Loss of vision is a social and psychologic handicap as well as a physical one. The patient's initial reactions to blindness may include self-pity, feelings of hopelessness and recrimination, and even suicidal ideation. The ophthalmologist should encourage expression of these feelings. Severe or lasting emotional problems are often associated with previous psychologic problems, previous eye disease, coexisting physical handicaps, middle age, low income, poor education, humility and shyness. Acceptance of one's visual loss is crucial to good adjustment. The ophthalmologist should be understanding and supportive but should help the patient avoid false hope. Every ophthalmologist should be able to provide blind patients with information about local agencies that offer social support and rehabilitation services.