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Conjuctivitis


Homeopathic Journal :: Volume: 3, Issue: 5, Mar, 2010 (New Papers)   -   from Homeorizon.com
Author : Dr. Krishnendu Maity, BHMS, MD (Home. Repertory)


Article Updated: Mar 24, 2010
INTRODUCTION: - The conjunctiva is frequently the site of disease, as it is exposed to all types of exogenous irritants & pathogens and it is prone to allergic reactions. Beside these, endogenous diseases & metabolic disturbances often affect it.
It is an attempt to present the characteristic clinical manifestations of various types of conjunctivitis in a comprehensive form, as "CONJUNCTIVITIS & IT'S HOMEOPATHIC REMEDIES". This compilation work not only gives an insight into the classical symptoms of such conjunctivitis - but also attempts to present the etiology & possible Homeopathic treatment, available.

ANATOMY OF CONJUNCTIVA: - The conjunctiva is the delicate mucous membrane lining the inner surface of the eyelids; from the lids it is reflected upon the Globe and covers the Sclera and the Cornea, with which is becomes continuous. The conjunctiva is divided into three portions:-

  • The Palpebral, covering the inner surface of the lids.
  • The Bulbar, covering the sclerotic.
  • The Fornix, or loose folded portion connecting these two.

At the cornea, the conjunctiva overlaps slightly, and is called Corneal Limbus.

STRUCTURE OF CONJUNCTIVA: - Histologically, conjunctiva consists of 03 layers; viz. :-
a. Epithelium Layer - Epithelial layer is formed of cylindrical cells externally & smaller cells at deeper
layer.
b. Adenoid Layer - Adenoid layer also called lymphoid layer and consists of fine connective tissue &
reticulum in the meshes - of which lie lymphocytes.
c. Fibrous Layer - Fibrous layer consists of meshwork of collagen & elastic fibres.

GLANDS OF CONJUNCTIVA: - The conjunctiva contains 02 types of glands ------
a. Mucin Secretory Glands - These are goblet cells. Crypts of Henle and Glands of Manz secrete mucus -
which is essential for wetting the Cornea & Conjunctiva.
b. Accessory Lachrymal Glands - These are Glands of Krause and Glands of Wolfring.

SUPPLY OF CONJUNCTIVA: -
A. Arteries, supplying the conjunctiva are ------
Peripheral Arterial Arcade of the Eyelids.
Marginal Arcade of the Eyelids.
Anterior Ciliary Arteries.
B. Veins, draining the blood of conjunctiva, are, veins from the conjunctiva drain into the Venous Plexus of
Eyelids and some around the Cornea through the Anterior Ciliary Veins.
C. Lymphatics, Conjunctival lymphatics are arranged in two layers - Superficial and Deep. Lymphatics
from lateral side drain into Pre-auricular Lymph Nodes & from medial side, into the Sub-mandibular
Lymph Nodes.
D. Nerve Supply, A circumcorneal zone of Conjunctiva is supplied by branches from Long Ciliary Nerves,
which supply the Cornea. Rest of the Conjunctiva is supplied by branches from Lacrymal
Intratrochlear, Supratrochlear, Supraorbital & Frontal Nerves.

CONJUNCTIVITIS: Inflammation of conjunctiva is classically defined as - Conjunctival Hyperemia associated with a discharge, which may be watery, mucoid, mucopurulent of purulent.

CLASSIFICATION OF CONJUNCTIVITIS

  1. INFECTIVE CONJUNCTIVITIS
    1. Bacterial Conjunctivitis
      1. Acute Catarrhal or Mucopurulent
      2. Acute Purulent
      3. Acute Membranous
      4. Acute Pseudo-membranous
      5. Chronic Bacterial or Chronic Catarrhal
      6. Chronic Angular
    2. Chlamydial Conjunctivitis
      1. Trachoma
      2. Adult Inclusion Conjunctivitis
    3. Viral Conjunctivitis
      1. Acute Serous
      2. Acute Hemorrhagic
      3. Follicular - 02 types; Acute and Chronic.
  2. ALLERGIC CONJUNCTIVITIS
    1. Simple Allergic Conjunctivitis
      1. Hay-Fever Conjunctivitis
      2. Seasonal Allergic Conjunctivitis [SAC]
      3. Perennial Allergic Conjunctivitis [PAC]
    2. Vernal Kerato-Conjunctivitis [VKC]
    3. Atopic Kerato Conjunctivitis [AKC]
    4. Gaint Papillary Conjunctivitis [GPC]
    5. Phlyctenular Kerato-Conjunctivitis [PKC]
    6. Contact Dermo-Conjunctivitis [CDC]
  3. GRANULOMATOUS CONJUNCTIVITIS
  4. OPHTHALMIA NEONATORUM

