The Misuse and Abuse of Ophthalmic Preparations: a Scoping Review of Clinical Case Presentations and Extant Literature

Abstract

The emergent trend of misuse and abuse of ophthalmic drugs is a public health concern. Common ophthalmic preparations contain anticholinergics, antihistamines, decongestants, anesthetics, and vasoconstrictive and topically applied nonsteroidal anti-inflammatory drugs. Misuse and abuse relates to their effect in causing euphoria, relaxation, hallucination, and reduction of depression symptoms. A scoping review of literature was conducted using Arskey and O’Malley (International Journal of Social Research Methodology 8(1):9–32, 2005) framework for mapping extant literature on the current knowledge of the issue. Four themes emerged: abuse of cycloplegics and mydriatics, misuse and abuse of topical ophthalmic anesthetics, misuse of topical ophthalmic vasoconstrictive and topically applied nonsteroidal anti-inflammatory drugs (NSAIDs), and public and pharmacist views on ophthalmic drug abuse/misuse. The review underscores the complex motives for misuse and abuse, availability of ophthalmic products, self-medication practices, presence of co-morbidities, and low public awareness which harms the important role of health professionals regarding suspected misuse of these common products.