{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:04:56Z","timestamp":1780031096371,"version":"3.53.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union-NextGenerationEU, through the National Recovery and Resilience Plan of the Republic of Bulgaria","award":["BG-RRP-2.004-0009-C02"],"award-info":[{"award-number":["BG-RRP-2.004-0009-C02"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ophthalmic self-medication, defined as the use of over-the-counter eye medications without prescription, represents a significant public health concern due to potential complications such as delayed diagnosis, antimicrobial resistance, and vision impairment. Despite its global prevalence, data on this practice in Bulgaria remain limited. This study aimed to comprehensively assess the prevalence, patterns, determinants, and self-reported outcomes of ophthalmic self-medication among adults in Bulgaria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional online survey was conducted between March and May 2025 among adults aged \u226518\u202fyears residing in Bulgaria. An anonymous questionnaire comprising 15 items assessed sociodemographic characteristics, ocular complaints, motivations for self-medication, perceived safety and knowledge, and self-reported outcomes. A total of 1,000 respondents were included in the analysis. Descriptive statistics and inferential analyses (Pearson\u2019s chi-square and Fisher\u2019s exact test with Monte Carlo simulation) were performed, with statistical significance set at\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The sample was predominantly female (90.8%), aged 31\u201350\u202fyears (75.6%), highly educated (85.1%), and employed (83.1%). The prevalence of ophthalmic self-medication was 63.7%. The most common complaints were infectious conditions (37.3%) and dry-eye symptoms (23.1%). Primary motivations included lack of time to seek specialist care (41.1%) and the perception that consultation was unnecessary (33.7%). Most participants (66.2%) considered self-medication safe, while 39.6% reported poor or no knowledge of ophthalmic medications. Among self-treated respondents (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f637), adverse reactions were rare (0.6%), and 34.5% sought ophthalmological consultation, mainly for routine examination (20.6%). Significant associations were observed between age and self-medication (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), type of complaint and motivation (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and adverse reactions and consultation (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), whereas no significant associations were found with gender, education, or perceived safety.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ophthalmic self-medication was highly prevalent in this Bulgarian sample and was primarily driven by accessibility barriers and perceived low necessity for specialist consultation. Although adverse events were rarely reported, the discrepancy between perceived safety and self-assessed knowledge highlights potential risks. These findings underscore the need for targeted patient education, improved access to ophthalmic care, and pharmacist-supported referral strategies to promote safer self-care practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1830788","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:46:57Z","timestamp":1780030017000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns and prevalence of ophthalmic self-medication in Bulgaria: results from a cross-sectional survey"],"prefix":"10.3389","volume":"13","author":[{"given":"Mladena","family":"Radeva","sequence":"first","affiliation":[{"name":"Medical University of Varna","place":["Varna, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elitsa","family":"Hristova","sequence":"additional","affiliation":[{"name":"Medical University of Varna","place":["Varna, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Kontny","sequence":"additional","affiliation":[{"name":"Medical University of Varna","place":["Varna, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zornitsa","family":"Zlatarova","sequence":"additional","affiliation":[{"name":"Medical University of Varna","place":["Varna, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Resnick","sequence":"additional","affiliation":[{"name":"Medical University of Varna","place":["Varna, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e43110","DOI":"10.7759\/cureus.43110","article-title":"Ophthalmic self-medication practices and associated factors of using steroid eye drops among adult ophthalmic patients","volume":"15","author":"Alamer","year":"2023","journal-title":"Cureus"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1590\/S1807-59322009000800005","article-title":"Self-medication: initial treatments used by patients seen in an ophthalmologic emergency room","volume":"64","author":"Carvalho","year":"2009","journal-title":"Clinics"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"236","DOI":"10.3109\/09286586.2012.689076","article-title":"Self-medication in ophthalmology: a questionnaire-based study in an Argentinean population","volume":"19","author":"Marquez","year":"2012","journal-title":"Ophthalmic Epidemiol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e063147","DOI":"10.1136\/bmjopen-2022-063147","article-title":"Self-medication with ophthalmic drugs and its associated factors among ophthalmic patients attending three hospitals in Asmara, Eritrea: a cross-sectional study","volume":"12","author":"Tesfay","year":"2022","journal-title":"BMJ Open"},{"key":"ref5","article-title":"What does self-medication counseling in Bulgarian community pharmacies look like \u2013 a field study","year":""},{"key":"ref6","doi-asserted-by":"publisher","first-page":"723","DOI":"10.2147\/OPTH.S352964","article-title":"Knowledge, attitudes, and practices toward self-medicating eye symptoms in Saudi Arabia","volume":"16","author":"Alessa","year":"2022","journal-title":"Clin Ophthalmol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"16","DOI":"10.4103\/mjmsr.mjmsr_59_22","article-title":"A study on self-medication in ophthalmic emergencies in the rural population of South India","volume":"14","author":"Shetty","year":"2023","journal-title":"Muller J Med Sci Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"372","DOI":"10.3390\/healthcare13040372","article-title":"Prevalence and predictors of self-medication among ophthalmic patients in Jordan: a cross-sectional analysis","volume":"13","author":"Ahmad","year":"2025","journal-title":"Healthcare"},{"key":"ref9","article-title":"Self-medication during eye affections among consultant patients at chu-iota","year":""},{"key":"ref10","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1007\/s10654-024-01153-1","article-title":"Self-medication among general population in the European Union: prevalence and associated factors","volume":"39","author":"Yeamans","year":"2024","journal-title":"Eur J Epidemiol"},{"key":"ref11","volume-title":"Guideline on Self-care Interventions for Health and well-Being, 2022 Revision","year":""},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.2165\/00002018-200124140-00002","article-title":"Benefits and risks of self medication","volume":"24","author":"Hughes","year":"2001","journal-title":"Drug 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Opt"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"847","DOI":"10.31128\/AJGP-09-23-6960","article-title":"Conjunctivitis: a review","volume":"53","author":"Gin","year":"2024","journal-title":"Aust J Gen Pract"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"372","DOI":"10.18502\/jovr.v15i3.7456","article-title":"Conjunctivitis: a systematic review","volume":"15","author":"Azari","year":"2020","journal-title":"J Ophthalmic Vis Res"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1136\/bjophthalmol-2019-314336","article-title":"Estimated Number of Ophthalmologists Worldwide (International Council of Ophthalmology Update): will we meet the Needs?","volume":"104","author":"Resnikoff","year":"2020","journal-title":"Br J Ophthalmol"}],"container-title":["Frontiers in 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