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May 2013

Vision Function, Functional Vision, and Depression

Author Affiliations

Author Affiliations: Jewish Guild Healthcare, and Department of Ophthalmology, College of Physicians and Surgeons, Columbia University, New York, New York.

JAMA Ophthalmol. 2013;131(5):667-668. doi:10.1001/jamaophthalmol.2013.61

Vision loss and depression have long been linked but their relationship has not been well understood. Each condition by itself can be life altering but, when combined, their deleterious effects may be compounded. In this issue of JAMA Ophthalmology, Zhang et al1 address the relationship between vision loss and depression, and they provide evidence that loss of functional vision (ie, actual task-related visual performance) is linked to depression. This finding underscores the importance of addressing not only the causes of vision loss but their consequences in everyday life. Their analysis of data from the National Health and Nutrition Examination Survey, which used a population-based probability sample, found an overall prevalence of depression of 4.8% in the general US population without vision loss but 11.3% among US adults with self-reported vision loss, which reflects a decline in vision that interferes with an individual's normal or desired functioning. Depression in the National Health and Nutrition Examination Survey sample was assessed using the 9-Item Patient Health Questionnaire,2 a brief, easily administered tool that identifies and grades the severity of depression. Among those with visual acuity of less than 20/40 in the better eye with correction, the prevalence of depression was 10.7% compared with 6.8% among adults with better visual acuity. Importantly, self-reported vision loss, an individual's perception about how their vision loss affects their performance in everyday activities, was significantly related to depression while acuity was not.

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