Exploring Herbal Alternatives for Conjunctivitis Management: Opportunities and Challenges
Abstract
The eyes, vital sensory organs, are particularly vulnerable to various ophthalmic conditions. Conjunctivitis, or “pink eye”, is one such condition characterized by inflammation and redness of the conjunctival mucosa, caused by both infectious and non-infectious agents. Affecting approximately 6 million people annually in the United States alone, its highly contagious nature presents a public health concern. Current treatments, predominantly synthetic drugs, often result in undesirable side effects. In response, there is growing interest in exploring herbal remedies as safer alternatives. Medicinal plants, rich in bioactive compounds such as alkaloids, glycosides, and terpenoids, show potential in managing conjunctivitis. Specific herbs, including Euphrasia officinalis L. (eyebright), Matricaria chamomilla L. (chamomile), and Aloe vera (L.) Burm.f., have demonstrated promising results in in vitro and animal studies by mitigating mast cell degranulation and modulating key inflammatory pathways. This review aims to delve into the efficacy, safety, and mechanisms of action of these and other herbal treatments for conjunctivitis, offering a focused evaluation of their therapeutic potential.
Azari AA, Barney NP. Conjunctivitis. JAMA 2013;310:1721-1729.
Azari AA, Arabi A, Conjunctivitis: a systematic review, J Ophthalmic Vis Res 2020;15:372-395.
Morrow GL, Abbott RL, Conjunctivitis, american family physician 1998;57:735-746.
Alfonso SA, Fawley JD, Conjunctivitis., primary care 2015;42:325-345.
Rietveld RP, van Weert HC, ter Riet G, BindelsPJ. Diagnostic impact of signs and symptoms in acute infectious conjunctivitis: systematic literature search, BMJ 2003;327:789.
Bielory L. Allergic conjunctivitis and the impact of allergic rhinitis. Curr Allergy Asthma Rep 2010;10:122-134.
Nichols BA. Conjunctiva. Microsc Res Tech 1996;33:296-319.
Shumway CL, Motlagh M, Wade M, Anatomy, head and neck, eye conjunctiva, in: statpearls, statpearls publishing. Treasure Island 2023.
Gipson IK, Stepp MA, Anatomy and cell biology of the cornea, Superficial Limbus, and Conjunctiva, in: D.M. Albert, J.W. Miller, D.T. Azar, L.H. Young (Eds.), Albert and Jakobiec’s Principles and Practice of Ophthalmology, Springer International Publishing, Cham 2022; pp 3-30.
Messmer EM, Mackert MJ, Zapp DM, Kampik A. In vivo confocal microscopy of normal conjunctiva and conjunctivitis. Cornea 2006;25:781-788.
Abelson M, Shetty S, Korchak M, Butrus SI, Smith LM. Advances in pharmacotherapy for allergic conjunctivitis. Expert Opin Pharmacother 2015;16:1219-1231.
Abokyi S, Koffuor GA, Abu EK, Kyei S, Abraham CH. Dry eyes: an adverse effect of systemic antihistamine use in allergic conjunctivitis management. Res J Pharmacol 2012;6:71-77.
Buckley RJ, Kirkness CM, Kanski JJ, Ridgway AE, Tullo AB, et al. Is it time to stop using chloramphenicol on the eye? Safe in patients with no history of blood dyscrasia. BMJ 1995;311:450-451.
Bispo PJM, Sahm DF, Asbell PA. A systematic review of multi-decade antibiotic resistance data for ocular bacterial pathogens in the United States. Ophthalmol Ther 2022;11:503-520.
Bertino Jr JS. Impact of antibiotic resistance in the management of ocular infections: the role of current and future antibiotics. Clin Ophthalmol 2009;3:507-521.
Senthil S, Thakur M, Rao HL, Mohamed A, Jonnadula GB, et al. Steroid-induced glaucoma and blindness in vernal keratoconjunctivitis. Br J Ophthalmol 2020;104:265-269.
Sthapit PR, Tuladhar NR. Conjunctival flora of normal human eye. JSMOphthalmol 2014;2:1021.
Perkins RE, Kundsin RB, Pratt MV, Abrahamsen I, Leibowitz HM. Bacteriology of normal and infected conjunctiva. J Clin Microbiol 1975;1:147-149.
