Traditional eye medicine use by newly presenting ophthalmic patients to a teaching hospital in south-eastern Nigeria: socio-demographic and clinical correlates

Prevalence of traditional eye medicine and self-treatment in Gurage Zone, Rural Ethiopia

INTRODUCTION

Traditional medicines are commonly used worldwide, especially in Africa-however, there is limited information on the prevalence and types of traditional eye medicine utilization in Ethiopia. The goal of this study was to determine the prevalence, the type and nature of traditional eye medicine use and practices related to self-medication for ophthalmic diseases in a rural Ethiopian population.

METHODS

A cross-sectional study was conducted in six randomly selected primary health centers in rural Gurage Zone, Southern Ethiopia. Health-seeking behavior, use of self-medication, and traditional eye medicine were assessed in the population using a semi-structured questionnaire. Descriptive statistics and multivariable logistic regression analysis were computed to determine associated factors for using self-medication and traditional eye medicine.

RESULT

Of the 814 participants interviewed, 487 (59.8%) reported using traditional eye medicine, mainly for combinations of symptoms of ocular redness, irritation, and eye discharge (95.5%). Besides, 604 (74.2%) participants reported self-treatment with tetracycline 1% eye ointment. Older age, females, low income, no formal education, and lack of access to media were risks for utilizing traditional eye medicine.

CONCLUSION

The use of traditional eye medicine and self-treatment are common in this population. Regulatory legislation, public awareness, and making eye care are vital activities required to monitor such practices.

Traditional eye medicine practice and its determinant factors among ophthalmic patients in the West Bank

Background

Traditional eye medicine (TEM) is becoming more widely used across the world. Depending on the drugs used, TEM usage can be considered harmful or innocuous. The therapy may induce infection or irreparable blindness in the already injured eye.The aim of the study was to determine the proportion of traditional eye medicine practices and associated factors among adult ophthalmic patients attending ophthalmic clinics in the governmental hospitals in the West Bank.

Design and methods

A cross-sectional study conducted on 300 patients. The data was collected using a structured, self-administered questionnaire.

Results

The results of the study revealed that 65.7% of people use TEM. The most common symptoms that necessitated the use of traditional eye practice were inflammatory symptoms of the eye (49.2%), blurred vision (15.7%), and allergic conjunctivitis (10.7%). The most common TEM used was tea (34.0%), followed by herbal products (25.4%) and vegetable slices (potato, cucumber, and onion) (14.7%). The most traditional eye treatment was the topical route (92.9%). The majority of prescribers of traditional eye practice were traditional healers (48.7%). Furthermore, the current study found that occupation and the income were predictors of using traditional eye practice among ophthalmic patients attending ophthalmic clinics in selected West Bank hospitals.

Conclusion

The proportion of traditional eye medicine practice was high among ophthalmic patients in the West Bank. The predictors of using traditional eye treatment were occupation and the income. The most common TEM used was tea, followed by herbal products and vegetable slices (potato, cucumber, and onion).

Medicinal Plants Used for Eye Conditions in Mexico-A Review

Medicinal plants have been historically significant for treating common human diseases in Mexico. Although some ethnobotanical research exists, limited ethnomedicinal data has documented medicinal plants employed for eye health. This review focuses on ethnomedicinal information and preclinical and clinical studies regarding medicinal plants used in Mexico for treating symptoms associated with eye conditions. An electronic database search was conducted by consulting scientific articles, books about Mexican herbal medicine, and academic theses. This work recorded 69 plant species belonging to 26 plant families, especially plants from the Crassulaceae family, which are used as remedies for irritation and infections in the eye. Eight of these medicinal plants have been the subject of preclinical studies using ocular models, and one medicinal plant has been tested in clinical trials. The evidence of pharmacological effects indicates the promising therapeutic potential of these medicinal plants for developing new treatments for eye conditions. However, toxicological studies are necessary to ensure safe application to the eye, particularly as traditional medicine continues to be relied upon worldwide. In addition, this review highlights the need to perform ethnobotanical and phytochemical studies in Mexico regarding the medicinal flora used as remedies for eye conditions.

Ocular complications and associated factors among traditional eye medicines users attending the eye clinic at Mulago national referral hospital, Uganda

Background

Over the past decades there has been a phenomenal increase in the use of Traditional Eye medicines (TEM) worldwide and there are several factors that compel patients to use TEM.

Objectives

We conducted a study to determine the types of traditional eye medicine, ocular complications, and associated factors among traditional eye medicine users at the Mulago National Referral Hospital (MNRH) eye clinic.

Methods and Materials

A hospital-based cross-sectional study among TEM users at MNRH eye clinic from June to August 2021. Epi Data version 4.2 and STATA version 15 used for analysis. A modified Poisson regression with robust standard errors was used to determine the associated factors.

