Ophthalmic Therapeutics


Materia medica of the homeopathic remedies useful in treating various diseases of the eye. An excellent resource for treatment of ophthalmic diseases….


ACETIC ACID.

Clinical.- The benefit obtained from Acid aceticum in croupous inflammation of the air-passages led to its use in croupous conjunctivitis. Though empirically prescribed at first, it has proved of decided value in certain forms of this inflammation. It is adapted to those cases in which the false membrane is dense, yellowish-white, tough and so closely adherent that removal is almost impossible; thus differing from Kali bichr., in which the membrane is loosely attached, easily rolled up and separated in shreds or strings. The lids are oedematously swollen and red, especially the upper, which hangs down over the lower. It does not seem t correspond to the diphtheritic form of conjunctivitis, for, though the false membrane is closely adherent, it does not extend deeply into the conjunctival tissue-no scars remaining after resolution-and at no time is there firm, rigid infiltration of the lids. Little or no benefit cab be derived from its use if the discharge is profuse and purulent, mixed with small portions of the membrane, or if the cornea has become involved.

Compare Argentum nitr., Pulsat. and Hepar.

ACONITE.

Objective.- The lids (especially the upper) are swollen, red and hard, with a tight feeling, worse mornings. Edges of lids sore, red and inflamed. Pupils dilated. The conjunctiva is intensely hyperaemic and oedematous, mostly toward the inner canthus. Lachrymation with local inflammations is usually slight, if any.

Subjective.- In the lids, dryness, burning, sensitiveness to air. Pressure into the upper lids, as if the whole ball were pushed into the orbit, causing a bruised pain in the eye; itching, smarting, burning in the eyes, especially worse in the evening. Sticking and tearing pains around the eyes, worse at night. The eye is generally sensitive, with much heat, burning and aching, worse on looking down or turning the eyes; feeling as if the eyes were swollen, or as if sand was in them. The ball, especially the upper half, is sensitive if moved; feeling as if it would be forced out of the orbit, relieved on stooping; the ball feels enlarged, as if protruding and making the lids tense. Sparks before the eyes, flickering. Vision as through a veil; it is difficult to distinguish faces, anxiety and vertigo. Photophobia.

Clinical.- Aconite is the remedy for inflammation of the eye in general, which are very painful, with heat and burning, as well as dryness; also for inflammatory conditions resulting form injuries, ranging from those of a most severe character, as when all the tissues of the globe have been injured by a perforating wound, to those dependent upon the irritant action of foreign bodies in the cornea or conjunctiva, or the irritation caused by ingrowing the lashes.

Sometimes it is indicated in acute inflammation of the lids or lachrymal sac, though not as frequently as some other remedies.

The verifications of the drug in the following forms of inflammation of the conjunctiva are every-day occurrences: Catarrhal inflammation (first stage, prior to exudation), marked by great redness, heat, burning and pain; chemosis, with pain so terrible that patient wishes to die. Early in purulent inflammation, as illustrated in the case of a child with following conditions: Lids red and swollen; intense redness of conjunctiva and chemosis, worse in the right eye; much purulent discharge, with heat and sticking pains; aggravated in the morning.

Acute aggravations of granular lids and pannus, with excessive hyperaemia, heat and dryness, especially if the aggravation be induced by overheating, from violent exercise, or by exposure to dry, cold air.

Affection of the cornea seldom require its use, except when of traumatic origin, although one case of superficial ulceration of the cornea in a woman fifty years of age which had been present ten days, with burning heat in the eye and sharp pain on looking at the light or reading, was quickly relieved under Aconite3, after Hepar had failed.

Benefit may be derived in the acute stage of scleritis, with contracted pupils, sticking or tearing pains, photophobia, blue circle around the cornea and aching in the ball. (Compare Spigelia)

For traumatic iritis Aconite is one of the first remedies to be thought of. It may also be required in simple plastic iritis when caused by exposure to cold, or in recurrent iritis.

Of use in the earlier stages of violent acute inflammation of the deep structures of the ball, when it becomes sensitive to touch and feels as if it were protruding (rarely, if ever, called for after the exudative stage is reached).