Abokyi S, Kyei S, Koffuor GA, Abu EK, Abraham CH. Bacterial conjunctivitis (pink eye): practice essentials, background, pathophysiology. Res J Pharmacol 2023.
Bhat A, Jhanji V. Bacterial conjunctivitis. In: Das S, Jhanji V, editors. Infections of the cornea and conjunctiva. Springer 2021; pp 1-16.
Epling J. Bacterial conjunctivitis. BMJ Clin Evid 2012;2012:0704.
Hovding G. Acute bacterial conjunctivitis. Acta Ophthalmol 2008;86:5-17.
Lacy HM, Bowlin AK, Hennings L, Scurlock AM, Nagarajan UM, et al. Essential role for neutrophils in pathogenesis and adaptive immunity in *Chlamydia caviae* ocular infections. Infect Immun 2011;79:1889-1897.
Tarabishy AB, Jeng BH. Bacterial conjunctivitis: a review for internists. Cleve Clin J Med 2008;75:507-512.
Tang S, Li M, Chen H, Ping G, Zhang C, et al. A chronological study of the bacterial pathogen changes in acute neonatal bacterial conjunctivitis in southern China. BMC Ophthalmol 2017;17:174.
Sandström KI, Bell TA, Chandler JW, Kuo C-C, Wang S-P, et al. Microbial causes of neonatal conjunctivitis. J Pediatr 1984;105:706-711.
Mallika PS, Asok T, Faisal HA, Aziz S, Tan AK, et al. Neonatal conjunctivitis—a review. Malays Fam Physician 2008;3:77.
Buznach N, Dagan R, Greenberg D. Clinical and bacterial characteristics of acute bacterial conjunctivitis in children in the antibiotic resistance era. Pediatr Infect Dis J 2005;24:823-828.
Patel PB, Diaz MC, Bennett JE, Attia MW. Clinical features of bacterial conjunctivitis in children. Acad Emerg Med 2007;14:1-5.
Crum NF, Barrozo CP, Chapman FA, Ryan MAK, Russell KL. An outbreak of conjunctivitis due to a novel unencapsulated Streptococcus pneumoniae among military trainees. Clin Infect Dis 2004;39:1148-1154.
Bodor FF. Conjunctivitis-otitis syndrome. Pediatrics 1982;69:695-698.
Singer TR, Isenberg SJ, Apt L. Conjunctival anaerobic and aerobic bacterial flora in paediatric versus adult subjects. Br J Ophthalmol 1988;72:448-451.
Al-Eryani S, Al-Rafiq A, Yahya E, Al-Shamahy H. Bacterial conjunctivitis of adults: causes and ophthalmic antibiotic resistance patterns for the common bacterial isolates. Univ J Pharm Res 2021;6:25-28.
Kato T, Hayasaka S. Methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococci from conjunctivas of preoperative patients. Jpn J Ophthalmol 1998;42:461-465.
Kluytmans J, van Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 1997;10:505-520.
Mondal S, Gupta I, Nandi A, Mitra G. A study on bacteriological profile of conjunctivitis patients attending in a peripheral tertiary medical college of west bengal. J Adv Med Dent Scie Res 2016;4:5.
DeCory HH, Sanfilippo CM, Proskin HM, Blondeau JM. Characterization of baseline polybacterial versus monobacterial infections in three randomized controlled bacterial conjunctivitis trials and microbial interactions with besifloxacin ophthalmic suspension 0.6%. PLOS ONE 2020;15:e0237603.
Blondeau JM, Proskin HM, Sanfilippo CM, DeCory HH. Characterization of polybacterial versus monobacterial conjunctivitis infections in pediatric subjects across multiple studies and microbiological outcomes with besifloxacin ophthalmic suspension 0.6%. Ophthalmol Ther 2022;15:4419-4430.
Muto T, Imaizumi S, Kamoi K. Viral conjunctivitis. Viruses 2023;15:676.
Garcia-Zalisnak D, Rapuano CJ, Sheppard JD, Davis AR. Adenovirus ocular infections: prevalence, pathology, pitfalls, and practical pointers. Eye Contact Lens 2018;44:S1-S7.
Higgins PG. Adenovirus type 8 conjunctivitis and epidemic keratoconjunctivitis. Arch Virol 1983;73:91-101.
