Düsseldorf, Germany—Recent reports have revealed
that 27-year-old Germanwings pilot, Andreas Lubitz, sought treatment for vision problems before he crashed a plane into the French Alps, killing himself and the 149 passengers and crewmembers.
According to The New York Times,
the pilot was being treated for psychological problems—including a history of depression. While the exact nature and cause of the vision problems remains unclear, the newspaper reports that authorities have not ruled out the possibility that the vision problems were psychosomatic.
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Der Spiegal reports
that Lubitz visited multiple healthcare professionals, including a neurologist and a psychiatrist. International Business Times reports
that Lubtiz’s Internet searches revealed the pilot looked for information on impaired vision, bipolarity, manic depression, migraines, and acoustic trauma in the week before the crash.
Next: Optometry weighs in
Optometry weighs in
“This in an interesting development,” says Leonard Messner, OD, FAAO, executive director of the Illinois Eye Institute. “My suspicion from the article is that he may have had some type of functional vision loss. These individuals have no organic or clinical findings to support their vision problem. The majority have a significant history of depression/psychiatric illness. Again, this is purely speculative on my part.”
While the authorities have not released details of Lubtiz’s visual or mental health diagnoses, Mark Swanson, OD, MSPH, associate professor at the University of Alabama at Birmingham School of Optometry, says one such vision problem that can occur with mental health problems include conversion disorder
, a condition in which patients show psychological stress in physical ways.
Dr. Swanson says this can manifest visually through an unexplained loss in vision or a decrease in peripheral vision that doesn’t follow a pattern that you would expect with another diagnosis. But the patient doesn’t function as if they have a vision problem—they don’t go bumping into furniture or anything. That is because the problem is psychological, not visual or physical.
“Basically, the person functions internally as if he has a vision problem, but he really doesn’t have one. You can’t find anything in the eye, all the tests come up normal,” he says. “But the person internally believes he has a vision problem.”
Next: Depression and vision problems
Depression and vision problems
According to Dr. Swanson, a very high percentage of people develop depression after suffering a vision loss, and even five years after they lose their vision, about half are still depressed.
Dr. Swanson says there are two schools of thought: those who believe these patients’ symptoms are actually depression and those who believe that it is just an adjustment to the loss of vision.
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“Some people would argue that it’s not true depression—it’s just an adjustment,” he says. “It’s along the same lines to the adjustment to grief, losing a loved one. You’ve lost something that’s important to you. So, depending on your psychological bent, some people wouldn’t call it depression, per se, but more of an adjustment problem.”
Next: Study assesses visual acuity's influence on suicide
Study assesses visual acuity’s influence on suicide
Low visual acuity was associated with the occurrence of suicidal thoughts and attempts, according to a recent study published in the British Journal of Ophthalmology.
Researchers in South Korea looked at 28,919 nationally representative participants age 19 and older between 2008 and 2012 for the Korea National Health and Nutrition Examination Survey. The participants underwent an ophthalmological examination by a member of the Korean Ophthalmologic Society.
Associations between best-corrected visual acuity in the better-seeing eye based on decimal fraction and mental health were identified after adjusting for possible biopsychosocial confounders. Through direct interviews, researchers evaluated the participants’ self-reported mental health (suicidal ideation, suicide attempt, and depression), Euro Quality of Life-Visual Analog Scale, and counseling. Researchers generated a nomogram for risk of suicidal thoughts.
Researchers found that low visual acuity was significantly associated with suicidal thoughts and suicide attempt but not depression. Participants with a visual acuity of no light perception to 0.2 had a nearly twofold increased risk of suicidal thoughts and a threefold increased risk suicidal attempt compared with participants with a VA of 1.0. Sociodemographic disparities—including age and socioeconomic status—existed for suicidal thoughts, suicidal attempt, and depression. Euro Quality of Life-Visual Analog Scale significantly decreased as visual acuity decreased and was lower in participants who attempted suicide.
The researchers concluded that eyecare professionals should embrace their responsibility to help prevent suicides in patients with low visual acuity by encouraging them to seek psychiatric care.
While the connection between vision problems and depression has been studied and documented several times before, this study may give some insight into the recent Germanwings tragedy.
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