How stress can affect your vision

Stress can cause anxiety, depression, elevated blood pressure, digestive issues, migraines and even vision changes.

The psychosomatic aspect to symptoms of stress cannot be underestimated. Those familiar with the work of John Sarno, M.D., former professor of rehabilitation at NYU School of Medicine, recall that he views tension as the primary cause of chronic pain and most other symptoms.

Sarno sees these symptoms — including changes within the eye and vision system — as physical manifestations of repressed emotions. The purpose of the symptoms is to keep the patient focused on the physical body and away from surfacing emotion.

IS STRESS CAUSING YOU VISION ISSUES? Find an eye doctor near you and make an appointment.

How stress affects vision

When the body is stressed, your pupils dilate to allow more light to enter so you can see potential threats more clearly. However, high levels of adrenaline can cause pressure on the eyes, resulting in blurred vision.

“Many patients are not always aware of the impact of stress on their visual health and function,” says Barbara Horn, OD and president of the American Optometric Association. “The ocular impact of stress may range from mild discomfort to severe, debilitating vision loss.”

Yes, stress may be causing your eye twitching (also known as a lid myokymia) This lid “twitching” is a result of the continuous contraction of the orbicularis oculi muscle. The twitching is typically in just one eye, benign and temporary.

Stress also can lead to vision loss. Furthermore, stress not only causes new conditions but worsens existing conditions.

For example, research published in 2018 in the EPMA Journal concludes that ongoing psychological stress and the associated increased level of cortisol are risk factors in the development and progression of deteriorating vision.

The researchers analyzed hundreds of studies and clinical trials, concluding that “while prolonged mental stress is clearly a consequence of vision loss, it may also aggravate the situation.”

Lead investigator Professor Bernhard Sabel, PhD and director of the Institute of Medical Psychology at Magdeburg University in Germany, notes that "continuous stress and elevated cortisol levels negatively impact the eye and brain” by disrupting blood flow to them.

Cortisol can be one of the major causes of serious vision diseases, including glaucoma, optic neuropathy, diabetic retinopathy and age-related macular degeneration.

Emotions and vision issues

The term functional or hysterical vision loss is used to describe any vision impairment that cannot be explained by pathology or structural abnormalities. It has also been described as a “conversion disorder.”

This loss of vision occurs outside the patient's conscious awareness.

The “conversion” is the repression of emotions (such as fear and/or anger) that are converted to a significant reduction in vision. These patients complain of significant blur in the absence of refractive error (need for glasses) or pathology (disease).

These patients have no issues with ocular motility (movement and alignment of the eyes) but do struggle with significant reduction in visual acuity. Their visual field is affected and appears to be “tubular.”

Hysterical amblyopia falls in line with Sarno's belief that our minds want us to focus on the physical symptoms rather than the difficult emotions.

Resolution often occurs with awareness of the condition, low plus lenses and/or the consideration of counseling to assist the patient.

Symptoms of stress

If the bad news is that stress can cause vision loss, the good news is that reducing stress levels may help reverse the decline and restore vision.

Horn notes that various common lifestyle factors and activities can induce eye stress, such as performing more close-up work, working longer hours and using more digital technology.

“As technology continues to advance, it’s difficult to escape the need to use our eyes more frequently and for longer periods of time,” she says.

Stress literally can make our eyes sore. Digital eye strain, for example, can cause the muscles around the eyes to become strained and trigger headaches.

Fortunately, most stress-related eye problems are temporary, especially once the stressor contributing to them is addressed.

Ways to ease your stress

Since stress is practically a given in our lives, learning how to reduce its effects on our bodies, minds and our eyes is paramount.

Some of the most basic steps to reduce stress are simple and cost little or nothing.

“Exercising, getting a full eight hours of sleep at night, eating a healthy diet, spending more time outdoors and meditation are great ways to relieve stress,” Horn advises.

Other approaches like deep breathing exercises, stress management training, talk therapy and meditation are recommended to slow the progression of vision loss.

If these approaches don’t work and stress-related vision symptoms persist, see your eye doctor for immediate attention. Detecting and treating problems early can help maintain good vision for the rest of your life, Horn says.