Mental, ocular health ‘inextricably linked,’ says OD turned psychotherapist
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NEW ORLEANS — Optometrists are in a unique position to help identify mental health conditions in patients, according to optometrist turned licensed psychotherapist Dennis Pardo, OD, MPH, FAAO, LCSW, MSW.
“As optometric physicians, we are the PCPs of the eye, and we may be the first to notice mental health in our patients,” Pardo told attendees at an Academy ’23 plenary session. “Just like diabetes, mental health and ocular health are inextricably linked.”
According to Pardo, collaboration between optometrists and other health care providers is essential to provide appropriate care to patients, and establishing relationships with mental health professionals is vital, as mental health has become a public health crisis.
Pardo also noted that psychotropic medications may have ocular side effects that optometrists should be aware of.
“I would argue that it starts with the intake,” Pardo said. “You need to have a separate section for mental health conditions, side by side with physical health conditions. It needs to be front and center and it needs to be separate. Same thing for medications, a separate section for psychotropic medications, because this gives you the baseline information about mental health issues that your patients sitting in your chair are facing.”
Pardo noted that an antipsychotic like chlorpromazine may cause blurry vision, diplopia, decreased mucus and tear production, and ocular pigment changes, while ADHD stimulants may cause myokymia.
Pardo also discussed the importance of understanding common mental health conditions like anxiety, phobias, PTSD, ADHD, schizophrenia, substance-related disorders, obsessive-compulsive disorder and abuse.
“Do we have patients who are afraid of coming to see us?” Pardo said. “Yes, we need to be aware of that.”
Furthermore, Pardo discussed the link between certain ocular conditions and mental health issues. He noted that patients diagnosed with keratoconus are more likely to have depressive disorders, and patients diagnosed with Sjogren’s syndrome or glaucoma are at increased risk for both depression and anxiety.
“We don’t just treat the eye; we treat the whole patient,” Pardo said.
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Pardo D. Plenary session: Mental health in optometry. Presented at: Academy; Oct. 11-14, 2023; New Orleans.
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