Vision Affects More than we See
by Iqrah Malik
This is a wonderful article submitted by a student, Iqrah Malik, who saw more in vision than most of us ever will. I hope you enjoy this article and learn as much as I did from her work.
Vision correction is not merely a medical intervention; it is a transformative tool that profoundly impacts a person’s well-being. The psychological impact of health literacy, refracted error, impaired, corrected, and uncorrected vision plays a significant role in everyday life. Vision impairment and uncorrected vision can be correlated with anxiety, depression, and lower self-esteem. Kozáková (2025) found that “vision impairment is associated with reduced quality of life, loneliness, and increased levels of anxiety” (p. 64). Improving vision is important, as it plays a key role in a person’s social confidence, self-esteem, and overall well-being. Both corrected and uncorrected vision will be examined to assess their impact on psychological well-being. Understanding these effects is crucial for optometrists and ophthalmologists to optimize patient care and improve mental health outcomes. Corrected vision has also been connected with reports of reduced anxiety and strengthened social engagement. For optometrists and ophthalmologists, understanding these psychological benefits is crucial, as it allows for patient-centered care that addresses both visual and mental health outcomes. Vision is often overlooked until eye-related symptoms interfere with daily functioning, emotional well-being, and overall health. This analysis will cover common refractive errors and vision impairments, explain the role of health literacy in ocular health, and examine how uncorrected vision affects quality of life, mental health in both adults and children, and neuroplasticity. Refractive errors include myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, which occurs when the eye cannot focus light properly, resulting in blurry vision. Astigmatism can usually be corrected with glasses, contacts, or surgery. More serious vision impairments, such as cataracts, glaucoma, macular degeneration, or diabetic retinopathy, cannot be fully corrected. Eye examinations are beneficial for overall health, as the retina can reveal early indicators of underlying systemic conditions. Maintaining eye health requires health literacy, defined as the ability to understand and use health information provided by medical professionals. Individuals with low health literacy are less likely to get regular eye exams or recognize eye problems, increasing the risk of poor outcomes.
According to Jindrová (2012), “quality of life includes materialistic aspects, social conditions, social status, and physical health” (p. 147). Studies categorize reductions in quality of life into economic, social, cultural, and environmental factors. Uncorrected vision is associated with emotional and mental challenges. Detecting vision problems early is critical for both physical and mental health. In children, uncorrected vision or conditions such as amblyopia affect learning and social interaction. Thorud (2021) found that limited awareness of vision-related symptoms in children can negatively affect academic performance and quality of life. In adults, visual impairment is linked with eye strain, headaches, and loneliness. Vision troubles in adults make daily activities more difficult, reducing quality of life. Vision correction allows the brain and eyes to work together, improving daily activities and overall quality of life. Neuroplasticity enables the brain to adapt to vision loss by strengthening other senses, but uncorrected vision can strain cognitive processes and affect learning and everyday functioning.
Literature Review
Health Literacy: Quality of Life
An essential starting point for understanding ocular health is health literacy. Li (2021) defines health literacy as “an individual’s ability to acquire, process, and understand basic health information and services in order to make appropriate health decisions” (p. 2). Li (2021) also reported that health literacy is associated with depression and health-related quality of life. Health literacy, in simple terms, is an individual’s ability to understand and use the medical information given to make proper decisions. This ability is linked to many different health outcomes, such as depression, anxiety, and quality of life. For clarity, the following defines depression, anxiety, and quality of life as key health outcomes discussed in this study. Malhi (2018) defines depression as a “disorder based on symptoms forming a syndrome and causing functional impairment” (p. 2300). Malhi notes that some symptoms more specific to depressive disorder include anhedonia (a reduced ability to feel pleasure), diurnal variation (with symptoms worse at certain times of day), and intensified guilt about being ill (p. 2300). As stated by Craske (2016), “To be diagnosed as an anxiety disorder, the fear and anxiety are marked (excessive or out of proportion to the actual threat posed), persistent, and associated with impairments in social, occupational, or other important areas of functioning” (p. 3048). According to Jindrová (2012), quality of life results from the interaction of social, health, economic, and environmental factors that influence human development. These concepts are closely correlated with health literacy, as they affect how individuals interpret and act on information about their health.
