Stress and Your Vision

There has been lots of research about how stress, depression, anxiety and other mental concerns impact health, but not a great deal about how such stressors impact vision. Nonetheless, many researchers agree that there is a strong connection between the two. No part of the body exists in isolation. The way that stress affects the immune system, the respiratory system and the presence of inflammation in the body are intertwined. All three are associated not only with health problems, but with vision problems. Chronic stress both negatively effects good circulation and impacts our ability to digest food well. This reduces the ability of the body to deliver essential nutrients to the eyes and other organs.

Stress and the Immune System

Our modern fast-paced life contributes to our experience of feeling stressed, harried, overwhelmed -- and this experience contributes to a host of health concerns, not least our vision. For a start, stress is known to impact the general immune system directly. General immunity is in turn tied to our digestive system's ability to function properly. Some researchers have additionally associated the increased use of antibiotics with a decrease in beneficial bacteria in the gut and corresponding weaker immune systems.

Stress and Oxygen Availability

Under stressful situations we breathe less deeply which reduces blood levels of oxygen. Lowered levels of blood oxygen means that less oxygen gets to the cells of the body, including the cells of the eye. When the retina receives less oxygen, cell damage and cell death result.

Stress and Inflammation

Scientists know that stress and depression increase chronic inflammation in the body. Increased experience of stress in conditions like PTSD and phobias activates the stress response in immune cells to release cytokines.1 Targeting inflammation as a way of treating these conditions is a possible future subject for investigation. C-reactive protein is a biochemical which marks the presence of systemic inflammation has been associated with stress disorders like PTSD and major depressive disorder (MDD).2

Stress and Eye Disease

Researchers have connected quality of life with many eye conditions including glaucoma, macular degeneration, cataracts and other conditions.

  • Glaucoma
    Researchers have associated a life of stressful experience with glaucoma, finding that anxiety/depression are higher in patients with un-diagnosed glaucoma. In other words, the anxiety/depression are not caused by the patient being aware of their condition. 3 Scientists have pointed to stress as a cause of glaucoma. Since the late 1990's scientists have indicated that stress is a major factor in both acute closed-angle glaucoma and open-angle glacuoma.10
  • Macular Degeneration & Stress
    While it is clear from the research that patients with macular degeneration have higher rates of anxiety and depression, those conditions as a contributing cause are not so clear. There are anecdotal reports that macular degeneration patients feel that their vision is worse when they are stressed. In part, this ties back to the glaucoma research. When stressed, we breathe more shallowly. When we breathe more shallowly the body and the retina get less oxygen and vision worsens. This is one reason why eye exercises like palming are so helpful. As we relax away from staring at the computer (for example) our breathing improves and our entire system, including our eyes, normalizes a bit.

    Wet macular degeneration is associated with inflammation and so there is a likely connection between stress and wet AMD. Researchers at Ohio State University have begun an NIH-sponsored study to determine whether or not the connection is causative.4
  • Cataracts
    One of the contributing causes of cataracts is over-consumption of alcohol. More than one alcoholic drink a day doubles the risk of developing cataracts. While the causal relationship is indirect, it is true that stress due to any number of psychological reasons can cause alcoholism. Chronic physical stress due to injury, dental pain, or stress-related restricted movement of the head and neck also increases the risk of cataracts. As discussed above the experience of feeling stressed limits the amount of oxygen we can take in which in turn starves the cells of the body, including the eyes, of oxygen.
  • Central Serous Choroidopathy
    Central Serous Choiroidopathy (CSC) has a clear tie to stress. Most patients with CSC are young men with aggressive "type A" personalities, and their experience of feeling stressed, under pressure and overwhelmed is an important risk factor. These "type A" personalities often also experience hypertension, lowered immunity and sleeping problems, all of which are associated with the body's inability to cope with stress.5
  • Macular Edema
    Type A personalities are also at greater risk of developing macular edema than most people and it often appears in times of acute stress.
  • Asthenopia (tired eyes) and Computer Vision Syndrome
    Researchers evaluating the habits of Chinese college students found that mental status was an important factor in whether they suffered from asthenopia.6 Similarly, researchers found that psychosocial factors were part of the contributing factors to call center employees in Brazil.7
  • Dry eyes
    A meta-analysis (a study evaluating eleven studies) of metabolic syndrome risk factors and dry eye syndrome found that hypertension, one symptom of inability to physical cope (often expressed as frequent anger or anxiety) with stress was a risk factor for dry eye syndrome.8 Another study found that use of anti-hypertensive medications was also a factor. And yet another study of more than 300 bank employees found that those with a type A personality were more likely to experience dry eye syndrome.9

Manage Stress

As part of our eye disease prevention protocol we recommend that you manage the level of stress in your life. Not only should you take time-out from computer and mobile devices screens, but you should take time out for yourself.

Take time to take a quiet walk every day - without earphone music to keep you going. Take a look at the world around you instead. Other mild exercise such as swimming or yoga helps to keep anxiety or the feeling of being overwhelmed at bay.

Spend some time quietly with your eyes closed. Some people enjoy non-focused meditation. A cat nap will help others, even if they don't "sleep." Start dinner and lie down while it's cooking to give yourself a 15 minute break.

And, particularly before bed, get off the computer and do something you enjoy. For some people, reading a book (not an ebook!) is relaxing ... for others, painting, gardening, or needlepoint. Make time each day to do what you enjoy doing in order to live a more relaxed life.

Footnotes

1. V. Michooulos, et al, Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD and Beyond, Neuropsychopharmacology, August, 2016
2. A. Powers, et al, Emotion Dysregulation and Inflammation in African-American Women with Type 2 Diabetes, Neural Plasticity, July, 2016
3. K.I. Jung, C.K. Park, Mental Health Status and Quality of Life in Undiagnosed Glaucoma Patients: A Nationwide Population-Based Study, Medicine, May, 2016
4. Is Stress Affecting Your Eye Health?
5. B. Liu, et al, Risk Factors for Central Serous Chorioretinopathy: A Systematic Review and Meta-Analysis, Retina, January, 2016.
6. C. C. Han, et al., Prevalence of asthenopia and its risk factors in Chinese college students, International Journal of Ophthalmology, October, 2013.
7. E. C. Sa, et al, Risk factors for computer visual syndrome (CVS) among operators of two call centers in Sao Paulo, Brazil, Work, 2012
8. Y. L. Tang, Metabolic syndrome risk factors and dry eye syndrome: a Meta-analysis, International Journal of Ophthalmology, July, 2016
9. Kazauma Sagahara, et al, Effects of Stress or Personality Types on Ocular Dryness, Dizziness, and Autonomic Nervous Dysfunction of Healthy Subjects in the Workplace, Journal of Clinical & Experimental Ophthalmology, October, 2014.
10. B.G. Shily, Psychophysiological stress, elevated intraocular pressure, and acute closed-angle glaucoma, American Journal of Optometry and Physiological Optics, Nov. 1987.