According to the World Health Organization (WHO), self-medication is defined as “the practice whereby an individual selects and uses a medicine to treat a condition or symptom that they have identified themselves” (WHO-DAP 98-13) [1] - [3] . This approach typically involves self-diagnosis, followed by self-prescription, and then the acquisition of the medicine through one’s own means, often using traditional remedies, over-the-counter products, or drugs available at home [1] - [4] .

In many contexts, this practice is encouraged by the increasing accessibility of drugs, particularly those sold informally on the street, without control or prescription [5] - [8] . Although it may meet an immediate need for treatment, self-medication exposes patients to many risks: microbial resistance, dangerous drug interactions, addiction, adverse effects, and even toxicity [5] - [9] .

In the field of ophthalmology, the consequences can be particularly serious due to the sensitivity of the ocular tissues and the risk of delayed diagnosis [9] .

This study aimed to assess the extent of self-medication for eye conditions in our context and to identify the socioeconomic, cultural, and medical factors that motivate this practice among patients consulting ophthalmologists in Niamey.

In this study, we observed a prevalence of ophthalmic self-medication of 24.65%, a rate comparable to that reported by Gabriel E. in Argentina (25.6%) [10] , although slightly lower than that reported by Angeline S. in India (37.5%) [11] . In contrast, a study conducted by Wangara N. A. in Mali reported a significantly lower prevalence (2.12%) [12] , probably due to methodological differences, particularly the method of patient selection and the definition of self-medication used.

In other African contexts, the prevalence may be much higher: for example, nearly 60% of residents in the rural area of Gurage in Ethiopia use traditional remedies for eye conditions [13] .

Regarding gender, our results revealed a slight female predominance (50.7%), which is consistent with the data from Gabriel E. [10] and Wangara N. A. [12] , who found 57% and 66.41% female patients, respectively. However, other authors such as Gupta R. [14] and Carvalho R. S. [15] report a male predominance. These discrepancies suggest that gender is not a universal determining factor in the practice of ophthalmic self-medication and may depend on the sociocultural context.

The mean age of our patients was 33.8 ± 22.27 years, with extremes ranging from 50 days to 80 years. This finding is consistent with those of Wangara N. A. (37.7 years) [12] and Carvalho R. S. (39.8 years) [15] . All these data confirm that young adults are the most likely to resort to self-medication, without excluding other age groups.

The main motivation for self-medication in our population was economic (26.71%). Patients considered this option more affordable, allowing them to avoid the costs associated with consultations, additional tests, or pharmacy purchases. This factor was also identified by Wangara N. A. (66.79%) [12] . Similar determinants have been reported in other contexts, such as in Tanzania, where more than 41% of antibiotics were used without prescription [16] , or in Ghana during the COVID-19 pandemic, where 76% of adults resorted to antibiotic self-medication [17] .

In more than half of cases (52.11%), self-medication was initiated by the patients themselves. In 38.03% of cases, it was recommended by a relative, and in 8.45% by a pharmacist. These data contrast with those of Wangara N. A. [12] and Gabriel E. [10] , where the pharmacist’s intervention was predominant (50.86% and 31%, respectively). This difference could reflect regulatory or sociocultural realities specific to each country. In some disadvantaged urban areas, such as the Kibera slums in Nairobi, widespread self-medication can be explained by poverty, limited access to healthcare, and insufficient regulation [18] .

In terms of the drugs used, antibiotics (49.06%) were the most common, followed by non-steroidal anti-inflammatory drugs (NSAIDs) (20.75%) and corticosteroids (13.21%). This usage profile is consistent with the literature, where ophthalmic antibiotics are the most frequently self-administered molecules [19] . In Eritrea, Tesfay et al. [19] reported a prevalence of 63.6% for antibiotics, followed by corticosteroids (22.7%). In Saudi Arabia, artificial tears were the most commonly used products (52.67% and 71.2%) according to Dalal I. A. [20] and Khalid B. A. [21] .

Our study also confirms the persistent use of traditional or unconventional treatments, including medicinal herbs (72.22%), olive oil, honey, and “Zamzam” holy water. These practices are strongly influenced by cultural and religious beliefs, as observed by Angeline S. [11] and Dalal I. A. [20] . Similar practices have been described in rural Ethiopia [13] and other African regions [22] [23] .

Finally, more than 60% of patients were unaware of the exact nature of the product used, which represents a major risk factor. This lack of knowledge has also been documented in Ethiopia, where 87% of patients were unaware of the name of the medication used and 82.6% were unaware of its expiry date [24] . Among students, the prevalence of self-medication can reach 97%, highlighting the influence of educational level and social context [25] .

Self-medication also contributes to the growing problem of antimicrobial resistance, a public health concern strongly emphasized by the WHO [26] [27] . These findings confirm the need to strengthen therapeutic education and to better regulate the dispensing of medications.

However, our study has some limitations: recall bias inherent to self-reported data, which may lead to under- or over-reporting of self-medication practices; hospital-based setting, which may not be representative of the community at large, as patients attending a referral center could differ systematically from the general population; and the absence of clinical outcome assessment beyond self-reported satisfaction or worsening of symptoms, which limits the evaluation of the real impact of self-medication on ocular health.

Self-medication for eye conditions remains common in our context, mainly motivated by economic considerations. Antibiotics remain the most commonly used drugs, often purchased without a prescription, exposing patients to the risks of microbial resistance and avoidable complications. The persistence of traditional practices, which are sometimes inappropriate or even harmful, reflects a lack of health information among the population.

We acknowledge the staff members of the ophthalmology department at Niamey National Hospital.

Abba Kaka HY: study design, data collection, manuscript drafting; Nouhoum G: methodological support, data analysis; Lamyne AR, Dan Jouma A ML, Mamadou IC, Garba AS, Soumaila MD: data collection; Amza A: critical revision and supervision. All authors approved the final manuscript.

The datasets generated during the current study are available from the corresponding author on reasonable request.