Self-Medication: Not Something to be Independent About

Varsha Singh, M. Optom

Assistant Professor, KD Institute of Allied Health Sciences, Ahmedabad, India

 

Self-medication, a widespread form of medication misuse globally, involves taking drugs without a prescription to address self-diagnosed conditions or symptoms. ⁽¹⁾ Per the World Health Organisation (WHO), self-medication entails consumers using medicinal products to address self-recognized disorders or symptoms, or ongoing/intermittent use of previously prescribed drugs for chronic/recurrent conditions, absent consultation with healthcare providers. ^(2,3)Self-medication with eye drops for ophthalmic conditions without professional guidance is prevalent in both developed and developing nations, with rates ranging from 25.6% to 73.6%, and is particularly widespread among rural populations. (4-6) Globally, developing countries account for 80% of all drugs bought without a prescription. ⁽⁷⁾ It can postpone the initiation of effective treatment and adversely affect visual outcomes. ⁽⁸⁾Improper self-medication leads to irrational drug use, resource waste, and rising antimicrobial resistance, posing grave health risks like adverse effects and extended patient suffering. ⁽⁹⁾

Scenario in India

In rural populations, traditional eye medicines such as surma/kajal, honey, ghee, rose water, and other plant, dairy, and animal products were commonly employed; self-medication is well-documented across various settings, particularly among rural residents, and these remedies play a significant role in both initiating and delaying or complicating corneal ulcer presentations in such populations. ^(10,12) Common conditions for which individuals refrain from consultation and rely on self-medication include symptoms of watering, redness, itching, redness with discharge, painful eyes, foreign body sensation, diminished vision, and burning eyes.^(10,13) Individuals are also using medications without a prescription from a consultant for eye cleaning, foreign body removal, ocular discharge, glare, swelling, ocular trauma, eye tiredness, and cataract prevention. ^(10,13) The common medications that patients usually use are steroid eye drops and ointments, antibiotics, non-steroidal anti-inflammatory drugs, vasoconstrictors, saline solution, herbal preparations, and indigenous eye drops.^(10,13)

Why Do People Self-Medicate?

The primary drivers of self-medication were advice from pharmacists, opticians, or dispensers, followed by the belief that symptoms were minor and recommendations from family or friends. Many also cited prior experiences with comparable symptoms and limited time to see a doctor. Other notable factors included frustration with prolonged wait times, high treatment costs, and remoteness of healthcare centers. Fewer people mentioned self-reliance in handling their condition or having medications readily available at home. Negative prior encounters with healthcare providers were the rarest reason cited.⁽¹⁴⁾

Table 1: Factors and Reasons Affecting Self-Medication. ⁽¹⁴⁾

Risks and Side Effects

Self-medication-related adverse events, as documented, comprised excessive lacrimation, ocular discharge, redness, itching, swelling, aggravated pain, inflammatory responses, corneal ulceration, and diminished visual acuity. ^(13,14)It may even result in severe complications, including corneal ulcers, endophthalmitis, evisceration, exenteration, and blindness. ^(15,16)

Conclusion

Self-medication with eye drugs is a common yet underrecognized issue, especially in rural and marginalized areas. ⁽⁴⁾ This highlights the critical need for heightened public education, robust health policy enforcement, and readily available quality primary eye care backed by efficient referral systems. Traditional eye medicines exacerbate the problem, frequently causing avoidable complications. ^(13,14)Tackling this issue requires bolstering eye health initiatives and enhancing promotive, preventive, and therapeutic services to promote safer habits and improved vision results. ^(6,10)

References

1. Fresle DA, Wolfheim C. Public education in rational drug use: a global survey (No. WHO/DAP/97.5). World Health Organization. 1997.
2. Araia ZZ, Gebregziabher NK, Mesfun AB. Self medication practice and associated factors among students of Asmara College of Health Sciences, Eritrea: a cross sectional study. Journal of Pharmaceutical Policy and Practice. 2019;12(1):3.
3. Ruiz ME. Risks of self-medication practices. Current Drug Safety. 2010;5(4):315–323.
4. Bisika T, Courtright P, Geneau R, Kasote A, Chimombo L, Chirambo M. Self treatment of eye diseases in Malawi. African Journal of Traditional, Complementary, and Alternative Medicines. 2008;6(1):23.
5. Ajayi IA, Omotoye OJ, Ajite KO, Fadamiro CO, Ajayi EA. Self medication practices among patients seen in a suburban tertiary eye care centre in Nigeria. Asian Journal of Medical Sciences. 2014;5(2):85–90.
6. Adimassu NF, Woldetsadik ZG, Alemu HW. Proportion of ophthalmic self-medication and associated factors among adult ophthalmic patients attending Borumeda Hospital, Dessie, Northeast Ethiopia. Journal of Ophthalmology. 2020;2020:6932686.
7. Carvalho RS, Kara-José N, Temporini ER, Kara-Junior N, Noma-Campos R. Self-medication: initial treatments used by patients seen in an ophthalmologic emergency room. Clinics (Sao Paulo). 2009;64(8):735–741.
8. Gupta N, Vashist P, Tandon R, Gupta SK, Kalaivani M, Dwivedi SN. Use of traditional eye medicine and self-medication in rural India: A population-based study. PLOS One. 2017;12(8):e0183461.
9. Bennadi D. Self-medication: A current challenge. Journal of Basic and Clinical Pharmacy. 2013;5(1):19–23.
10. Shalini A, Logaraj M. Prevalence and determinants of self medication use among the adult population residing in a sub urban areas near Chennai, Tamil Nadu. Journal of Family Medicine and Primary Care. 2021;10(5):1835–1838.
11. Prajna VN, Pillai MR, Manimegalai TK, Srinivasan M. Use of traditional eye medicines by corneal ulcer patients presenting to a hospital in South India. Indian Journal of Ophthalmology. 1999;47:15–18. PMID:16130279.
12. Courtright P, Lewallen S, Kanjaloti S, Divala DJ. Traditional eye medicine use among patients with corneal disease in rural Malawi. British Journal of Ophthalmology. 1994;78:810–812. PMID:7848973.
13. Malhotra P. Self-medication in ophthalmology—a northern Indian tertiary hospital experience. International Journal of Basic and Clinical Pharmacology. 2016.
14. Ahmad AI, Huwari MAA, Alsharif AA, Alrawashdeh HM, Naser AY. Prevalence and predictors of self-medication among ophthalmic patients in Jordan: A cross-sectional analysis. Healthcare (Basel, Switzerland). 2025;13(4):372.
15. Ayanwale MB, Okafor IP, Odukoya OO. Self-medication among rural residents in Lagos, Nigeria. Journal of Medical Tropical. 2017;19(1):65.
16. Jaya Y, Masanganise R. The prevalence, types and effects of traditional eye medicine use among newly presenting patients at Sekuru Kaguvi Hospital Eye Unit in Harare, Zimbabwe. Central African Journal of Medicine. 2014;60(2):36–44.

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About the Author

Varsha Singh

Assistant Professor

 

KD Institute of Allied Health Sciences, Ahmedabad, India