Health literacy is defined as the ability to understand various ocular diseases, as mentioned before. Health literacy involves understanding and utilizing health information and services provided by doctors to comprehend terminology and the underlying meaning behind symptoms or concerns. Health literacy is central to eye health. Capó (2022) emphasize:
Ophthalmology-related outcomes are equally affected by low health literacy. Poor health literacy is also associated with worse glycemic control and higher rates of diabetic retinopathy. Patients with glaucoma and low health literacy are more likely to miss appointments and less likely to use glaucoma medications properly. In addition, they often have more advanced loss of visual fields at the time of diagnosis (p. e137).
Various groups within the population have a limited understanding of ocular diseases, the symptoms, and the importance of regular eye exams. Low health literacy negatively impacts ophthalmology outcomes, contributing to delayed care, poorer disease management, and increased risk of vision loss. Capó (2022) conducted a study involving two groups: the first group involved patients with diabetes, and the other involved patients with glaucoma. The study found that patients with the highest health literacy did not significantly change their behavior after receiving educational materials aimed at advanced readers. It also showed that patients at all literacy levels prefer simplified informed consent forms. The study results suggested that materials that are easy to understand are generally preferred. Individuals prefer clear and straightforward educational terms and material, which are beneficial for all patients, and complexity has not been found to have advantages, even with those with high literacy. It was also noted in this article that eye health disparities are linked to low health literacy. Capó (2022) noted that many individuals do not seek eye care because they perceive it as unnecessary:
An analysis of 2006–2010 Behavioral Risk Factor Surveillance System data showed that among adults with diagnosed diabetes, the most commonly reported reasons for not receiving eye care in the preceding year were “no need” and on racial and ethnic disparities in diabetic retinopathy screening found that minorities were not receiving a recommendation from a healthcare professional to obtain an eye examination (p. e138).
Certain populations, such as ethnic minorities and those with a low socioeconomic status, experience higher rates of preventable visual impairment, lower use of eye care resources, and reduced interpretation of ocular diseases such as glaucoma, diabetic retinopathy, and amblyopia. Particular communities experience higher rates of preventable visual impairment due to low health literacy, including ethnic minorities and those with lower socioeconomic status. Capó (2022) also explores disparities across ethnic groups:
Among all participants, Hispanic respondents reported the lowest access to information about eye health, knew the least about it, and were least likely to have their eyes examined. A patient survey conducted online in 2019 on behalf of the American Academy of Ophthalmology (AAO) revealed that only 19% of respondents were able to identify the 3 main causes of blindness in the US: glaucoma, macular degeneration, and diabetic eye disease. Forty-seven percent were aware that vision loss and blindness do not affect all persons equally, and only 37% knew that many causes of vision loss can be asymptomatic in the early stages. A study that evaluated knowledge of diabetic retinopathy in Hispanic patients found that only 52% of those diagnosed with diabetes > 1 year before the study knew about diabetic eye disease. In addition, only 34% knew that strict control could prevent ocular complications. Only 48% of patients with diabetes knew that dilated eye examinations were important (p. e138).
This indicates that most individuals are aware of conditions such as glaucoma and diabetic retinopathy and understand that they can be treated; however, very few understand that certain ocular diseases often have no symptoms in their early stages. As mentioned in the article, a 2019 survey conducted on behalf of the American Academy of Ophthalmology found that only 19% of respondents could identify the three leading causes of blindness in the United States, which were listed as glaucoma, macular degeneration, and diabetic eye disease, and only 37% knew that the many causes of blindness are initially asymptomatic. As the results showed, the Hispanic patients with diabetes, only about half were aware of diabetic eye diseases after having diabetes for more than a year, but only ⅓ understood that a regimented and strict diabetes control could prevent ocular complications, and lastly, fewer than half admitted they were unaware of the importance of regular dilated eye examinations. This article highlights the findings for the need for improved public engagement to promote eye health awareness and preventive care. By addressing disparities in knowledge and access, healthcare providers can reduce preventable vision loss and support the well-being of diverse populations. By improving knowledge about ocular diseases, individuals are more prepared to address refractive errors, seek vision correction promptly, and prevent or manage vision impairment.
Refractive Errors
Refractive errors, such as nearsightedness, farsightedness, and astigmatism, are common vision conditions that affect how the eye focuses light. This interferes with daily activities, cognitive performance, and overall quality of life. The following definitions provide a closer look at the specific types of refractive errors and how they impact vision. According to Werner and Dineen (2003), refractive error occurs when the eye’s anatomy prevents light from focusing properly on the retina. A refractive error does not mean permanent vision loss; it is usually correctable with glasses, contact lenses, or surgery. According to Britannica Academic (2025), myopia occurs when the eye focuses images of distant objects in front of the retina, causing blurred vision. This is also known as nearsightedness, which makes distant objects appear blurry. According to Britannica Academic (2025), hyperopia, also known as farsightedness, is a refractive error in which near objects appear blurry because the eye focuses images behind the retina, even though distant objects may be in focus. This condition makes close objects difficult to see clearly. According to Britannica Academic (2025), astigmatism occurs when the cornea or lens has an irregular shape, causing light to focus at different distances and resulting in distorted or blurred vision.
