Vision.-Vanishing of sight. Vision is impeded by fiery zig zags before the eyes. Fiery sparks before the eyes, with great weakness. Flickering before the eyes when looking into light; he sees a zigzag circle of colors. Many black spots before the eyes. During the menses everything gets black and clouded before the eyes, in the evening, accompanied by great weakness, which passes off when lying.
Clinical.-Sepia is especially adapted to ophthalmic disorders dependent upon uterine troubles and in prescribing this drug great reliance should be placed upon these accessory symptoms.
The aggravation morning and evening, and the amelioration in the middles of the day are almost always present.
In chronic ciliary blepharitis very favorable results have been obtained from Sepia. In addition to the scaly condition of the lid margin, small pustules will usually be found on the ciliary border (Ant. crud). The subjective symptoms will also indicate our choice, as feeling of heaviness in the lids in the morning, or on waking at night; soreness or numb pain in the internal canthi and scratching sensation in the eyes, worse at night and at any time during the day, upon closing the lids, as they feel as if they were too tight and did not cover the eye. The aggravation of the symptoms morning and evening will usually be noticed.
Tarsal tumors have been benefited by Sepia 30.
Acute catarrhal conjunctivitis, with drawings sensation in the external canthus and smarting in the eyes, ameliorated by bathing in cold water and aggravated morning and evening; also conjunctivitis, with muco-purulent discharge in the morning and great dryness in the evening, have been quickly relieved under this remedy.
In follicular conjunctivitis, or a mixed form of follicular and trachomatous conjunctivitis, and in conjunctivitis vernalis, which is only observed during the summer, or always made worse by hot weather, Sepia is especially indicated. It may be serviceable in trachoma, with or without pannus, especially in tea-drinking females. It is indicated if there is excessive irritability of the eye to both use and light, particularly night and morning, better through the day; lids close in spite of him and sparks may be flashing before the eyes.
It is sometimes indicated in phlyctenular conjunctivitis, though not as frequently as when the cornea is implicated.
For keratitis phlyctenularis, especially in females suffering from uterine disturbances, Sepia is of great value. The pains are usually of a drawing, aching or sticking character, aggravated by rubbing, pressing the lids together, or pressing upon the eye. The light of day dazzles and causes the head to ache, with lachrymation, especially in the open air. The conjunctiva may be swollen, with considerable purulent discharge, edges of lids raw and sore and eruption on the face. The usual time of aggravation is present.
Dr. C. Th. Liebold has used it with very favorable results in keratitis parenchymatosa complicated with uterine troubles.
At Dr. W.H. Woodyatt’s suggestion, Sepia has been employed in several cases of cataract, especially in women, with manifest advantage, arresting the progress of the disease and often improving the vision very decidedly. The concomitant symptoms will guide us in the selection of this remedy in diseases of the lens.
SILICEA.
Objective.-Swelling in the region of the right lachrymal gland and lachrymal sac. Lachrymation. Agglutination of the eyes. Twitching of the eyelids. Redness at first around the eyes, then also of the white of the eyes, with inflammation and lachrymation. Redness of the whites of the eyes. Ulcer on the left eye.
Subjective.-Pressure in the upper lid, with violent stitches, as from a splinter, and vanishing of visual power. The eyes are painful, as if too dry and full of sand, in the morning. Tension in the eyes and forehead, with weakness of the body. Piercing, stinging pain in the left eye. Tearing and burning in the eyes on pressing them together. Heat and smarting in the eyes.
Vision.-Vision indistinct, misty, with flickering before the eyes. She could neither read nor write; everything ran together.
Clinical.-Silicea is more commonly indicated in caries of the orbit than any other remedy in the materia medica.
