Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine

Bernhard A. Sabel, Jiaqi Wang, Lizbeth Cárdenas-Morales, Muneeb Faiq, Christine Marcelle Heim

Research output: Contribution to journalReview article

13 Citations (Scopus)

Abstract

The loss of vision after damage to the retina, optic nerve, or brain has often grave consequences in everyday life such as problems with recognizing faces, reading, or mobility. Because vision loss is considered to be irreversible and often progressive, patients experience continuous mental stress due to worries, anxiety, or fear with secondary consequences such as depression and social isolation. While prolonged mental stress is clearly a consequence of vision loss, it may also aggravate the situation. In fact, continuous stress and elevated cortisol levels negatively impact the eye and brain due to autonomous nervous system (sympathetic) imbalance and vascular dysregulation; hence stress may also be one of the major causes of visual system diseases such as glaucoma and optic neuropathy. Although stress is a known risk factor, its causal role in the development or progression of certain visual system disorders is not widely appreciated. This review of the literature discusses the relationship of stress and ophthalmological diseases. We conclude that stress is both consequence and cause of vision loss. This creates a vicious cycle of a downward spiral, in which initial vision loss creates stress which further accelerates vision loss, creating even more stress and so forth. This new psychosomatic perspective has several implications for clinical practice. Firstly, stress reduction and relaxation techniques (e.g., meditation, autogenic training, stress management training, and psychotherapy to learn to cope) should be recommended not only as complementary to traditional treatments of vision loss but possibly as preventive means to reduce progression of vision loss. Secondly, doctors should try their best to inculcate positivity and optimism in their patients while giving them the information the patients are entitled to, especially regarding the important value of stress reduction. In this way, the vicious cycle could be interrupted. More clinical studies are now needed to confirm the causal role of stress in different low vision diseases to evaluate the efficacy of different anti-stress therapies for preventing progression and improving vision recovery and restoration in randomized trials as a foundation of psychosomatic ophthalmology.

Original languageEnglish (US)
Pages (from-to)133-160
Number of pages28
JournalEPMA Journal
Volume9
Issue number2
DOIs
StatePublished - Jun 1 2018

Fingerprint

Ophthalmology
Precision Medicine
Preventive Medicine
Medicine
Autogenic Training
Relaxation Therapy
Meditation
Low Vision
Social Isolation
Optic Nerve Diseases
Optics
Vision Disorders
Brain
Sympathetic Nervous System
Optic Nerve
Psychotherapy
Glaucoma
Fear
Blood Vessels
Hydrocortisone

All Science Journal Classification (ASJC) codes

  • Drug Discovery
  • Health Policy
  • Biochemistry, medical

Cite this

Sabel, Bernhard A. ; Wang, Jiaqi ; Cárdenas-Morales, Lizbeth ; Faiq, Muneeb ; Heim, Christine Marcelle. / Mental stress as consequence and cause of vision loss : the dawn of psychosomatic ophthalmology for preventive and personalized medicine. In: EPMA Journal. 2018 ; Vol. 9, No. 2. pp. 133-160.
@article{6b50733ddb8d45c5be1af874d5a79f65,
title = "Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine",
abstract = "The loss of vision after damage to the retina, optic nerve, or brain has often grave consequences in everyday life such as problems with recognizing faces, reading, or mobility. Because vision loss is considered to be irreversible and often progressive, patients experience continuous mental stress due to worries, anxiety, or fear with secondary consequences such as depression and social isolation. While prolonged mental stress is clearly a consequence of vision loss, it may also aggravate the situation. In fact, continuous stress and elevated cortisol levels negatively impact the eye and brain due to autonomous nervous system (sympathetic) imbalance and vascular dysregulation; hence stress may also be one of the major causes of visual system diseases such as glaucoma and optic neuropathy. Although stress is a known risk factor, its causal role in the development or progression of certain visual system disorders is not widely appreciated. This review of the literature discusses the relationship of stress and ophthalmological diseases. We conclude that stress is both consequence and cause of vision loss. This creates a vicious cycle of a downward spiral, in which initial vision loss creates stress which further accelerates vision loss, creating even more stress and so forth. This new psychosomatic perspective has several implications for clinical practice. Firstly, stress reduction and relaxation techniques (e.g., meditation, autogenic training, stress management training, and psychotherapy to learn to cope) should be recommended not only as complementary to traditional treatments of vision loss but possibly as preventive means to reduce progression of vision loss. Secondly, doctors should try their best to inculcate positivity and optimism in their patients while giving them the information the patients are entitled to, especially regarding the important value of stress reduction. In this way, the vicious cycle could be interrupted. More clinical studies are now needed to confirm the causal role of stress in different low vision diseases to evaluate the efficacy of different anti-stress therapies for preventing progression and improving vision recovery and restoration in randomized trials as a foundation of psychosomatic ophthalmology.",
author = "Sabel, {Bernhard A.} and Jiaqi Wang and Lizbeth C{\'a}rdenas-Morales and Muneeb Faiq and Heim, {Christine Marcelle}",
year = "2018",
month = "6",
day = "1",
doi = "10.1007/s13167-018-0136-8",
language = "English (US)",
volume = "9",
pages = "133--160",
journal = "EPMA Journal",
issn = "1878-5077",
publisher = "BioMed Central",
number = "2",

}

Mental stress as consequence and cause of vision loss : the dawn of psychosomatic ophthalmology for preventive and personalized medicine. / Sabel, Bernhard A.; Wang, Jiaqi; Cárdenas-Morales, Lizbeth; Faiq, Muneeb; Heim, Christine Marcelle.

