​​Visually Impaired Children Have Higher Odds of Depression, Anxiety, Cognitive Impairment

This study's findings highlight how interconnected factors—social, cognitive and environmental—are associated with mental health and behavior, emphasizing the need for early intervention and holistic support strategies for vision impaired youth. Photo: Getty Images. Click image to enlarge. While the psychological effects of vision loss in adults have often been investigated, not much research has been done on the adolescent population. In a recent study, authors sought to characterize the association between mental health indicators and vision impairment in children in the United States. They found that these children exhibit greater odds of depression, anxiety, cognitive impairments and behavioral difficulties compared to non-visually impaired children. The findings were reported in American Journal of Ophthalmology.A total of 6,429 children up to age 17 from the 2022 National Health Interview Survey (NHIS) were included. Participants completed a household interview survey and Mental Health Assessment from the Strengths and Difficulties Questionnaire (SDQ).The findings showed that 5% had visual impairments despite correction with glasses or contacts. Vision-impaired children had higher rates of depression (44%) and anxiety (64%) compared to unaffected kids (33% and 53%, respectively). They also had greater odds of learning and memory difficulties. Vision-impaired children showed higher total SDQ scores, indicating more peer relationship issues, hyperactivity/inattention and emotional symptoms. Additionally, there was a 30% to 50% decrease in the usage of mental health therapy and special education between youth with severe vs. moderate depression and anxiety.Girls exhibited higher rates of caregiver-reported vision issues overall, at  5.7% vs. 4.4% for boys, as well as in each of the levels of vision impairment. Interestingly, the proportion of depression and anxiety in visually impaired youth is also two times greater for girls than boys. “These trends suggest that female children may be more likely to report vision impairment, which could compound existing mental health challenges and help explain some of the gender differences in mental health indicators,” the researchers wrote in their AJO paper.With mental health more prevalent in these patients, depression and anxiety screening should be performed for those with vision impairments, and their potential unique challenges addressed accordingly, the authors suggest. Children with mental health conditions are often less likely to access healthcare due to stigma, limited resources, systemic barriers, financial constraints and social factors, they also point out.While the majority of vision-impaired youth with severe depression and anxiety use mental health therapy and special education services, there is a steep drop-off for kids with mild to moderate mental health conditions. “This drop-off of 30% to 50% less usage in mental health therapy and special education between severely and moderately depressed or anxious youth suggests that there may be a gap in early intervention,” the authors noted in their article. “Also, those with moderate depression and mild anxiety experience the greatest delays in therapy due to the cost. The extent of emotional and mental impairment shown in this research, as well as the gaps in access to care for affected individuals, “present an opportunity for patient-level to policy-level intervention: addressing moderate depression or emotional distress before they become more severe can reduce the overall impact of mental health problems,” the article continues. “Hence, it is crucial to identify individuals who might be at risk and connect them to appropriate services early.”Exploring potential mechanisms linking vision impairment with mental health and behavioral changes in children suggest that several factors contribute. “First, visual impairment can limit a child’s ability to engage with their environment, leading to social isolation and reduced participation in activities, which are crucial for emotional and behavioral development,” the authors explained in their article. “The lack of visual input may affect cognitive processing, contributing to difficulties in learning and self-esteem and subsequently heightening the risk of anxiety and depression.”Caregiver-reported vision impairment is associated with a child’s cognitive and behavioral abilities, which may negatively impact a child’s capacity to socialize and perform well in school. Understanding the mental capabilities of vision-impaired children is crucial in helping them adapt to educational settings and find special programs or schools that support their specific needs, the authors explained.They add that parents and caregivers may unintentionally reinforce these negative outcomes by overprotecting or underestimating the child’s abilities, which can exacerbate feelings of helplessness or frustration. Limited access to supportive resources or specialized care can further hinder the child's mental health.“This study's findings highlight how these interconnected factors—social, cognitive and environmental—are associated with mental health and behavior, emphasizing the need for early intervention and holistic support strategies for vision impaired youth,” the authors concluded in their article.“Acknowledging the connection between vision impairment and mental health conditions in children may aid in the early diagnosis and treatment of depression and anxiety, more streamlined placement of children in schools with special assistance for their needs and increased resources to help children develop interpersonal skills.”Click here for the journal source. Du K, Patil P, Boland MV. Mental health of US children with vision impairment: an analysis of the National Health Interview Survey. Amer J Ophthalmol. June 4, 2025. [Epub ahead of print.]