Li J, Yang L, Lin C, Li W, Yang Y, et al. Etiology of acute conjunctivitis due to coxsackievirus A24 variant, human adenovirus, herpes simplex virus, and chlamydia in Beijing, China. Jpn J Infect Dis 2014;67:349-355.
Yoshida M, Hayasaka S, Yamada S, Yanagisawa S, Hayasaka Y, et al. Ocular findings in Japanese patients with varicella-zoster virus infection. Ophthalmologica 2005;219:272-275.
Toker MI, Erdem H, Erdogan H, Arici MK, Topalkara A, et al. The effects of topical ketorolac and fluorometholone on measles conjunctivitis: randomized controlled trial. Am J Ophthalmol 2006;141:902-905.
Meyer RF, Sullivan JH. Mumps conjunctivitis. Am J Ophthalmol 1974;78:1022-1024.
Solano D, Fu C, Czyz CN. Viral conjunctivitis. StatPearls Publishing 2019.
Akçay E, Çarhan G, Hondur A, Tufan ZK, Duru N, et al. Molecular identification of viral agents associated with acute conjunctivitis: a prospective controlled study. Braz J Infect Dis 2017;21:391-395.
Boulanger MJ, Lethagneur F, Gosselin SJ, Hong D, Gobeil E, et al. Protein adjuvant for activation of a cellular immune response. J Virol 2002;76:127-135.
Sambursky RP, Fram N, Cohen EJ. The prevalence of adenoviral conjunctivitis at the wills eye hospital emergency room. Optometry 2007;78:236-239.
Sgrulletta R, Bonini S, Lambiase A, Bonini S. Allergy and infections: long-term improvement of vernal keratoconjunctivitis following viral conjunctivitis. Eur J Ophthalmol 2006;16:470-472.
Chodosh J. Eye infections. In: Encyclopedia of Virology. 1999:522.
Bonini S, Sgrulletta R, Coassin M, Bonini S. Allergic conjunctivitis: update on its pathophysiology and perspectives for future treatment. In: Pawankar R, Holgate ST, Rosenwasser LJ, editors. Allergy frontiers: clinical manifestations. Springer Japan, Tokyo 2009; pp 25-48.
Villegas BV, Benítez-del-Castillo JM. Current knowledge in allergic conjunctivitis. Turk J Ophthalmol 2021;51:45-54.
Imtath MM, Raza M, Rasheed E, Arsalan S, Patel S, et al. Chronic kidney disease: the systematic overview. YMER 2023;22:475-498.
La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, et al. Allergic conjunctivitis: a comprehensive review of the literature. Ital J Pediatr 2013;39:18.
Kumar D, Shankar K, Patel S, Gupta A, Varshney S, et al. Gaikwad, Chronic hyperinsulinemia promotes meta-inflammation and extracellular matrix deposition in adipose tissue: Implications of nitric oxide. Mol Cell Endocrinol 2018;477:15-28.
Patel S, Shukla J, Jain S, Paliwal V, Tripathi N, et al, Repositioning of tubocurarine as analgesic and anti-inflammatory agent: Exploring beyond myorelaxant activity. Biochem Pharmacol 2022;205:115248.
Patel S, Sathyanathan V, Salaman SD. Molecular mechanisms underlying cisplatin-induced nephrotoxicity and the potential ameliorative effects of essential oils: A comprehensive review, Tissue Cell 2024;88:102377.
Dupuis P, Prokopich CL, Hynes A, Kim H. A contemporary look at allergic conjunctivitis, Allergy Asthma Clin Immunol 2020;16:5.
Joshi P, Patel S, Paliwal A, Jain S, Verma K, et al, Tinospora cordifolia ameliorates paclitaxel-induced neuropathic pain in albino rats. J Ethnopharmacol 2024;321:117559.
Labib BA, Chigbu DI. Therapeutic targets in allergic conjunctivitis. Pharmaceuticals 2022;15:547.
Stern ME, Siemasko K, Gao J, Duong A, Beauregard C, et al. Role of interferon-γ in a mouse model of allergic conjunctivitis. Invest Ophthalmol Vis Sci 2005;46:3239-3246.
Miyazaki D, Fukagawa K, Okamoto S, Fukushima A, Uchio E,et al. Shimizu, Epidemiological aspects of allergic conjunctivitis. Allergol Int 2020;69:487-495.
