Role of homoeopathy in ophthalmological conditions with special emphasis on
CENTRAL SEROUS RETINOPATHY ( CSR )
By Dr Anmol Arora (Sr Homoeopathic specialist)
This condition usually occurs in patients between the ages of 30 and 50 and presents with mild blurring of vision in one eye. This is caused by a small collection of fluid beneath the macula (retina) secondary to malfunction of the tissue supporting the retina (the retinal pigment epithelium or RPE). Another common symptom is feeling that objects appear smaller in the affected eye (micropsia).
The underlying cause of the problem is an unexplained defect in the vascular layer supporting the retinal pigment epithelium (the choroicapillaris) which becomes more leaky and creates a small blister in the retinal pigment epithelium. In some patients, this is all that happens (an RPE detachment or PED), but in others, a defect in the RPE lets fluid escape under the retina and this is usually associated with clinical symptoms.
It is an idiopathic , self limiting , non inflammatory serous detachment of retina involving posterior pole mainly macula.
Symptoms
Unilateral central loss or blurring of vision with or without distortion of shape of objects seen. Patient sees central dark ring. Signs
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Diagnosis
Clinical examination itself is sufficient to diagnose the disease . Fluorescein angiography will show the leak beginning in early phase at level of retinal pigment epithelium increasing in size in later phases. The leaks are normally uniform. |
Management
Disease is mostly self limiting and vision improves in 2 to 3 months in most of the cases.
Steroids are contraindicated.
Prognosis
The prognosis for CSR is generally excellent. Over 90% of patients regain 20/30 vision or better within 6 months. Some visual abnormalities can remain even if visual acuity is measured at 20/20. Lasting problems can include decreased night vision, color discrimination problems, and some distortion. Long term complications can include subretinal neovascularization and pigment epitheliopathy.
Homoeopathic wonders in Ophthalmology
The range of eye conditions that are treated by Homoeopathy is so wide that i would be impossible to condense it in one paper and in the time available. Bearing it mind the practice of individualisation, i would also not be possible to pinpoint specific, single remedies for different pathological conditions I will try to highlight those conditions where either a specific remedy has been repeatedly found useful, or those when allopathic therapeutics does not have much to offer and you may profitably try these medicines in your work. Even though the scope offered by Homoeopathy is wide, being a drug based therapeutic system it excludes the vary large number of surgical conditions. I may add here, that some of the so called surgical conditions are amendable to medical treatment by the Homoeopaths, and they may add some pre-operative and postoperative medication from their field to augment the success of the operation when this is necessary. Some of the conditions treated successfully by Homoeopathy are Blocked Lacrymal Duct & Dacrocystitis The remedy most used for this is Silica. Obviously, success is possible only if it is either inflammation or a partial stricture. A congenital absence or an absolute organic closure would of course, need surgery. Styes : Treating an odd stye is not noteworthy; it can even heal naturally. However, the tendency to recurrent styes is treated with much benefit. The most important remedies are Sulphur and Silica. Meibomian cyst This has again responded remarkably to Homoeopathic treatment. I could cite innumerable cases from my practice, and some of these cures have been witnessed by Eye Specialists who were being consulted at the same time. The most popular remedies ar Staphsagria (Dephinium Staphisagria) any Thuja occidentalis Thuja is particularly chosen where the patient has been ‘over -vaccinated’, which is or at least has been, quite common in our country. Staphisagria is mostly for persons with a wild temper or a condition of suppressed anger. An example of suppressed anger is where a junior cannot answer back to his boss or a conventional daughter-in-law is in a similar predicament in her relationship with her parents-in-law. This also highlights the importance of a total individual approach (psychosomatic) as mentioned earlier. Haemorrhages For haemorrhages of varied aetiology, whether traumatic or pathological, the general remedy to help absorption of the extravasated blood is Arnica montana. This is almost specific, and especially when haemorrhage is the result of injury, it could certainly be the first choice. This would cover paraorbital bleeding (black eye) after trauma; sub• conjunctival haemorrhages and also haemorrhages inside the eye. It is also one of the remedies for ecchymosis from coughing. For retinal haemorrhage, after such first aid with Arnica there is likely to be a need for one of the other remedies to control further bleeding and prevent recurrences. Choice of this follow-up remedy would vary with the general constitution of the patient. Haemorrhage may of course be a sign of leukamia and other haematologlcal diseases in which case they have to be treated according to the cause. The most popular medicines, and with which I have had very definite success, are either snake venoms-specially of Lachesis a huge and extremely poisonous snake from the Amazon region in Brazil) and of the Rattle Snake Grotalus horridu,, and Phosphorus. 