ACUTE CATARRHAL / MUCOPURULENT CONJUNCTIVITIS: It is most common type of Bacterial Conjunctivitis, characterized by --- marked Conjunctival Hyperemia & Mucopurulent discharge. It is caused by several organisms, viz.

  1. Staphylococcus Aureus
  2. Hemophilus Aegyptius
  3. Pneumococcus
  4. Streptococcus
  5. Adeno Virus
  6. Koch-Weeks' Bacillus

INCIDENCE

  1. It occurs in epidemics and is bilateral, usually.
  2. It is contagious and spreads by flies, fingers & fomites.
  3. It is often self-limiting.

SYMPTOMS

  • Discomfort and foreign body sensation, due to engorgement of vessels.
  • Mild photophobia; with slight blurring of vision.
  • Muco-purulent discharge from the eyes.
  • Sticking together of lids margin with discharge during sleep.

SIGNS

  1. Conjunctival congestion - more marked in Palpebral conjunctiva.
  2. Chemosis; i.e. swelling of Conjunctiva.
  3. Petechial hemorrhages.
  4. Flacks of muco-pus are seen in the fornices, canthi and lid margins.

HOMEOPATHIC REMEDIES

  1. Allium Cepa
  2. Apis Mel.
  3. Arsenicum Alb.
  4. Aconitum Nap.
  5. Atr. Belladonna
  6. Euphrasia
  7. Lycopodium Clav.
  8. Rhus Toxicodendron
  9. Sulphur
  10. Hepar Sulph.

============================

ACUTE PURULENT CONJUNCTIVITIS / ACUTE BLENORRHEA: It is an acute inflammation of conjunctiva occurring in adult. It is characterized by violent inflammatory response. Common causative organisms are :-

  1. Gonococcus most common
  2. Pneumococcus
  3. Staphylococcus Aureus

INCIDENCE

  1. It occurs in males, commonly affecting the Right eye first.
  2. It may be associated with Genital infection and/or Urethritis.
  3. Incubation Period - Few hours to 03 days.

CLINICAL PICTURE
It can be divided into three stages :-

Stage of Infiltration - Lasts for 04 to 05 days and characterized by -----

Painful & tender eyeball.
Bright red, velvety, chemosed conjunctiva.
Lids are tense & swollen.
Discharge is watery & sanguinous.
Pre-auricular lymph nodes are enlarged.

Stage of Blenorrhœa - It starts about 5TH day & lasts for several days and is characterized by -------

Frankly purulent, copious, thick discharge --- trickling down the cheeks.
Other symptoms are increased; but tension in the lid is decreased.

Stage of Slow Healing - This stage is characterized by ------

Pain decreased & swelling in lids is subsided.
Conjunctiva remains red, thickened & velvety.
Discharge diminished slowly & at the end, resolution is complete.

HOMEOPATHIC REMEDIES

  1. Aconitum Nap.
  2. Apis Mel.
  3. Arg. Nitricum
  4. Euphrasia
  5. Hepar Sulph.
  6. Merc. Solubilis
  7. Rhus Toxicodendron

============================

ACUTE MEMBRANOUS CONJUNCTIVITIS / DIPHTHERITIC CONJUNCTIVITIS: It is an acute inflammation of conjunctiva ---- characterized by formation of a true membrane on the conjunctiva. Now- a-days, it is a very rare occurrence. The disease is caused by:-

  • Corynebacterium Diphtheriæ most common
  • Gonococcus
  • Streptococcus Hæmolyticus

INCIDENCE

  1. Commonly seen in children ---- who are not immunized previously.
  2. It often occurs in weak children, after measles.

