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  • Ophthalmologists Have Front Row Seat to America’s Loneliness Epidemic

    At the height of the pandemic, retina specialists were some of the few doctors still seeing patients regularly. People living with macular degeneration and other vision-threatening retinal diseases depend on monthly or bimonthly eye injections to preserve their sight.

    Sunir Garg, MD, a retina specialist at Wills Eye Hospital in Philadelphia, assumed the reason so many people continued showing up for their appointments—double facemasked and rubber gloved—was fear of going blind. But after talking to some of his older patients, he was surprised to hear that they were motivated by something much more fundamental: human connection. Their ophthalmologist was often one of the few people they interacted with for weeks at a time. 

    Loneliness and isolation have become an epidemic in this country, says U.S. Surgeon General Dr. Vivek Murthy. Early this year, he issued an alarming report on the subject, saying this lack of social connection is having profound effects on our overall health. More than half of Americans are lonely, according to a 2021 poll.

    “I’ve never met so many seniors who literally have no one in their life,” said Thomas Steinemann, MD, an ophthalmologist at MetroHealth Medical Center in Cleveland, Ohio who regularly sees seniors postponing or canceling eye surgery because they don’t have someone available to drive them home afterwards.

    How are loneliness and eye health connected? 

    The Surgeon General’s report suggests that a lack of social connection may increase chances of premature death by 60 percent. Dementia, heart disease, and stroke were listed as common health complications associated with feelings of loneliness.

    Another study show that loneliness is particularly high among people with low vision. Eye conditions that are difficult to treat are also associated with loneliness, including severe dry eye or living with an artificial eye.

    “There can be strong feelings of social isolation, and even embarrassment, among people dealing with vision loss,”  Dr. Garg said. “I think there are two main reasons for this: the activities, like playing cards, they typically do to socialize may become challenging as they lose their ability to see. The second reason is the loss of independence. They need help with tasks like reading the menu at the restaurant. Maybe someone waved at them and they couldn’t recognize who it was. Some people choose to isolate themselves to avoid these potentially awkward moments.”

    A study of people who were legally blind from macular degeneration seems to bear out this struggle, finding that they experience significant emotional distress, a profound reduction in quality of life and were reliant on help to accomplish daily activities. It's important to note that this same study showed the longer someone lived with vision loss, the less likely they were to report emotional distress, suggesting that with the right tools and resources, people coping with vision loss can lead fulfilling lives. 

    How important are personal relationships when it comes to good health? 

    There’s a more practical benefit of having family or friends nearby: some medical clinics require a loved one take patients home after surgery.  

    While it’s unclear  how many people cancel medical procedures because they don’t have someone to drive them home, ophthalmologists say it’s common. Dr. Steinemann’s office staff estimate about 5 to 10 percent of their patients cancel sight-saving eye surgeries because they couldn’t find an escort. The New York Times recently published an article about seniors struggling to get the medical procedures they need because of a lack of close social ties.

    Dr. Garg echoes the same concern. “I’ve driven patients home myself,”  Dr. Garg said. “It’s completely against protocol, but what else am I supposed to do?”

    The need for support and connection 

    While there are financial assistance programs like EyeCare America for those who can’t afford the cost of an eye exam, the question of how to solve the loneliness crisis among Americans dealing with vision loss remains. Research suggests that making psychological therapy a standard part of low vision rehabilitation could lower one’s chances of depression by 50 percent. Social media could also help people maintain relationships with loved ones and find online support groups for those living with eye disease.

    “There’s a real opportunity to reach out to seniors in need; this can mean educating hospital professionals, but also at a community level, like starting a volunteer support group in your neighborhood or faith-based center,” said Dr. Steinemann. “That’s how we can help each other maintain vision and independence, and avoid the serious mental health battles associated with vision loss.”

    “Our relationships are a source of healing and well-being hiding in plain sight,”  Dr. Murthy said in his report. “We must prioritize building social connection the same way we have prioritized other critical public health issues such as tobacco, obesity, and substance use disorders. Together, we can build a country that’s healthier, more resilient, less lonely, and more connected.”