Doctors across India are raising concern over the widespread and often unsupervised use of steroids, warning that it is emerging as a major trigger for secondary glaucoma, a sight-threatening condition that can lead to irreversible blindness. Steroids commonly used for allergies, skin conditions, respiratory illnesses, and even as over-the-counter eye drops can significantly raise eye pressure when used for prolonged periods, often without patients realizing the long-term damage being caused to the optic nerve.
India is already home to an estimated 12–13 million people living with glaucoma, accounting for nearly one-sixth of the global burden. Globally, glaucoma affects around 75–80 million individuals, a number expected to rise beyond 110 million by 2040. Despite being the leading cause of irreversible blindness worldwide, glaucoma remains vastly underdiagnosed in India.
A particularly alarming concern is that 85–90% of glaucoma cases in the country remain undiagnosed. The disease progresses silently, and by the time symptoms become evident, irreversible optic nerve damage has often already occurred. Late diagnosis results in avoidable vision loss, reduced quality of life, and significant socioeconomic impact.
“We are seeing a noticeable rise in steroid-induced glaucoma, particularly in patients who use steroid medications or eye drops without medical supervision,” said Dr Soundari S, Regional Head – Clinical Services, Dr Agarwals Eye Hospital, Chennai. “What makes this dangerous is that patients feel symptom-free initially, while eye pressure continues to rise silently, causing permanent damage”, she added.
Over the past two to three years, doctors have reported a notable rise in diagnosed glaucoma cases, driven by an ageing population, a higher prevalence of diabetes and myopia, advancements in diagnostic technologies, and improved public awareness. However, experts caution that a growing proportion of cases are linked to secondary glaucoma caused by prolonged or unsupervised steroid use, an avoidable risk factor if identified and addressed early through timely screening and medical guidance.
Glaucoma is most commonly diagnosed in individuals above 40 years of age, with incidence peaking between 50 and 70 years. That said, clinicians are increasingly detecting juvenile and early-onset glaucoma, particularly among individuals with a family history of the disease or secondary triggers. Primary open-angle glaucoma continues to be the most prevalent form, followed by primary angle-closure disease, while steroid-induced glaucoma and pseudoexfoliation glaucoma are also frequently observed in clinical practice.
“Many patients don’t recognize early signs like peripheral vision loss, frequent changes in glasses, or seeing halos. Since central vision is often unaffected at first, this can delay timely diagnosis and treatment. Additionally, individuals with a history of eye trauma, including childhood injuries, are at a higher risk of late-onset glaucoma and should undergo annual screening” Dr. Murali Ariga, Senior Consultant Ophthalmologist, Dr Agarwals Eye Hospital adds.
Doctors also caution against common myths, including the belief that good vision means healthy eyes, that glaucoma affects only older adults, or that normal eye pressure rules out the disease. Individuals with diabetes, hypertension, thyroid disorders, high myopia, long-term steroid use, or a history of eye injury including injuries sustained during childhood are at a higher risk and should undergo annual eye screening.
As part of Glaucoma Awareness Month, experts stress that routine eye examinations are crucial. Individuals over 40 years should undergo comprehensive screening every one to two years, while high-risk groups require yearly evaluations. Vision tests alone are insufficient without assessment of eye pressure and optic nerve health.
