Steroid eye drops abuse, self-medication can lead to blindness, glaucoma

He was a 20-year-old university student looking at a bright future. Now, he is half-blind. Self-medication for conjunctivitis has robbed him of the sight in one eye.
He is not alone. At least five people have lost their vision after self-medication with steroid eye drops.
Four children are suffering from glaucoma, also the result of using steroid eye drops.
This eye-opening revelation comes from interviews with several ophthalmologists here. There are probably more cases in other parts of the country.
The specialists say the problem arises when people reach for eye drops to relieve itchiness or dry eyes without consulting doctors. Some continue earlier prescriptions by their doctors, without a second visit.
There are different types of eye drops. Some have no medication, some contain antihistamines, some have steroids and others don’t.
The indiscriminate and prolonged use of steroid eye drops can lead to glaucoma and blindness.
The consultant ophthalmologist at the Selayang Hospital, Dr Choong Yee Fong, confirmed that five of his patients had lost their vision as a result of prolonged use of steroid eye drops.
"Many more of my patients have raised eye pressure," he said. Raised pressure within the eye, or intraocular pressure (IOP), can damage the optic nerves.
Chairman of the Ophthalmological Society of the Malaysian Medical Association Prof Dr Muhaya Mohamad said four of her patients, aged 12 to 13, suffered glaucoma after using steroid eye drops.
She said: "Steroid eye drops cure itchiness and discomfort quickly and so they buy it again and again. They don’t know that the drops can damage the eyes."
The university student mentioned above is a patient of Dr Nooraini Nadior at the Damansara Specialist Hospital.
She said the student had initially seen an ophthalmologist who prescribed a certain steroid eye drops. However, without going for another check-up, the student bought the same brand and continued using it.
"When he came to my clinic, he already had end-stage glaucoma. It’s sad, he’s still young," she said.
Dr Choong said the prolonged use of steroid eye drops (between two weeks and three months) would increase pressure in the eyes.
"The pressure remains high, and if left untreated, will damage the optic nerves. Loss of vision can occur between six months and five years," he warned.
Asked how many such cases there were at Hospital Universiti Kebangsaan Malaysia, Dr Muhaya, a senior consultant ophthalmologist at the hospital, said:
"It is not the number, it is the fact that it occurs, that is frightening."
She urged pharmacies not to sell these eye drops over the counter.
Dr Choong warned contact lens users not to buy steroid eye drops without a prescription.
"Many contact lens users buy these drops to cure redness, dry eyes and irritation. The drops work but it is the wrong medication. It should not be used that way."
Lubricants were safe to reduce discomfort and dry eyes resulting from wearing contact lenses.
Dr Nooraini said: "Consumers should be cautious when buying eye drops. Don’t buy eye drops without a prescription because they might contain steroids and you may end up with glaucoma or cataracts."
Buyers should look for ingredients such as dexamethasone, fluromethalone and betamethasone, which indicate steroids.
"If you don’t want to see a doctor, please look out for these ingredients and avoid them," she advised.
Doctors normally prescribe steroid eye drops after operations (such as for cataract) eye inflammation, severe viral conjunctivitis and allergic conjunctivitis.
But the ophthalmologists were quick to point out that those prescribed steroid eye drops should stop using them once healed.
"What is important is to make sure you are monitored by a doctor.
"Drugs with steroids should not be self-medicated," said Dr Choong.
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