Use of traditional eye medicine

Worldwide, the last two decades have witnessed a
phenomenal increase in the use of traditional eye
medicine, although, that till date, there is no
sound scientific evidence to justify their
effectiveness in treating eye diseases.
Various surveys on traditional eye medicine
have documented varying popularity of
traditional eye medicine use, and
established that its use cuts across diverse
ages, gender, educational status, occupation
and socio-economic status.
Traditional eye medicines are a form of
biologically-based therapies or practices
that are instilled or applied to the eye or
administered orally to achieve a desired
therapeutic effect in eye.
Its patronage has been variously attributed
to ignorance, barriers to accessing primary
eye care services, preference, failure of
conventional treatment, desire to take
control over medical treatment,
communication gap between patients and
orthodox eye care providers, and influence
of friends and relations.
Even in Nigeria, a study correlates the
tendency (TEMP) of many people to use
traditional eye medicines in persons coming
newly to eye clinic of the University of
Nigeria Teaching Hospital (UNTH), Enugu,
between August 2004 and July 2006. This is
a tertiary eye care centre in South-East
Nigeria.
The study carried out by Boniface Ikenna
Eze, Chimdi Memnofu Chuka-Okosa and
Judith Nkechi Uche, all from the Department
of Ophthalmology, UNTH, Enugu, had 2,542
participants. Of the studied population, 149
had used traditional eye medicine for their
current eye disease before reporting to the
eye clinic. In more than half of all the cases,
some chemical substances had been
previously applied before reporting to the
hospital. Others had also applied plant
products (37.7 per cent), and animal
products (4.7 per cent).
The researchers found that the usage of
these traditional eye medicines were on
account of vision loss in one out of two eye
problems; itchy eyes in one out of four
cases and eye discharges in some cases(3.8
per cent). Reported efficacy from previous
users (67.1 per cent) and belief in potency
(28.2 per cent) were the main reasons for
their use.
Meanwhile, civil servants (20.1 per cent),
farmers (17.7 per cent), and traders (14.1
per cent) were the leading users of these
eye medicines, according to the report in a
2009 issue of BMC Complementary and
Alternative Medicine.
The study found that at presentation,
majority of TEM users had stopped the use
of TEM. Of these, unsatisfactory response to
TEM therapy (71, 59.1 per cent), worsening
of eye condition (40, 33.3 per cent), and
advice from others (6, 5.0 per cent) were
the main reasons for abandonment of TEM
use. Of the TEM users, 34(23.0 per cent)
were blind (best corrected distant visual
acuity less than 3/60 in the better eye) at
presentation.
Although the incidence of TEM use observed
in this study was small when compared
with that reported in such countries as
India, the Democratic Republic of Congo and
Tanzania, but the rate was however higher
than 1.72 per cent previously reported in
Nigeria. The variations in the rates may be
attributed to the differences in the study
settings, populations, and the specific use of
TEM for the eye diseases.
They wrote:”Rural residence imposes both
geographic and economic barriers to access
eye care services, which at present in
Nigeria, are concentrated in urban areas;
this leaves the rural dwellers with no other
alternative eye care provider except the
traditional medical practitioners, who reside
with them in the rural areas. The higher
tendency to use TEM among rural dwellers,
which this study has established, implies
either rural non-availability or reduced
uptake of available promotive and
preventive eye care services in the rural
areas.”
Although the traditional medical practitioner
is the originator of TEM therapy, they
pointed out that societal input plays a
crucial role in the perpetuation of the
practice,given that reported therapeutic
benefit from other TEM users and patients’
belief in the potency of TEM contributed
more to the decision to use TEM than cost
and awareness barriers to access orthodox
eye care.
Contrarily, preference and proximity, and
absence of side effects and low cost, have
been previously reported as overriding
reasons for using TEM.
Although the present survey did not
document any adverse effect of TEM, the
possibility of their use constituting a great
hazard to the eye even though there are
probably some definite therapeutic benefits
inherent in their use, they affirmed,
suggested that products used as TEM should
be subjected to further research to isolate,
purify, and determine their active contents
for possible use in allopathic medicine.
Meanwhile, the authors suggested
strengthening of promotive and preventive
eye care programmes, even distribution of
eye care resources, active and continuous
collaboration with traditional medical
practitioners, and intensification of
pharmacological research efforts, to
establish the efficacy or otherwise of the
“supposedly potent” TEMs.