Vision loss, vision difficulty and psychological distress in South Africa: results from SANHANES-1

Abstract

Background Psychological distress in vision impairments and blindness is a complex issue and a major public health concern. Sudden adjustments in routine lifestyle and career aspirations in such persons culminate in and/or aggravate their level of stress. Yet, psychological distress in persons with visual difficulties and vision loss in South Africa is poorly understood. We investigated the association between psychological distress and self-reported vision difficulties as well as clinician-assessed vision loss using data from the South African National Health and Nutrition Examination Survey (SANHANES-1). Methods Data was analysed on participants aged ≥ 15 years who participated in the SANHANES-1 clinical examinations and interviews. Data on demographic, socio-economic, and health status variables were gathered using a structured questionnaire. Psychological distress was assessed using the Kessler psychological distress scale (K10). Vision assessment was conducted by clinicians adhering to standard protocols as well as by participants’ subjective response to vision-related questions. Vision loss was defined as presenting visual acuity worse than Snellen 6/12 in the better eye. Bivariate and multiple logistic regressions were used to examine the association between vision parameters and psychological distress. Results The analytic sample comprised 6859 participants with mean age of 38.4 years (60.8% females). The prevalence of psychological distress was 19.9%. After adjusting for demographics, socioeconomic, health risk and eye care variables, self-reported myopia (mild adjusted odds ratio [AOR] = 1.9, 95% CI 1.3–2.7; moderate AOR = 2.4, 95% CI 1.6–3.7; severe AOR = 3.6, 95% CI 1.8–7.3) and self-reported hyperopia (mild AOR = 1.7, 95% CI 1.2–2.5; moderate AOR = 2.4, 95% CI 1.5–3.8; severe AOR = 3.5, 95% CI 1.8–6.8) were significantly associated with psychological distress. While psychological distress was higher in patients with clinician assessed vision loss than those with normal vision, the association was not statistically significant after adjusting for confounders (AOR: 1.0, 95% CI 0.7–1.4). Conclusions Persons who self-reported vision difficulty experienced a higher prevalence of psychological distress. Therefore, comprehensive psychological care is needed for patients with eye disease or vision difficulties as part of a governmental strategy to provide mental health care for all South Africans.

Visual Impairment and Blindness among Patients at Nigeria Army Eye Centre, Bonny Cantonment Lagos, Nigeria

“…Consistent with these studies, the distribution of different categories of VI was found to increase with age, particularly among the older population in our study, with the proportion of participants who were blind among the adult age group being almost double the proportion who were blind in all other age groups combined. Similar findings were recorded in other studies [ 9 , 19 , 21 , 22 , 23 , 24 , 25 ]. Although these studies were conducted in different settings compared to ours, the age range for adults in these studies and ours overlap; hence, a comparison of our study to these studies in terms of tested age groups is a valid one.…”

Enhancing Vision Care through Psychological Assessment in Sub-Saharan Africa: An Overview

“…Individuals with eye diseases in Sub-Saharan Africa may experience heightened stress and mental health challenges due to the impact of their condition on daily activities, social interactions, and overall well-being (Courtright et al, 2016). The psychological burden of coping with vision loss can lead to feelings of frustration, anxiety, and depression, affecting their mental health (Akuffo et al, 2021;Courtright et al, 2016), hence the need for psychological assessment in eye clinics in SSA.…”

Health Management Service Models for the Elderly with Visual Impairment: A Scoping Review

“… 10 , 11 VI may also increase other physical challenges, such as cognitive decline, 12 , 13 reduced vision-related quality of life (VRQoL), 14 and increased risk of chronic disease and death. 15 , 16 The elderly with VI will also have psychological problems, 17 such as anxiety and depression. 18 , 19 The incidence of depression and anxiety of the elderly with VI is twice that of the general elderly.…”

“…with VI will also have psychological problems, 17 such as anxiety and depression. 18,19 The incidence of depression and anxiety of the elderly with VI is twice that of the general elderly.…”