Tag: glaucoma risk assessment

Travelling To India for Eye Care

Travelling to India for eye treatment? Travel for medical care is not simply about finding treatment. It is about finding the right diagnosis, understanding your options, and making important decisions with confidence. Dr Shibal Bhartiya provides specialist eye care for international patients seeking expert evaluation, second opinions, advanced diagnostics, and long-term management of complex eye conditions.

Dr Shibal Bhartiya is a fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator with over 25 years of experience. Her approach focuses on identifying risk before damage is irreversible, simplifying treatment decisions, and protecting vision long-term. Emphasis on early detection, risk assessment, and continuity of care. She is rated 5 stars across 1,500+ patient reviews on Google.

Expert Eye Care in India for Patients Seeking Clarity, Confidence, and Specialist Opinion

Glaucoma • Neuro-Ophthalmology • Dry Eye & Ocular Surface Disease • Complex Eye Care

Patients travel from the UK, USA, UAE, Singapore, Bangladesh, Nepal, East Africa, and across South Asia for consultations focused on careful assessment, evidence-based recommendations, and clear communication.

25+ Years Experience | 200+ Publications | 28 Textbooks | 1,500+ Five-Star Reviews | International Patients from 20+ Countries | 40000+ patients

Why International Patients Choose Dr Shibal Bhartiya

A Specialist Perspective for Complex Problems

Many patients seeking international consultations are not looking for another routine eye examination.

They are seeking answers to questions such as:

  • Am I actually progressing?
  • Do I really need surgery?
  • Why do my symptoms not match my test results?
  • Has something important been missed?
  • Why am I still struggling despite treatment?
  • Should I seek a second opinion before making a major decision?

Our consultations are designed to answer these questions through detailed evaluation, advanced diagnostics, and careful clinical interpretation.

Areas of Special Expertise

Glaucoma

Glaucoma is often diagnosed late because patients may continue seeing well while irreversible damage accumulates silently.

Dr Bhartiya’s glaucoma practice focuses on:

  • Early glaucoma diagnosis
  • Glaucoma suspects and risk assessment
  • Progression analysis
  • Normal tension glaucoma
  • Complex glaucoma management
  • Surgical decision-making
  • Second opinions before surgery
  • Long-term vision preservation strategies

Many international patients seek consultation after receiving conflicting advice or when they are uncertain whether treatment escalation is truly necessary.

You can read more about glaucoma here

Neuro-Ophthalmology

Neuro-ophthalmology bridges the gap between ophthalmology and neurology.

Common reasons for referral include:

  • Optic nerve disorders
  • Unexplained visual loss
  • Visual field abnormalities
  • Pituitary-related visual problems
  • Double vision
  • Intracranial hypertension
  • Neurological causes of visual symptoms
  • Complex diagnostic uncertainty

Patients are often referred after multiple consultations when symptoms, scans, and examinations do not fit together neatly.

You can read more about neuro-ophthalmology care here

Dry Eye & Ocular Surface Disease

Many patients with ocular surface disease have been treated repeatedly without understanding the underlying drivers of their symptoms.

Areas of focus include:

  • Chronic dry eye disease
  • Meibomian gland dysfunction
  • Ocular surface inflammation
  • Computer-related eye strain
  • Autoimmune ocular surface disease
  • Refractory dry eye
  • Ocular GVHD
  • Complex ocular discomfort syndromes

The goal is not simply prescribing more drops, but understanding why symptoms persist.

You can read more about ocular surface diseases including dry eye, and allergies, here

Comprehensive Ophthalmology & Diagnostic Second Opinions

Not every patient arrives with a diagnosis.

Many simply know that something is wrong.

We frequently evaluate patients seeking answers regarding:

  • Unexplained visual symptoms
  • Diagnostic uncertainty
  • Cataract and glaucoma overlap
  • Complex treatment decisions
  • Risk assessment before intervention
  • Long-term monitoring plans

Explore Our Specialist Eye Care Services

International patients often arrive with a diagnosis, a recommendation, or simply a concern that something is being missed.

