Indo American Journal of Pharmaceutical Research, 2014

ISSN NO: 2231-6876

DRUG USAGE PATTERN FOR CATARACT IN OPHTHALMOLOGY OUT PATIENT

DEPARTMENT OF TERTIARY CARE HOSPITAL
Rajesh Kumar Suman*1, Varshav S. Gore2, Ipseeta Ray Mohanty1, Neeraj Israni2, Y A Deshmukh1
1

Department of Pharmacology, MGM Medical College, Kamothe, Navi Mumbai.

Department of Opthalmology, MGM Medical College, Kamothe, Navi Mumbai.

ARTICLE INFO
Article history
Received 17/12/2014
Available online
29/12/2014

Keywords
Cataract,
Drug Usage Pattern.
Ciprofloxacin,
Steroids.

ABSTRACT
Cataract is a clouding of the lens sufficient to reduce vision. The present study evaluates the
pattern of drug usage of cataract Patients The Study was conducted in Department of
Ophthalmology, MGM Hospital, Navi Mumbai between October 2013 to may 2014. A
questionnaire was specifically designed factoring patients demographical profile, diagnosis
of disease, Drug regimen. A total 100 prescriptions of patients were analyzed who visited
Ophthalmology OPD Department. The total 352 drug were prescribed in 100 prescriptions of
the patients. Among all 100 prescription, 45 prescription showed Four drug,30 prescription
(Two drug), 15 prescription (5 drug) and 10 prescription with one drug prescribed. Average
drug prescribed was 3.52. Maximum no of drugs were found in the form eye drops (65%),
tablet (23%) ,Ointment (10%) and 2% other dosage form. Around 95% of diagnosis
accounted for senile immature cataract remaining 5% acconting for congenital cataract .The
no of drug prescribed were antibiotic(10%), Steriod(10%), Analgesic(5%), Mydriatic(5%)
Antibiotc+Steriod(60%) and Other(10%). Most common antibiotic prescribed was
Ciprofloxacin and prednisolone was most common steroid prescribed. Other Miscellenious
drug found in cataract prescription were Timolol, Acetazolamide, Prostglandin, Ranitidine,
dorzolamide, Lubricants etc. All the drugs were prescribed by brand name. Most commonly
prescribed drug was antibiotic mainly Ciprofloxacin followed by prednisolone as Steroids.

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Please cite this article in press as Rajesh Kumar suman et al. Drug Usage Pattern For Cataract in Ophthalmology out Patient
Department of Tertiary Care Hospital. Indo American Journal of Pharm Research.2014:4(12).

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Corresponding author
Rajesh Kumar suman
Tutor, Dept. Of Pharmacology
MGM Medical College, Kamothe,
Navi Mumbai-410209
rajeshsuman2043@gmail.com

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INTRODUCTION
Cataract is a clouding of the lens sufficient to reduce vision and is the major cause of blindness in the world & the most
prevalent ocular disease. Recently in the discipline of ophthalmology, there have been many drug developments and introduction of
new ocular therapeutic agents. Antibiotics are widely prescribed for various ophthalmic diseases. Evidences have shown trends of
resistance to different class of antibiotics often used in ocular therapeutics[1].
The term cataract is derived from latin word CATARACTA and Greek word Katarraktes that denotes a water fall. A
cataract is a complete or partial Opacification of Sufficient Severity on or in the Human lens or Capsule. There are Various
Classification of Cataract according to age of onset, Morphology, Etiology or Severity of opacity[2].
Etiology of Cataract
Although exact etiopathogenesis of senile cataract is not clearly known. The age related cataract may have multifactorial and
synergestic causes[3]. Personal factors like protein deficiency has been reported in many article for causing cataract. Vitamins like
riboflavin, Vitamin C and Vitamin E are involved in lens metabolism. Calcium Deficiency leading to Hypokalemia can cause Zonular
Cataract. Defieciency of Zink, copper and Selenium Causing Developmental cataract has also been Postulated. Deficiency of Zink,
Copper and Selenium Causing Developmental Cataract has also been Postulated[4].
Medical factors like Diabetes in which increased blood sugar causes accumulation of sorbitol in the lens which leads to
cataract by causing Osmotic stress, Dehydration Crisis due to Severe Diarrhea,Cholera and Heat stroke leads to Senile cataract has
also been suggested[5,6]. Environmental Factors like ultraviolet light, Infrared or microwaves generates free radical by causing photo
peroxidation of lens constitutents that leads to cataractous changes[7,8].
Sign
Lens Opacification is seen after pupilary Dilatation with the help of slit lamp or distant direct fundoscopy. Iris shadow or
grayish white reflex is seen by direct torch light. White reflex is seen in case of mature cataract.
Symptoms
1) Blurred vision
2) Increased difficulty with vision at night
3) Halos around lights
4) Glare especially at night
5) Double vision in single eye
6) Fading or yellowing of colors
7) Need for brighter light for reading.
The Study regarding Prescribing pattern of drugs used in cataract patients are very less from India and abroad .Hence this
study has been designed to assess the patterns of drugs used in cataract patients at MGM Medical college and Hospital.
OBJECTIVE
1. To analyze the patterns of drugs used in cataract patients.

