Hyperaesthesia of the retina has been relieved, in which there was much lachrymation and burning in the morning, with some conjunctival injection; also in cases in which, on looking at a bright light, there was great photophobia, severe sticking in the temples and, on reading, objects seemed to swim before the sight. It is especially indicated in chlorotic females.
In asthenopia, particularly muscular, and dependent upon overuse of the eyes, in either ametropia or emmetropia, Natrum mur. is a most important remedy. By reference to the verified symptomatology of this drug, it will be seen how closely indicated it is in a large majority of asthenopic troubles, In addition to which many clinical indications have been observed, as follows: Drawing, stiff sensation in the muscles of the eyes on moving them (this is very characteristic of Natr. mur.). Pain, burning and smarting of the eyes on attempting to use them and after using them. Heat and a feeling as though there was a rush of blood to the eyes. Pain on looking steadily at distant or near objects. Severe pain over the right internal rectus muscle (BUFFUM). Use of the eyes brings on heaviness and drooping of the lids; causes letters or sketches to blur and, if continued, produces aching in the balls; lamplight is particularly troublesome; retinal images are retained; right lower lid twitches a great deal (WOODYATT). Lids smart and feel heavy on slight use of eyes, we desire to rub them; sharp shooting pains in the globe; blurred vision; constant dull aching pain in the globes; photophobia, especially to gaslight (WOODYATT). Headaches coming on in the morning, often before rising, beginning in one eye with a sensation as if the eye would be pressed out, accompanied by nausea and vomiting; when looking down, objects appear larger than when looking forward (BUFFUM). Together with the above symptoms, marked weakness of the internal recti muscle will usually be found, though in some cases the weakness of the ciliary muscle will be more pronounced. A corresponding decrease in the acuteness of vision is frequently observed and remedied by the use of Natr. mur.
NATRUM SALICYLICUM.
Clinical.- The salicylate of soda, although an empirical remedy, often renders valuable service in relieving severe pain in and around the eye. In severe cases of iritis and other diseases if may not only relieve the ciliary neuralgia, but also have a beneficial influence over the progress of the disease. Its use has been particularly noted for the relief of the pain of iritis following severe operations, as cataract extraction. From three to five grain doses, repeated from one to three hours or even oftener in some cases, will usually be found necessary.
NATRUM SULPHURICUM.
Both eyes agglutinated in the morning, with photophobia.
Clinical.- As a local application in maculae of the corneal it has seemed to hasten the absorption of the new elements and clear the cornea.
NITRICUM ACIDUM.
Yellowness about the eyes, with red cheeks. Difficulty in opening the eyes and raising the upper lid in the morning. Eyelids swollen, hard, smart and burn.
Burning, biting and stitches in the eyes. Photophobia.
Vision.- Double vision of horizontal objects at some distance. Obscuration of the eyes while reading. She can clearly distinguish nothing at night and everything seems double. Shortsighted; objects at a moderate distance were indistinct. He was obliged to stop reading in the twilight sooner than usual.
Clinical.- Nitric acid is of special importance in diseases of the eye of syphilitic origin, or if the patient has been over- dosed with mercury or potash.
In one case of gonorrhoeal ophthalmia, in which the discharge was profuse and cornea ulcerated, with burning pain, favorable results were obtained from Nitric acid3 internally and a weak solution externally.
More benefit has been derived from this remedy in syphilitic iritis than in any other ophthalmic disease. It seem to be adapted to those cases which are chronic in their course and unaccompanied by the customary nightly pain, or this pain is very mild in comparison with the usual iritic pains; sometimes the pain may be more severe during the day than at night. Posterior synechiae, often very firm, will usually be found when these patients appear for treatment.
NUX MOSCHATA.
Blue rings around the eyes.
Sensation of dryness in the eyes; reading by artificial light was difficult; the eyes would close from sleep; the head and forehead were dull in the evening. Sensation of fullness in eyes.
Everything looks too large. Lids heavy and stiff.