1 may mention here in passing that Homoeopaths have used snake venoms for more than 150 years. In fact the first experiment with a snake venom; was made by a Homoeopath with Lachesis as long ago as 1828. Subsequent work on snake venoms, with which we are familiar, brings out their haemorrhagic tendencies. Therefore even simply applying the Similia principle to these substances should bring out their utility. Traumatic conditions of the Eye Homoeopathy has a lot to offer here. The usefulness of Arnica in traumatic conditions has already been emphasized. Following are the other remedies particularly useful in this field. Symphytum Offzcinale : This is most useful for pain in the eye after a blow from an obtuse body e.g. shuttle cock, tennis Ball, the elbow or hand of a baby that is being carried etc. Please try it and I am sure you will be surprised at its efficacy and the rapidity of results. Staphisagria : This is for lacerated or incised, wounds of cornea. Ledum Palustre : This is used for contused wounds and extravasation of blood in lids, conjunctiva, aqueous or vitreous. Cataract The utility of Cineraria Maritima Eye Drops is well known to many Ophthalmologists. I personally feel that it should be used only in the initial stages with a view to prevent or slow down the process, I am not very sure if it can actually clear the lens. When the Cataract is far advanced. I think it is pointless to treat it with drugs. In addition to these drops the Homoeopaths also use remedies internally. This needs selection from a fairly large list and depends on the rest of the history of the patient. The most popular remedies are from Calcium Group-Calcarea carbonica and Calceria fluorata. A case is reported in the British Homoeopathic Journal of a person 82 years of age having had bilateral cataract cleared by Silica. The Cataracts resulting from injuries the remedies are Couium maculatum or Arnica montana. Glaucoma Some cases of Glaucoma respond well to Homoeopathic treatment. The remedies particularly useful are Spigelia anthelmia (specially if the trouble is in the left eye) and Phosphorus. Such cases have, of course, to be kept under close observation and those that do not respond quickly have to be handed over the surgeon. Paralysis of muscles of the Eye Ball The patient usually reports with diplopia when looking in a particular direction. The remedies most popular are Causticum and Gelsemium sempervivens. I have successfully treated a large number of cases of this condition. The condition can again be met by the remedies mentioned above and in some patients by Curare. This as you know is the arrow poison used by South Americans in ancient times and has a paralysing affect. Pterygium : This has disappeared time and again by the use of Calcarea picrata. Effects of Watching Solar Eclipse This was very much in the news recently, and because of sustained publicity and advance information, most people remained indoors during the total solar eclipse, however, the Homoeopaths have a special remedy for this condition which is Hepar Sulph. For conditions resulting from eye strain (Pain and tiredness of the eye and headache) The two most popular remedies are Ruta graveollns and Natrum muraticul. The latter, incidentally is the common salt of daily use which has been converted into a powerful remedy by the genius of Hahnemann and his special pharmaceutical techniques of preparing infinitesimal doses. Optic Atrophy From the usual stand point, this should be an irreversible change. Please do not ask what is the mechanism of the reversal, but I have seen considerable clinical improvement in a number of such patients. The remedies most used are Phosphorus and Tabacum. However, where the atrophy has occurred as a use of tobacco it is remedied by giving Arsenicum album : One fairly large field of utility of homoeopathy is the management of Viral conditions, refer to conditions like viral conjunctivitis, of which we have had epidemics in the recent past, as also Herpes. I have treated success fully not only herpes on the eye lid but also herpes of the cornea.
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