CLINICAL PICTURE
It can be divided into three stages :-

Stage of Infiltration - Characterized by ------

Scanty conjunctival discharge & severe pain.
Lids swollen & hard.
Conjunctiva is red & covered with thick gray-yellow membrane. The membrane is tough & firmly adherent; which on removing, bleeds & leaves behind a raw area.
Pre-auricular lymph nodes are enlarged.

Stage of Suppuration - Characterized by -----

Pain decreases & lids become soft.
Membrane is sloughed off leaving a raw surface.
Copious, out pouring of purulent discharge.

Stage of Cicatrization - Characterized by ----

Raw surface covered with epithelial granulation tissue.
Healing occurred by cicatrisation - which may cause Trichiasis and Conjunctival Xerosis.

INDICATED HOMEOPATHIC REMEDIES

  1. Apis Mel.
  2. Arg. Nitricum
  3. Kali Bichromicum

============================

ACUTE PSEUDOMEMBRANOUS CONJUNCTIVITIS: It is characterized by formation of pseudo-membrane on the conjunctiva. It is caused by :-

  1. Bacterial infection
    • Corynebacterium Diphtheriæ most common
    • Staphylococcus
    • Streptococcus
    • Hemophilus Influenzæ
  2. Viral infection
    • Herpes simplex
    • Adeno virus
  3. Chemical Irritants
    • Acids
    • NH3
    • AgNo3
    • CuSO4

CLINICAL PICTURE: It presents as muco-purulent conjunctivitis associated with formation of thin yellowish-white membrane in the Fornices & Palpebral Conjunctiva. This membrane can be peeled off easily & does not bleed.

INDICATED HOMEOPATHIC REMEDIES

  1. Kali Bichromicum
  2. Euphrasia

============================

CHRONIC CATARRHAL / BACTERIAL CONJUNCTIVITIS: It is also known as Simple Chronic Conjunctivitis - characterized by mild catarrhal inflammation of conjunctiva.

ÆTIOLOGY

  1. Irritation by smoke, dust, heat, allergens etc.
  2. Concretion, misplaced eyelashes, dacryocystitis, chronic rhinitis aggravate it.
  3. Retained foreign body in the fornix.
  4. Seborrhœa, chronic intranasal infection & dandruff.

SYMPTOMS

  1. Burning & grittiness in eyes, especially in the evening.
  2. Mild chronic redness in the eye.
    • The edges of lids feel hot & dry and difficulty in keeping the eye open.
  3. Mild mucoid discharge, especially in the canthi.
  4. Off & on lachrymation.

SIGNS

  1. Grossly, the eye looks normal; but careful examination may reveal -------
  2. Congestion of posterior conjunctival vessels.
  3. Mild papillary hypertrophy.
  4. Surface of conjunctiva looks sticky.
  5. Lids margin may be congested.

INDICATED HOMEOPATHIC REMEDIES

  1. Arsenicum Alb.
  2. Graphites
  3. Sulphur
  4. Thuja Occidentalis.

============================

ANGULAR / DIPLOBACILLARY CONJUNCTIVITIS: It is a type of chronic conjunctivitis - characterized by mild grade inflammation confined to the conjunctiva & lids margin near the angle associated with maceration of surrounding skin.
It is caused by MOREX-AXENFIELD Diplobacillus. It produces proteolytic ferment, which macerate the conjunctival epithelium.

SYMPTOMS

  1. Irritation, smarting sensation & feeling of discomfort in the eyes.
  2. History of collection of dirty white foamy discharge at the angles.
  3. Redness in the angles of the eyes.

SIGNS

  1. Hyperemia of bulbar conjunctiva, near the canthi & of lid-margin, near the angle.
  2. Excoriation of skin around the angles.
  3. Presence of foamy muco-purulent discharge at the angle.