Results

Overall, 182 TEM users (males:53.3%) were enrolled, with a mean age of 36±21SD years. The most frequently used type of TEM were plant products (47.8%). 70% of TEM users had ocular complications, the most frequent manifestation was conjunctivitis (53.9%). Ocular complications were significantly associated with living in the urban areas (p< 0.006) and participants who reported ease and availability of TEM (p < 0.001).

Conclusion

Plant-based products were the most frequently used types of TEM, a large proportion of the TEM users were found with sight-threatening ocular complications.

Barriers to Accessing Eye Health Services in Suburban Communities in Nampula, Mozambique

Globally, an estimated 2.2 billion people are visually impaired (VI) or blind, and a large proportion (90%) of those affected live in low- and middle-income countries (LMICs), where access to eye health services is limited. This study aimed to identify barriers to accessing eye health services and associated factors in suburban communities of Nampula. A cross-sectional community-based study was carried out on adults ≥18 years old. A total of 338 adults were randomly selected from three communities (Muthita, Piloto, and Nthotta). Individual interviews were carried out and socio-demographic data, eye symptoms, date of last eye examination, and barriers to access to eye health services were extracted. Among participants, 49.4% had eye symptoms and 41.7% did not have their eye examinations up to date. The most cited barriers were crowding in hospitals (40.7%), financial difficulties (30.0%), self-medication (20.5%), traditional treatment (17.8%), and buying eyeglasses on the street (11.6%). Barriers limited the service target to 33%. Lower levels of schooling and monthly family income and farmer occupation were statistically associated with the most barriers as risk factors. The use of eye health services was lower due to barriers to accessing eye services. More specific intervention plans and greater cooperation between sectors are needed to improve these indicators.

Assessment of Ocular Surface Disease in Glaucoma Patients in Ghana

PRECIS

Dry eye disease (DED) observed in this study is associated with ocular surface abnormalities as shown by specific dry eye tests. Changes in tear quality may be responsible for dry eye symptoms among the participants.

PURPOSE

This study sought to evaluate DED in glaucoma patients in Ghana.

MATERIALS AND METHODS

This was a hospital-based descriptive cross-sectional study involving glaucoma patients on topical glaucoma treatment for at least 6 months. The medical records of participants were thoroughly reviewed for information on demographics, ocular history, medical history, number of topical antiglaucoma medications used within the last 6 months, and any other ophthalmic medications used by the participants. An Ocular Surface Disease Index (OSDI) questionnaire was administered to each participant, after which Schirmer test and tear break-up time (TBUT) were performed on each participant in a controlled environment.

RESULTS

A total of 100 individuals participated in the study. The mean±SD age of participants was 60.44±14.05 years. The majority (60.0%) of the participants were females and 55.0% of participants used 2 or more topical antiglaucoma medication. Of the participants, 81.0% reported subjective dry eye symptoms. Schirmer test and TBUT showed that 55.0% and 87.0% of the participants had decreased tear production and abnormal tear quality, respectively. Multiple logistic regression showed a significant association between age and abnormal OSDI (P=0.037), Schirmer test (P=0.003), and TBUT (P=0.042); the number of topical glaucoma medications and OSDI (P=0.016) and Schirmer test (P=0.009). The prevalence of DED was 23.0%. Increasing age was associated with an ∼7 times higher odds of having DED (P=0.0019), using >2 glaucoma medications with ∼4.5 times higher odds of having DED (P=0.001), 5 or more years of glaucoma medication use with ∼4 times higher odds of DED (P=0.009), and both benzalkonium chloride and sodium chlorite as preservative was associated with ∼3.5 times higher odds of DED (P=0.047).

CONCLUSION

DED is prevalent among glaucoma patients in Ghana and is associated with age, duration of glaucoma medication, type of preservatives, and number of topical glaucoma medications.

The Proportion of Complementary and Alternative Medicine Utilization Among Saudi Population for Eye Care: Cross-Sectional Study

Purpose

To estimate the prevalence, determinants and perceived benefit of complementary and alternative medicine (CAM) use for ophthalmic purposes among the Saudi population.

Methods

A cross-sectional study was carried out in 2019 targeting visitors of King Khaled Eye Specialist Hospital (KKESH), Riyadh, Saudi Arabia. The survey had 18 questions in Arabic regarding the use of CAM for eye ailments. The magnitude was associated to the demographic and eye-related factors.

Results

We interviewed 999 participants. The prevalence of CAM usage was 21.9% (95% confidence interval 19.3; 24.5). Castor oil (49.3%), antimony (khohl alethmed) (40.6%), chamomile (19.6%), and green tea leaves (11.4%) were the most common medications used. Other traditional eye treatments included eye vitamins, faith healing (prayer, reciting Quran, Zamzam water), cautery, cupping, and acupuncture.

