CHENNAI: Widespread and often unsupervised use of steroids is emerging as a major and preventable trigger for secondary glaucoma, a sight-threatening condition that can cause irreversible blindness if left undetected, eye specialists at Dr Agarwals Eye Hospital have warned.
Doctors say steroids, commonly used for allergies, skin disorders, respiratory illnesses and even as over-the-counter eye drops, can significantly raise intraocular pressure when taken for prolonged periods without medical supervision. The damage, they caution, is usually silent and progressive, with patients remaining symptom-free until permanent injury to the optic nerve has already occurred.
India is estimated to have 12–13 million people living with glaucoma, accounting for nearly one-sixth of the global burden. Worldwide, about 75–80 million people are affected, a number projected to cross 110 million by 2040. Despite being the leading cause of irreversible blindness, glaucoma remains grossly underdiagnosed in the country, with nearly 85–90 per cent of cases believed to go undetected.
“We are seeing a noticeable rise in steroid-induced glaucoma, particularly among patients using steroid medications or eye drops without supervision,” said Dr Soundari S, Regional Head - Clinical Services, Dr Agarwals Eye Hospital. “The danger lies in the absence of early symptoms. Eye pressure continues to rise silently, causing permanent damage before patients realise something is wrong,” she said.
Over the past two to three years, ophthalmologists have reported an increase in diagnosed glaucoma cases, attributed to an ageing population, rising diabetes and myopia, better diagnostic tools and improved awareness. However, clinicians note that a growing share of cases is linked to secondary glaucoma caused by prolonged or inappropriate steroid use, an avoidable risk factor with timely screening and medical guidance.
Glaucoma is most commonly detected after the age of 40, with peak incidence between 50 and 70 years. Doctors, however, are increasingly identifying juvenile and early-onset cases, especially among individuals with a family history of glaucoma or secondary triggers.
“Early signs such as peripheral vision loss, frequent changes in spectacle power or seeing halos often go unnoticed because central vision is initially spared,” said Dr Murali Ariga, Senior Consultant Ophthalmologist at the hospital. “People with a history of eye trauma, including childhood injuries, face a higher risk of late-onset glaucoma and should undergo annual screening,” he added.
Experts also cautioned against common misconceptions, that good vision guarantees healthy eyes, that glaucoma affects only the elderly, or that normal eye pressure rules out the disease. Individuals with diabetes, hypertension, thyroid disorders, high myopia, long-term steroid use or past eye injuries are at higher risk and should undergo regular eye examinations.
As part of an awareness drive, Dr Agarwals Eye Hospital is offering a free glaucoma work-up for diabetic patients across India until February 15. Doctors stress that routine eye examinations, including assessment of eye pressure and optic nerve health, remain the most effective defence against avoidable blindness.