Global Prevalence and Clinical Consequences of Traditional Eye Medicine: A Descriptive Review.

BACKGROUND: Traditional eye medicine (TEM) is widely used in low- to middle-income countries as an accessible, affordable, and culturally accepted approach to eye care. Despite its prevalence, persons using TEM commonly present for formal late for eye care after the onset of significant ocular complications. PURPOSE: To synthesize evidence on global TEM utilization, perceptions, determinants, types, administration methods, and associated ocular complications. METHODS: Google Scholar, ScienceDirect, Scopus, PubMed and grey literature up to September 2025 were used to conduct a comprehensive literature search. Studies reporting on TEM use, perceptions, determinants, remedies, administration, and ocular outcomes were included. Fifty-seven studies met inclusion criteria following systematic screening. RESULTS: TEM prevalence varied widely, from 4.3% in Nigeria to 80% in Ethiopia, with other regions reporting rates of 36-65.7%. TEM was used to manage redness, itching, tearing, pain, poor vision, cataracts, and glaucoma. Remedies included plant extracts, honey, rosewater, milk, salts, animal products, and ritualistic substances, administered topically, orally, dermally, nasally, auricularly, or in combination. Determinants of use include accessibility, affordability, cultural beliefs, family influence, rural residence, and dissatisfaction with modern medicine. Perceptions were generally positive, particularly among older adults and communities with active traditional healers (THs). TEM use was frequently linked to ocular complications such as conjunctivitis, corneal ulcers, microbial keratitis, uveitis, staphyloma, panophthalmitis, and blindness. TEM users often presented later to eye care facilities, resulting in poorer visual outcomes compared to non-users. CONCLUSION: TEM remains a culturally entrenched and widely used form of eye care but carries substantial risks of ocular morbidity and vision loss. Reducing harmful outcomes requires strengthening access to formal eye care, educating communities, and engaging THs to promote safe practices.