Conclusions

One in five Saudi eye patients used CAM. The factors governing this health behavior should be studied to change this practice pattern.

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

Background

The WHO estimates that a considerable number of people in Sub-Saharan Africa (SSA) rely on traditional, complementary and alternative medicine (TCAM) to meet their primary healthcare needs, yet there remains a dearth of research evidence on the overall picture of TCAM utilisation in the region.

Methods

We conducted a literature search of original articles examining TCAM use in SSA between 1 January 2006 and 28 February 2017, employing Medline, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Scopus, ProQuest, PubMed, Embase and African Journals Online databases. A critical appraisal of relevant articles reporting a quantitative or mixed-method design was undertaken.

Results

Despite the heterogeneity and general low quality of the identified literature, the review highlights a relatively high use of TCAM alone or in combination with orthodox medicine, in both general population and in specific health conditions in SSA. TCAM users compared with non-TCAM users are more likely to be of low socioeconomic and educational status, while there were inconsistencies in age, sex, spatial location and religious affiliation between TCAM users and non-TCAM users. Most TCAM users (55.8%–100%) in SSA fail to disclose TCAM use to their healthcare providers, with the main reasons for non-disclosure being fear of receiving improper care, healthcare providers’ negative attitude and a lack of enquiry about TCAM use from healthcare providers.

Conclusion

TCAM use in SSA is significant, although most studies emerge from a few countries. Factors associated with TCAM use in SSA are similar to those observed in other regions, but further research may be required to further elucidate challenges and opportunities related to TCAM use specific to SSA.

Use of traditional eye medicine and self-medication in rural India: A population-based study

OBJECTIVE

To determine the type and nature of traditional eye medicine (TEM), their sources and use and practices related to self-medication for ophthalmic diseases in a rural Indian population.

METHODS

A population-based, cross-sectional study was conducted in 25 randomly selected clusters of Rural Gurgaon, Haryana, India as part of CORE (Cornea Opacity Rural Epidemiological) study. In addition to comprehensive ophthalmic examination, health-seeking behavior and use of self-medication and TEM was assessed in the adult population using a semi-structured questionnaire. Physical verification of available ophthalmic medications in the enumerated households was conducted by the study team. Descriptive statistics were computed along with multivariable logistic regression analysis to determine associated factors for use of self-medication and TEM.

RESULTS

Of the 2160 participants interviewed, 396 (18.2%) reported using ophthalmic medications without consulting an ophthalmologist, mainly for symptoms like watering (37.1%), redness (27.7%), itching (19.2%) and infection (13.6%). On physical verification of available eye drops that were being used without prescription, 26.4% participants were practicing self-medication. Steroid, expired/unlabeled and indigenous eye drops were being used by 151(26.5%), 120(21.1%) and 75 (13.2%) participants respectively. Additionally, 25.7% (529) participants resorted to home remedies like 'kajal'(61.4%), honey (31.4%), ghee (11.7%) and rose water (9.1%).

CONCLUSION

Use of TEM is prevalent in this population. The rampant use of steroid eye drops without prescription along with use of expired or unlabelled eye drops warrants greater emphasis on safe eye care practices in this population. Public awareness and regulatory legislations must be implemented to decrease harmful effects arising due to such practices.

Ethnomedical survey and safety evaluation of traditional eye medicines used in Misungwi district, Tanzania

Aim:

This study aimed at documenting products used as traditional eye medicine (TEM) in Misungwi district, Tanzania, and performing preliminary analysis on safety status.

Methodology:

Ethnomedical study was conducted in Misungwi district. Information was sourced by face-to-face interview with traditional healers, traditional medicine vendors, and knowledgeable people guided by a well-structured questionnaire. Safety was evaluated by determining pH using pH meter and mineral analysis using the Delta, Portable X-ray fluorescence equipment, and qualitative chemical tests.

Results:

A total of 23 TEM products were recorded from botanical (79%) and zoological (21%) sources including animal excreta. Liquid preparation ranked highest among dosage forms. Safety evaluation showed that only one product possessed the pH value of 7.4 as recommended for topical ophthalmic medicines. Fourteen minerals were detected and quantified in three samples; some of these minerals are known for their negative effects to the eyes, of medical interest is strontium used for the management of benign eye tumors. Information providers were unaware of health risks associated with the use of TEM.

Conclusion:

This study has revealed the common use of TEM in Misungwi district. The majority of the products are from the botanical source. Although literature provides supporting data for the application to some of the recorded TEM, safety evaluation by pH and mineral analysis in this study have indicated possible ophthalmological medical problems that could result from using such products. Extensive scientific studies including animal experiments and identification of bioactive compounds are essential to develop safe TEMs.

