Persistent psychological stress is a major contributor to the development and progression of vision loss according to an analysis of hundreds of published research and clinical reports on the relationship of stress and eye disease.
The research, spearheaded by Professor Bernhard Sabel from the Institute of Medical Psychology at Magdeburg University, has led the investigators believe a holistic approach could be used more widely in the clinical management of eye diseases.
“There is clear evidence of a psychosomatic component to vision loss, as stress is an important cause − not just a consequence − of progressive vision loss resulting from diseases such as glaucoma, optic neuropathy, diabetic retinopathy, and age-related macular degeneration,” Sabel said.
Sabel noted that of the relatively few scientific reports in the field of psychosomatic ophthalmology available, even fewer explore the relationship of stress, vision loss, and vision restoration, despite many patients suspecting that mental stress had contributed to their vision loss.
Study co-investigator Dr Muneed Faiq, an ophthalmologist at the New York State University School of Medicine, said the disconnect represented a large disconnect between scientific activity and public need.
“The behaviour and words of the treating physician can have far-reaching consequences for the prognosis of vision loss,” Faiq said.
“Many patients are told that the prognosis is poor and that they should be prepared to become blind one day. Even when this is far from certain and full blindness almost never occurs, the ensuing fear and anxiety are a neurological and psychological double burden with physiological consequences that often worsen the disease condition.”
The research suggests increased intraocular pressure, endothelial dysfunction (Flammer syndrome), and inflammation are some of the consequences of stress that may cause further damage. As such, Sabel said that clinicians should utilise a more ‘holistic’ approach and provide stress-reduction treatments, such as meditation, autogenic training, stress management training, and psychotherapy as preventive measures to reduce the progression of vision loss.
The study, published in the EPMA Journal of the European Association for Predictive, Preventive, and Personalized Medicine, will be presented later this year at the 5th International Conference of “Low Vision and Brain” in Berlin, and is set to include case reports to show how stress can induce vision loss.
“Continuous stress and elevated cortisol levels negatively impact the eye and brain due to autonomic nervous system (sympathetic) imbalance and vascular deregulation,” Sabel said while emphasising that both the eye and the brain are involved in vision loss.
“Clinical studies are underway to confirm the causal role of stress in different low vision diseases to evaluate the efficacy of different anti-stress therapies for preventing progression and improving vision restoration.”
He also said that adjunct therapies like brain stimulation, anxiety management and social support have previously been used successfully in tandem with therapies to increase blood flow to the eye.