Sandford, Emma C., et al. Clinical and Experimental Optometry 104.3 (2021): 315-322.
Blepharitis, meibomian gland dysfunction, and dry eye disease share a multifactorial pathogenesis that poses challenges to therapeutic management. Current treatments are mostly palliative, with success limited by perceived inefficacy and poor patient compliance. Castor oil, a natural derivative of the Ricinus communis plant, possesses antimicrobial, anti-inflammatory, antioxidant, and wound-healing properties. Its main constituent, ricinoleic acid, has a bipolar molecular structure that may supplement deficient tear lipids and reduce aqueous tear evaporation.
Experimental Protocol: This review synthesized the literature on castor oil's biochemical and medicinal properties relevant to ocular surface disease. Castor oil composition (87-90% ricinoleic acid, with smaller amounts of oleic, linoleic, and palmitic acids) and the bipolar structure of ricinoleic acid were examined. Studies evaluating topical castor oil application to the ocular surface were reviewed, including assessments of residence time, tear lipid layer thickness, tear film stability, ocular surface staining, and symptom improvement. Castor oil's antimicrobial, anti-demodectic, anti-inflammatory, and antioxidant mechanisms were also addressed.
Performance Evaluation: Studies revealed that topical castor oil has a prolonged residence time on the ocular surface, facilitating increased tear lipid layer thickness, improved tear film stability, and reduced ocular surface staining and symptoms. Ricinoleic acid's bipolar structure enables it to supplement deficient physiological tear lipids, enhancing lipid spreading and reducing aqueous tear evaporation. Castor oil demonstrated antimicrobial properties against Staphylococcus species and Propionibacterium acnes, implicated in blepharitis pathogenesis. Commercial ophthalmic preparations containing castor oil have proven effective in counteracting tear film lipid insufficiency. The review concluded that castor oil has significant therapeutic potential in managing ocular surface disease, with a good safety and tolerability profile.