Graphites.-A very valuable remedy in ulceration of the cornea, especially occurring in scrofulous children who are covered with eczematous eruptions, particularly on the head and behind the ears; eruptions are moist, fissured and glutinous. Is especially adapted to superficial resulting from pustules, though it has also been useful in deep ulcers even with hypopyon. The cornea is more frequently found quite vascular and conjunctiva much injected, though both may be slight in degree. The photophobia is usually intense and the lachrymation profuse, but may be very moderate in amount. The pains are variable and the discharges generally thin and excoriating. The lids are sometimes covered with dry scales (the edges), though they are more commonly red and sore, with cracking and bleeding of the external canthi upon any attempt to open the eyes. Generally accompanying the above symptoms we find an acrid discharge from the nose, which makes the nostrils sore and covered with scabs.
Photophobia is generally present, as well as profuse, acrid, white, muco-purulent discharge from the eyes, which makes the lids red and excoriated, giving them and the cheek an appearance as if varnished. The conjunctiva is quite red and the eyes smart and burn. Blurring of the eyes, relieved by winking.
Ipecacuanha.-Vascular ulceration of the cornea, with much photophobia.
Pulsatilla.-Superficial ulcers, especially in females of a mild temperament. Thick, bland, white or yellow discharge from the eyes and general amelioration of the symptoms in open air. Small ulcers on the centre of the cornea, with no vascularity and only moderate irritation of the eye.
Silicea.-Adapted to sloughing ulcers of the cornea and the crescentic form of ulceration; also to small, round ulcers which have a tendency to perforate, especially if situated near the centre of the cornea and having no blood-vessels running to them. Paint, photophobia, lachrymation, redness and discharge vary, though the latter are generally profuse in the sloughing form of the disease. Hypopyon may be present. The Silicea patient is usually very sensitive to cold and therefore wishes to keep wrapped up warm, especially about the head.
Cinnabaris.-When accompanied by that characteristic pain above the eye, extending from the internal to the external canthus or running around the eye. This pain varies greatly both in intensity and character. Photophobia and lachrymation are usually present.
Argentum nit.-Ulceration of the cornea in new-born infants, or from any form of purulent ophthalmia, with profuse discharge from the eyes. Ulceration with pains like darts through the eye morning and evening. The pains are usually better in the cool, open air and aggravated in a warm room. The lids are generally red, thick and swollen; conjunctiva oedematous and there is a profuse discharge of yellowish-white pus.
Aconite.-Superficial ulceration of the cornea of traumatic origin. First stage of ulceration caused from exposure in the open air. Conjunctiva very red, chemosis, photophobia and lachrymation; or, more commonly, the eye is dry, hot, burning and very sensitive to air. Patient restless, feverish and thirsty.
Apis.-Ulcerations of the cornea, vascular, with photophobia, hot lachrymation and burning, stinging pains; sometimes the pains are very severe and shoot through the eye, with swollen, oedematous conditions of the lids and conjunctiva. Patient drowsy and thirstless.
Arnica.-Traumatic ulceration with much haemorrhage into the anterior chamber. (Superficial traumatic ulcerations generally yield more readily to Aconite).
Asafoetida.-Ulceration, accompanied by iritic pains which extend from within outward, and are relieved by rest and pressure.
Aurum.-Ulceration of the cornea, especially occurring during the course of pannus or scrofulous ophthalmia. Cornea quite vascular, and the patient very irritable and sensitive to noise. Cervical glands often enlarged and inflamed. The photophobia is marked, lachrymation profuse and scalding and the eyes very sensitive to touch. The pains extend from without inward and are worse on touch (reverse of Asaf).
Belladonna.-Superficial ulceration of the cornea, with in tense photophobia and some throbbing pain, aggravated afternoon and evening.
Cantharis.-Superficial ulceration caused by burns, with burning pains and lachrymation.
Chamomilla.-Ulceration occurring in cross peevish children during dentition.
Chininum mur.-ULceration of the cornea of malarial origin or dependent upon anaemic conditions, especially if the iris has become affected and there are severe pains, either in or above the eye, periodic in character and accompanied by chills. Ulcers found in the course of pannus, with much pain in the morning.
Cimicifuga.-Ulcers with sharp, neuralgic pains through the eye into the head.
Croton tig.-Ulceration with marked pain in the superciliary region at night, especially if accompanied by a vesicular eruption on the face and lids.
Cundurango.-Superficial ulceration, with sores or cracks at the corners of the mouth.