In diseases of the lachrymal apparatus it is a remedy of prime importance. It is often indicated in inflammation of the lachrymal sac (dacryocystitis) characterized by all the prominent symptoms, swelling, tenderness, pain and lachrymation, especially if the patient takes cold easily or is very sensitive to a draught of air. Several cases even though so far advanced that suppuration seemed inevitable, have been cured without breaking externally and without the aid of an operation. But, notwithstanding, ex-perience shows how much may be sometimes gained from the administration of Silicea and other remedies, yet we would not advise delay in opening the canaliculus as soon as pus has begun to form.
Blenorrhoea of the lachrymal sac has quite frequently been controlled, and Silicea should be one of the first remedies thought of in connection with this trouble.
The treatment of acute lachrymal fistulae by Silicea has been attended with favorable results, but chronic cases do not seem to yield to this or any other drug.
Blepharitis, either acute or chronic, caused or aggravated from working in a damp place or from being in the cold air will often require Silicea (compare Calcarea).
It has been useful in tarsal tumors when indicated by concomitant symptoms.
Silicea is often the remedy for sloughing ulcers of the cornea, with or without hypopyon; for crescentic ulcers; for small round ulcers which have a tendency to perforate, and also for non-vascular ulcers centrally located. The pains, photophobia and lachrymation are not particularly marked. The discharge is frequently very profuse, though it may be moderate in quantity. But there is almost always present in these cases, in fact in the majority of ophthalmic disorders which call for Silicea, a great sensitiveness to cold and desire to be warmly wrapped, especially about the head.
For hypopyon it is especially valuable.
It has also proved useful in choroiditis in a myope in whom, upon any exertion of the eye, excessive pain extended to the head and ears.-T.F.A.
Irido-choroiditis, with great tenderness of the eye to touch, deep ciliary injection, contraction of the pupil, posterior synechiae and excessive sensitiveness to a draught of air will be found amenable to Silicea.
Many brilliant cures of cataract under this remedy are reported, though grave doubts are entertained regarding the correctness of the diagnosis. It may be serviceable, however, in checking the progress of cataract when indicated by concomitant symptoms, upon which chief reliance is placed in prescribing for disease of the lens.
Ciliary neuralgia, characterized by darting pains through the eyes and head upon exposure to any draught of air, or just before a storm, has been speedily relieved by Silicea.
Silicea and Hepar should be compared with each other, as their actions are very similar. Both are indicated in ulceration, are relieved by warmth and aggravated by cold. The ulceration of Hepar is, however, usually accompanied by more pain, redness, photophobia and sensitiveness to touch than that of Silicea.
SPIGELIA.
Objective.-Lids lax and paralyzed; they hang low down and must be raised with the hand, with dilated pupils. Redness and inflammation of the white of the eye; in the morning the lids are so heavy that he can scarcely open them. Lachrymation.
Subjective.-Pain as if the upper lid were hard or immovable; he cannot raise it easily. Fine painful cutting on the margin of the left lower lid like a knife. Striking pressure under both lids. Pain as if the left orbit were pressed from above downward. Tensive, tearing pain in the forehead, especially beneath the left frontal eminence, extending toward the orbits. Thrust-like tearing pain in the forehead, worse in the right frontal eminence. A shoot of pain through the forehead. Burning pain in the right side of the forehead, extending to the eye, so that he could not turn it without pain. The eyes hurt on motion, as if too larger for their orbits. He could not turn the eyes in all direction without pain. Violent burrowing stitch in the middle of the eye and inner canthus that does not prevent vision, but presses the upper lid downward. Intolerable pressive pain in the eyeballs, still more painful on turning the eyes; on attempting to look with the eyes turned he became dizzy, so that he was obliged to turn the whole head. Pressive pain in the eye-balls. A contractive burning pain in the right eyeball. Constant sticking pain in the right eyeball also on moving it. Itching stitch in the right eyeball that returned after rubbing.
Clinical.-Spigelia is especially applicable to severe neuralgic pains arising in a great variety of ophthalmic trouble, particularly in rheumatic and arthritic inflammations. In all cases the character and intensity of the pains furnish the chief indications for the selection of this remedy.
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.