Urgent need to curb over-the-counter steroid eye drop misuse

Dear Editor, We write this letter to highlight an increasingly concerning issue observed in clinical ophthalmic practice – the rampant misuse of steroid eye drops by the general public due to easy over-the-counter (OTC) availability.[1] Topical corticosteroids, while indispensable in managing numerous ocular inflammatory conditions, are potent medications that demand judicious use under professional supervision.[2] Sometimes, under social media misinformation, especially during epidemics of conjunctivitis, this misuse is seen commonly. We also see frequently cases of vernal keratoconjunctivitis in children, in whom self-medication and misuse of steroid eye drops gets complicated with steroid induced glaucoma causing permanent visual damage. Steroid misuse has also been reported to flare fungal keratitis.[3] Steroid eye drop misuse leads to a rise in preventable complications including steroid-induced glaucoma, cataract formation, delayed diagnosis of infectious keratitis, and worsening of viral eye diseases.[4–6] As a practitioner, most of ophthalmologists do warn the patients about not to self-medicate with steroid eye drops. However, this can only be reinforced by regulatory measures. It is imperative that our national ophthalmic society takes a proactive stand on this matter. We urge the society to consider issuing a formal advisory to all members and regulatory bodies against OTC sale of steroid eye drops without an ophthalmologist’s prescription. Initiating dialogue with health authorities and pharmacy councils to enforce strict dispensing guidelines and mandatory prescription requirements will further help the cause. The misuse of steroid eye drops is not just a clinical problem – it is a public health concern. Raising public awareness through educational campaigns about the risks of unsupervised steroid use can be undertaken by the society. As guardians of ocular health, our society must lead this advocacy to protect patients from unnecessary visual morbidity. We sincerely urge the editorial board and the society at large to prioritize this issue and take decisive steps toward policy change and public safety. Data availability statement Data will be made available on reasonable request to the corresponding authors. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.