Jun J, Bielory L, Raizman MB, Vernal conjunctivitis. Immunol Allergy Clin North Am 2008;28:59-82.
Ghiglioni DG, Zicari AM, Parisi GF, Marchese G, Indolfi C, et al, Vernal keratoconjunctivitis: An update. Eur J Ophthalmol 2021;31:2828-2842.
De Smedt S, Wildner G, Kestelyn P, Vernal keratoconjunctivitis: an update. Br J Ophthalmol 2013;97:9-14.
Hom MM, Bielory L. The anatomical and functional relationship between allergic conjunctivitis and allergic rhinitis. Allergy Rhinol (Providence) 2013;4:0067. https://doi.org/10.2500/ar.2013.4.0067.
Iordache A, Boruga M, Mușat O, Jipa DA, Tătaru CP, et al, Relationship between allergic rhinitis and allergic conjunctivitis (allergic rhinoconjunctivitis) - review. Rom J Ophthalmol 2022;66:8-12.
Rajvaidhya S, Nagori BP, Singh GK, Dubey BK, Desai P, et al. A review on Acacia arabica-an Indian medicinal plant, Int J Pharm Sci Res 2012;3:1995.
Nweze EI, Eze EE. Justification for the use of Ocimum gratissimum L in herbal medicine and its interaction with disc antibiotics. BMC Complement Altern Med 2009;9:37.
Patil MV, Pawar S, Patil DA. Ethnobotany of Butea monosperma (Lam.) Kuntze in North Maharashtra, India 2006;5.
Tominaga T, Kawaguchi K, Kanesaka M, Kawauchi H, Jirillo E, et al, Suppression of type-I allergic responses by oral administration of grape marc fermented with Lactobacillus plantarum. Immunopharmacol Immunotoxicol 2010;32:593-599.
Malik F. Phyto-chemical analysis, anti-allergic and anti-inflammatory activity of Mentha arvensis in animals. Afr J Pharm Pharmacol 2012;6.
Kemper KJ, Calendula (Calendula officinalis), Longwood Herbal Task Force 1999.
Gururani R, Patel S, Yaduvanshi N, Dwivedi J, Paliwal S, et al, Tylophora indica (Burm. f.) merr: An insight into phytochemistry and pharmacology, J Ethnopharmacol 2020;262:113122.
Pandey V, Patel S, Danai P, Yadav G, Kumar A. Phyto-constituents profiling of Prosopis cineraria and in vitro assessment of antioxidant and anti-ulcerogenicity activities, Phytomedicine Plus 2023;3:100452.
Sharma D, Patel S, Verma K, Gudlawar S, Chakraborty D, S. et al. Antibacterial and antidiarrheal activity of Butea Monospermea bark extract against waterborne enterobacter Cloacae in rodents: In-vitro, Ex-vivo and In-Vivo evidences, J Ethnopharmacol 2019;241:112014.
Danai P, Patel S, Pandey V, Singh P, Yadav G, et al, Antiulcerogenic activity of Anogeissus pendula hydroalcoholic extract on pylorus ligated induced gastric ulcers in Albino Wistar rats, Phytomedicine Plus 2021;1:100127.
Bevans N, Alford M, Guanchez F, Aregullin M, Rodriguez E. Preliminary phytochemical study of two Caribbean Malvaceae used in the treatment of conjunctivitis. J Undergrad Study Indep Res 2001;1:20-24.
Kyei S, Koffuor GA, Ramkissoon P, Abokyi S, Owusu-Afriyie O, et al. Possible mechanism of action of the antiallergic effect of an aqueous extract of Heliotropium indicum L. in Ovalbumin-Induced Allergic Conjunctivitis. J Allergy 2015;2015:1-7.
Mocanu AI, Mocanu H, Lupașcu M, Neagu AC, Andreescu M, et al. International Journal of Modern Pharmaceutical Research.
Bakrania AK, Patel SS. Combination treatment for allergic conjunctivitis – Plant derived histidine decarboxylase inhibitor and H1 antihistaminic drug, Exp Eye Res 2015;137:32-38.
Jayaraman S, Variyar EJ. Role of taraxerone isolated from Leucas lavandulifolia, as an immunomodulator. J Ethnopharmacol 2021;278:114307.