The following case illustrates the good effects of Aconite in asthenopia; A middle-aged man was employed to sort railroad tickets, to run through columns of figures and do other fine work by a dim light; in eight days he began to have a spasmodic closure of the lids and heavy feeling over the eyes; then his eyes would get very hot- ” felt as thought they could set a match on fire,” or as after a lash with a whip. The conjunctiva of the lids was intensely red, with constant winking and closing of the lids; could hardly force them open. The heat was always dry and temporarily relieved by cloths wet in cold water; vision normal; refraction normal. Aconite relieved these symptoms magically and allowed the man to continue his work (which he was obliged to do) till time enabled him to change his occupation.- T.F.A.

In a case of paralysis of the ciliary muscle of one day’s standing, caused by sleeping near an open window, the accommodation was wholly restored within forty eight hours after using Aconite 30.

AGARICUS.

Objective.- The lids are half-close, swollen, especially toward the inner canthus; ptosis, twitchings of the lids, with a contracted palpebral fissure, without swelling. Twitchings, of the ball, often painful; twitching of the ball while reading (especially the left); very little appearance of inflammatory action.

Subjective.- Pressure and heaviness in the eyes, especially painful on moving them or exerting them by lamplight, with left- sided headache and involuntary twitching of the facial muscles. Yellow spots before the vision when looking at white. The bitings, itchings and jerkings about the brow and in the lids are very numerous in the provings. In the eyeball the sensations are mostly pressive and aching; the ball is sensitive to touch. Vision dim, as through a veil, with flickering; reads with difficulty, as the type seems to move. Short-sightedness. Beating in vertex driving almost to despair. Headache with chorea. Tearing in the head.

Clinical.- Agaricus is of the greatest service spasmodic affections of the lids and muscles of the ball. Its value hardly be overestimated in morbid nictitation or chorea-like spasms of the lids, with general heaviness of them, especially if the spasm occur on waking, or are relieved temporarily by washing with cold water. Four drop doses of the tincture, two or three times a day, will often relieve when the higher attenuations have no effect.

Dr. Linnell reports a case of lagophthalmos of the left eyelid with paralysis of the same side of the head. There was marked twitching of the eyelids on the unaffected or right side, together with right trigeminal neuralgia. These symptoms which had existed for one year were promptly cured by Agaricus.

An interesting case of anaemia of the optic nerve, retina and choroid, with a general tendency to chorea, has been cured by this drug.- T.F.A.

Benefit has been obtained from Agaricus in myopia dependent upon spasm of the ciliary muscle, especially if complicated with twitchings of the lids.

Its usefulness in nystagmus is illustrated by the following case: A school girl, age 14, was unable to read, owing to spasm of the orbicularis and oscillation of the globes. The motion was circulatory in both eyes and continual, whether eyes were fixed at near or far points; it caused much pain, indistinctness of vision and occasional attacks of vertigo. In three months’ treatment with Agaricus, 3d trit., a powder three times daily and gymnastic exercises of the ocular muscles, the globes were so far controlled as to cease oscillating when the vision was fixed upon near objects. Improvement continued.- W.H. WINSLOW.

That its action upon the muscles is not confined to spasm is shown in the following case of weakness of the internal recti: A lady suffered from muscular asthenopia consequent upon uterine disorders and spinal anaemia. The spine was very sensitive to touch between the shoulders. She could not fix the eyes long even upon distant objects; could not converge the eyes (weak internal recti). She had sudden jerks in the ball itself; twitches of the lids and at times in other parts of the body; the lids seemed heavy, as if stuck together, but were not; she had been given prisms (which allowed binocular vision without effort) and had been under various forms of general and local treatment. After Agaricus the change was marvellous; within a week the eyes could be fixed on objects at ten feet without conscious effort; the unpleasant sensations had entirely vanished and the patient was enabled to begin systematic gymnastics for the eye (initiated by fixing the eyes on white object while it is moved slowly right and left). The eyes have steadily improved, but the old pain returned in the spine; relieved only temporarily by applications of cold water.- T.F.A.

A. B. Norton
Norton, A. B. (Arthur Brigham), 1856-1919
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.