Visual impairment linked to symptoms of depression, anxiety in children
August 16, 2022
2 minute read
Li D, et al. Ophthalmology. 2022; doi:10.1016/j.ophtha.2022.05.020.
Disclosures: Li does not report any relevant financial information. Please see the study for relevant financial information from all other authors.
Children with visual impairment were more likely to have symptoms of depression and anxiety, which improved significantly after strabismus surgery, according to a systematic review and meta-analysis in Ophthalmology.
“Although the prevalence of ocular morbidity, depression and anxiety is lower in children than in adults, the total burden of these conditions is higher due to the length of time children are affected if the underlying disorders are not identified and corrected”, Dongfeng Li, MMedfrom the Department of Ophthalmology at Sichuan Provincial People’s Hospital at the University of Electronic Science and Technology of China, and colleagues wrote.
The researchers searched nine electronic databases of observational and interventional studies to determine whether visual impairment, ocular morbidity, and subsequent treatment affect the mental health of children under 18 years of age. Databases included were Medline, Embase, Web of Science, PsycINFO, Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials in the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Wanfang Med Online and China National Knowledge Infrastructure.
Of 28,992 studies identified, more than 99% were duplicates or contained unrelated content, leaving 36 studies to be included in the review. Of these, 21 (58.3%) were observational studies of visual impairment, eight (22.2%) were observational studies of strabismus and seven (19.4%) were interventional studies.
Eleven studies included depression scores, in which visually impaired children had higher depression scores than normal sighted children (standard mean difference [SMD] = 0.57; 95% CI, 0.26-0.89). Higher depression scores were also found in children in six studies in which myopia was the visual impairment (SMD = 0.58; 95% CI, 0.36-0.81). Additionally, visually impaired children showed significantly higher anxiety scores (SMD = 0.62; 95% CI, 0.4-0.83) in 14 studies.
The results also revealed that strabismus surgery significantly improved symptoms of depression in children in three studies (SMD = 0.59; 95% CI, 0.12-1.06) and anxiety in four studies ( SMD = 0.69; 95% CI, 0.25-1.14).
Li and his colleagues acknowledged that the results of their review and analysis may not be widely applicable, as 22 studies were from low- and middle-income countries and nine focusing on myopia were conducted in China.
“We suggest that further [randomized, controlled trials] on myopia correction and its impact on mental health are needed to identify strategies to improve the mental health of children with myopia,” Li and colleagues wrote. “This review also underscores the importance and potential impact of early detection and treatment of strabismus in children and provides evidence in support of timely insurance coverage for strabismus surgery in order to help improve the overall health of children and therefore reduce the costs of future mental health disorders.”