While glaucoma, neuro-ophthalmology, and ocular surface disease are areas of particular expertise, every patient journey is different. Explore our specialist services below to better understand your condition and the options available.

Glaucoma Care

Glaucoma can cause permanent vision loss before symptoms become obvious. Learn about glaucoma diagnosis, risk assessment, progression monitoring, treatment options, and specialist second opinions.

Explore Glaucoma Care →

Neuro-Ophthalmology

Visual symptoms are not always caused by the eye itself. Neuro-ophthalmology evaluates disorders affecting the optic nerve, visual pathways, eye movements, and the connection between the eye and brain.

Explore Neuro-Ophthalmology →

Dry Eye & Ocular Surface Disease

Persistent irritation, burning, watering, fluctuating vision, and discomfort often require a deeper evaluation than routine eye examinations provide. Learn more about dry eye disease, meibomian gland dysfunction, ocular GVHD, and ocular surface disorders.

Explore Dry Eye & Ocular Surface Disease →

Second Opinions

Many patients seek reassurance before surgery, treatment escalation, or major decisions. A specialist second opinion can provide clarity, confirm a diagnosis, or identify alternative approaches.

Explore Second Opinions →

Advanced Diagnostic Testing

Accurate diagnosis depends on more than a single test result. Learn how OCT imaging, visual field analysis, optic nerve evaluation, and ocular surface assessment contribute to clinical decision-making.

Explore Advanced Diagnostics →

Comprehensive Eye Care

Not every patient arrives with a diagnosis. Some simply know that their vision has changed or that something does not feel right. Explore common eye conditions, symptoms, and specialist evaluation pathways.

Explore Comprehensive Eye Care →

Whether you are seeking a second opinion, treatment recommendations, or answers to a complex diagnostic question, our goal is to help you understand your condition clearly and make confident decisions about your eye health.

Popular Searches: glaucoma specialist India, neuro-ophthalmologist India, dry eye specialist India, glaucoma second opinion India, ocular surface disease specialist India, international eye specialist India, advanced eye care India, ophthalmologist for international patients.

International Patient Journey

Step 1: Send Your Records

Before travelling, patients may share:

  • Previous consultation notes
  • OCT scans
  • Visual field reports
  • MRI or CT reports
  • Surgical recommendations
  • Current medication lists

This allows preliminary review and helps ensure efficient use of consultation time.

Step 2: Pre-Visit Review

Records are reviewed before your appointment whenever possible.

This means consultations begin with context rather than starting from zero.

Step 3: Specialist Evaluation

Consultations may include:

  • Comprehensive examination
  • Advanced imaging
  • Functional testing
  • Risk assessment
  • Discussion of treatment options
  • Clarification of previous findings

Most investigations can be completed in a single visit.

Step 4: Written Clinical Opinion

Patients receive:

  • Detailed findings
  • Interpretation of investigations
  • Diagnosis (where possible)
  • Treatment recommendations
  • Follow-up strategy

Reports can be shared with treating doctors in the patient’s home country to support continuity of care.

Step 5: Ongoing Follow-Up

Many eye conditions require continuity rather than isolated intervention.

Where appropriate, follow-up planning may include:

  • Remote review of reports
  • Communication with local specialists
  • Monitoring recommendations
  • Long-term management planning

Why Patients Travel to India

India offers access to:

  • Advanced ophthalmic diagnostics
  • Internationally recognised specialists
  • Minimal waiting times
  • Comprehensive investigations in one location
  • Cost-effective care compared with many Western healthcare systems

Many patients are able to complete evaluation and decision-making within a short visit.

About Dr Shibal Bhartiya

Dr Shibal Bhartiya is a fellowship-trained glaucoma specialist with over 25 years of clinical experience. Her work combines clinical care, research, education, and international collaboration.