Sahoo S, Gouda S, Das S, Pandey M, Bhattacharyay D. In silico analysis of phytochemicals from glycyrrhiza glabra against conjunctivitis. Eur J Med Plants 2020;31:11-16.
Lubis RR, Marlisa, DD. Wahyuni, antibacterial activity of betle leaf (piper betle l.) extract on inhibiting staphylococcus aureus in conjunctivitis patient. Am J Clin Exp Immunol 2020;9:1.
Córdova C, Gutiérrez B, Martínez-García C, Martín R, Gallego-Muñoz P, et al. Oleanolic acid controls allergic and inflammatory responses in experimental allergic conjunctivitis. PLOS ONE 2014;9:e91282.
Abokyi S, Koffuor GA, Ofori EA, Thomford AK, Osei KA. Evaluating the effect of an aqueous extract of Pistia stratiotes Linn (Araceae) on tear secretion and tear film stability in ICR mice. J App Pharm Sci 2014;4:001-005.
Kyei S, Koffuor GA, Ramkissoon P, Abokyi S, Owusu-Afriyie O, et al. Possible mechanism of action of the antiallergic effect of an aqueous extract of Heliotropium indicum L. in ovalbumin-induced allergic conjunctivitis, J Allergy 2015;2015:245370. https://downloads.hindawi.com/archive/2015/245370.pdf (accessed November 28, 2023).
Paduch R, Woźniak A, Niedziela P, Rejdak R. Assessment of eyebright (Euphrasia officinalis L.) extract activity in relation to human corneal cells using in vitro tests. Balkan Med J 2014; 2014:29-36.
Ding Y, Li C, Zhang Y, Ma P, Zhao T, et al, Quercetin as a Lyn kinase inhibitor inhibits IgE-mediated allergic conjunctivitis, Food Chem Toxicol 2020;135:110924.
Magpantay HD, Malaluan IN, Manzano JAH, Quimque MT, Pueblos KR, et al. Macabeo, antibacterial and COX-2 inhibitory tetrahydrobisbenzylisoquinoline alkaloids from the philippine medicinal plant phaeanthus ophthalmicus. Plants 2021;10:462. https://doi.org/10.3390/plants10030462.
Ekenze CJ, Utin SM, Ogundeko TO, Umunnakwe OL, Owunna LC, et al. Explorative in vitro evaluation of the inhibitory effect of Vitellaria paradoxa seed oil extract on Staphylococcal conjunctivitis, Magna Sci Adv Biol Pharm 2022;5:001–007. https://doi.org/10.30574/msabp.2022.5.1.0052.
Hayat K, Asim MR, Nawaz M, Li M, Zhang L, et al, Ameliorative effect of thymoquinone on ovalbumin-induced allergic conjunctivitis in balb/c mice. Curr Eye Res 2011;36:591-598.
Albuquerque RJdM, Leal LKAM, Bandeira MB, Viana GSdB, Rodrigues LV, Chalcones from Myracrodruon urundeuva are efficacious in guinea pig ovalbumin-induced allergic conjunctivitis. Rev Bras Farmacogn 2011;21:953-962.
Al-Ahbabi HH, Al-Ahbab MH, Amer M, Hasson SO, Abed WF, et al. Antimicrobial activity of aloe vera extract on cases of keratoconjunctivitisin sheep (in vivo and invitro study)and compared with penicillin –streptomycin. Basra J Vet Res 2016;15:227-245.
Farsi S, Chaudhry S, Khan A, Gardner J, Ogwo M, et al. Antimicrobial effect of chamomile-containing over-the-counter ear and eye drops. J Investig Med 2024;72:305-311.
Soliman AM, Sim RH, Das S, Mahakkanukrauh P. Therapeutic targeting of inflammatory pathways with emphasis on NLRP3 inflammasomes by natural products: a novel approach for the treatment of inflammatory eye diseases. Curr Med Chem 2022;29:2891-2912.
Terryo M. Hydrastis canadensis as an antiseptic and curative agent in catarrhal and purulent conjunctivitis. U S Med Investig (1875-1887) 1884;19:27.
Markova NV, Batovska DI, Kozuharova EK, Enchev VG, Anti-conjunctivitis effect of fresh juice of xGraptoveria (Crassulaceae): A phytochemical and ethnobotanical study, J Intercult Ethnopharmacol 2014;4:24-28.
