Aconite.- Chiefly called for in the acute variety of this trouble especially when caused from exposure to cold dry winds and in the very first stage of abscess. The lids-especially the upper – are red and swollen with a tight feeling in them, while great heat, dryness, burning and sensitiveness to air are present; the dry heat is temporarily relieved by cold water. The conjunctiva is usually implicated.
Alumina.- Chronic inflammation of the lids (particularly if complicated with granulations) characterized by burning and dryness of the lids especially in the evenings; itching dryness, and excoriation at the canthi. Absence of lachrymation. There is not usually much destruction of tissue not great thickening of the lids.
Apis mel.- Incipient stage of abscess before the formation of pus, if there is great puffiness of the lids, especially of the upper with stinging pains. Much reddish-blue swelling of the lids; temporary relief from cold water. There is often chemosis and the lachrymation is profuse, hot and burning (Rhus), though not acrid, as under Arsenicum. Drowsiness and absence of thirst are often present.
Argentum nit.- Lids sore, very red and swollen especially when complicated with granular conjunctivitis or some other external trouble. There is usually profuse discharge from the eyes, causing firm agglutination in the morning. The symptoms are often relieved in the cold air, or by cold application and may be associated with headache, pain in the root of nose, etc.
Aurum.- Rarely useful in uncomplicated blepharitis, except when occurring in scrofulous or syphilitic subjects, after the abuse of Mercury. The lids may be red and ulcerated, with stinging, pricking or itching pain in them. Cilia rapidly fall out.
Causticum.- Blepharitis, with warts on the eyebrows and lids. The symptoms are ameliorated in the open air. Feeling of sand in the eye.
Chamomilla.- Of benefit as an intercurrent remedy, even if it does not complete the cure, in cross, peevish children who want to be carried. The local symptoms are not marked,
Cinnabaris.- Ciliary blepharitis, with dull pain over or around the eye. There may be dryness of the eye, or considerable discharge.
Croton tig.- When there is complicated with the blepharitis a vesicular eruption on the lids and face.
Euphrasia.- A valuable remedy if the lids are red, swollen and excoriated by the profuse, acrid, muco-purulent discharge, or even if ulcerated. The lachrymation is also profuse, acrid and burning; often accompanied by fluent coryza. The cheek around the eye is usually sore and red from the nature of the discharges.
Mercurius Corr.- This from of Mercury differs very little in its symptomatology from the solubis, and that is chiefly in degree, as the pains are generally more severe and spasmodic in character, lachrymation more profuse and acrid, secretions thinner and more excoriating and inflammatory swelling greater than in any other preparation. It has proved curative in inflammatory swelling of indurated lids; inflammatory swelling of cheeks and parts around the orbits which are covered with small pustules and especially in scrofulous inflammation present.
Natrum mur.- Ciliary blepharitis, particularly if caused by the use of caustics (nitrate of silver). The lids are thick and inflamed, smart and burn, with a feeling of sand in the eye. The lachrymation is acrid, excoriating the lids and cheeks, making them glossy and shining; often accompanied by eczema.
Nux-vom.- Chronic inflammation of the lids, with smarting and dryness, especially worse in the morning. It is particularly indicated in blepharitis dependent upon gastric disturbances.
Petroleum.- Has been of benefit in blepharitis, especially if combined with the use of cosmoline externally. Great reliance should be placed on the occipital headache, rough skin, etc., generally found when this drug is indicated, though it has been used with advantage when no marked symptoms were present.
Sepia.- Chronic inflammation of the edges of the lids with scales on the cilia and small pustules on the lid margins (acne ciliaris). Feeling as if the lids were two heavy or as if they were too tight and did not cover the ball. Worse morning and evening.
Silicea.- Blepharitis from working in a damp place or being in the cold air. (Calcarea, Rhus.) Indicated in abscesses, after suppuration has commenced. Silicea is more particularly called for in the carbuncular form and especially if the patient is very nervous and the local symptoms are accompanied by sharp pains in the head, relieved by wrapping up warm.
