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Low Vision & Depression

Posted by Ilena Di Toro | Posted on September 12, 2017

It is no secret that a greater number of people are experiencing low vision from conditions, such as macular degeneration, glaucoma and cataracts. While these conditions don’t lead to sudden vision loss, they do take their toll. In addition to reduction of mobility and difficulty with near work activities (e.g., reading) vision limiting conditions can leave people feeling depressed.

On the bright side, there are ways to help those with low vision. That is where occupational therapy comes in. Occupational therapy works to promote independence through working with the patient to best utilize whatever amount of vision remains.

A study was done at Johns Hopkins to show how occupational therapy helps those with low vision. The study consisted of 188 patients with an average age of 84. Seventy percent of study participants were women. They all had age-related macular degeneration and their average visual acuity was 20/96. The patients in this study reported borderline depression symptoms.

After visiting a low vision optometrist, the patients were separated into two groups, an occupational therapy group and a supportive therapy group. The occupational therapy group met with an occupational therapist for six one-hour session in their home. This group worked on learning how to use tools like magnifying glasses and electronic devices, as well as how to find ways to performs tasks that low vision made difficult, like cooking or navigating around the home. The supportive therapy group met with a social worker for six one-hour sessions of conversational therapy. The sessions focused on personal expression about loss and disability. There was no therapy that lead to improved function.

Four months after treatment, researchers followed up with patients. Before the study, the occupational therapy group had an average score of 5.5 on the Patient Health Questionnaire-9(PHQ-9) and the supportive therapy group’s average score was 5.6, this meant that both groups were at the borderline of having a depressive disorder. After treatment, the patients took the questionnaire again and occupational therapy patient group’s average score was 4.62 and the supportive therapy’s score was to 4.54.

Yet there is more to this story than decreased scores on the PHQ-9. Researchers found that 26 percent of the supportive therapy patients reported that their depression symptoms worsened. In contrast, just 12 percent of the occupational therapy patients said that depression symptoms worsened. That means while the supportive therapy patients felt better in the short term with conversational therapy, what made those with low vision feel better in the long term was actually occupational therapy, since that is what helped them perform activities of daily living despite having low vision.

While current treatments for low vision only work to preserve functional vision, this study shows the value of occupational therapy. There are vision assistance devices available that can help people to perform the activities of daily living. Learning how to use these aids can help to reduce depression, which improves overall health.


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