In: EPMA Journal, Vol. 9, No. 2, 01.06.2018, p. 133-160.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Mental stress as consequence and cause of vision loss

T2 - the dawn of psychosomatic ophthalmology for preventive and personalized medicine

AU - Sabel, Bernhard A.

AU - Wang, Jiaqi

AU - Cárdenas-Morales, Lizbeth

AU - Faiq, Muneeb

AU - Heim, Christine Marcelle

PY - 2018/6/1

Y1 - 2018/6/1

N2 - The loss of vision after damage to the retina, optic nerve, or brain has often grave consequences in everyday life such as problems with recognizing faces, reading, or mobility. Because vision loss is considered to be irreversible and often progressive, patients experience continuous mental stress due to worries, anxiety, or fear with secondary consequences such as depression and social isolation. While prolonged mental stress is clearly a consequence of vision loss, it may also aggravate the situation. In fact, continuous stress and elevated cortisol levels negatively impact the eye and brain due to autonomous nervous system (sympathetic) imbalance and vascular dysregulation; hence stress may also be one of the major causes of visual system diseases such as glaucoma and optic neuropathy. Although stress is a known risk factor, its causal role in the development or progression of certain visual system disorders is not widely appreciated. This review of the literature discusses the relationship of stress and ophthalmological diseases. We conclude that stress is both consequence and cause of vision loss. This creates a vicious cycle of a downward spiral, in which initial vision loss creates stress which further accelerates vision loss, creating even more stress and so forth. This new psychosomatic perspective has several implications for clinical practice. Firstly, stress reduction and relaxation techniques (e.g., meditation, autogenic training, stress management training, and psychotherapy to learn to cope) should be recommended not only as complementary to traditional treatments of vision loss but possibly as preventive means to reduce progression of vision loss. Secondly, doctors should try their best to inculcate positivity and optimism in their patients while giving them the information the patients are entitled to, especially regarding the important value of stress reduction. In this way, the vicious cycle could be interrupted. More clinical studies are now needed to confirm the causal role of stress in different low vision diseases to evaluate the efficacy of different anti-stress therapies for preventing progression and improving vision recovery and restoration in randomized trials as a foundation of psychosomatic ophthalmology.

AB - The loss of vision after damage to the retina, optic nerve, or brain has often grave consequences in everyday life such as problems with recognizing faces, reading, or mobility. Because vision loss is considered to be irreversible and often progressive, patients experience continuous mental stress due to worries, anxiety, or fear with secondary consequences such as depression and social isolation. While prolonged mental stress is clearly a consequence of vision loss, it may also aggravate the situation. In fact, continuous stress and elevated cortisol levels negatively impact the eye and brain due to autonomous nervous system (sympathetic) imbalance and vascular dysregulation; hence stress may also be one of the major causes of visual system diseases such as glaucoma and optic neuropathy. Although stress is a known risk factor, its causal role in the development or progression of certain visual system disorders is not widely appreciated. This review of the literature discusses the relationship of stress and ophthalmological diseases. We conclude that stress is both consequence and cause of vision loss. This creates a vicious cycle of a downward spiral, in which initial vision loss creates stress which further accelerates vision loss, creating even more stress and so forth. This new psychosomatic perspective has several implications for clinical practice. Firstly, stress reduction and relaxation techniques (e.g., meditation, autogenic training, stress management training, and psychotherapy to learn to cope) should be recommended not only as complementary to traditional treatments of vision loss but possibly as preventive means to reduce progression of vision loss. Secondly, doctors should try their best to inculcate positivity and optimism in their patients while giving them the information the patients are entitled to, especially regarding the important value of stress reduction. In this way, the vicious cycle could be interrupted. More clinical studies are now needed to confirm the causal role of stress in different low vision diseases to evaluate the efficacy of different anti-stress therapies for preventing progression and improving vision recovery and restoration in randomized trials as a foundation of psychosomatic ophthalmology.

UR - http://www.scopus.com/inward/record.url?scp=85047625084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047625084&partnerID=8YFLogxK

U2 - 10.1007/s13167-018-0136-8

DO - 10.1007/s13167-018-0136-8

M3 - Review article

C2 - 29896314

AN - SCOPUS:85047625084

VL - 9

SP - 133

EP - 160

JO - EPMA Journal

JF - EPMA Journal

SN - 1878-5077

IS - 2

ER -