Jain S, Sharma S, Paliwal A, Dwivedi J, Paliwal S, et al, Discovery of novel fatty acid amide hydrolase (FAAH) inhibitors as anti-Alzheimer’s agents through pharmacophore-based virtual screening, molecular docking and experimental validation. Med Chem Res 2024;33:136-150.
Gururani R, Patel S, Bisht A, Jain S, Paliwal S, et al, Tylophora indica (Burm. f.) Merr alleviates tracheal smooth muscle hyperresponsiveness in ovalbumin‐induced allergic‐asthma model in guinea‐pigs: Evidences from ex vivo, in silico and in vivo studies. Fundam Clin Pharmacol 2023;37:1153-1169.
Jain S, Bisht A, Verma K, Negi S, Paliwal S, et al. The role of fatty acid amide hydrolase enzyme inhibitors in Alzheimer’s disease. Cell Biochem Funct 2022;40:106-117.
Paliwal S, Tilak A, Sharma J, Dave V, Sharma S, et al. Flurbiprofen loaded ethosomes-transdermal delivery of anti-inflammatory effect in rat model, Lipids Health Dis 2019;18:1-15.
Wagh VD, Deshmukh KH, Wagh KV. Formulation and evaluation of in situ gel drug delivery system of Sesbania grandiflora flower extract for the treatment of bacterial conjunctivitis, J Pharm Sci Res 2012;4:1880.
Namita P, Mukesh R, Vijay KJ. Camellia Sinensis (Green Tea): A Review. 2012.
Yang M, Zhu B, Zhang Y, Yang Q, Amraii SA. Protective properties of AgNPs green-synthesized by Camellia sinensis on ovalbumin-induced allergic conjunctivitis. J Eng Res 2024;12:17-24.
Kumar P, Khokhar A, Dey SR. Evidence from the Use of Herbal Medicines in the Management and Prevention of Common Eye Diseases, in: S.C. Izah, M.C. Ogwu, M. Akram (Eds.), Herbal Medicine Phytochemistry, Springer International Publishing, Cham 2024;pp 763-795.
Muzammil S, Mazhar A, Yeni DK, Andleeb R, Ashraf A, et al. Nanospanlastic as a promising nanovesicle for drug delivery, in: Systems of Nanovesicular Drug Delivery, Elsevier, 2022: pp. 337–352. https://www.sciencedirect.com/science/article/pii/B9780323918640000073 (accessed July 25, 2024).
Ibrahim SRM, Mohamed SGA, Abdallah HM, Mohamed GA. Ethnomedicinal uses, phytochemistry, and pharmacological relevance of Justicia procumbens (Oriental Water Willow) - A promising traditional plant, J Ethnopharmacol 2023;317:116819.
Babu A. Development and evaluation of herbal ointment from justicia procumbens linn. for Inflammation on eye, PhD Thesis, College of Pharmacy, Madras Medical College, Chennai, 2017.
Mohamed KP, Maajitha Begam A, Kandasamy Prabakar P, Christobher C. Blepharis maderaspatensis (L.) hyene ex roth: a review. Int J New Chem 2020;7:125-136.
Jacob J, Aleykutty NA, Harindran J. In vitro evaluation of indigenous formulation of Blepharis maderaspatensis (L.) B. Heyne ex Roth in the treatment of acute conjunctivitis. The Pharma Innovation 2017;6:240-242.
Azari AA, Barney NP. Conjunctivitis: a systematic review of diagnosis and treatment. JAMA 2013;310:1721-1730.
Diao H, She Z, Cao D, Wang Z, Lin Z. Comparison of tacrolimus, fluorometholone, and saline in mild-to-moderate contact lens-induced papillary conjunctivitis. Adv Ther 2012;29:645-653.
Lindquist TD, Lindquist TP. Conjunctivitis: an overview and classification. Cornea 1997:745-868.
Leung AK, Hon KL, Wong AH, Wong AS. Bacterial conjunctivitis in childhood: etiology, clinical manifestations, diagnosis, and management. Recent Patents on Inflammation & Allergy Drug Discovery 2018;12:120-127.
Ashokkumar D. Pharmacognostical investigations on Triphala churnam, Anc Sci Life 2007;26:40-44.