The words vision impairment and vision correction are not interchangeable. Vision impairment is the result of a total or partial inability to be corrected with glasses, contacts, or surgery. Common causes include cataracts, glaucoma, macular degeneration, and diabetic retinopathy. Vision impairment is known as tunnel vision, where only a limited area of vision is perceived. Blurred vision, floaters, and difficulty seeing in low light will be symptoms of this. Vision correction is the use of procedures or medical necessities to improve vision. This includes glasses, contact lenses, and medical procedures such as LASIK, which helps reshape the cornea to fix the eye’s focus. Vision correction helps refractive errors such as myopia, nearsightedness, hyperopia, farsightedness, and astigmatism. Understanding the importance of eye care and the health behind it is essential for daily lives and overall well-being. Uncorrected vision can significantly reduce the quality of life by making everyday tasks more difficult and limiting independence. Vision impairment has its physical challenges; however, there are psychological effects such as stress, anxiety, and social isolation due to navigating through the world. Remillard (2024) emphasizes that “Activity and participation restrictions in the home and community are associated with loneliness and social isolation, which are prevalent among older adults with vision impairment” (p. 2). Also, it is demonstrated that vision impairment has its physical challenges, which Hayes (2022) states, “Evidence suggests a consistent correlation between vision impairments, social isolation, and cognitive decline” (p. 651). The nature of the eye and the various refractive errors are often misunderstood and overlooked. Eyes are a vital organ in the body, and eye conditions can help diagnose and determine a condition in the human body. High blood sugar associated with diabetes can cause blurry vision and damage to the blood vessels in the retina, leading to diabetic retinopathy. Richdale (2020) explains:
Diabetes is identified in eye clinics in an advanced stage, only after visible signs of diabetic retinopathy. Patients with diabetes have increased Meibomian gland dysfunction, blepharitis, and reduced tear production, resulting in increased rates of dry eye disease and discomfort. Early detection of metabolic disease may allow eye care providers to be more proactive in recommending referral and intervention in order to reduce the risk of blindness and other diabetes-related morbidity (p. 1).
Determining these ocular changes allows diseases to be detected at an earlier stage to reduce the risk of blindness and other related complications.
Richdale (2020) also discusses:
Research in diabetes in the eye has historically been focused on the retina. More recently, researchers have begun to explore the effects of type 1 and 2 diabetes on the anterior segment of the eye and have revealed significant structural and functional alterations, including dry eye disease, even early in the disease process. Population-based studies would be required to confirm the effect of diabetes on dry eye (p. 6).
This shows that recent studies have identified early eye changes in both type 1 and type 2 diabetes, such as dry eye disease. Another condition that can be determined is to detect clogged arteries and other cardiovascular conditions by examining the blood vessels in the retina, by detecting high blood pressure, and cholesterol. By looking into the vessels of the eye, researchers can gain insight into heart and vascular health. Streese (2021) discusses retinal vessel analysis, which “is a non-invasive, reproducible, and easily applicable diagnostic tool that offers a microvascular window to the heart. Our findings allow for a better understanding of retinal vessel physiology and differentiation of pathophysiology” (p. 10). Examining the blood vessels in the back of the eye reflects small blood vessels throughout the body, which indicates the health of the heart and circulatory system. Retinal vessel analysis, as described by Streese (2021), is a simple, non-invasive tool that helps researchers understand both normal vascular function and disease-related alterations. Identifying refractive errors and the consequences of uncorrected vision highlights that vision is not only a physical sense but also intertwined with emotional and social functioning. This will be explored in the following section, which emphasizes the physical and psychological impacts on both adults and children.
