Main Article Content



  1. Anxiety is an important morbidity among visually impaired older adults.

  2. There is potential for stakeholders to specifically channel their interventions towards particular IVI domains in order to reduce anxiety prevalence.



Visual impairment is a significant morbidity among adults globally. It has negative impacts on work force participation and productivity, as and well as higher depression and anxiety disorder rates. In the case of older adults, vision impairment can contribute to social isolation and a greater likelihood of early entry into nursing or care homes. This hospital-based, cross-sectional study was designed to determine anxiety disorder’s prevalence among the study population and which Impact of Visual Impairment (IVI) domain is most correlated with anxiety disorder. The study was carried out at the Ophthalmology Clinic of the Ekiti State University Teaching Hospital, Ado Ekiti, Nigera. Questionnaires were used to collect information from 115 respondents. Information sought included sociodemographic information, anxiety status, and visual impairment’s impact on daily functions. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety disorder, while the IVI scale was used to assess the impact of visual impairment. The IVI scale is an instrument used for determining the impact of visual impairment under three domains: (reading and accessing information, mobility and independence, and emotional well-being). Anxiety disorder was detected in 10.4% of all the respondents, and the IVI’s mobility and independence domain of IVI was most strongly correlated with anxiety disorder.


Older adults Impact of Visual Impairment anxiety disorder psychological harm mental disorder

Article Details

Author Biography

Iyiade Adeseye Ajayi, Department of Ophthalmology, College of Medicine, Ekiti State University Ado Ekiti, Nigeria




How to Cite
Aina, F. O., Ajayi, I. A., Omotoye, J. O., Agbesanwa, T. A. ., Dada, M. U., Fadare, J. O. ., Ajite, O. K., & Prajjwal, P. (2023). Anxiety Disorder among Older Adults with Visual Impairment in Ekiti, Nigeria: Implications for the Potential Opportunity to Mitigate the Impact of the Disability and Prevent Psychological Harm. Folia Medica Indonesiana, 59(1), 1–7.