Highlights include:

  • Fellowship-Trained Glaucoma Specialist
  • Mayo Clinic Research Collaborator
  • 200+ Scientific Publications
  • 90+ PubMed-Indexed Papers
  • 28 Edited Textbooks
  • Editor-in-Chief, CLEVER
  • Executive Editor, Journal of Current Glaucoma Practice
  • International Speaker and Research Collaborator

Languages Spoken

To make complex medical discussions easier for international patients, consultations may be conducted with an interpreter, or facilitator if required. However, Dr Shibal Bhartiya speaks several languages:

  • English
  • Hindi
  • Urdu
  • French
  • Bangla (conversational)
  • Arabic (basic conversational)
  • Persian / Farsi (basic conversational)

Medical records and formal clinical documentation are provided in English, and may be provided in Hindi, French or Urdu on request .

Frequently Asked Questions

Can I send my reports before travelling?

Yes. Sharing reports beforehand helps determine what additional testing may be needed and allows more focused consultations.

Can I obtain a second opinion without surgery?

Absolutely. A large proportion of international patients seek clarity and confirmation before making treatment decisions.

How long should I stay in India?

Most second-opinion evaluations can be completed within 2–3 days. Surgical patients may require longer depending on the procedure.

Will my doctor at home receive a report?

Yes. With your permission, a detailed written opinion can be shared with your treating physician.

Do you assist with medical visa documentation?

Supporting medical documentation can be provided where required.

Send Your Reports Before You Travel

If you are considering travelling to India for glaucoma, neuro-ophthalmology, dry eye treatment, or a specialist second opinion, the process can begin before you leave home.

Send your reports, scans, or questions for review.

Dr Shibal Bhartiya
Glaucoma • Neuro-Ophthalmology • Advanced Eye Care • Second Opinion

🌐 www.drshibalbhartiya.com
📞 +91 88826 38735

About the Author

This article was written by Dr Shibal Bhartiya, fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator, Clinical Director at Marengo Asia Hospitals, Gurugram, known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also the Program Director for Community Outreach & Wellness; and for the Marengo Asia International Institute of Neuro and Spine.

She has published peer-reviewed research on glaucoma management, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.

As Editor-in-Chief of Clinical and Experimental Vision and Eye Research and Executive Editor of the Journal of Current Glaucoma Practice (Pubmed Indexed, official journal of the International Society of Glaucoma Surgery), Dr Shibal Bhartiya brings editorial and research depth to every clinical decision. Her 200+ publications, including 90+ PubMed-indexed publications and 28 edited textbooks span glaucoma biology, surgical outcomes, health equity, and emerging diagnostics.

1500+ Five Star Patient Reviews Google Business Profile

If you are unable to come to Dr Bhartiya’s clinic: Read more about teleconsultation

Read her research on PubMed | Google Scholar | ResearchGate | ORCID

Upload your reports for a structured review.| www.drshibalbhartiya.com | +91 88826 38735

Leave a review on Google

Are steroid eye drops dangerous?

Steroid eye drops prescribed by a doctor are not dangerous. They become dangerous when used without a prescription, unsupervised, or for longer than directed, because they may increase your eye pressure. This puts you at risk for steroid induced glaucoma. But when your doctor prescribes them, the benefit — stopping inflammation, saving vision — outweighs the risk. Avoiding a necessary prescription is where real harm begins, explains Dr Shibal Bhartiya.

Dr Shibal Bhartiya is a fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator with over 25 years of experience. Her approach focuses on identifying risk before damage is irreversible, simplifying treatment decisions, and protecting vision long-term. Emphasis on early detection, risk assessment, and continuity of care. She is rated 5 stars across 1,500+ patient reviews on Google.

Steroids in the Eye: When Fear of the Drop Does More Damage

She was a psychiatrist. A trained physician. She understood pharmacology, and she had read about intraocular pressure and steroid response. So when her ophthalmologist prescribed steroid eye drops after an adenoviral conjunctivitis, she quietly decided not to use them.