Physical and Psychological Aspects: Adults & Children
Understanding both the physical and psychological aspects of vision correction is essential in patient care. In adults, it can cause cognitive strain, reduced independence, and difficulty with daily activities. Wolffsohn (2011) states that within adults, “This would make reading tasks more difficult to perform and less pleasurable and is likely to lead to a reduction in independence and quality of life. Difficulties with night driving and glare are reported by elderly drivers with visual impairment and those with healthy eyes” (p. 458). This results in concerns about safety, such as the rise of accidents, mobility issues with driving, and, in certain occupations, the requirement to have sharp vision, which becomes an occupational consequence. Individuals who use corrective lenses or undergo procedures such as LASIK often report increased self-esteem. Kožáková (2025) notes global visual impairment:
The World Health Organization reports that around 2.2 billion people worldwide have some degree of visual impairment, with the majority being over the age of 50. More than two-thirds of all severely visually impaired individuals are aged 65 and older (p. 259).
This widespread impairment can transform how individuals perceive themselves, identify themselves, and interact with society. Among older adults, visual impairment is often accompanied by anxiety and loneliness, which can further complicate mental health. Difficulties in participating in social activities due to vision problems may intensify social isolation, with about half of older adults with visual impairments reporting significant loneliness.
Kožáková (2025) also highlights gender differences in quality of life:
When comparing men and women from the monitored group, differences are evident in all domains of quality of life. Women evaluate their overall quality of life and satisfaction with their health better. Men evaluate the domain of mental health, social relationships, and environment better. Women achieved higher values in the domain of physical health. Women and men achieve the highest value in the domain of psychological health. Both men and women achieved the lowest value in the domain of social relationships. Significant relationships were found only in the domain of social relationships. We found a statistically significant difference in the loneliness scale, where women achieved a worse score than men (p. 261).
In other words, this showed that men and women differed across all aspects of quality of life. Women rated their overall quality of life, health satisfaction, and physical health higher, while men scored better in mental health, social relationships, and environmental domains. Both groups had the highest scores in psychological health and the lowest in social relationships. In particular, women reported greater loneliness than men. Uncorrected vision impairment causes concern among older adults that can affect daily functioning and independence. Lee (2020) mentions that uncorrected refractive error “is the most common cause of impaired vision in older adults with profound implications on quality of life and independence. Prior studies have demonstrated that poor visual acuity is associated with increased difficulty with daily activities. A few studies have also shown that impaired vision due to uncorrected refractive error is also associated with worse health outcomes, such as increased rates of falls and fractures, and all-cause mortality” (p. 219). Lee (2020) found that individuals with uncorrected refractive errors are at a higher risk of frailty compared to those whose refractive errors are corrected. These findings highlight that uncorrected refractive error affects not only vision but also overall health, daily functioning, and quality of life in older adults. Addressing these errors may help preserve independence, reduce frailty, and lower the risk of falls and other adverse health outcomes. Uncorrected refractive error illustrates significant consequences for the overall health outcome in older adults.
Children are heavily impacted by vision-related problems. Children with vision problems often struggle; these challenges affect both learning and overall well-being. Children with undetected vision problems, according to Falkenberg (2019), “reduced academic achievement, performance in everyday life and self-esteem” (p. 1). Falkenberg also emphasizes that maintaining good vision and eye health is essential for achieving social, educational, and economic independence and success. Additionally, Falkenberg (2019) conducted a study that “suggests that many children, parents and teachers are unaware of vision problems that may influence academic performance and quality of life, and supports previous studies” (p. 6). This illustrates that many of these challenges faced by children can be prevented by proper eye health care. The impact of amblyopia treatment on children will focus on how interventions, such as occlusion therapy, influence not only visual outcomes but also quality of life and mental health. Vision in one eye can be significantly weaker than that in the other eye, which is called the lazy eye, also known as amblyopia. Studies have shown that while occlusion therapy can effectively improve visual acuity, it also affects the well-being, feelings of self-consciousness, or social discomfort in some children. Guimarães (2019) evaluated both the functional and psychological outcomes of amblyopia, stating, “Our main objective was to determine whether psychosocial effects reported for occlusion therapy in children persist beyond the treatment period. By excluding children with strabismic amblyopia, either alone or combined with refractive amblyopia, we controlled for the psychosocial effects of strabismus. Another novel aspect of this study is that we assessed anxiety, stress, depression, and HRQoL among caregivers to rule out their influence on the children’s results” (p. 339.e2). The study investigated whether occlusion therapy has lasting effects on children’s social and emotional well-being after treatment. Children treated without occlusion therapy may experience fewer social and emotional challenges. In children, uncorrected vision results in low academic performance, deterring learning. Thorud (2021) conducted a study that “shows that many school children, parents, and teachers are unaware of symptoms of vision problems that may influence academic performance and quality of life. Symptoms of headaches and the need for glasses are difficult to reveal in school children, and awareness should be raised in parents, teachers, and school health services, as solutions may be easily available and important for quality of life” (p. 8). Raising awareness of vision problems in children is important, as early intervention can improve academic performance and quality of life. Uncorrected vision affects both children and adults, causing physical and psychological challenges such as reduced independence, social isolation, and lower self-esteem. The brain also adapts to changes in vision through neuroplasticity, highlighting the close link between vision and brain function, which will be discussed in the next section
Neuroplasticity
When vision is lost or impaired, the brain does not shut down; in fact, it rewires itself through neuroplasticity, which enhances other senses like hearing, touch, and smell, and reorganizes neural pathways to process information in newer ways. The brain works in remarkable ways, demonstrating the importance of the brain and eyes working together for learning and experiencing the world. The brain compensates for lost vision through neuroplasticity. Silva (2018) discusses neuroplasticity and visual impairment:
According to the literature consulted, the occipital cortex participates in the tactile, auditory and olfactory functions improvement. Moreover, brain plasticity depends on the age of vision loss and can occur basically in two ways: cross-plasticity and multimodal. This fact corroborates to confirm what the scientists discovered more than half a decade through the neuroplasticity studies (p. 112).