INDICATED HOMOEOPATHIC REMEDIES

  1. Apis Mel.
  2. Hepar Sulph.

============================

TRACHOMA: It is a chronic kerato-conjunctivitis, primarily affecting the superficial epithelium of conjunctiva & cornea, simultaneously. It is characterized by mixed follicular & papillary response of conjunctival tissue. It is caused by - Chlamydia Trachomatis, a Bedsonian Organism [Serotypes A, B, Ba & C]. It belongs to Psittacosis Lymphogranuloma group. It lies between virus & bacteria. It is seen in conjunctival scrapping of the epithelial cells - as the Halberstaedterprowazek inclusion bodies.

INCIDENCE

  1. 1/5TH of the World population is affected by trachoma.
  2. It is commonly seen in unhygienic, crowded, dusty & dirty environment.
  3. It is contagious in acute stage. Finger, flies, towels & formites spread it.
  4. Incubation period: It varies from 05 to 21 days. Onset is usually insidious.

SYMPTOMS

  1. Mild irritation & foreign body sensation is often present.
  2. Frequent blinking may be present.
  3. Mild itching.
  4. In chronic stage, cornea is involved - causing pain, lachrymation & photophobia.

SIGNS

  1. CONJUNCTIVAL SIGN
    1. Red, velvety, jelly-like thickening of palpebral conjunctiva.
    2. Papillæ - They may be present in palpebral conjunctiva.
    3. Follicles - They are seen in upper & lower fornix, palpebral conjunctiva, plica, bulbar conjunctiva. They measure 01 to 05 mm in size.
    4. Typical star shaped scarring is seen at the centre of the follicle, in late stage.
    5. Arlt's line - A line of palpebral conjunctival scarring is seen, 02 mm from the upper lid margin.
  2. CORNEAL SIGN
    1. Superficial Keratitis may be present in the upper part.
    2. Herbert's pits - There is follicle like infiltration near the limbus in the upper part. This, later, results in depression --- caused by cicatrization of limbal follicles.
    3. Pannus - There is lymphoid infiltration with vascularization, seen in the upper part of cornea. Pannus may resolve completely, if Bowman's membrane is not disturbed. It is of 02 types - Progressive Pannus and Regressive Pannus.

Mc.CALLAN'S Classification
Mc. Callan, in 1908, divided the Clinical Course of Trachoma, into 04 stages ---

Stage 1 : Incipient Trachoma or Stage of Infiltration.
Stage 2 : Established Trachoma or Stage of Florid Infiltration.
Stage 3 : Cicatrizing Trachoma or Stage of Scarring.
Stage 4 : Healed Trachoma or Stage of Sequelæ.

INDICATED HOMEOPATHIC REMEDIES

  1. Acon. Nap.
  2. Ars. Alb.
  3. Arg. Nit.
  4. Calc. Carb.
  5. Nat. Sulph.
  6. Puls. Nig.
  7. Merc. Sol.
  8. Rhus Tox.
  9. Sepia

============================

ADULT INCLUSION CONJUNCTIVITIS: It is a type of acute follicular conjunctivitis --- associated with muco-purulent discharge - usually affects the sexually active young adults.
It is caused by Sero-types D to K of Chlamydala Trachomatis. Primary source of infection is Urethritis in male & Cervicitis in female. It transmitted through contaminated finger or through contaminated water of swimming pool - so, it is also known as swimming pool conjunctivitis. The incubation period is 04 to 12 days.

SYMPTOMS

  1. Ocular discomfort - foreign body sensation.
  2. Mild photophobia & muco-purulent discharge from eye.

SIGNS

  1. Conjunctival hyperæmia - more marked in the fornices.
  2. Acute follicular hypertrophy of lower palpebral conjunctiva.
  3. Superficial keratitis.
  4. Pre-auricular lymphadenopathy.

INDICATED HOMEOPATHIC REMEDIES

  1. Argentum Nitricum.
  2. Natrum Sulph.
  3. Pulsatilla Nigricans.

============================

ACUTE SEROUS CONJUNCTIVITIS: It is typically caused by a mild grade viral infection - which does not give rise to follicular response.