Dhiman KS, Agarwal R, Gopinathan G, Shukla VJ. Optimization of Parisheka kriyakalpa (procedure for closed eye irrigation) 3: A clinical study on acute conjunctivitis with Triphala decoction. Indian J Tradit Knowle 2017;16.
Hirulkar NB, Agrawal M. Antimicrobial activity of rose petals extract against some pathogenic bacteria. Int J Pharm Biol Arch 2010;1:478-484.
Bell L. The Care and Keeping of Sensitive Skin: A Practical Guide to Holistic Skin Care, iUniverse, 2012.
Bilkhu PS, Wolffsohn JS, Naroo SA, Robertson L, Kennedy R. Effectiveness of nonpharmacologic treatments for acute seasonal allergic conjunctivitis. Ophthalmology 2014;121:72-78.
Luo L, Li DQ, Corrales RM, Pflugfelder SC. Hyperosmolar saline is a proinflammatory stress on the mouse ocular surface. Eye Contact Lens 2005;31:186.
Patel S, Gururani R, Jain S, Tripathi N, Paliwal S, et al. Repurposing of digoxin in pain and inflammation: An evidence‐based study. Drug Dev Res 2022;83:1097-1110.
Segal R, Pilote L. Warfarin interaction with Matricaria chamomilla. CMAJ 2006;174:1281-1282.
Kharat M, Du Z, Zhang G, McClements DJ. Physical and chemical stability of curcumin in aqueous solutions and emulsions: impact of ph, temperature, and molecular environment. J Agric Food Chem 2017;65:1525-1532.
Stoss M, Michels C, Peter E, Beutke R, Gorter RW. Prospective cohort trial of euphrasia single-dose eye drops in conjunctivitis. Https://Home.Liebertpub.Com/Acm (2007). https://doi.org/10.1089/acm.2000.6.499.
Grulova D, De Feo V. Euphrasia rostkoviana hayne-active components and biological activity for the treatment of eye disorders, scientific bulletin of the uzhgorod university. Ser Chem 2017;1:5-13.
Siddiqui TA, Zafar S, Iqbal N. Comparative double-blind randomized placebo-controlled clinical trial of a herbal eye drop formulation (Qatoor Ramad) of Unani medicine in conjunctivitis. J Ethnopharmacol 2002;83:13–17.
Comparative double-blind randomized placebo-controlled clinical trial of a herbal eye drop formulation (Qatoor Ramad) of Unani medicine in conjunctivitis - ScienceDirect, (n.d.). https://www.sciencedirect.com/science/article/abs/pii/S0378874102001630 (accessed January 17, 2024).
Salehi A, Jabarzare S, Neurmohamadi M, Kheiri S, Rafieian-Kopaei M. A double blind clinical trial on the efficacy of honey drop in vernal keratoconjunctivitis. Evid Based Complement Alternat Med 2014;2014:e287540.
Purello‐D’Ambrosio F, Gangemi S, Lsola S, La Motta N, Ricciardi L, et al. Sublingual immunotherapy: a double‐blind, placebo‐controlled trial with Parietaria judaica extract standardized in mass units in patients with rhinoconjunctivitis, asthma, or both, Allergy 1999;54:968-973.
Srikanth N, Dua M, Mishra DK. Effect of daruharidra aschyotana in allergic conjunctival inflammation: a clinical study. Aryavaidyan 2004;17:235-240.
Sheppard JDJ, Singh R, McClellan AJ, Weikert MP, Scoper SV, et al. Long-term Supplementation With n-6 and n-3 PUFAs Improves Moderate-to-Severe Keratoconjunctivitis Sicca: A Randomized Double-Blind Clinical Trial. Cornea 2013;32:1297.
Kumar R, Kumar M, Chandra A, Joshi VK. Treatment of Infective Conjunctivitis with Ayurvedic Eye Drops: A Single-Blind, Randomized, Clinical Trial with Levofloxacin Ophthalmic Solution as Control. J Ayurvedic Herb Med 2024;10:37-44.
| Files | ||
| Issue | Vol 10, No 3, 2025 | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/tim.v10i3.19763 | |
| Keywords | ||
| Conjunctivitis Inflammation Medicinal herbs Anti-allergic Efficacy Prevention | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
