Abstract
ObjectiveTo determine the type and nature of traditional eye medicine (TEM), their sources and use and practices related to self-medication for ophthalmic diseases in a rural Indian population.MethodsA population-based, cross-sectional study was conducted in 25 randomly selected clusters of Rural Gurgaon, Haryana, India as part of CORE (Cornea Opacity Rural Epidemiological) study. In addition to comprehensive ophthalmic examination, health-seeking behavior and use of self-medication and TEM was assessed in the adult population using a semi-structured questionnaire. Physical verification of available ophthalmic medications in the enumerated households was conducted by the study team. Descriptive statistics were computed along with multivariable logistic regression analysis to determine associated factors for use of self-medication and TEM.ResultsOf the 2160 participants interviewed, 396 (18.2%) reported using ophthalmic medications without consulting an ophthalmologist, mainly for symptoms like watering (37.1%), redness (27.7%), itching (19.2%) and infection (13.6%). On physical verification of available eye drops that were being used without prescription, 26.4% participants were practicing self-medication. Steroid, expired/unlabeled and indigenous eye drops were being used by 151(26.5%), 120(21.1%) and 75 (13.2%) participants respectively. Additionally, 25.7% (529) participants resorted to home remedies like ‘kajal’(61.4%), honey (31.4%), ghee (11.7%) and rose water (9.1%).ConclusionUse of TEM is prevalent in this population. The rampant use of steroid eye drops without prescription along with use of expired or unlabelled eye drops warrants greater emphasis on safe eye care practices in this population. Public awareness and regulatory legislations must be implemented to decrease harmful effects arising due to such practices.
Highlights
Infectious keratitis contributes significantly to ocular morbidity and corneal blindness, especially in developing nations. [1,2] In India, corneal blindness is the leading cause of blindness after cataract. [3] The indiscriminate use of traditional eye medicines (TEM) in developing countries including India is responsible for increased occurrence of corneal infections and ulcerations in these regions. [4]Traditional eye medicines are biologically derived therapies that are usually dried parts of various plants that are rendered soluble in an aqueous medium
On physical verification of available eye drops that were being used without prescription, 26.4% participants were practicing selfmedication
Use of self-administered eye drops for ophthalmic conditions is a common practice in rural populations. [10]The use of self-administered therapy in cases of ophthalmic disease can delay institution of effective therapy and negatively impact visual outcome.[11]It has been reported to be an expected outcome of a malfunctional health care system with poor accessibility to quality eye care services.[10]Attitudes and practices related to self-treatment have not been studied extensively in the Indian population, especially in North India
Summary
Infectious keratitis contributes significantly to ocular morbidity and corneal blindness, especially in developing nations. [1,2] In India, corneal blindness is the leading cause of blindness after cataract. [3] The indiscriminate use of traditional eye medicines (TEM) in developing countries including India is responsible for increased occurrence of corneal infections and ulcerations in these regions. [4]Traditional eye medicines are biologically derived therapies that are usually dried parts of various plants that are rendered soluble in an aqueous medium. [10]The use of self-administered therapy in cases of ophthalmic disease can delay institution of effective therapy and negatively impact visual outcome.[11]It has been reported to be an expected outcome of a malfunctional health care system with poor accessibility to quality eye care services.[10]Attitudes and practices related to self-treatment have not been studied extensively in the Indian population, especially in North India This cross-sectional, population-based study was planned to understand the current practices and behaviour of a rural Indian population and to determine the frequency, occurrence and characteristics of use of TEM and self-medication through a population-based, house-to-house survey. As per guidelines laid down by Declaration of Helsinki, written informed consent for enrolment, ophthalmic examination and questionnaire administration was taken from all eligible adults
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