Traditional Eye Remedies and Ocular Complications in Sub-Saharan Africa: A Systematic Review.

Traditional eye medicine (TEM) refers to substances or practices used outside conventional ophthalmic care to treat eye conditions, including plant extracts, animal products, oils, breast milk, and locally prepared mixtures applied directly to the eye. In Sub-Saharan Africa, TEM remains widely used due to cultural beliefs, limited access to formal eye care, and reliance on traditional healers, with reported prevalence ranging from 5.9% to 82.3%. This systematic review evaluates the prevalence, types, and ocular outcomes associated with TEM use in Sub-Saharan Africa. The review was conducted in accordance with PRISMA 2020 guidelines. Databases searched included PubMed, Scopus, Web of Science, Cochrane Library, and African Journals Online, with supplementary grey literature identified through Google Scholar. Studies were included if they examined TEM use in human populations within Sub-Saharan Africa and reported clinical outcomes or complications. Methodological quality was assessed using the Newcastle-Ottawa Scale and a structured epidemiological framework. Twelve studies across five countries were included. Plant-based remedies were the most frequently reported, followed by chemical substances, breast milk, and honey. TEM use was consistently associated with delayed hospital presentation, increased disease severity at admission, and a higher burden of corneal complications. Reported outcomes included corneal ulceration, corneal opacity, endophthalmitis, panophthalmitis, and irreversible vision loss. TEM remains a significant contributor to preventable ocular morbidity in Sub-Saharan Africa. Addressing this requires community education on the risks of unregulated eye treatments, improved access to ophthalmic care, and collaboration with traditional healers to promote timely referral.