Three months later, she sat in front of me. A psychiatrist — a trained physician — spent three months losing vision because she was afraid to use a prescribed drop. Here is what that case teaches every patient.

Her vision had dropped to 6/18 in both eyes. Her corneas were covered in superficial punctate keratitis — so dense and widespread it looked almost like numular keratitis. What began as a straightforward viral conjunctivitis had become a prolonged, damaging inflammatory response, because her immune system was never asked to stand down.

She had never had her eye pressure checked, and was not a known steroid responder. She had simply been afraid of a word.

Within three to four days of starting the prescribed drops, she began to improve. Her vision normalised in two weeks. Three months of avoidable suffering — from one decision to skip a prescription. Her pressures remained well within normal limits.

Why the Fear Exists — and the Risk

Steroids raise eye pressure in susceptible individuals. This is true. In long-term, unsupervised use, the kind that happens when people buy steroid drops over the counter, this risk is real and serious. Steroid Induced Glaucoma can cause irreversible vision loss.

But this is not the situation your doctor creates when they hand you a prescription. She will check your eye pressures before starting eye drops, and monitor it through the duration of therapy.

A doctor prescribing steroid drops accounts for:

  • The specific diagnosis — inflammation, allergy, or a post-viral immune response
  • The right steroid molecule and strength for that condition
  • A taper plan, not an open-ended course
  • Pressure monitoring if the course extends beyond the short term

The risk of not using the drops, in the right condition, is often far greater than any monitored, time-limited course.

Important

In India, steroid eye drops can be purchased without a prescription. This does not make it safe. Unsupervised, over-the-counter steroid use is the primary source of steroid-related eye damage: not prescribed, monitored courses. The two situations carry entirely different risk profiles.

To know more about glaucoma, risks and symptoms, you may want to listen to this conversation

VKC in Children: Where Hesitation Costs Sight

Parents of children with vernal keratoconjunctivitis (VKC) frequently arrive distressed at the idea of steroids for their child. The concern is understandable. It is also, when correctly informed, less alarming than the disease itself.

Fluorometholone and loteprednol are approved for children as young as one year in the United States. These are not aggressive systemic steroids. They are targeted molecules with well-established paediatric safety records, prescribed precisely because the risks of the disease exceed the risks of the treatment.

Giant papillary conjunctivitis does not respond to antiallergic drops alone. Corneal shields (or shield ulcers) — the plaques that form in severe VKC — do not respond to cold compresses, and mild anti allergies. The window for preventing permanent corneal damage is not infinite.

In these cases, the right medicine at the right time, under supervision, is the difference between a child who sees normally and one who does not.

Steroid Eye Drops at a Glance

Molecules, indications, risk by scenario, and cost of avoidance — combined reference

Steroid / ScenarioCommon UseApproved AgeSupervised RiskUnsupervised / OTC RiskCost of Avoidance
Steroid Molecules
Prednisolone acetateSevere inflammation, post-surgical, uveitisAdults (caution in children)Moderate
Higher IOP risk; needs monitoring		High
Glaucoma, cataract risk		Corneal scarring, vision loss
Fluorometholone (FML)Allergic conjunctivitis, VKC, mild-moderate inflammation≥ 2 years (US approval)Lower
Reduced IOP penetration		Moderate
Still causes pressure rise if prolonged		Persistent giant papillae, corneal shield
LoteprednolVKC, seasonal allergy, post-surgical≥ 1 year (US approval)Low
Metabolised locally; lowest IOP burden		Moderate
Risk increases with duration		Persistent severe allergy, corneal damage
DexamethasoneSevere ocular inflammation, post-op, uveitisAdults; children under specialist careModerate–High
Strong molecule; close monitoring needed		Very High
Rapid IOP rise possible		Irreversible optic nerve damage if pressure unchecked
Clinical Scenarios
Post-viral keratitis (adenoviral)Subepithelial infiltrates, SPK, vision dropAll agesLow–Moderate
Short course, tapered		High
Prolonged use → pressure crisis		Persistent SPKs, 6/18 or worse vision — as seen in case above
VKC (children)Giant papillae, shield ulcer risk, corneal involvementAs young as 1 year with appropriate moleculeLow
With loteprednol / FML and monitoring		High
Inappropriate molecule + no monitoring		Corneal shield ulcer, permanent visual impairment
Giant papillary conjunctivitisSevere allergic response, contact lens–relatedAdults and older childrenLow–Moderate
Under supervision		ModerateNo response to antiallergics alone; chronic discomfort, corneal involvement
Use Pattern Risk
Prescribed short course (7–14 days, tapered)Any indicated condition—LowN/A — by definition supervisedAvoidance causes disease progression
OTC self-medication, IndiaOften misused for red eye, irritation—N/AVery High
No diagnosis, no taper, no monitoring		Steroid-induced glaucoma, cataract — often irreversible

