International Ophthalmology

, Volume 37, Issue 3, pp 767–777 | Cite as

Depression and burden among the caregivers of visually impaired patients: a systematic review

  • Robin K. Kuriakose
  • Zainab Khan
  • David R. P. Almeida
  • Puneet S. Braich


Caregiving has evolved as an important issue not only for those receiving care, but for those providing it as well. While caregiving allows those with disabilities to better adapt, it has been shown to take a toll on the caregiver on various levels, such as invoking depression and burden. The purpose of this study was to perform a systematic review of the literature pertaining to depression and burden among caregivers of patients with visual impairment. A comprehensive literature search using multiple databases was conducted to include all articles on burden of care or depression among the caregivers of the visually impaired. Nine studies were included in this review. There was demonstrable association of depression and burden with the caregivers of the visually impaired. Communication theory, emotional contagion, and care burden were cited as factors associated with depression in these studies. A number of other elements were also identified to play a role in depression and burden, such as providing greater hours of supervision to the patient, multiple chronic conditions in the patient or caregiver, patient not completing vision rehabilitation, and female gender of the caregiver. By identifying those at risk for decreased quality of life outcomes, health care providers may be able to alter the management of the visually impaired, such as advocating the use of vision rehabilitation clinics in order to minimize the caregiver burden and depression.


Caregiver depression Blind patients Low vision 


Compliance with ethical standards

Conflict of interest

None of the authors have any proprietary interests or conflicts of interest related to this submission.


