Abstract
Purpose :
The impact of eye removal and other blinding conditions on the development of psychiatric conditions has only been minimally evaluated. Eye removal is most commonly performed for malignancy and traumatic open globe injury (OGI). Prospective studies on ocular malignancy have shown no increases in depression or anxiety and worsening of quality of life and a cross-sectional study on open globe injuries found them to be associated with depression. However, no studies to date have looked at rates of suicidal ideation or intentional self-harm. This study aims to elucidate the impact of eye removal and related ocular pathology on new-onset intentional self-harm.
Methods :
The United States Collaborative Network within TriNetX was used to identify patients with ocular malignancy, traumatic OGI, eye removal, no eye, and blindness. These subjects were compared to controls matched on age, sex, gender, race, and ethnicity who had seen an ophthalmologist. Patients with no prior history of the outcome of interest were evaluated for the development of new-onset psychiatric conditions: depression, anxiety, PTSD, suicidal ideation, and nonfatal suicide attempt and intentional self-harm. Risk ratios were used to compare the development of psychiatric outcomes.
Results :
After matching, all cohorts were identical in demographics. Age, percent female, and percent white among the groups were: ocular malignancy (54.0±25.0, 48.7%, 74.3%), traumatic OGI (42.8±23.0, 28.7%, 60.8%) eye removal (50.0±24.3, 41.6%, 61.8 %), no eye (50.4±24.0, 59.9%, 41.9%), and blind (56.9±22.2, 50.5%, 59.9%). Risk for development of incident nonfatal suicide attempt was increased in blind patients (RR: 1.77, 95% CI: 1.61-1.95) while ocular malignancy was found to reduce the risk (RR: 0.52, 95% CI: 0.38-0.71) (Table 1).
Conclusions :
This is the first study to examine associations between eye removal and new-onset suicide attempt. This study revealed that while eye removal, traumatic OGI, and no eye were not associated with the rate of suicide attempt, blindness increased the risk of new-onset nonfatal suicide attempt. These results may help in screening and identifying individuals at higher risk and facilitating appropriate referrals.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.