title: Psychologic adjustment to irreversible vision loss in adults: a systematic review.
abstract: OBJECTIVE
  To summarize relevant evidence investigating the psychologic adjustment to irreversible vision loss (IVL) in adults.
  
  
  METHODS
  Irreversible vision loss entails a challenging medical condition in which rehabilitation outcomes are strongly dependent on the patient's psychologic adjustment to illness and impairment. So far, no study has systematically reviewed the psychologic adjustment to IVL in adults.
  
  
  METHODS
  We reviewed all articles examining the psychologic adjustment to IVL in adults. We included articles published in English in peer-reviewed journals. We performed a keyword literature search using 4 databases (PubMed, EBSCO, Cochrane Library, and Science Direct) for all years through July 2014. We assessed risk of bias of selected studies using the RTI Item Bank for Assessing Risk of Bias and Confounding for Observational Studies of Interventions or Exposures and the Cochrane risk of bias tool for randomized controlled trials.
  
  
  RESULTS
  Of a total of 3948 citations retrieved, we selected 52 eligible studies published between 1946 and 2014. The majority of studies were observational and cross-sectional in nature. Our review suggests that high levels of depression occur during the adjustment to IVL. Better adjustment to IVL was associated with greater acceptance of vision loss and use of instrumental coping, good social support, positivity, and use of assistive aids.
  
  
  CONCLUSIONS
  The overall findings indicate that IVL often has negative effects on patients' quality of life and mental health and that such effects tend to remain over time. Specific factors and variables associated with the adjustment to IVL need to be clarified through further in-depth and longitudinal research.
authors.affiliation: Centre of Psychology, University of Porto, Porto, Portugal. Electronic address: hugo_senra@hotmail.com.
authors.forename: Hugo
authors.initials: H
authors.lastname: Senra
authors.affiliation: Faculty of Psychology and Education Sciences, University of Porto, Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Barbosa
authors.affiliation: Health Psychologist, Lisboa, Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Ferreira
authors.affiliation: ESCULCA Research Group, University of Santiago de Compostela, Spain.
authors.forename: Cristina R
authors.initials: CR
authors.lastname: Vieira
authors.affiliation: Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Perrin
authors.affiliation: Department of Methodology and Experimental Psychology, University of Deusto, Spain.
authors.forename: Heather
authors.initials: H
authors.lastname: Rogers
authors.affiliation: Department of Methodology and Experimental Psychology, University of Deusto, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Rivera
authors.affiliation: Psychology & Health Research Unit (UIPES, I&D), ISPA - Instituto Universitário, Lisbon, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Leal
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D001766:Blindness / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology; D006801:Humans; D011788:Quality of Life / Q000523:psychology; D012917:Social Adjustment; D012944:Social Support