Eye drop abuse can blind you, doctors warn

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Many people feel the need to clean their eyes several times a day with eye drops, but doctors caution that their overuse can lead to conditions ending in sight impairment. 

The Ho Chi Minh City Ophthalmology Hospital receives many young patients every day, who come with the same question: How is that their eyes feel painful and itchy with blurred eyesight despite the regular use of eye drops.

Most of them had prescribed the eye drops for themselves and some did not forget to use these even while waiting for the doctor.

Diu, one of the patients, said she has to give herself eight drops each four to five times a day. "It feels significantly comfortable immediately. But generally, my eyes have gotten worse," she said.

Doctor Trang Thanh Nghiep, deputy head of the glaucoma department at the hospital, said some people are creating problems for themselves. 

"Many people think the eye drops are very harmless, so they will use them every time their eyes feel dry, itchy, shed tears or when they come home from a drive or a swim.

"That kind of abuse, without doctors' advice, is causing glaucoma in many people," Nghiep said.

Glaucoma is an eye disease where the optic nerve is damaged. Lack of timely diagnosis and treatment will result in the condition worsening to permanent loss of vision.

Nghiep said less severe complications include cataracts, cornea infections and ocular hypertension, which means the pressure inside eyeballs is higher than normal.

The damage also inhibits the pituitary gland the growth-influencing gland at base of brain, and the adrenal cortex which is the cover layer of adrenal glands that sit at the top of the kidneys, producing hormones to mediate stress response, he said.

He said it is not so simple that people just need to stop using eye drops at some point. A sudden stop can increase intracranial pressure, one of the most damaging aspects of brain trauma.

Although glaucoma risks are mostly associated with genetics problems, the doctor said that one of the causes is prolonged use of eye drops with corticoid, a drug that acts like a steroid hormone.

Dr. Vu Anh Tuan, deputy head of the glaucoma department at the Central Ophthalmology Hospital in Hanoi, was quoted in a Lao Dong report last month as saying corticoid is a prescribed drug, but products containing it are widely available in the market under commercial names like Polydexa, Vigadexa, Tobradex, Gentadexa, Maxitron or Oziadecodex, all at cheap prices.

"Corticoid is anti-inflammatory and thus can comfort the eyes quickly. That makes many people easily addicted to it.

"But one side effect is limiting the flow of eye fluid, thus increasing fluid pressure in the eye, which is a direct cause of glaucoma," Tuan said.

He said the hospital receives between 100 and 150 severe glaucoma cases every year, many caused by the overuse of corticoid-containing eye drops.

Statistics compiled by the hospital in 2009 showed that between 31 and 33 percent of ocular hypertension patients coming to the hospital had a long history of using corticoid, and 60 percent of them were of working age -  between 25 and 59 years old.

A survey carried over 16 cities and provinces also found that around 25,000 people, or 6.5 percent of blind people in Vietnam, had lost their vision due to glaucoma, the hospital leaders said at a conference last month, adding that almost all of the surveyed people knew nothing about the condition.

Tuan said using corticoid eye drops regularly for more than two weeks will put the eyes at risk of glaucoma. He said some conditions require long-term use of corticoids, and the subjects need to receive regular eye checks so that treatment can be provided as soon as necessary.

Glaucoma can be treated by medication or surgery, he said.

He said the condition can be noticed early with symptoms of pain, increased tear shedding, and blurred vision.

But the doctor also said that corticoid induced glaucoma develops rather silently and people only recognize it when they are in the later stages of the disease, with visual field loss, and in such cases, the success rate for treatment is low.

Tuan said other than corticoid, risk factors for glaucoma include genetic vulnerability, constant stress, diabetes, high blood pressure, and severe long-sightedness, especially among those above 35.

Dr. Nghiep from Ho Chi Minh City also warned about other dangers that many eye drops or eye creams on the market can expose users to.

He said some products contain chloramphenicol, an antibiotic that can cause aplastic anemia which happens when the capacity of bone marrow cells to generate red blood cells is diminished, while ciprofloxacin a powerful antibiotic ingredient, can cause crystallization of the eyes.

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