American Liverleaf (Hepatica americana) has a history of use in North American traditional herbalism, primarily among Indigenous peoples and early European settlers. Its leaves were sometimes employed as a folk remedy for a variety of ailments, including eye conditions such as conjunctivitis (commonly referred to as "pink eye"). The basis for its use in eye health was largely empirical and likely influenced by the "Doctrine of Signatures," a historical belief that plants resembling certain body parts could be used to treat ailments of those parts. There are references in 19th-century herbal compendiums noting the topical use of Hepatica infusions or decoctions as eyewashes for mild inflammatory eye conditions.

However, there is no modern scientific research or clinical trial data validating the efficacy or safety of American Liverleaf for conjunctivitis. Contemporary herbal medicine references rarely mention Hepatica for eye health, and authoritative sources like the American Herbal Pharmacopoeia and Herbal Medicine: Biomolecular and Clinical Aspects do not list it as relevant for this condition. Overall, its use for conjunctivitis is rooted in historical tradition rather than scientific validation, and current evidence is anecdotal and weak, meriting a low evidence score.