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Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Depression and Anxiety in Children: A Systematic Review.

Publication ,  Journal Article
Li, D; Chan, VF; Virgili, G; Piyasena, P; Negash, H; Whitestone, N; O'Connor, S; Xiao, B; Clarke, M; Cherwek, DH; Singh, MK; She, X; Wang, H ...
Published in: Ophthalmology
October 2022

TOPIC: This systematic review and meta-analysis summarizes existing evidence to establish whether vision impairment, ocular morbidity, and their treatment are associated with depression and anxiety in children. CLINICAL RELEVANCE: Understanding and quantifying these associations support early detection and management of mental health symptoms in children with vision impairment and ocular morbidity. Additionally, this review provides evidence in favor of insurance coverage for timely strabismus surgery. METHODS: We searched 9 electronic databases from inception through February 18, 2021, including observational and interventional studies assessing whether vision impairment, ocular morbidity, or both and their treatment are associated with depression, anxiety, or both in children. We used narrative synthesis and meta-analysis with the residual maximum likelihood method. A protocol was registered and published on The International Prospective Register of Systematic Reviews (identifier: CRD42021233323). RESULTS: Among 28 992 studies, 28 956 studies (99.9%) were excluded as duplicates or unrelated content. Among 36 remaining studies, 21 studies (58.3%) were observational studies concerning vision impairment, 8 studies (22.2%) were observational studies concerning strabismus, and 7 studies (19.4%) were interventional studies. Vision impaired children demonstrated significantly higher scores of depression (standard mean difference [SMD], 0.57; 95% confidence interval [CI], 0.26-0.89; 11 studies) and anxiety (SMD, 0.62; 95% CI, 0.40-0.83; 14 studies) than normally sighted children. In particular, children with myopia demonstrated higher scores of depression (SMD, 0.58; 95% CI, 0.36-0.81; 6 studies) than normally sighted children. Strabismus surgery significantly improved symptoms of depression (SMD, 0.59; 95% CI, 0.12-1.06; 3 studies) and anxiety (SMD, 0.69; 95% CI, 0.25-1.14; 4 studies) in children. CONCLUSION: Among children, vision impairment is associated with greater symptoms of depression and anxiety. Surgical treatment of strabismus improved these symptoms. Further randomized controlled trials exploring the impact of public health measures for myopia correction on mental health in children are needed. Scaling up access to strabismus surgery could improve the mental health of affected children.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

October 2022

Volume

129

Issue

10

Start / End Page

1152 / 1170

Location

United States

Related Subject Headings

  • Strabismus
  • Ophthalmology & Optometry
  • Myopia
  • Morbidity
  • Humans
  • Depression
  • Child
  • Anxiety
  • 3212 Ophthalmology and optometry
  • 1117 Public Health and Health Services
 

Citation

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Chicago
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Li, D., Chan, V. F., Virgili, G., Piyasena, P., Negash, H., Whitestone, N., … Congdon, N. (2022). Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Depression and Anxiety in Children: A Systematic Review. Ophthalmology, 129(10), 1152–1170. https://doi.org/10.1016/j.ophtha.2022.05.020
Li, Dongfeng, Ving Fai Chan, Gianni Virgili, Prabhath Piyasena, Habtamu Negash, Noelle Whitestone, Sara O’Connor, et al. “Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Depression and Anxiety in Children: A Systematic Review.Ophthalmology 129, no. 10 (October 2022): 1152–70. https://doi.org/10.1016/j.ophtha.2022.05.020.
Li D, Chan VF, Virgili G, Piyasena P, Negash H, Whitestone N, et al. Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Depression and Anxiety in Children: A Systematic Review. Ophthalmology. 2022 Oct;129(10):1152–70.
Li, Dongfeng, et al. “Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Depression and Anxiety in Children: A Systematic Review.Ophthalmology, vol. 129, no. 10, Oct. 2022, pp. 1152–70. Pubmed, doi:10.1016/j.ophtha.2022.05.020.
Li D, Chan VF, Virgili G, Piyasena P, Negash H, Whitestone N, O’Connor S, Xiao B, Clarke M, Cherwek DH, Singh MK, She X, Wang H, Boswell M, Prakalapakorn SG, Patnaik JL, Congdon N. Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Depression and Anxiety in Children: A Systematic Review. Ophthalmology. 2022 Oct;129(10):1152–1170.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

October 2022

Volume

129

Issue

10

Start / End Page

1152 / 1170

Location

United States

Related Subject Headings

  • Strabismus
  • Ophthalmology & Optometry
  • Myopia
  • Morbidity
  • Humans
  • Depression
  • Child
  • Anxiety
  • 3212 Ophthalmology and optometry
  • 1117 Public Health and Health Services