Corneal Dystrophy Linked to Higher Rates of Mental Health Conditions

Nearly a third of patients with corneal dystrophy were reported to experience depression, and another third had anxiety disorders, compared to just 13.7% and 16.0% of controls, respectively. These associations persisted across all races, genders and income strata. Researchers suggest these findings underscore the importance of “exploring opportunities to incorporate mental health support into clinical care when appropriate.” Photo: Christina Cherny, OD, and Suzanne Sherman, OD. Click image to enlarge.  Chronic eye diseases are known to contribute to significant psychological burdens, but a new study appearing in American Journal of Ophthalmology is the first to specifically explore how corneal dystrophies affect mental health. Its findings revealed that individuals with untreated corneal dystrophy exhibited a substantially higher prevalence of depression and anxiety, emphasizing the need for integrated mental health care within ophthalmic practice.The study conducted a propensity score-matched cross-sectional analysis using electronic health record data from the All of Us Research Program database, comprising a diverse cohort of more than 600,000 American adults. The analysis included 2,393 adults diagnosed with corneal dystrophy and 301,031 matched controls without the condition. Individuals who previously received surgical treatment for corneal dystrophy were excluded. The mean age of all participants was 73.1 years. Of the corneal dystrophy cohort, 61.9% of subjects were female and 84.7% self-identified as white, while 10.5% identified as Black or African American. Educational attainment was high, with 60.5% reporting a college degree or higher. Most participants had health insurance coverage (97.7%), though 13% reported an annual income under $25,000. Key demographics such as race, gender, income and health insurance status were balanced during the matching process.Results showed that individuals with corneal dystrophy had a significantly higher prevalence of depression (32% vs. 13.7%) and anxiety disorders (32.4% vs. 16%) compared to propensity score matched controls without those diseases. Notably, none of the demographic factors modified these associations. The researchers pointed out in their AJO paper that while race, gender and income strata “influence baseline mental health vulnerability, the psychological burden associated with corneal dystrophy persists across populations.”These findings correspond with previous studies emphasizing the mental health impact of chronic eye diseases, including glaucoma, diabetic retinopathy, age-related macular degeneration and cataracts, the study authors noted. For example, they explained, research indicates that individuals with diabetic retinopathy are 2.6 times more likely to report depressive symptoms, while AMD has been associated with a 1.8 times greater risk of depression.“Several factors may contribute to the increased mental health burden in individuals with corneal dystrophy,” they noted, including progressive vision loss and recurrent corneal erosions, of which the latter often leads to pain, photophobia, excessive tearing and blurred vision. “These symptoms can significantly disrupt daily activities and social interactions, exacerbating emotional distress. The unpredictability of symptom flare-ups further contributes to psychological strain, potentially affecting relationships and overall quality of life.”In conclusion, the research team wrote, “By highlighting the overlooked mental health challenges associated with corneal dystrophy, our study emphasizes the importance of recognizing psychological distress in ophthalmic populations and exploring opportunities to incorporate mental health support into clinical care when appropriate.”Click here for the journal source. Nishihara TW, Afshari NA. Investigating the relationship between corneal dystrophy and mental health conditions using the All of Us research program database. Am J Ophthalmol. August 1, 2025. [Epub ahead of print].  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.