Because the whole city of Wuhan has been locked down since January 23, 2020, multiple aspects of the lives of residents of the city have been affected. Acitywide lock down can cause various psychological problems, such as panic disorder, anxiety disorder, and depression. [13].At the initial stage of the COVID-19 outbreak in China, Wang C observed that more than half of the respondents rated the psychological impact as moderate to severe, and about one-third reported moderate to severe anxiety. [14]. Previous studies have shown that patients with glaucoma are more anxious or depressed than healthy people. [15]. The prevalence of anxiety and depression in glaucoma patients is, respectively, 22.92% and 16.40% in China, 64% and 30% in Singapore, and 44% and 41.8% in southeastern Nigeria. [16,17,18].The fear of being blind and worries of financial problems associated with the treatment impose major burdens on the patients, which may result in anxiety and depression. We investigated the psychological conditions and sleep quality of glaucoma patients during the COVID-19 outbreak through a WeChat questionnaire. Of the 53 patients with glaucoma, 31 (58.5%) reported increased negative emotions (anxiety, depression, and indignation) during the outbreak. Thus, 29 (54.7%) patients were concerned about the progression of glaucoma; 10 (18.9%) patients were worried about being infected with COVID-19; while 13 (24.5%) patients were worried about the impact of COVID-19on life and work.
The subjective sleep quality of glaucoma patients is related to their emotional state. [19].In our survey, the 39 (73.6%) patients with insomnia included 27 patients with occasional insomnia and 12 (22.6%) people with frequent insomnia. This result is consistent with another analysis in our survey showing 40 (75.5%) cases of early waking (22 [41.5%] occasionally and 18 [34.0%] frequently).
During the period of personal isolation in the COVID-19 epidemic in China, increased social activity could improve sleep quality by reducing anxiety and stress. [20]. Of the 53 glaucoma patients, 44% (83%) chose to stay home by themselves with psychological cues, yoga, walking at home, or other activities such as reading, watching TV, and cooking. Two patients contacted a doctor for guidance. Only 9 (17.0%) patients wanted to communicate with family and friends. This result suggests that glaucoma patients generally have poorer sleep quality and fewer social activities.
According to a research conducted by Skalicky,treatment of glaucoma can reduce anxiety in newly diagnosed glaucoma patients. [21]. We recommend that patients with glaucoma should be offered treatment and psychological counseling online frequently in the form of text, pictures, and videos.