  1. Aina F, Agbesanwa T, Ohuakin A, et al (2018). Functional disability, psychological morbidity and acceptance of geriatric nursing home care among the elderly presenting at a geriatrics clinics, south west Nigeria. Nigeria Hospital Practice Journal 22, 3–6.
  2. Assi L, Chamseddine F, Ibrahim P, et al. (2021). A global assessment of eye health and quality of life. JAMA Ophthalmology 139, 526. doi: 10.1001/jamaophthalmol.2021.0146.
  3. Binder K, Wrzesińska M, Kocur J (2020). Anxiety in persons with visual impairment. Psychiatria Polska 54, 279–88. doi: 10.12740/PP/OnlineFirst/85408.
  4. Brown TA, Tung ES (2018). The contribution of worry behaviors to the diagnosis of generalized anxiety disorder. Journal of Psychopathology and Behavioral Assessment 40, 636–44. doi: 10.1007/s10862-018-9683-5.
  5. Cimarolli V, Casten R, Rovner B, et al. (2015). Anxiety and depression in patients with advanced macular degeneration: current perspectives. Clinical Ophthalmology, 55. doi: 10.2147/opth.S80489.
  6. Dawson SR, Mallen CD, Gouldstone MB, et al (2014). The prevalence of anxiety and depression in people with age-related macular degeneration: a systematic review of observational study data. BMC Ophthalmology 14, 78. doi: 10.1186/1471-2415-14-78.
  7. Demmin DL, Silverstein SM (2020). Visual impairment and mental health: Unmet needs and treatment options. Clinical Ophthalmology 14, 4229–51. doi: 10.2147/opth.S258783.
  8. Djukanovic I, Carlsson J, Årestedt K (2017). Is the Hospital Anxiety and Depression Scale (HADS) a valid measure in a general population 65–80 years old? A psychometric evaluation study. Health and Quality of Life Outcomes 15, 193. doi: 10.1186/s12955-017-0759-9.
  9. Dong M, Zeng L-N, Zhang Q, et al (2019). Concurrent antipsychotic use in older adults treated with antidepressants in Asia. Psychogeriatrics 19, 333–9. doi: 10.1111/psyg.12416.
  10. Fadare JO, Obimakinde AM, Aina FO, et al (2021). Anti-cholinergic drug burden among ambulatory elderly patients in a Nigerian Tertiary Healthcare Facility. Frontiers in Pharmacology, doi: 10.3389/fphar.2021.580152.
  11. Finger RP, Tellis B, Crewe J, et al (2014). Developing the impact of Vision Impairment–Very Low Vision (IVI-VLV) Questionnaire as Part of the LoVADA Protocol. Investigative Opthalmology & Visual Science 55, 6150. doi: 10.1167/iovs.14-14731.
  12. Gascoyne B, Jolley E, Penzin S, et al. (2022). Vision impairment and self-reported anxiety and depression in older adults in Nigeria: evidence from a cross-sectional survey in Kogi State. International Health 14, i9–16. doi: 10.1093/inthealth/ihab070.
  13. Heesterbeek TJ, Aa HPA, Rens GHMB, et al (2017). The incidence and predictors of depressive and anxiety symptoms in older adults with vision impairment: a longitudinal prospective cohort study. Ophthalmic and Physiological Optics 37, 385–98. doi: 10.1111/opo.12388.
  14. Kempen GIJM, Zijlstra GAR (2014). Clinically relevant symptoms of anxiety and depression in low-vision community-living older adults. The American Journal of Geriatric Psychiatry 22, 309–13. doi: 10.1016/j.jagp.2012.08.007.
  15. McKnight PE, Monfort SS, Kashdan TB, et al (2016). Anxiety symptoms and functional impairment: A systematic review of the correlation between the two measures. Clinical Psychology Review 45, 115–30. doi: 10.1016/j.cpr.2015.10.005.
  16. Naipal S, Rampersad N (2018). A review of visual impairment. AVEH African Vision and Eye Health. doi: 10.4102/aveh.v77:1.393.
  17. Okudo AC, Babalola OE, Ogunro AT (2021). A comparative analysis of anxiety and depression among glaucoma and cataractous patients in Southwest Nigeria. Open Journal of Ophthalmology 11, 105–33. doi: 10.4236/ojoph.2021.112009.
  18. Praba VM, Primitasari Y, Qorib MF, et al. (2021). Selection of medical therapy in glaucoma patients in the outpatient eye clinic Soetomo General Academic Hospital Surabaya. Folia Medica Indonesiana 57, 324. doi: 10.20473/fmi.v57i4.29663.
  19. Pratista MB, Nurwasis N, Purwantari KE, et al. (2022). Effectiveness of medication, surgery, and combination therapy to decrease intraocular pressure on glaucoma outpatient at Outpatient Ophthalmic Clinic Dr. Soetomo General Hospital Surabaya in January – December 2017. JUXTA Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga 13, 67–72. doi: 10.20473/juxta.V13I22022.67-72.
  20. Ratanasukon M, Tongsomboon J, Bhurayanontachai P, et al (2016). The Impact of Vision Impairment (IVI) questionnaire; Validation of the Thai-version and the implementation on vision-related quality of life in Thai Rural Community ed. Virgili G. PLoS One 11, e0155509. doi: 10.1371/journal.pone.0155509.
  21. Senra H, Hernandez-Moreno L, Moreno N, et al (2022). Anxiety levels moderate the association between visual acuity and health-related quality of life in chronic eye disease patients. Scientific Reports 12, 2313.
  22. Starcevic V, Schimmenti A, Billieux J (2020). A model of multifaceted fear during the Covid-19 pandemic and balancing between overemphasising and neglecting the distinction between fear and anxiety: A reply to. Clinical neuropsychiatry 17, 255–9. doi: 10.36131/cnfioritieditore20200407.
  23. Ulhaq ZS, Soraya GV, Dewi NA, et al. (2022). The prevalence of anxiety symptoms and disorders among ophthalmic disease patients. Therapeutic Advances in Ophthalmology 14, 251584142210901. doi: 10.1177/25158414221090100.
  24. van der Aa HPA, Comijs HC, Penninx BWJH, et al (2015). Major depressive and anxiety disorders in visually impaired older adults. Investigative Ophthalmology & Visual Science 56, 849–54. doi: 10.1167/iovs.14-15848.
  25. Wilmer MT, Anderson K, Reynolds M (2021). Correlates of quality of life in anxiety disorders: Review of recent research. Current Psychiatry Reports 23, 77. doi: 10.1007/s11920-021-01290-4.
  26. World Health Organization (2019). International Classification of Diseases 11th Revision. WHO.
  27. World Health Organization (2021). Eye health. WHO.
  28. World Health Organization (2022). Blindness and vision impairment. WHO.
  29. Yolanda S, Primitasari Y, Sari DR (2021). Characteristics of primary open-angle glaucoma patients in Dr. Soetomo General Hospital Surabaya. JUXTA Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga 12, 6. doi: 10.20473/juxta.V12I12021.6-9.
  30. Zhong X-M, Dong M, Wang F, et al (2018). Physical comorbidities in older adults receiving antidepressants in Asia. Psychogeriatrics 18, 351–6. doi: 10.1111/psyg.12327.