For low vision specialists and those who consult them
Journal article: Management of depression in people with visual impairment
August 18, 2009Posted by on
I have noticed an increase in the number of conference presentations in the last 2-3 years concerning depression in visual impairment. It seems reasonably well established that people with low vision are about twice as likely to suffer from depression as the general population.
There is a nice paper in this month’s Optometry and Vision Science by Fenwick and colleagues from Australia which uses qualitative research techniques to explore how staff in a large eye hospital detect and manage depression in people with low vision.
Whilst most of the staff acknowledged that they saw many patients who were depressed, only 11.5% of the staff in the study group had received any training in the management of depression. Other key findings were that there was no clear mechanism for referral or other management of people with depression, and that the volume of patients seen in the clinic was a barrier to spending enough time with each person to effectively build a rapport.
In the hospital where I do my clinical work, there is a counselling service available and several UK charities such as the Macular Disease Society offer a counselling and emotional support service to people with poor vision. However I can certainly identify with the finding that in a busy clinic, there may not be enough time to discuss fully the emotional effects of visual impairment on the individual.
It would be wrong to imply that everyone with poor vision will become depressed. In particular to say that having low vision causes depression would be inaccurate and would send the wrong message to people. Indeed, there is some thought that depression may be over-reported amongst people with visual impairment because some of the screening questions (eg “have you found less enjoyment from doing things you used to like doing?” may be altered because of visual changes rather than depression). However, this paper reminds us that we should be aware of the identification and appropriate management of people in the low vision clinic who show signs of depression.