DETERMINANTS OF THE USE OF TRADITIONAL EYE MEDICATION IN A SEMI-URBAN COMMUNITY IN SOUTHERN NIGERIA

BACKGROUND

The use of traditional eye medication is still practised in some communities in Nigeria.

AIM

To assess the determinants of the use of traditional eye medication (TEM) by adults in Ekiadolor community.

METHOD

A descriptive cross-sectional study on the determinants of the use of traditional eye medication among adults was done between the months of September and November 2011 in Ekiadolor community in Edo state, Nigeria.

RESULTS

Out of the 430 participants in this study, 57.2% were females and 42.8% males. Majority of the respondents (92.1%) knew about TEM. The prevalence of the use of TEM was 48.7%. Affordability (21.8%) was the main reason for the use of TEM. The male gender, persons of low socio economic class and people that lacked formal education were more likely to use TEM (p=0.001).

CONCLUSION

The determinants of the use of traditional eye medication in this community are affordability, low socio economic status and lack of formal education. Formal education is of great importance, as this will go a long way in addressing the issues directly relating to the use of traditional eye medication in our communities.

Ocular injuries and eye care seeking patterns following injuries among cocoa farmers in Ghana

BACKGROUND

The work environment of cocoa farmers exposes them to several ocular hazards that predispose them to eye diseases and injuries. However, the extent of ocular injuries and health seeking patterns following these injuries are unknown among cocoa farmers in Ghana.

OBJECTIVES

To determine the prevalence of ocular injuries and health seeking behaviour following injury among cocoa farmers in Ghana.

METHODS

Five hundred and fifty six participants were recruited through simple random sampling using a multistage approach from four cocoa growing districts in Ghana. A structured questionnaire was used to collect relevant information such as demography, ocular hazards and injuries experienced. An ocular examination was also conducted to assess the eye health of the participants. Descriptive and regression statistics were used to analyze the data. The rate of ocular injuries was calculated by using the number of injuries reported that resulted in lost work time/days divided by the number of worker years at risk of injury (sum of years worked in cocoa farms for all the participants).

RESULTS

The rate of ocular injuries was 11.3/1000 worker years (95% CI: 9.4 - 31) which led to lost work time of 37.3/1000 worker years (95% CI: 34.1 - 40.8). The major causes of ocular injury were plants/branches (n=73, 51.1%), chemicals (n=27, 18.9%), cocoa pod/husk (n=14, 9.8%) and occurred mostly during weeding, harvesting and chemical spraying. Few (n=34, 6.1%) participants reported the use of ocular protection. Fifty-five (38.5%) participants visited the local chemical shops, while 37 (25.9%) visited hospitals/clinics for ocular treatment of their injuries.

CONCLUSION

There is a high rate of ocular injuries among cocoa farmers who make insufficient use of appropriate eye care services. There is the need for eye health education among cocoa farmers in Ghana.

Prevalence of harmful/traditional medication use in traumatic eye injury

Aim:

Ocular trauma of varying aetiologies do occur frequently, however when different traditional/harmful substances are applied before presentation in the hospital, prognosis in terms of visual outcome following treatment may be worse than expected. This study is aimed at determining the prevalence of harmful/traditional eye medication practices among patients with traumatic eye injury in a tertiary institution.

Study Design/Setting:

It is a retrospective study of patients seen at the eye clinic of the Ekiti State University Teaching Hospital (a state government owned hospital), Ado Ekiti, from January to December 2009.

Method:

A review of case notes (medical records) of patients with history of ocular trauma both open and closed globe injury and who presented to the eye clinic of the Ekiti State University Teaching Hospital, Ado Ekiti from January to December 2009 was carried out. Demographic data of the patients, nature of the ocular trauma, substances applied to the eyes, visual acuity at presentation and after treatment were extracted. Frequencies and percentages were used in analysing the data.

Result:

A total of 1420 new patients attended the eye clinic during the study period (January to December 2009). Forty eight (3.4%) applied various substances into their eyes after sustaining ocular injury. Substances applied include Kerosene 25%, cassava water 20.8%, breast milk 12.5%, personal urine 10.8%, and cow urine 8.3%. Nearly half of the patients 23 (47.9%) presented with low vision and after treatment there was no visual improvement in almost all of them, 22 (45.8%). The period before presentation ranges between 1hr -2weeks post injury. However, the number of monocular blindness reduced from 8 (16.7%) to 5 (10.4%) after treatment.

Conclusion:

Kerosene and Cassava water were the common substances applied to the injured eye. The use of these harmful and traditional eye medications on injured eyes can reduce further the visual prognosis despite ophthalmic intervention.