Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Silver, in the form of silver nitrate, has a long history of use in ophthalmology, particularly for the prevention and sometimes treatment of conjunctivitis, especially neonatal conjunctivitis (ophthalmia neonatorum). In the late 19th and early 20th centuries, the Credé method—applying a 1% silver nitrate solution to the eyes of newborns—was widely adopted to prevent gonococcal ophthalmia, a leading cause of blindness in infants at the time. This practice was based on empirical success rather than detailed scientific understanding of antimicrobial mechanisms. Over time, as the bacterial etiology of conjunctivitis became clearer and as antibiotics were developed, silver nitrate use declined due to its limited spectrum of activity, potential toxicity (chemical conjunctivitis), and the superior efficacy and safety profile of antibiotics. There is limited modern scientific evidence supporting the use of silver or silver compounds for the treatment (as opposed to prevention) of conjunctivitis, and its use today is rare outside of specific historical or low-resource settings. While silver has documented broad-spectrum antimicrobial properties, clinical trials and guidelines now overwhelmingly favor antibiotic eye drops or ointments. Silver sulfadiazine and colloidal silver are sometimes discussed in alternative medicine, but there is insufficient scientific evidence to recommend these for conjunctivitis. In summary, silver’s use is primarily justified by historical tradition, with only moderate evidence from past clinical practice and little support from current scientific research.

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