Staphisagria.- Bleeding in which the margins of the lids are dry, with hard nodules on the borders and destruction of the hair follicles. Itching of the lids.
Tellurium.- Eczema of the lids especially if complicated with a moist eruption behind the ears and offensive otorrhoea smelling like fish brine.
In addition to the above, the following remedies have also proved serviceable: Lycop., Mercurius, nitr., Mercurius prot., Sanguinaria, Senega.
Abscess of the Lid.- (Phlegmon, Furuncle).- Suppuration in the connective tissue of the lid is generally the result of trauma, and is then due to a breaking down of the blood-clot formed at the time of the contusion. It may also follow debilitating diseases, or be associated with adenitis in scrofulous children. There will be great swelling of the lid, with more or less heat, redness and pain. Fluctuation maybe detected early and inflammation of the conjunctiva is apt to be associated with this disease. General inflammation of the lid may sometimes be seen in children without suppuration; while in cachectic subjects we may have a gangrenous condition. Furuncle differs from abscess or phlegmon, in that it is less diffuse, less evidence of fluctuation and more necrosis of tissue.
TREATMENT.- By a careful selection of our remedy in the first stage, we can often cause the inflammation to subside before suppuration has taken place. It is also possible to promote the resolution and discharge of pus already formed. Cold (iced) application are recommended if the disease is seen at the outset; but if we suspect that the formation of pus has commenced, a change to hot applications (poultices) should be made.
As soon as fluctuation can be felt, a free incision into the swelling parallel to the margin of the lids should be made in order to give free vent to the confined pus. After the escape of the pus, warm application of Calendula and water (ten drops to the ounce) are advised. A compress bandage should also be employed if the abscess is extensive, so as to keep the lid in position and the walls of the abscess in contact and thus hasten the union.
If it has already spontaneously opened, the perforation should be enlarged if it be insufficient and unfavorably situated; also if there be several apertures, they should be united by an incision, in order to leave as small a cicatrix as possible. A generous diet should be prescribed. For remedies, see blepharitis page 107.
Hordeolum (Stye, Acne). Is an acute inflammation of the cellular tissue of the lid leading to suppuration and pointing at the edge of the lid. The location of the inflammation is usually in the tissue surrounding a hair follicle.
SYMPTOMS.- At first it appears as a hard circumscribed redness and swelling which frequently extends so that the whole lid will become oedematously swollen. There is at first much severe throbbing pain. Occasionally there are two or more at the same time, and they often occur in successive crops.
COURSE.- They usually point and break in three or four days, though they may undergo absorption without breaking.
CAUSES.- It is especially found young people, and is usually due to general debility associated with overuse of the eyes; chronic blepharitis or conjunctivitis and exposure to cold winds may cause cause it.
TREATMENT.- We are not often called upon to prescribe for a single stye, but usually to prevent the recurrence of successive crops. If the case is seen at its very outset cold compresses or dry heat will sometimes abort the attack; though usually more benefit is derived especially after its commencement; from hot poultices.
If pus has formed, as shown by a yellow point, an incision should be made to permit its escape. If dependent as it frequently is, upon impairment of the general health, proper hygienic measures must be advised.
Pulsatilla.- This is an excellent remedy for styes of every description and in every stage of the disease. If given early, before the formation of pus, it will often cause them to abort; if used later, relief from the pain and hastening of the process of cure is frequently produced, while, as a remedy for the prevention of the recurrence of successive crops it is of great value. It is especially useful if dependent upon some gastric derangement, as from indulgence in high living fat food, etc. and if accompanied by acne of the face; also when found in amenorrhoeic females or the peculiar Pulsatilla temperament.
Hepar.- Indicated if suppuration has already commenced, with throbbing pain, great sensitiveness to touch and amelioration by warmth.
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.