  1. 1.
    Talley RC, Crews J, Dorn P, Silvernail J, Hunt G, Zeitzer J (2004) Caregiving in America as an emerging public health issue: surveillance and response by the nation’s public health system. In: Second national center on birth defects and developmental disabilities conferenceGoogle Scholar
  2. 2.
    Levine C, Reinhard S, Feinberg LF, Albert S, Hart A (2003) Family caregivers on the job: moving beyond ADLs and IADLs. Generations 27:17–23Google Scholar
  3. 3.
    Perkins M, Howard VJ, Wadley VG, Crowe M, Safford MM, Haley WE, Howard G, Roth DL (2013) Caregiving strain and all-cause mortality: evidence from the REGARDS study. J Gerontolol Ser B 68:504–512CrossRefGoogle Scholar
  4. 4.
    Centers for disease control and prevention (CDC) (2011) Reasons for not seeking eye care among adults aged ≥40 years with moderate-to-severe visual impairment-21 States, 2006–2009. MMWR Morb Mortal Wkly Rep 60:610Google Scholar
  5. 5.
    Zarit SH, Reever KE, Bach-Peterson J (1980) Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 20:649–655CrossRefPubMedGoogle Scholar
  6. 6.
    Vitaliano PP, Zhang J, Scanlan JM (2003) Is caregiving hazardous to one’s physical health? A meta-analysis. Psychol Bull 129:946CrossRefPubMedGoogle Scholar
  7. 7.
    Schulz R, Mendelsohn AB, Haley WE, Mahoney D, Allen RS, Zhang S, Thompson L, Belle SH (2003) End-of-life care and the effects of bereavement on family caregivers of persons with dementia. N Engl J Med 349:1936–1942CrossRefPubMedGoogle Scholar
  8. 8.
    Gutiérrez-Maldonado J, Caqueo-Urízar A, Kavanagh DJ (2005) Burden of care and general health in families of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 40:899–904CrossRefPubMedGoogle Scholar
  9. 9.
    Fadden G, Bebbington P, Kuipers L (1987) The burden of care: the impact of functional psychiatric illness on the patient’s family. Br J Psychiatry 150:285–292CrossRefPubMedGoogle Scholar
  10. 10.
    Whetten-Goldstein K, Sloan F, Kulas E, Cutson T, Schenkman M (1997) The burden of Parkinson’s disease on society, family, and the individual. J Am Geriatr Soc 45:844–849CrossRefPubMedGoogle Scholar
  11. 11.
    Vitaliano PP, Russo J, Young HM, Teri L, Maiuro RD (1991) Predictors of burden in spouse caregivers of individuals with Alzheimer’s disease. Psychol Aging 6:392CrossRefPubMedGoogle Scholar
  12. 12.
    Miyashita M, Narita Y, Sakamoto A, Kawada N, Akiyama M, Kayama M, Suzukamo Y, Fukuhara S (2009) Care burden and depression in caregivers caring for patients with intractable neurological diseases at home in Japan. J Neurol Sci 276:148–152CrossRefPubMedGoogle Scholar
  13. 13.
    Robinson BC (1983) Validation of a caregiver strain index. J Gerontol 38:344–348CrossRefPubMedGoogle Scholar
  14. 14.
    Novak M, Guest C (1989) Application of a multidimensional caregiver burden inventory. Gerontologist 29:798–803CrossRefPubMedGoogle Scholar
  15. 15.
    Given CW, Given B, Stommel M, Collins C, King S, Franklin S (1992) The caregiver reaction assessment (CRA) for caregivers to persons with chronic physical and mental impairments. Res Nurs Health 15:271–283CrossRefPubMedGoogle Scholar
  16. 16.
    Weitzner MA, Jacobsen PB, Wagner H Jr, Friedland J, Cox C (1999) The Caregiver Quality of Life Index-Cancer (CQOLC) scale: development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer. Qual Life Res 8:55–63CrossRefPubMedGoogle Scholar
  17. 17.
    Miyashita M, Yamaguchi A, Kayama M, Narita Y, Kawada N, Akiyama M, Hagiwara A, Suzukamo Y, Fukuhara S (2006) Validation of the Burden Index of Caregivers (BIC), a multidimensional short care burden scale from Japan. Health Qual Life Out 4:1CrossRefGoogle Scholar
  18. 18.
    Bernbaum M, Albert SG, Duckro PN, Merkel W (1993) Personal and family stress in individuals with diabetes and vision loss. J Clin Psychol 49:670–677CrossRefPubMedGoogle Scholar
  19. 19.
    Goodman CR, Shippy RA (2002) Is it contagious? Affect similarity among spouses. Aging Mental Health 6:266–274CrossRefPubMedGoogle Scholar
  20. 20.
    Lawton MP, Kleban MH, Moss M, Rovine M, Glicksman A (1989) Measuring caregiving appraisal. J Gerontol 44:61–71CrossRefGoogle Scholar
  21. 21.
    Horowitz A, Goodman CR, Reinhardt JP (2004) Congruence between disabled elders and their primary caregivers. Gerontologist 44:532–542CrossRefPubMedGoogle Scholar
  22. 22.
    Strawbridge WJ, Wallhagen MI, Shema SJ (2007) Impact of spouse vision impairment on partner health and well-being: a longitudinal analysis of couples. J Gerontol Ser B 62:S315–S322CrossRefGoogle Scholar
  23. 23.
    Bambara JK, Owsley C, Wadley V, Martin R, Porter C, Dreer LE (2009) Family caregiver social problem-solving abilities and adjustment to caring for a relative with vision loss. Invest Ophthalmol Vis Sci 50:1585–1592CrossRefPubMedGoogle Scholar
  24. 24.
    Westaway L, Wittich W, Overbury O (2011) Depression and burden in spouses of individuals with sensory impairment. Insight: Res Pract Vis Impair Blind 4(1):29–36Google Scholar
  25. 25.
    Braich PS, Lal V, Hollands S, Almeida DR (2012) Burden and depression in the caregivers of blind patients in India. Ophthalmology 119:221–226CrossRefPubMedGoogle Scholar
  26. 26.
    Khan Z, Braich P, Rahim K, Rayat J, Xing L, Iqbal M et al (2016) Burden and depression among caregivers of visually impaired patients in a Canadian population. Adv Med 2016:1–8CrossRefGoogle Scholar
  27. 27.
    Braich P, Jackson M, Knohl S, Bhoiwala D, Gandham S, Almeida D (2016) Burden and depression in caregivers of blind patients in New York state. Ophthalmic Epidemiol 23(3):1–9CrossRefGoogle Scholar
  28. 28.
    Cimarolli VR, Boerner K (2005) Social support and well-being in adults who are visually impaired. J Vis Impair Blind 99:521Google Scholar
  29. 29.
    Bambara JK, Wadley V, Owsley C, Martin RC, Porter C, Dreer LE (2009) Family functioning and low vision: a systematic review. J Visual Impair Blind 103:137Google Scholar
  30. 30.
    Zarit SH, Femia EE, Whitlatch CJ (2015) The importance of caregiving and caregiver mental health. In: Encyclopedia of mental health, p 233Google Scholar
  31. 31.
    Hinrichsen GA, Hernandez NA (1993) Factors associated with recovery from and relapse into major depressive disorder in the elderly. American J Psychiatry 50:1820Google Scholar
  32. 32.
    Pinquart M, Sörensen S (2006) Gender differences in caregiver stressors, social resources, and health: an updated meta-analysis. J Gerontol Ser B 61:33–45CrossRefGoogle Scholar
  33. 33.
    Braich PS, Howard MK, Singh JS (2015) Dyslipidemia and its association with meibomian gland dysfunction. Int Ophthalmol 36(4):469–476CrossRefPubMedGoogle Scholar
  34. 34.
    Braich PS, Almeida DR, Hollands S, Coleman MT (2011) Effects of pictograms in educating 3 distinct low-literacy populations on the use of postoperative cataract medication. Can J Ophthalmol 46(3):276–281CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Robin K. Kuriakose
    • 1
  • Zainab Khan
    • 2
  • David R. P. Almeida
    • 3
  • Puneet S. Braich
    • 1
  1. 1.Department of Ophthalmology, Nelson ClinicVirginia Commonwealth University School of MedicineRichmondUSA
  2. 2.Department of Ophthalmology, Hotel Dieu HospitalQueen’s UniversityKingstonCanada
  3. 3.VitreoRetinal Surgery PAMinneapolisUSA

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