Those seemingly harmless eye-drops, readily available over the counter and used for common conditions such as conjunctivitis can cause glaucoma — a fact that has been documented in multiple studies over the years but lack of awareness has ensured that the use of such medication continues.
Glaucoma can cause blindness and is an irreversible condition. While one form of glaucoma — primary glaucoma — is associated with old age and genetics, secondary glaucoma is caused by factors such as uncontrolled diabetes, an injury or use of steroidal drugs and ointments applied topically on the skin that are often prescribed in dermatology treatment.
“At least one in four cases of secondary glaucoma is because of usage of eye drops that have antibiotic-steroid combinations,” said Dr Rajul Parikh, ophthalmologist and member, advisory board of the World Glaucoma Association, adding that people should stop using these OTC drugs. Not just eye drops, even steroidal skin creams can be potentially harmful. Dr Parikh explains that it’s not just about the cream coming in contact with the eye; it gets absorbed in the body and finds its way to the eye through the blood vessels.
“If the dermatologist has prescribed a steroidal ointment, it is recommended that people get their eye pressure checked after three to four weeks,” said Dr Parikh.
Apart from stopping the use of steroidal drugs is the need to undergo regular screenings, particularly for people aged over 40. It is even more important for people who have a family history of glaucoma-linked blindness to go for routine evaluation.
Viji Venkatesh, India country head of Max Foundation, was 59 when she suddenly started losing vision in her right eye. “My mother had glaucoma, but it wasn’t until I started having trouble reading or gauging the height of steps — the same symptoms that my mother had displayed — did I realise that I could be suffering from glaucoma,” she said.
Since then she has had three surgeries, two of which were on the left eye that hadn’t lost vision to prevent further deterioration. She lost vision in her right eye.
Now 64, Ms Venkatesh said neither she nor her siblings ever thought of getting their eyes screened for glaucoma, which was a huge oversight given the family history.
It is for this reason that as part of the ongoing World Glaucoma Week that concludes on March 12, doctors across the country have been creating awareness on the need to undergo regular screenings.
“If you look at glaucoma in India, 90 per cent of people do not know that they were affected by the disease. In the West, the rate is 50 per cent, so we have a long way to go,” said Dr Ronnie Jacob George, senior consultant with Sankara Nethralaya, Chennai. He said awareness about glaucoma, a silent disease with no symptoms, ranges between 1 and 10 per cent. The solution lies in getting eye pressure and the optic nerve checked at least annually or once in two years after the age of 40. And if there is a family history, age is no criteria to undergo an evaluation for glaucoma and should be done regularly.
Doctors across big cities and small towns are working towards glaucoma awareness. “A lot of people come when they are almost blind. We are a referral centre and get cases from areas such as Saharanpur and Roorkee. People coming in at a late stage are a problem,” said Dr Smriti Jain, ophthalmologist with the Amritsar Eye Clinic in Dehra Dun. Working in glaucoma care for the last six years, Dr Jain said awareness remain abysmally poor.
90 per cent of Indians don’t know that they were affected by glaucomaDr Ronnie Jacob GeorgeSr consultant, Sankara Nethralaya