CLINICAL PICTURE

  1. A minimal degree of congestion and watery discharge.
  2. A boggy swelling of the conjunctival mucosa.

INDICATED HOMEOPATHIC REMEDIES

  1. Euphrasia
  2. Mercurius Sol.

============================

ACUTE HÆMORRHAGIC CONJUNCTIVITIS: It is an acute inflammation of conjunctiva, characterized by - Multiple conjunctival hemorrhages, Conjunctival hyperæmia and Mild follicular hyperplasia.
It is caused by Picorna viruses [Entero-virus, type 70] - which are RNA virus of small or pico size. The disease is very contagious and transmitted by direct hand to eye contact.
This disease has occurred in an epidemic form in the far East, Africa & England and hence, the name Epidemic Hemorrhagic Conjunctivitis. It is also known as Apollo Conjunctivitis. The incubation period is very short - 01 to 02 days.

SYMPTOMS

  1. Pain, redness, watering from the eyes and mild photophobia.
  2. Transient blurring of vision with lid swelling.

SIGNS

  1. Conjunctival congestion and mild follicular hyperplasia.
  2. Chemosis; lid œdema.
  3. Multiple hemorrhages in bulbar conjunctiva.
  4. Pre-auricular lymphadenopathy.

INDICATED HOMEOPATHIC REMEDIES

  1. Euphrasia
  2. Rhus Tox.

============================

FOLLICULAR CONJUNCTIVITIS: It is characterized by - Formation of follicles, Conjunctival hyperæmia and Discharge from eyes.
Follicles are formed due to localized aggregation of lymphocyte in the adenoid layer of conjunctiva. Follicles appear as tiny grayish white, translucent, rounded swellings, 01 to 02 mm in diameter. There appearance resembles boiled sago-grains.
It is of 02 types :-

ACUTE FOLLICULAR CONJUNCTIVITIS: It associated with marked follicular hyperplasia - especially of the lower fornix & lower palpebral conjunctiva.
This is Similar to catarrhal conjunctivitis & includes :-

  1. Redness, watering, mild mucoid discharge.
  2. Mild photophobia & feeling of discomfort.
  3. Foreign body sensation.
  4. Conjunctival hyperæmia; associated with multiple follicles - more prominent in lower lid.

CHRONIC FOLLICULAR CONJUNCTIVITIS: It is a mild type of chronic catarrhal conjunctivitis - associated with follicular hyperplasia, predominantly involving the lower lid.
Ætiologically, it is of 04 types :-

  1. Infective Chronic Follicular Conjuncitivitis.
  2. Toxic Chronic Follicular Conjunctivitis.
  3. Chemical Chronic Follicular Conjunctivitis.
  4. Chronic Allergic Follicular Conjunctivitis.

INDICATED HOMEOPATHIC REMEDIES

  1. Euphrasia.
  2. Sepia.

============================

ALLERGIC CONJUCTIVITIS: It is the inflammation of conjunctiva due to allergic reaction - which may be Immediate / Humoral and Delayed / Cellular.

TYPES

  1. Simple Allergic Conjunctivitis
    1. Hay-fever Conjunctivitis
    2. Seasonal Allergic Conjunctivitis [SAC]
    3. Perennial Allergic Conjunctivitis [PAC]
  2. Vernal Kerato-conjunctivitis
  3. Atopic Kerato-conjunctivitis
  4. Gaint Papillary Conjunctivitis
  5. Phlyctenular Kerato-conjunctivitis
  6. Contact Dermo-conjunctivitis

SIMPLE ALLERGIC CONJUNCTIVITIS: It is mild, non-specific allergic conjunctivitis - characterized by itching hyperæmia & mild papillary response. Basically, it is an acute or sub-acute urticarial reaction. It is seen in following forms :-

  1. Hay-fever Conjunctivitis - The common allergens are pollens, grass & animal dandruff.
  2. Seasonal Allergic Conjunctivitis - It is very common occurrence due to grass pollens.
  3. Perennial allergic conjunctivitis - It is due to perennial allergens; such as house dust & mite. It is uncommon.

