BY E. Reginald Drewry
It is not easy to set firm limit to the range of conditions which may rightly be said to come under the heading of “injuries” to the eyes. this being so, I have for the sake of making this article useful to the experienced practitioner as well as to the layman, set the limit high; it embraces simple injuries due to contusive and concussive causes, foreign bodies in the eye and lacerated wounds, as well as conditions due to the chronic effects of such injuries, post-operative conditions, etc. It should be clearly understood that conditions of the eyes due to acute diseases or chronic constitutional states will require more expert treatment than that which is indicated here.
At the end will be found a short repertory which will greatly assist in finding the most suitable remedy. In this, drugs are arranged in the usual alphabetical order under the several headings and not necessarily in order of grade.
With regard to methods of administration of remedies, repetition of doses and choice of potency, I have but little to say. Unless one possesses a fairly extensive knowledge of the remedies and the action of different potencies, it would be best to stick to low potencies, say up to the 12th centesimal; the experienced homoeopathy may prefer to use the higher potencies judiciously. Several of the remedies do certainly lend themselves to successful external application, I would say particularly Euphrasia and Hamamelis, and, for my part, I would certainly use these topically, as indicated, in potentized form, having frequently done this to the immediate and complete relief of the patient.
From the information and symptoms gathered from several authoritative sources had set out under the respective drug headings, it should be possible to select the single remedy which is the most suitable for a particular case, changing it only when it has obviously finished its work and another remedy is called for by the changed “symptom picture”. Of course, if in spite of a careful study of the remedies, one should select the wrong one, it should be changed at once; in injuries, one soon comes to expect very quick relief from the single correctly chosen remedy.
The single remedy will do all that is required but if any see fit to alternate remedies or to give one remedy internally at the same time as another remedy is applied locally, that is their affair. But they can scarcely expect more consistent and effective results than are obtainable from the correctly chosen single remedy, while alternated remedies may interfere with each other it should be remembered.
That rational mechanical treatment be carried out at once in eye injuries is, of course, a sine qua non. Foreign bodies must be removed with all possible speed, and in simple cases this is most easily done with a moistened “tail” of cotton wool or a clean camel hair brush, brushing action being towards the inner canthus rather than the outer; it may be necessary to ever the upper eyelid, but this should be attempted only by an experienced person.
Surgical attention is essential for particles which become embedded in the eyeball, and the best local treatment pending such attention is to place a drop of castor oil in the lower lid near the inner canthus and cover the eye with a pad of cotton wool. Rubbing of the eye is always injurious, and it is necessary to remember this when treating children; in infants, it is best to tie the hands down without further do. Aconite is usually the first remedy in the above condition, and this remedy should be continued for a few doses after the removal of embedded foreign bodies if it continues to give relief, when the indications for another remedy will become clear.
In a case of injury to the eyes by mortar, lime or any corrosive alkali, a warm wash of vinegar solution (a teaspoonful to the ounce of warm water) is the best local first aid treatment. In the case of corrosive acids coming into contact with the eyes, a solution of baking soda (bicarbonate of soda, a dessert spoonful to the pint of warm water ) is recommended.
A tip that makes selection of the first remedy – which, of course, is often the only one required – twice as easy: Ledum, hamamelis, Calcarea, Silica and Sulphur are but rarely indicated in the early stage of eye injuries.
Anxiety, restlessness and fear. Eyes red, inflamed. Feel dry and hot, as if sand in them. Lids swollen, hard and red. Profuse watering after exposure to dry, cold winds, reflection from snow, after extraction of cinders and other foreign bodies. (Boericke).
Eyes red and inflamed, with deep redness of the vessels, and intolerable pains. Heat and burning in the eyes, with pressive pains and shooting pains, especially on moving the balls. Swelling of the eyes. Dilated pupils. Lids feel dry, hard, heavy; sensitive to air. Red, hard swelling of the lids. Cannot bear reflection of the sun from the snow; it causes specks, sparks, and scintillations to dance before the eyes. Excessive photophobia; or a strong desire for light. Black spots and mists before the eyes. Disturbed by flickering. Vision as though through a veil. Ophthalmia, very painful, with blur eyedness, or from foreign bodies having come into the eyes (dust, sparks, etc.); from operations. (Clarke).
Aconite has an inflammation of the eyes that comes on so suddenly that one wonders how that inflammation came in so short a time. Eyes take on a sudden inflammation. Congestion of the eye. Blood-red appearance of the eye. Sudden inflammation of all the issues; conjunctivitis, etc., from taking cold, from exposure to dry, cold winds. The eyes take on a great swelling without any discharge, or only very thick discharges would never be Aconite. Aconite has no results of inflammation. Those conditions that are about to take on the results of inflammation will always indicate some other remedy. Violent aching and inflammation of the deep structures of the ball. Aconite has inflammation of the eyes, with burning and sudden swelling; the lids swell so rapidly that they cannot be opened except with great difficulty.
Aconite is a short acting remedy.
Concussions and contusions, results of shock or injury; without laceration of sort parts; prevents suppuration and septic conditions and promotes absorption. Conjunctival or retinal haemorrhage, with extravasation, from injuries. (Allen.).
Red, inflamed eyes. Inflammation of the eyes with suggillation after mechanical injuries. Eyelids swollen, and with ecchymosis. Obscuration of vision. Sore, lame, bruised feeling. (Clarke.).
