When Vision Loss Leads to Low Mood

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You once led按照自己的条件生活。但是，自从潮湿的AMD发展以来，这种疾病会导致眼睛血管异常生长，也许您已经失去了独立性，甚至失去了曾经是客气的前景。这种疾病通常与衰老息息相关，并可能导致失明，而预防是一线治疗的重点。但是，视力丧失的影响可能会带来自主权的终结，因此与湿AMD一起生活也会造成情感和心理伤害。

Currently affecting 11 million Americans, age-related macular degeneration (AMD) is the biggest driver of deteriorating central vision loss among people 50 and older. Andcentral vision is necessary to do basic tasks such as reading, driving, and recognizing faces, a.k.a., the fundamental skills for being self-sufficient in the world.

Wet AMDis the most serious form of the disease, making up just 10% to 15% of all AMD cases. Yet it’s linked to 90% of people who go on to develop legal blindness caused by AMD. And research shows that up to a third of all AMD patients grapple withclinical depression根据克利夫兰诊所的说法，在大多数日子里，至少两周的大部分日子都被定义为强烈的悲伤，情绪低落和/或毫无价值的感觉，同时应对其他症状，例如睡眠问题或食欲变化。根据最新的研究，当您考虑美国150万人受到湿AMD的高级阶段的影响时，很清楚的是，有限的视力正在使很多人陷入黑暗中，而不是一种。

It’s Not Just About Your Eyes

Unlike the more common, but gradual, dry AMD (where the deterioration of the retina is associated with thinning and drying out of the macula caused by aging and tiny clumps of protein), the progression of wet AMDcan be very quick and very sudden。

“有一天，您醒来，曾经看到的直线弯曲，您已经失去了一部分视力，”罗切斯特大学副教授Silvia Sorensen博士说。纽约的社区健康和预防。“但是[AMD]干燥的种类也可以变成潮湿的种类，或者您可以一只眼睛弄湿AMD，而另一只眼睛则是干燥的。因此，存在不确定性……这可能会很压力。”她补充说。

And despite advances inmedical treatmentsthat can stabilize eyesight in wet AMD, not every patient reaps the benefits, nor do these interventions typically reverse vision loss or constitute a cure.

The literature on what can happen as a result is pretty clear: Continual low mood is all too common in AMD patients, a by-product of vision loss. In some cases, it may also be pre-existing, meaning it’s then exacerbated by symptoms of the eye disease, says Sorensen.

索伦森解释说，无论其道路如何，与AMD相关的湿抑郁症通常都植根于如何变质的视力转化为缺乏对自己的生活，不足和无助的感觉的感觉。对流动性的限制也可能导致社会隔离。“如果您是音乐家，您将不再演奏……这些损失在某些方面比您实际看到的更深刻。她说：“失去有价值的活动，失去您的热情[将您与他人联系起来的事情确实是视力丧失的人的抑郁症的中介因素。”

看到没有真正存在的东西

Charles Bonnet综合征（CBS）是视力丧失的另一个令人不安的后果，包括那些因AMD而失去视力的人。以瑞士科学家的身份命名的病情以视觉幻觉为特征。

根据非营利性查尔斯·波内特综合症基金会的说法，CBS影响了20％至40％的黄斑变性。

In this case, the brain starts making up things because of the lack of visual stimulus from the damaged eyes, explains Sorensen. “You start seeing elaborate patterns or fields of flowers — some people report seeing an entire castle in front of them! It's not really a mental health problem, in the sense that they're quite aware that it's not actually there—but it makes them feel like they're going crazy if they don't know what to expect.”

Anxiety Soars for Many Reasons

引起恐惧的另一个因素是对湿AMD的常见但非常有效的治疗方法：eye injections。“Patients are not pleased when we tell them what we need to give them,” says Josef Huemer, M.D., a consultant ophthalmologist at the Moorfields Eye Hospital NHS Foundation Trust in London, UK. To date, nothing works as well as these injections, which are given every one to three months, depending on the patient’s needs. In fact, a review published in 2020 found that the use of anti-VEGF drugs has nearly halved the incidence of AMD-linked blindness.

The good news is, most people with wet AMD do eventually get used to this treatment—particularly since many patients experience a slowdown in the progression of their disease, says Sorensen. (In a fraction of cases, patients even see an improvement in vision).

尽管如此，尽管科学并未确定湿AMD的人的流行程度，但焦虑仍会随着视力丧失的增长。2015年论文发表在期刊上临床眼科。“There is consensus that anxiety is also an issue, although the numbers there aren't quite as clear,” says Sorensen. “Even in terms of depression, the range [of prevalence] is really large; it depends on what sample you're working with, the person’s age, how impaired they are—all those factors.”

Huemer博士指出，就目前而言，湿AMD的心理健康影响不足。他说：“从临床医生的角度来看，如果有可能花时间与患者进行交谈，每个人都希望这样做。“但是，如果您看着门诊部，我们就被患者淹没了。”这意味着整理疾病的情感后果并不是任何繁忙的医生办公室的首要任务。

The Struggle Is Real

Then there are the people with wet AMD who are just not willing to admit they are struggling mentally, Dr. Heumer adds.

索伦森（Sorensen）建议，作为政策问题，眼科医生对所有患有抑郁症等心理健康障碍患者的患者屏幕，以便在诊断后自动向精神卫生专业人员引用精神卫生专业人员。她说，眼科医生可以通过与患者交谈来做很多事情，以了解视力丧失的情感影响，并在需要时转介他们进行治疗beforedepression worsens.

此外，可以帮助人们适应新情况的低视力黑客可能非常有帮助。她说，例如，将凹凸点放在微波炉或炉子上可以帮助您在其按钮周围感觉到自己的路，并单独通过触摸安全地操作它。窃听到low vision services，教导这样的技巧：“这是真正简单的干预措施，但它们在生活质量上产生了巨大的影响。”

患者还应在病情恶化时处理如何处理日常任务的帮助，包括如何与家人谈谈，以尽可能长时间地过着独立的生活。有关指导，请访问美国《科学学院》websitefor a wide range of resources.

Although there is a growing awareness of the emotional and psychological effects of vision loss, Sorensen believes getting preventative services embedded into clinical practice will likely take longer.

“Most ophthalmologists are very focused on fixing the eye—and if they can't fix it, they might say something like, 'There's nothing I can do,'” she says. “But losing your vision doesn't have to mean losing hope. That's an important message to get out.”

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Natalie Grover

娜塔莉·格罗弗（Natalie Grover）是《健康中心》（HealthCentral）的作家，涵盖了所有事物及其他事物。她与路透社，撰写有关健康的业务和监管的文章，最近曾担任more

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