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Herbal, nutritional supplements linked to ocular side effects

ke years to disappear. Visual changes from this nutritional supplement are related to retinal abnormalities detected with visual field testing and electroretinography (a test of retinal function).

Jimson Weed is the most common member of the genus Datura. The dried leaves of this flower are used to treat eye inflammation as well as asthma, bronchitis, influenza and coughs. Fraunfelder found several instances of mydriasis, a prolonged dilation of the pupil.

Niacin can cause some of the most severe ocular reactions of all the products reviewed. Its cholesterol-lowering effects have proved successful in treating cardiovascular and cerebrovascular disease. It also is used for treatment of schizophrenia, diabetes, arthritis, hypertension, sexual dysfunction and migraine headaches. A comprehensive review of ocular side effects from niacin indicates a possible association with decreased vision, cystoid macular edema (CME), dry eyes, discoloration of the eyelids, eyelid edema and loss of eyebrows and eyelashes, among others. The ocular side effects appear to be dose related, but some instances would require discontinuation of niacin therapy.

Vitamin A is used primarily as an oral dietary supplement for vitamin A deficiency and for treatment of acne. Fraunfelder found reports linking high doses of vitamin A to cases of intracranial hypertension. In the majority of cases this condition resolves when vitamin A is discontinued.

Many herbal medicines interact with prescription medicines, and if the treating physician doesn't know what a patient is taking, it can be detrimental. For example, a patient taking ginkgo biloba plus aspirin or a nonsteroidal anti-inflammatory medication such as ibuprofen, may thin the blood too much, leading to ocular hemorrhage or even intracranial hemorrhage.

"Herbal medicines and nutritional supplements are being used without strong evidence of efficacy or safety. Ocu
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Contact: Liana Haywood
haywoodl@ohsu.edu
503 494-4530
Oregon Health & Science University
14-Oct-2004


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