An estimated 42 percent of Americans use herbal medicines or nutritional supplements. Many people taking these products and their physicians are unaware of the adverse reactions they can cause. An Oregon Health & Science University researcher reviewed reported cases of ocular side effects associated with these products. His findings are published in the American Journal of Ophthalmology this month. The researcher, Frederick W. Fraunfelder, M.D., assistant professor of ophthalmology in the OHSU School of Medicine and the OHSU Casey Eye Institute, found side effects ranging from dry eye to retinal hemorrhages and transient visual loss. Most of the side effects were associated with higher doses and topical application. While none of the reported cases caused permanent damage, many could have if the patient had not discontinued use of the product.