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RESULTS
The total 100 prescriptions of cataract patients were analyzed who visited Ophthalmology OPD. Maximum patients were
Male (60%) as compared to female(40%). The maximum patents were of age group 61-70 yr (55%). Daignosis were made as 95%
were Senile immature Cataract. while remaining 5% had Congenital Cataract. The total drug prescribed were 352 and Average Drug
prescribed is 3.52. Most common antibiotic prescribed was Ciprofloxacin and common Steriod prescribed was Prednisolone. Other
concomitant medication prescribed were Ranitidine, Timolol, Acetazolamide, Lubricants and Multivitamin. All the Drug were
prescribed by Brand name.( Table 1, Fig 1).

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MATERIAL AND METHODS

1. Study Design: This is cross sectional open label study.
2. Site and duration of Study: Department of Ophthalmology, MGM Medical College &Hospital, Kamothe, Navi Mumbai from
March 2014 to Sep 2014.
3. Sample Size:100 Patients were included in the study from OPD .
4. A questionnaire was specifically designed factoring patients demographical profile, OPD number, illness history, prescription
regimen.
5. The data were analyzed for the type of drug prescribed in Cataract.
6. Institutional ethical clearance was taken for the study

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Table1 Shows: Demographic data of cataract patients.

SN
1
2

3
4
5
6
7
8
9

Parameter
Total sample
Diagnosis
Senile Immature Cataract
Congenital cataract
Maximum age group
Total Drug prescribed
Average drug prescribed
Most common Antibiotic prescribed
Most common Steriod prescribed
Encounter with Brand name
Other concomitant Drug Prescribed

Results
100
95%
5%
61-70 yr (55%)
352
3.52
Ciprofloxacin
Prednisolone
100%
Lubricants,ranitidine, timolol, Acetazolamide etc

Fig 1: Gender wise distribution of Patients.

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Among total drug prescribed, the antibiotic plus steroid combination prescribed was maximum 60%, Antibiotic 10%,
Steroids 10%, Analgesic 5%, Mydriatic 5%, and 10% other drug were prescribed. The Antibiotic prescribed were Ciprofloxacin,
chloramphenicol, Moxifloxacin, Tobramycin and cefadroxil. The Steriods prescribed mainly prednisolone and Dexamethasone.
Diclofenac was prescribed as analgesic, Homatropine was prescribed as Mydriatic. The other drug prescribed were Ranatidine,
Timolol, Acetazolamide. Multivitamin and Lubricants. ( Fig 2, Fig 3)
While analyzing the prescription of cataract patients, it has been shown that maximum prescription 45% had four drug
prescribed while remaining 30 %, 15% and 10% prescription showed two drugs, five drug and Monotherapy prescribed.( Fig 4)
The drugs prescribed in cataract patients were in different dosage form. Maximum drug prescribed in Eye drop form (65%) while
Tablet(23%), ointment( 10%) , and other dosage form accounts 2%. ( Fig 5)

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Rajesh Kumar suman et al.

ISSN NO: 2231-6876

Fig 2 Shows: patterns of drug prescribed in Cataract patients.

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Fig 3 Shows: patterns of Antibiotic prescribed in Cataract patients.

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Fig 4 Shows: Pattern of poly pharmacy prescribed in Cataract patients.

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Rajesh Kumar suman et al.

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CONCLUSION
Most commonly prescribed drug antibiotic for cataract was Ciprofloxacin followed by prednisolone. All the Drugs were
prescribed by Brand Name. Maximum no of drugs were prescribed as eye drops (65%), tablets(23%) ,Ointment(10%) and 2%
accounted for other dosage forms.