Mechanical injuries; blows, thrusts on the globe of the eye. Pain in the eye after blow of an obtuse body; snowball strikes the eye; infant thrusts its fist into its mothers eye. (To soft tissues around the eye, Arnica.) (Allen.).
Ferrule of walking stick or umbrella. Absence of discolouration. (Clarke.)
Contused wounds. Extravasation of blood in lids, conjunctiva, aqueous or vitreous. Aching in eyes. (Boericke.).
Haemorrhage into anterior chamber after iridectomy. Contusions of eye and lids, especially if much extravasation of blood; ecchymosis of lids and conjunctiva. (Allen.).
Inflammation of eyes, with agglutination and tearing pains. Violent suppuration of eyes, with discharge of fetid pus. The tears are acrid, and make the lower lids and cheeks sore. Burning lachrymation of eyes. Pupils dilated. Confusion of sight, with sparkling before eyes. (Clarke).
Painful weakness; sore pain in eyes; bloodshot appearance. Hastens absorption of intra-ocular haemorrhage. Eyes feel forced out. (Boericke.).
Venous congestion. Chronic effects of mechanical injuries. Traumatic conjunctivitis; suggillations, or extravasations into chambers of eye; intense soreness. (Allen.).
Eyes inflamed; vessels greatly injected; caused by a foreign substance, as melted sugar; after operations. (Clarke.).
Profuse acrid lachrymation. Burning and swelling of the lids. Free discharge of acrid matter. Pressure in eyes. (Boericke.).
The eyes water all the time and are agglutinated in the morning; margins of lids red, swollen, burning. Pressive, cutting pains. Violent injection. (Boger).
Aching sensation in the eyes. Inflammation and redness of the eye from being wounded. Inflammation of the cornea. Photophobia. (Clarke.).
Cutting pain in the eyes extending into the head, pressure in the eyes as if caused by sand. Sensation of dryness, burning, biting in the eyes. Sensation of dust in the eyes. Violent itching of the eyes obliging rubbing and winking, with copious lachrymation. Pupils much contracted and much tumefaction of the mucous membrane with redness and enlarged blood vessels and smarting.
General inflammation of all the tissues of the eye. Opacity of the cornea after injuries to the eye. Copious lachrymation and burning. The mucous membranes of the eyeballs and lids are injected, red, and vascular. The lids are very sensitive and swollen. The margins of the lids itch and burn. Much swelling of the lids with inflammation. Blurred vision. (Kent.).
Lacerated or incised wounds of cornea. (Boericke.)
Mechanical injuries from sharp cutting instruments; post- surgical operations; stinging, smarting pains, like the cutting of a knife. (Allen.).
Laceration of cornea with prolapse of iris (after Aconite). After operations for cataract. Sparkling before eyes in
Sensitive to light. Spots and ulcers on cornea. Lachrymal ducts closed from exposure to cold. Chronic dilatation of pupils. Dimness of vision, as if looking through as mist. Lachrymal fistula. (Boericke.).
Inflammation of the eyes from foreign bodies coming into them, in infants or scrofulous subjects. (Clarke).
From exposure of the feet in water, from riding in the wind, from cold, damp weather he gets eye troubles. Photophobia. Eye- strain. (Kent) SILICA.
Swelling of lachrymal duct. Iritis and irido-choroiditis, with pus in anterior chamber. Abscess in cornea after traumatic injury. (Boericke.).
Fistula lachrymalis. Promotes expulsion of foreign bodies from the tissues. (Boericke.).
Intense lachrymalis. Promotes expulsion of foreign bodies from the tissues. (Allen.).
Intense photophobia in all eye complaints. Eyes inflamed from traumatic causes; foreign particles have lodged in the eyes; abscesses ; suppuration ; thin, watery, copious discharge, or bloody, thick and yellow like pus, with ulceration. (Kent).
SULPHUR. Complaints of the eyes in a Sulphur patient. (Kent.).
CONTUSIONS, BLOWS OF BLUNT BODY ; Aconite, Arnica, Hamamelis, Ledum, Symphytum.
FOREIGN BODY IN EYE ; Aconite, Calcarea, Euphrasia, Hamamelis, Silica.
DUST, SAND ETC. ; Aconite, Euphrasia, Hamamelis, Silica.
INJURIES FROM SHARP BODIES ; Euphrasia, Hamamelis, Staphysagria.
POST – OPERATIVE ; Aconite, Hamamelis, Ledum Staphysagria.
EFFECTS OF WEATHER ; Aconite, Calcarea.
DISCHARGE WATERY ; Aconite, Euphrasia, Ledum, Silica, Sulphur.
DISCHARGE THICK, PUS-LIKE : Calcarea, Ledum, Silica, Sulphur.
DISCHARGE ACRID, BURNING : Calcarea, Euphrasia, Sulphur.
ECCHYMOSIS, BLOODSHOT : Aconite, Arnica, Hamamelis, Ledum.
DILATATION OF PUPILS : Aconite, Calcarea, Ledum.
CONTRACTION OF PUPILS : Calcarea Euphrasia.
CHRONIC EFFECTS OF INJURIES : Calcarea, Hamamelis, Silica, Sulphur.