Clinical.- Dr. D. J. McGuire sends me the report of a ” case of episcleritis in a delicate girl of ten years, involving both eyes. The nodule over each external rectus was very large and very painful, had existed two weeks and was growing worse daily. The child was very sleepy, with dry lips and tongue, and has a tired, sleepy expression. Gave Nux mosch.30 every three hours the first day, then three times daily. After three days, as she was much relieved, gave blank powders for two days, during which time the patient became worse. Returned to Nux moschata with prompt relief and cure in twelve days.”
NUX VOMICA.
Objective.- Twitching of the eyelids. Blinking of the eyes. Swelling of the eyes, with red streaks in the whites and pressive, tensive pain. Inflammation of the eyes. The eye run water, as in a moist inflammation of the eyes or as in stopped coryza. While yawning, in the morning, the eyes stand full of water, with lachrymation.
Subjective.- The margin of the lid is painful, as if rubbed sore, especially on touch and in the morning. Pressure in the upper lids especially in the morning. The canthi are painful, as if sore. A smarting dry sensation in the inner canthi, in the morning, in bed. Biting in the eyes, especially in the external canthi, as from salt, with lachrymation. Itching in the eyes, relieved by rubbing.
Vision.- Vision extremely sensitive. Vision cloudy. Intolerance of the daylight, in the morning, with obscuration of vision. Photophobia. Glittering appearance with black and gray points before eyes.
Clinical.- The power of Nux vomica to relieve nervous irritability has led to it beneficial use in diverse affections of the eye, as the following clinical record will show.
In dacryocysto-blenorrhoea good results have been obtained form its use.- A. WANSTALL.
In ciliary blepharitis, with smarting and dryness of the lids, especially in the morning, our remedy will be found in Nux vomica It is also indicated in ciliary blepharitis dependent upon certain forms of gastric disturbances.
From its action in spasmodic affections we are led to its use in blepharospasm or morbid nictitation, in which it has been given with benefit, though it is not so frequently indicated as Agaricus.
As a remedy for conjunctivitis, it is not as often called for as when the cornea becomes involved, though in both catarrhal and scrofulous inflammation of the conjunctiva benefit has been derived, especially if there is marked morning aggravation and the usual concomitant symptoms. In acute conjunctivitis with haemorrhages in the conjunctiva it is also sometimes indicated.
Good results were obtained from its use ophthalmia neonatorum, in which the lids were much swollen, bled easily hand the child was troubled with vomiting, constipation and flatulent colic.
Old ceases of trachoma, especially if complicated with pannus and if they had much treatment, are often benefited by this remedy. It is, however, frequently of use, either to commence the treatment or as an intercurrent remedy in trachoma with or without pannus, though it rarely effects a cure unassisted by any other drug. It has been of service in trachoma and follicular conjunctivitis occurring only in the summer and worse in the morning (compare Sepia).
Nux vomica is frequently indicated in ulcers and pustules of the cornea, especially the former, with excessive photophobia. An important point regarding the photophobia, as well as the other symptoms, is the morning aggravation, which is rarely absent. In addition to this we usually have much lachrymation and a variety of pains, none of which, however, can be said to be very characteristic, though the following are a few which have been relieved: Sharp darting pains in the eye and over it, in some cases extending to the top of the head and always worse in the morning. Burning pain in the eyes and lids. Tearing pain in the eye at night, awakening from sleep. Eyes feel pressed out whenever she combs her hair. Sensation as of hot water in the eye. Pain in the lower lid as if something were cutting it. Burning pain when looking at a light, darting upward above the eyes, with pain in the eyebrow on going to bed. Pain in the eyes in the morning. Sometimes relief from the pain is obtained by bathing the eyes in cold water.
It has proved useful in iritis, as in one case of the syphilitic variety, with moderate ciliary injection, some photophobia, hot lachrymation, morning aggravation and great sensitiveness to the air, though it cannot be often indicated.
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.