What You Should — and Should Not — Do

Use steroid eye drops when your doctor prescribes them. Follow the taper exactly. Do not stop abruptly. Have your pressure checked if your doctor asks. Do not extend the course on your own judgment.

Do not buy steroid eye drops from a pharmacy without a prescription. In India, this is possible. It is also the origin of most steroid-related eye complications seen in clinical practice — not prescribed, monitored use.

Frequently Asked Questions

Can steroid eye drops damage my eyes?

Steroid eye drops used without medical supervision, and for longer than prescribed, can raise eye pressure, cause cataracts, and increase infection risk. Prescribed, monitored courses carry a very different risk profile. The damage in most cases comes from unsupervised, over-the-counter use — not from following a doctor’s prescription.

Why did my doctor prescribe steroid drops after conjunctivitis?

After viral conjunctivitis — particularly adenoviral — the eye can mount a prolonged inflammatory response even after the infection clears. Steroid drops are prescribed to control this immune response and protect the cornea. Skipping them does not protect you. It leaves the inflammation unchecked.

Are steroid eye drops safe for children with VKC?

Specific steroid molecules — fluorometholone, loteprednol — are approved for use in young children and have an established paediatric safety record. In vernal keratoconjunctivitis, the risk of corneal damage from untreated disease is often greater than the risk from a supervised steroid course.

Can I buy steroid eye drops without a prescription in India?

Unscrupulous pharmacies in India dispense them without a prescription. This does not mean it is safe. Unsupervised steroid use is the primary cause of steroid-related eye complications. Always use them under a doctor’s direction.

What is a steroid responder?

Some individuals — roughly 5% of the population — show a significant rise in eye pressure in response to steroid drops. This is a genetic predisposition. It does not mean everyone should avoid steroids; it means a doctor prescribing steroids should check your pressure during use, particularly if the course extends beyond two weeks.

About the Author

This article was written by Dr Shibal Bhartiya, fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator, Clinical Director at Marengo Asia Hospitals, Gurugram, known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also the Program Director for Community Outreach & Wellness; and for the Marengo Asia International Institute of Neuro and Spine.

She has published peer-reviewed research on glaucoma management, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.

As Editor-in-Chief of Clinical and Experimental Vision and Eye Research and Executive Editor of the Journal of Current Glaucoma Practice (Pubmed Indexed, official journal of the International Society of Glaucoma Surgery), Dr Shibal Bhartiya brings editorial and research depth to every clinical decision. Her 200+ publications, including 90+ PubMed-indexed publications and 28 edited textbooks span glaucoma biology, surgical outcomes, health equity, and emerging diagnostics.

1500+ Five Star Patient Reviews Google Business Profile

If you are unable to come to Dr Bhartiya’s clinic: Read more about teleconsultation

Read her research on PubMed | Google Scholar | ResearchGate | ORCID

Upload your reports for a structured review.| www.drshibalbhartiya.com | +91 88826 38735

Leave a review on Google

Risk Stratification in Glaucoma

Posted on by Dr Shibal Bhartiya

Most glaucoma decisions are not about what your reports show today. They are about what your eyes are likely to…