboration with mental health professionals. Serious consideration of this problem and definition of clear guidelines may prevent suicidal behaviour.”1

A survey by Macular Disease Foundation Australia found that carers of people with vision loss are also at greater risk of depression. Overall, depression rates among those who care for someone with wet age-related macular degeneration were more than triple those seen in the general population over 65 years of age.2 One in nine people aged under 70 reported suffering from the condition.

References

1. Psychosomatics 1999; 40:339–344

2. Macular Disease Foundation Australia, ‘New research uncovers the ripple effect of vision loss on carers’, www.mdfoundation.con.au/page12202129.aspx (accessed 9 April 2015).

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