What do the blind feel? Psychological distress and satisfaction with life of blind persons: A community-based study

Progressive loss of visual acuteness is known to be associated with anxiety, insecurity, loss of independence, and altered social functioning, which may lead to low mood and subsequently depression. Emotionally adjusting to vision loss can dramatically change one's independence. Reduced workplace productivity in adults with visual impairment is associated with lower rates of workforce participation and increased rates of anxiety and depression. Most studies for psychological comorbidities in the legally blind population are conducted in individuals who present to the psychiatry or psychology department/clinics or to facilities for blindness certification. Due to the paucity of community-based data in the Indian scenario, the current study was undertaken. To evaluate the psychological distress and satisfaction with life of people who were diagnosed as blind in the community. The sample was based on the identification of blind persons in a door-to-door screening for eye and vision problems in 44535 individuals conducted in 2015-16 in the middle to lower socioeconomic populations in the suburban area of Yerawada, Maharashtra. Those who were suspected of having low vision underwent a detailed clinical examination including visual acuity estimation, portable slit lamp examination, I-Kare tonometry, and fundoscopy, conducted by an ophthalmologist to assess and verify the lack of vision. Subsequently, the General Health Questionnaire-12 (GHQ-12) and Satisfaction with Life Scale (SWLS) were also applied upon revisiting the participants in 2020-2021. The majority of participants were middle-aged or elderly and no significant gender variation was noted in terms of blindness. Maximum psychological disability was seen after 6 to 15 years after the onset of blindness. More than 80% of the patients with complete blindness had some psychiatric comorbidity or distress and more than half reported that their daily activities were affected due to their diagnosis. Blind persons had significantly higher scores on the GHQ-12 and significantly lower scores on SWLS. Complete blindness was positively correlated with GHQ-12 scores and negatively correlated with SWLS scores and the age of the subject. This study demonstrates that psychological distress and low levels of satisfaction with life are common among the severely visually impaired and blind. There is a dire need to improve access to rehabilitation services and psychological support for the blind and their caregivers.