Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 7 1 2022 03 14 124 134 EN Mustehasan Mustehasan Central Council for Research in Unani Medicine, Janakpuri New Delhi, 110058, India Misbahuddin Azhar Regional Research Institute of Unani Medicine, Shahjahan Manzil, Near AMU Riding Club, Aligarh, 202002, India Sofia Naushin Central Council for Research in Unani Medicine, Janakpuri New Delhi, 110058, India Mohd Urooj National Research Institute of Unani Medicine for Skin Disorders, Hyderabad, 500038, India Gulam Mohammed Husain National Research Institute of Unani Medicine for Skin Disorders, Hyderabad, 500038, India 2021 06 18 2021 09 17 The ultra-fine powder of Sang-e-Surma (Surma Stone), also known as Kohl, is used for various eye ailments either alone or in combination with other herbal or mineral ingredients. The earliest use of Surma is reported in Egypt about 3100 BC. Data from a number of studies conducted on Sang-e-Surma using modern analytical techniques have cleared the uncertainty that Surma stone is mainly composed of lead sulphide. Surma is reported to be used for impaired eye-sight, ophthalmia, cataract, itching, redness, irritation, watering of eyes, shedding of eyelashes and in the initial stage of cataract. The use of lead based Surma is discouraged owing to reports of lead toxicity though the sun glare protection and antimicrobial effects of Surma have been established. Reports on lead toxicity by the application of Surma in eyes are conflicting. Appropriately planned studies are warranted to elaborate the toxic effects of lead based Surma/kohl in terms of detoxification of Sang-e-Surma, preclinical toxicity and clinical trial. https://jtim.tums.ac.ir/index.php/jtim/article/view/460