Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Depression and Anxiety in Children

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.

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.

Publication date

June 1, 2022




Dongfeng Li, MMed; Ving Fai Chan, PhD, Gianni Virgili, PhD, S. Grace Prakalapakorn, MD, MPH, Jennifer L. Patnaik, PhD, Nathan Congdon, MD, MPH
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