It is not uncommon for anyone who has loss of vision due to disease or accident to become depressed. Staff at UI Hospitals and Clinics also note that people who receive elective eye procedures that develop complications or have unintended outcomes are also at an increased risk for developing depression. Christie Sindt, OD, director of the Contact Lens Clinic in the Department of Ophthalmology and Visual Sciences at UI Hospitals and Clinics, talks about vision loss and depression:
What procedures are we talking about as elective eye procedures?
What we're discussing are refractive eye procedures such as LASIK surgery, PRK, or even the older version of the RK surgery that people may have had 20 years ago.
Who typically seeks an elective procedure?
People who are not happy with their vision status—people who want to be glasses-or contact lens-free or people who want to lower the power of their eyes so that they don't have to wear heavy or thick glasses.
Are patients warned before having any procedure involving the eyes of the risks involved and the possibility of complications?
Yes, all patients are warned about complications prior to having any refractive procedure on the eye. And the complications that they're warned about would include potential loss of vision, which only occurs in about 3 percent of patients seeking refractive surgery.
What happens after a procedure does not go as expected, are there options for those patients to correct the unintended negative result?
In most cases a second procedure, an enhancement procedure, can correct any under-correction or over-correction that happened during the refractive procedure. However, there are complications that are more difficult to correct such as dry eye, halos, flare, a lot of glare, or significant eye pain.
When do you typically see these patients?
I see the patients after they've had their procedure and they are either uncomfortable or they don't have the vision correction that they need. That's when we see them in the contact lens clinic, to try to get them to see better or get them more comfortable.
Are all optometrists and ophthalmologists trained to detect depression?
No, eye care professionals are trained to diagnose and treat eye diseases. And certainly, while we may realize a patient may be suffering from depression, we are not trained to treat depression, so it would be prudent for optometrists and ophthalmologists who, when they do note signs of depression in their patient, to refer those people to a mental health professional.
Why do you believe these patients who have elective procedures that do not go as planned suffer a higher rate of depression?
Anybody who suffers from chronic eye pain or chronic vision loss can suffer from depression. So this isn't exclusive to people with post-refractive surgery problems. It can happen when somebody has paid for a procedure as opposed to having a disease or an accident. When somebody has paid for a procedure, not only do they have to learn to adjust and live with their new vision or the pain in their eyes, they also have to learn to forgive themselves for having undergone a procedure that was elective. And for some people—it's very difficult for them to forgive themselves.
What are your suggestions for anyone considering an elective eye procedure?
I tell my patients when they're considering refractive surgery they need to consider that if they have problems, how that would roll out into their lives. If somebody is a visually-intensive person or what we call, a critical observer, then they may be less of a candidate if there was a problem because it would have more of an impact on their lives.
I tell my patients that we're not just treating eye balls; we're treating people that are wrapped around those eye balls and lives that are wrapped around those people. And we have to consider if you were to have a complication, how it would ultimately affect your life. Some people are very good and would probably have minimal impact on their lives, while other people would have a maximum impact on their life. And people can sort themselves out before a procedure. |
