Mental Health Scores Decreased in Patients Who Developed POAG

An association between primary open-angle glaucoma (POAG) and low mental health scores is possible after a new study published in JAMA Ophthalmology¹ found that those without POAG had higher mental health scores compared with those who developed POAG. Further studies will need to be conducted to confirm this relationship.

POAG was linked to a decrease in mental health score in those who had been diagnosed compared with those who had not. | Image credit: Africa Studio - stock.adobe.com

Diagnosis of health conditions has been linked to a self-reported decrease in mental health, even when the condition does not have immediate symptoms. This association has been found in those with diagnosed eye conditions, specifically in moderate to severe glaucoma.² The effect of a diagnosis of POAG has been less studied as it relates to mental health. This study aimed to use the Visual Function Questionnaire-25 (VFQ) mental health scale to assess the mental health of those who have been diagnosed with early POAG 2 years before and after diagnosis compared with those without POAG.

Data for this study came from the Ocular Hypertension Treatment Study (OHTS; NCT00000125) phases 1 and 2. Participants of the OHTS received the VFQ every 2 years between January 2001 and December 2008 and participants were chosen among those who completed the VFQ in that time. Individuals were included in this study if they completed the VFG and a clinical examination every 2 years, had been prescribed medication for ocular hypotension, and had gone through propensity score matching. The primary objective was to see if a decrease in mental health score was associated with a diagnosis of early POAG.

The study included 50 participants with POAG, of which 58% were men, and 100 participants without POAG, of which 63% were men. VFQs were completed a median of 132 (range, 66-150) months before POAG and 150 (range, 96-168) months after POAG diagnosis. Participants in both the POAG group and non-POAG group were primarily White or Hispanic (66%); both groups also included Black participants.

The prediagnosis mean (SD) VFQ mental health score was 94.5 (8.6) in the POAG group and the postdiagnosis score was 88.0 (13.6). This equaled a mean difference of –6.5 (11.3). The control group had a prediagnosis score of 93.3 (8.9) and a postdiagnosis score of 92.6 (8.0) for a mean difference of –0.7 (8.3). The mean difference between the 2 groups equaled –5.8 (9.4) with both groups not having any other significant differences in the other scale scores in the VFQ.

There were some limitations to this study. Detection of some changes could not be assessed due to the small sample size. Immediate effects of glaucoma diagnosis on the mental health of the participants could be missed with the 2-year intervals between each VFQ survey. An in-depth assessment of mental health could not be assessed with the VFQ as it was not designed for that purpose. The impact of comorbidities could have been underestimated due to their severity not being assessed.

The researchers concluded that “further studies are needed to confirm the association between POAG diagnosis and decrease in mental health score and to develop strategies to inform patients about their POAG diagnosis without producing undue distress, anxiety, and depression.” Mental health in this population continues to be a subject of continued importance to provide holistic treatment to those with POAG.

References

1. Gordon MO, Gao F, Burkland J, et al. Diagnosis of primary open-angle glaucoma and mental health. JAMA Ophthalmol. Published online June 5, 2025. doi:10.1001/jamaophthalmol.2025.1374

2. Huang W, Gao K, Liu Y, Liang M, Zhang X. The adverse impact of glaucoma on psychological function and daily physical activity. J Ophthalmol. 2020;2020:9606420. doi:10.1155/2020/9606420