Silva (2018) also examines how early vision loss affects brain plasticity:
The brain plasticity occurs in individuals who lost sight in the first years of life both from the functional point of view and in the recruited brain area extension. Cross-neuroplasticity has been associated with the recruitment of visual brain areas during sound and auditory processing. The hearing becomes more functional due to its frequent recruitment to locate auditory stimuli, tactile, and smell perception (p. 111).
The occipital cortex, the part of the brain for vision, can help improve hearing, touch, and smell when vision is lost. Brain plasticity depends on how old someone is when they lose their sight. Early vision loss can cause the brain to adapt by using visual areas to improve hearing, touch, and smell. Neuroplasticity is the ability of the brain to reorganize itself by forming new neural connections, like enhancing other senses such as hearing and touch. In uncorrected vision, binocular vision dysfunction forces the brain to work harder to align images, and a decline of cognitive abilities such as memory, attention, and identifying objects will be more prevalent. The brain’s response to misalignment can cause re-aligning eyes that will result in ocular symptoms such as eye strain and physical conditions such as headaches. The brain will process vision that is corrected, which will allow the brain to process visual information normally, where the brain is not forced to overwork to create a detailed image. The partnership of the brain and eyes is vital because signals are transmitted through the optic nerve to the brain. Vision is a primary way humans learn; most information we encounter comes through what we see, making healthy eyesight essential for education, communication, and daily functioning. In summary, while the brain can adapt to visual loss through neuroplasticity, these changes cannot fully compensate for uncorrected vision, emphasizing the need for regular vision exams to preserve psychological, physical, and quality of life.
The importance of vision has been demonstrated and emphasized as an essential feature of human functioning. Health literacy has been highlighted in which it plays a critical role in ocular health, as individuals with higher health literacy are more likely to recognize symptoms and seek care promptly. Meanwhile, low health literacy is associated with delayed diagnoses, failure to properly address eye health issues, and increased risk of preventable vision loss. Understanding this allows healthcare professionals to deliver more patient care and allows information to be accessible across all demographic groups. Refractive errors, such as myopia, hyperopia, and astigmatism, demonstrate the importance of early detection and correction. While these conditions are often addressed with glasses, contact lenses, or surgical procedures, uncorrected vision can significantly impact daily activities, learning, and independence. With everything being said, it has been shown that vision impairment extends beyond physical aspects and contributes to psychological aspects such as stress, anxiety, and social isolation. Both adults and children are affected differently. Adults who struggle to engage in social activities because of vision issues often face deeper social isolation. These challenges can contribute to reduced independence, greater feelings of loneliness, and an increased risk of depression. In children, uncorrected vision often results in lower academic performance, which can make learning more challenging. At the same time, these vision problems can undermine self-esteem, adding further obstacles to their personal and academic growth. Within both age groups, early intervention improves mental and emotional health. The brain’s ability for neuroplasticity illustrates the connection between vision and cognition. While the brain can adapt to visual loss by enhancing other senses and reorganizing neural pathways, these adaptations cannot fully replace the benefits of corrected vision. Proper vision care allows the brain to process visual information and reduces strain, which benefits mental health. These findings demonstrate that vision correction is not merely a medical procedure but a transformative tool that enhances physical, cognitive, and psychological health. Ultimately, protecting vision through early intervention is not only important but also essential for preserving independence, dignity, and meaningful engagement with the world.
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