Systematic internet-based review of complementary and alternative medicine for glaucoma.
OBJECTIVE
To identify the most popular forms of complementary and alternative medicine (CAM) for glaucoma on the Internet and to assess the quality of the most popular Web sites addressing CAM for glaucoma.


METHODS
Systematic Internet-based search.


METHODS
Using a predefined search algorithm, Web sites most likely to receive hits from people searching the Internet for information on CAM therapies for glaucoma were identified.


METHODS
Web sites were evaluated for quality based on the Sandvik score. Each Web site was also assessed for external validation based on listing on the Health on the Net (HON) Foundation Web site in accordance with their code of approval. Finally, the risk each Web site potentially posed to patients was assessed using a previously described scoring method.


RESULTS
Twenty-one Web sites were included in our study. Forty-four different CAM therapies were encountered; vitamin C supplements, forskolin, and diet and lifestyle modulation were the most common CAMs discussed. The mean Sandvik score for all Web sites was 9.4 (standard deviation, 2.6). Only one Web site was listed in the HON Foundation code of approval. Two of the 21 Web sites received the highest risk scores of 3 of a potential 4 points. None of the Web sites discouraged adhering to a clinician's advice. Fourteen of the 21 Web sites assessed provided commercial details promoting CAM, with the possibility of purchasing remedies or arranging consultations. Thirteen Web sites provided opinions and experiences without factual details.


CONCLUSIONS
Medical information conveyed over the Internet is of variable quality and is not subject to regulation. Many sources of information contain advice on therapies that have no evidence base and may put patients at risk. It is important that researchers and health care providers be aware of the content and quality of this information so as to offer advice to patients about the evidence and potential risks of CAM therapies. This can only be achieved by increasing awareness among ophthalmologists of the range of products and quality of information available for CAM therapies for glaucoma.
Gunasekera
Varuni
V
Western Eye Hospital, London, United Kingdom.
Ernst
Edzard
E
Ezra
Daniel George
DG
D000529:Complementary Therapies / Q000592:standards* / Q000706:statistics & numerical data; D005901:Glaucoma / Q000628:therapy*; D006801:Humans; D020407:Internet / Q000592:standards* / Q000706:statistics & numerical data; D008490:Medical Informatics / Q000592:standards*; D010353:Patient Education as Topic / Q000592:standards; D019984:Quality Indicators, Health Care / Q000592:standards / Q000706:statistics & numerical data