Duboisin.-Low form of ulceration, more or less deep, without photophobia and lachrymation.
Eserine.-Sloughing ulceration of the cornea, with tendency to increased intra-ocular tension.
Euphrasia.-Superficial ulceration (sometimes with pannus) may be relieved, though it rarely affects beneficially any extensive ulceration, excepts to palliate the symptoms in the first stage.
Hamamelis.-When dependent upon a blow or burn, especially when complicated with haemorrhage into the anterior chamber (hypaemia.)
Mercurius corr.-Called for when the mercurial symptoms are especially severe, particularly if the iris has become involved. The photophobia, acrid lachrymation discharges, pains, burning and excoriation of the lids are excessive (which are often found in those of a scrofulous diathesis).
Mercurius dulc.-Deep or superficial ulcers or abscesses found in pale, flabby, strumous children, with enlarged glands and general scrofulous cachexia. Other symptoms vary little from Mercurius sol.
Mercurius nitr.-Has been used empirically with excellent success in all kinds of ulceration, both in the acute and chronic, superficial and deep forms, whether accompanied by hypopyon or not, in cases in which there has been much photophobia, and in cases in which there has been none, where there has been much pain and where there has been no pain. In fact, it has been successfully employed in all imaginable forms of the disease, but it seems to act better in those cases in which there is a tendency to the formation of pustules. It is generally prescribed both externally and internally at the same time and in the lower potencies; the first potency in water externally and the third internally.
Mercurius praec. rub.-Ulceration of a cornea covered with pannus, lids granular and eye-symptoms of mercury. Aggravation from working over a fire.
Natrum mur.-Photophobia usually marked, so that a child will lie with the head buried in the pillows, lachrymation acrid, discharges thin and excoriating, lids swollen, eruption around the eye on face which is often shining, pains various, though often sharp and piercing above the eye on looking down, are the most prominent eye indications. Concomitants will decide our choice.
Nux vomica-Superficial ulceration of the cornea characterized by excessive photophobia, especially in the morning; during the day is often comparatively free from it. The amount of redness is not usually excessive, though it varies, as does also the character of the pains. Lachrymation is profuse. To be thought of in cases that have been previously over-dosed with medicine, both externally and internally. Neuro-paralytic inflammation of the cornea has been benefited.
Spigelia.-Ulcers with sharp, shooting pains through the eye and into the head.
All the symptoms are, as a rule, aggravated by bathing the eyes, so that child cannot bear to have any water touch them.
Thuja.- Ulcerations of a syphilitic origin, even when hypopyon is present, suffusion of the eyes and burning in them. Pain over the eye as if a nail were being driven in.
The following remedies have also been followed by favorable results in occasional cases; Alumina, Baryta carb. and jod., Cannabis, Causticum, China ars., Kali carb., Kali mur. and jod., Kreosotum, Nitric ac., Petrol., Sanguinaria, Secale, Seneg., Sepia and Vaccinum.
Hypopyon Keratitis (Ulcus Cornea Serpens, Serpiginous, Infecting).- Many of the deeper ulcers of the cornea just described, as well as abscesses, are accompanied by a deposition of pus in the anterior chamber (hypopyon) and hence are apt to be diagnosticated as hypopyon keratitis. (see Chromo-Lithograph, Plate 1, Fig.5.) This, however, is wrong and such cases should be diagnosed as ulcus corneae cum hypopyon. True hypopyon keratitis is a much more serious condition than the preceding, as shown by the fact that formerly many eyes were completely lost from this disease. In the clinic of Schmidt-Rimpler Lucanus, “Ulcus Corneae Serpens.” inaug. dissert, Marburg, 1882. the proportion of disastrous cases being as high as 19.2 per cent. The progressive course of this ulcer, from which it derives the name of serpiginous, is by infection. Its infectious origin is proven by the fact that it may be produced in animals by introducing putrid or fermenting substances into wounds made in the cornea.
Professor of Ophthalmology in the College of the New York Ophthalmic Hospital; Surgeon to the New York Ophthalmic Hospital. Visiting Oculist to the Laura Franklin Free Hospital for Children; Ex-President American Homoeopathic Ophthalmological, Otological and Laryngological Society. First Vice-President American Institute of Homoeopathy : President Homoeopathic Medical Society of the State of New York ; Editor Homoeopathic Eye. Ear and Throat Journal : Associate Editor. Department of Ophthalmology, North American Journal of Homoeopathy, etc.