Ocular side effects associated with dietary supplements and herbal medicines

Dietary supplements are prevalent worldwide and play a significant role in the treatment of human disease. In the United States, allopathic physicians are at the early stage of learning how to treat patients with natural remedies and other forms of alternative medicine. Elsewhere, however, alternative remedies have been embraced more fully. In Germany, for example, the German Federal Health Agency created Commission E, which has allowed for a more sophisticated approach to assessing the efficacy and safety of dietary supplements and herbal medicines. Health insurance in Germany frequently covers costs for doctor-prescribed herbal remedies. While there is strong evidence that many herbal products have therapeutic effects, there are also a large number of cases of severe adverse reactions due to some of the many thousands of herbal products. One of the first signs of potential toxicity is in the visual system, as in many cases patients notice loss of vision more than systemic side effects. In addition, ophthalmologists are able to detect objective findings through external eye exams and dilated fundus exams. Presented here are some of the more common ocular side effects from frequently prescribed dietary supplements. In most instances, stopping the treatment or decreasing the dose allows for full resolution of symptoms. In addition, comment is made on the regulatory confusion that exists for this industry, especially in the United States.