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DISCUSSION
Drugs Prescription form a very important Point of cataract between the Health Care Provider and the user. The total drug
prescribed and average number of drug per prescription are essential parameter for analysis of prescription.
The total number of prescription analyzed were 100 in which 352 drug were prescribed. Analysis of the prescription showed
that, average number of drug per prescription was 3.52. Around 95% diagnosis accounted for Senile immature Cataract while
remaining 5% accounted for Congenital Cataract. The similar study conducted by Bhavik kumar et al 1 in South Gujrat , they had
analyzed 317 prescription of cataract patients and they found that 733 drug were prescribed and average drug per prescription was
2.31, which is less than present study. The Lower incidence of drug per prescription in ophthalmology Department also reported by
Rajesh kumar Suman et al[9] i.e 1.23. The study supported by Pooja Prajwal[10] in which Average drug per prescription was 3.281,
and total 9,486 drugs prescribed in 2,891 prescription.
The Present study reported patterns of drugs in cataract patients were, the Combination of antibiotic plus Steriod prescribed
was maximum 60%, followed by Antibiotic 10% Steroids 10%, Analgesic 5%, Mydriatic 5%, and 10% other drug were prescribed.
The Antibiotic prescribed were Ciprofloxacin, chloramphenicol, Moxifloxacin, Tobramycin and cefadroxil. The Steriods prescribed
mainly prednisolone and Dexamethasone. Diclofenac was prescribed as analgesic, Homatropine was prescribed as Mydriatic. The
other drug prescribed were Pantaprazole, Timolol, Acetazolamide. Multivitamin and Lubricants. This is almost similar the study
conducted Bhavik kumar[1] et al but their study has wide range of antibiotic which could differ from present study. Combination of
antibiotic plus steroids prescribed in previous study was lesser than present study.The previous study conducted by Pooja prajwal[10]
also reveals wider range of antibiotic used.
Poly pharmacy were seen in present study, while analyzing the prescription of cataract patients, it has been shown that
maximum prescription 45% had four drug prescribed while remaining 30 %, 15% and 10% prescription showed two drugs, five drug
and Monotherapy prescribed. No prescription showed with three drug prescription which could differ from previous study conducted
by Bhavik kumar[1] et al had also analyzed 30% prescription prescribed with three drug.
During analyzing the data of present study found that, the drugs prescribed in cataract patients were in different dosage form.
Maximum drug prescribed in Eye drop form (65%) while Tablet(23%), ointment( 10%) , and other dosage form accounts 2%. The
previous study by Bhavik Kumar[1] et al and pooja prajwal[10] reported that maximum number of drug prescribed as eye drop similar
to present study .But the previous study reveals that Ointments were prescribed in larger number than Tablet which the is difference
from present study. Injectable mode of drug delivery was not seen in present study as compare to previous study. The present study
also reported that, there was use of Timolol, acetazolamide, Diclofenac, Lubricants, Multivitamin which is similar to reported by
previous study.
Mostly drugs which were prescribed in present study were in topical Dosage form, which could be minimizing the systemic
side effects. Lubricants were used to minimize irritation. Anti-inflammatory and analgesics were also used to minimize pain and
inflammation . Steroids were used to prevent inflammation and with antibiotic to enhance cure rate. Broad spectrum antibiotic were
used to prevent infection. Thus, the present study reveals remarkable prescribing pattern in post cataract surgary patients.

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Fig 5 Shows: Pattern of Dosage form.

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REFERENCES
1. Bhavik kumar HS, Bhavin V. Divyesh JV, Jasmina SS. Drug utilization Study in cataract Patients from South Gujrat region.
Indian Journal of Pharmacy Practice 2011;4(3):46-50.
2. Dorlands illustrated medical dictionary,(28 th edition)WB Philadelphia 276.
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International congress of ophthalmology.Philadelphia:JB Lippincot 1983;1308-12.
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5. Minassian D,Mehra v,Verry J.Dehydration crisis.A major risk factor in blindin cataract.BrJ ophthalmol 1989;73-100.
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MGM medical college and Hospital. Int J of Sci research 2013;2(7):433-435.
10. Pooja Prajwal. Assessment of the prescription in cataract patients for the Drug Utilization Pattern. International journal of
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