NEW DELHI: Widespread steroid use in India is emerging as a key trigger for secondary glaucoma, a sight-threatening condition that can lead to irreversible blindness, said experts on Tuesday. Steroids are commonly used for allergies, skin conditions, respiratory illnesses, and even as over-the-counter eye drops, and this can significantly raise eye pressure when used for prolonged periods.
As January is observed as Glaucoma Awareness Month, doctors across India are flagging the increasing and often unsupervised use of steroids, which is leading to secondary glaucoma — the name used to describe glaucomas that occur as a side effect or “secondary” to another underlying medical condition or trauma.
“Steroid-induced glaucoma is increasingly being seen in routine clinical practice, especially among patients who have used steroid medications or eye drops without medical supervision,” said Dr JS Titiyal, Regional Head, Dr Agarwals Eye Hospital, New Delhi. “What makes this dangerous is that patients feel symptom-free initially, while eye pressure continues to rise silently, causing permanent damage,” he said.
Patients often don’t realise the long-term damage being caused to the optic nerve, according to experts
India is home to an estimated 12-13 million people living with glaucoma, accounting for nearly one-sixth of the global burden. Globally, glaucoma affects around 75-80 million individuals, a number expected to rise beyond 110 million by 2040.
Despite being the leading cause of irreversible blindness worldwide, glaucoma remains underdiagnosed in India.
What is alarming is that 85-90% of glaucoma cases in India remain undiagnosed. The disease progresses silently, and by the time symptoms become evident, irreversible optic nerve damage has often already occurred. Late diagnosis results in avoidable vision loss.
According to Dr Kalpana R, Senior Consultant, Ophthalmology, SIMS Hospital, Chennai, steroid induced glaucoma is a condition that occurs due to steroid use by any route of administration viz pills, eye drops, inhalers, patches and creams.
“If not stopped at the right time, it can lead to irreversible optic nerve damage and vision loss. It happens more commonly in patients who are steroid responders (hypersensitive to steroids). Long term steroid use can also cause cataract. Hence anyone on prolonged use of steroids should have a thorough eye exam,” she added.
Experts said that doctors in the past two and three years have reported a notable rise in diagnosed glaucoma cases, driven by an ageing population, a higher prevalence of diabetes and myopia, advancements in diagnostic technologies, and improved public awareness.
Glaucoma is most commonly diagnosed in people above 40 years of age, with incidence peaking between 50 and 70 years. However, experts said that clinicians are also increasingly detecting juvenile and early-onset glaucoma, particularly among individuals with a family history of the disease or secondary triggers.
“Many patients tend to ignore early warning signs such as frequent changes in glasses, eye strain, headaches,
difficulty seeing in low light, or halos around lights. Since central vision is often preserved in the early stages, it creates a false sense of reassurance — ultimately delaying timely diagnosis and treatment,” Dr Titiyal said.