Schizophrenia Eyes: How Schizophrenia Can Affect The Eye

Schizophrenia, a mental illness that usually starts in early adulthood, is generally known for causing delusions, hallucinations, and changes in mood and behavior. But did you know that it may also affect the eyes?

Recent research has found differences in the eye movement and vision of people with schizophrenia, as well as other physical differences in the eye itself. Although studies are ongoing, these visual symptoms may give us greater insight into schizophrenia and its complex effects. If you’re living with schizophrenia, symptoms can often be managed with a combination of doctor-prescribed medication and therapy.

Understanding the mental illness of schizophrenia disorder

Schizophrenia is a mental illness that can change the ways people think, act, and experience the world. People are usually diagnosed with the disorder between their late teens and early thirties. In rare cases, schizophrenia may emerge later in life. Although we don’t know exactly what causes schizophrenia, there are a few known risk factors:

• Having relatives with schizophrenia
• Living in poverty
• Being exposed to viruses before birth
• Living in stressful or dangerous environments

Two types of schizophrenia symptoms

Schizophrenia can cause two main types of symptoms: positive and negative.

Positive symptoms of schizophrenia disorder

Positive symptoms can be thought of as experiences and behaviors that are present in people with schizophrenia. Some examples can include the following:

• Hallucinations (hearing voices, seeing things that aren’t there, or experiencing other auditory or visual distortions)
• Delusions (false or fantastic beliefs that can’t be changed with facts or logic)
• Disorganized thinking and speech (mixing up words and ideas, jumping from one thought to another, or talking in ways others can’t understand)

Negative symptoms of schizophrenia disorder

Negative symptoms can be defined as experiences and behaviors that are absent in people with schizophrenia. These may include those listed below:

• Lack of emotional expression (lacking facial expressions or speaking in a flat tone of voice)
• Lack of ability to feel pleasure
• Lack of motivation to do daily tasks, such as bathing, going to work, or getting dressed
• Lack of interest in interacting with others

Cognitive symptoms of schizophrenia and related mental illness

In addition to these symptoms, schizophrenia may also have noticeable effects on mental abilities. These effects are sometimes referred to as cognitive symptoms. People with schizophrenia may struggle to pay attention, think abstractly, or make plans. They may also be at a higher risk of experiencing other mental illnesses, such as depression and anxiety. 

Schizophrenia eyes: Eye movements, eye tracking, and smooth pursuit

Now that we’ve reviewed its core symptoms, let’s explore another aspect of schizophrenia that may be less well-known: its effects on the eyes.

Eye movement characteristics in schizophrenia patients

Eye movements, and eye tracking, and smooth pursuit in schizophrenia

In a report from 2019, researchers reviewed existing studies on schizophrenia and eye movement, finding that the disorder can cause changes in several types of eye movements. These usually include “smooth pursuit” eye movements (the movements of the eyes when tracking a moving target) and the movements of the eyes when searching for something. 

Eye movement effects in schizophrenia patients

However, the eye-related effects of schizophrenia may go beyond movement. Studies have found that the disorder can affect other aspects of people’s vision, too.

Contrast sensitivity of the eye

Contrast sensitivity can be defined as the ability to tell the difference between an object and its background. In a 2015 study, scientists gave 43 individuals with schizophrenia computer-based tests to measure their contrast sensitivity. They found that, compared to a control group, contrast sensitivity was typically lower in those with schizophrenia. 

Visual processing

Visual processing generally refers to the brain’s ability to interpret the information it receives from the eyes. In a 2023 study, researchers gave visual processing tasks to a group of people with schizophrenia, a group of people with bipolar disorder, and a control group. Both the group with schizophrenia and the group with bipolar disorder frequently showed visual processing impairments.

Visual acuity

Visual acuity can be thought of as the ability to make out the details of faraway objects. People with poor visual acuity may experience blurred vision or have a hard time reading at a distance. In a 2023 review, researchers analyzed mental health and vision data from 90 different existing studies and over 14,000 participants. They found a small association between schizophrenia and poor visual acuity. 

Strabismus

Strabismus is a condition where the eyes don’t point in the same direction. In an analysis from 2022, researchers looked at health insurance claim data from over 12 million people to see if there was a connection between strabismus and mental health. They found that schizophrenia could be linked to strabismus, as well as other mental illnesses like bipolar disorder and anxiety. 

The retina

Finally, studies have also found that schizophrenia may affect the physical parts of the eye, such as the retina. The retina can be defined as a structure at the back of the eye that grows from the same tissue as the brain. In 2021, researchers scanned the backs of the eyes of 58 people with schizophrenia and 35 people without it. They found that the retinas of those with schizophrenia usually had thinner layers of nerve fibers, which typically carry information from the eye to the brain. 

Schizophrenia eyes: Insights for diagnosis and treatment

This is a small sample of what science has uncovered about the relationship between schizophrenia and the eye. Whether these findings have clinical implications isn’t yet clear. That said, these and future studies may give us new insights for diagnosing and treating schizophrenia. 

Managing schizophrenia and its effects on the eyes

There’s a lot we still don’t know about schizophrenia’s effects on the eyes. However, we do know that schizophrenia can often be treated. According to the World Health Organization, at least one in three people may fully recover from their symptoms with proper care. Treatment for schizophrenia normally includes a combination of medication and ongoing mental health support.

Therapy for schizophrenia

Therapy may be helpful for managing the effects of schizophrenia. By working with a therapist, you may be able to change negative thought and behavior patterns, develop healthy coping skills, and improve your overall mental health. 

Work with therapists online

That said, it might not always be easy to travel to a therapist’s office if schizophrenia is affecting your motivation. With online therapy, you can work with a therapist without having to leave the house. This may make the online format an easier option than in-person therapy, although it may be necessary to seek care in person if you’re experiencing acute psychosis symptoms.

Research shows that online therapy may reduce symptoms of anxiety and depression, which can be common in people with schizophrenia. In a 2017 study, researchers analyzed data from 373 studies of internet-based therapy. They found that online therapy was often effective in treating depression and anxiety, as well as bipolar disorder, OCD, phobias, and more.