Use of herbal medicines and nutritional supplements in ocular disorders: an evidence-based review.

We sought to examine the evidence regarding the use of herbal medicines and nutritional supplements in age-related macular degeneration (AMD), cataracts, diabetic retinopathy and glaucoma, and to review the ocular adverse effects of herbal and nutritional agents of clinical importance to ophthalmologists. We performed a literature search of Ovid MEDLINE and selected websites including the American Academy of Ophthalmology (AAO), the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH) and the World Health Organization (WHO). There is strong evidence supporting the use of antioxidants and zinc in patients with certain forms of intermediate and advanced AMD. However, there has been growing evidence regarding potential significant adverse effects associated with the AREDS (Age-Related Eye Disease Study) formula vitamins. Current data does not support the use of antioxidants or herbal medications in the prevention or treatment of cataracts, glaucoma or diabetic retinopathy. It is important for providers to be aware of the benefits and the significant potential adverse effects that have been associated with nutritional supplements and herbal medications, and to properly inform their patients when making decisions about supplementation. Further rigorous evaluation of nutritional supplements and herbal medicines in the treatment of eye disease is needed to determine their safety and efficacy.