SYMPTOMS

  1. Intense itching.
  2. Burning sensation in eyes associated with watery discharge.
  3. Mild photophobia.

SIGNS

  1. Hyperemia & chemosis - swollen juicy appearance to the conjunctiva.
  2. Mild papillary reaction and Œdema of lids.

INDICATED HOMEOPATHIC REMEDIES

  1. Acon. Nap.
  2. Allium Cepa.
  3. Ars. Alb.
  4. Hepar Sulph.

-----------------------

VERNAL KERATOCONJUNCTIVITIS / SPRING CATARRH: It is a recurrent, bilateral, interstitial, self-limiting, allergic inflammation of the conjunctiva - having a periodic seasonal incidence.
It is considered as a hypersensitivity reaction to some exogenous allergen - viz. grass, pollen etc. In many cases IgE mediated mechanisms play an important role. Family history of other atopic diseases - e.g. Hay-fever, Bronchial Asthma or Eczema etc. and their peripheral blood shows Eosinophilia & increased Serum IgE level.

PREDISPOSING FACTORS

  1. Age & Sex - 04 to 20 years; more common in boys.
  2. Climate - More prevalent in tropics; less in temperate zones and almost non- existent in cold climate.
  3. Season - More common in summer; also known as warm water conjunctivitis.

SYMPTOMS: It is characterized by - marked burning & itching sensation. Itching is more marked with palpebral form of disease. Other associated symptoms are - mild photophobia, lachrymation, stringy ropy discharge & heaviness of lids.

SIGNS: Clinically, it is with 02 clinical forms -------

  1. Palpebral Form - Usually upper tarsal conjunctiva of both eyes are involved. The typical lesions is characterized by the presence of hard, flat topped, papillæ arrange in a 'cobble - stone'/ 'pavement stone' fashion.
  2. Bulbar Form - It is characterized by - dusky-red triangular congestion of bulbar conjunctiva in palpebral area; gelatinous thickened accumulation of tissue around the limbus and presence of discrete whitish raised dots along the limbus.

INDICATED HOMEOPATHIC REMEDIES

  1. Sepia.
  2. Sulphur.
  3. Thuja Occ.

-------------------------

ATOPIC KERATO-CONJUNCTIVITIS: It can be thought of as an adult equivalent of Vernal Kerato-Conjunctivitis and is often associated with Atopic Dermatitis.
It commonly occurs in adult groups and predominantly males are affected.

SYMPTOMS

  1. Itching, soreness, dry sensation.
  2. Mucoid discharge.
  3. Photophobia.

SIGNS: Lids margin are chronically inflamed with rounded posterior borders. Tarsal conjunctiva has a milky appearance. There are very fine papillæ, hyperæmia & scarring with shrinkage. Cornea may show Punctate Epithelial Keratitis. It is often more severe in lower half. There may also be corneal vascularisation, thining & plaques.

INDICATED HOMEOPATHIC REMEDIES

  1. Euphrasia.
  2. Pulsatilla Nigricans.
  3. Rhus Toxicodendron.

------------------------

GAINT PAPILLARY CONJUNCTIVITIS: It is the inflammation of conjunctiva with formation of very large size papillæ.
It is a localized allergic response to a physically rough or deposited surface - e.g. Contact lens, Prosthesis, Left-out nylon Sutures etc. Probably, it is a sensitivity reaction to component of the plastic leached out by the reaction of tear.

SYMPTOMS & SIGNS

  1. Itching, stringy discharge and reduced wearing time of contact lens.
  2. Papillary hypertrophy of the upper tarsal conjunctiva.

INDICATED HOMEOPATHIC REMEDIES

  1. Apis Mel.
  2. Thuja Occ.

--------------------------

PHLYCTENULAR KERATOCONJUNCTIVITIS: It is a characteristic nodular affection occurring as an allergic response by the conjunctival & corneal epithelium to some endogenous allergens - to which they have become sensitized.
It is believed to be a delayed hypersensitivity [Type IV cell-mediated] response to endogenous microbial proteins.

  1. Causative Allergens
    1. Tuberculous protein.
    2. (b) Staphylococcus protein.
    3. Moraxella-axenfeld Bacillus & certain parasites.
  2. Predisposing Factors
    1. Age - 03 to 15 yrs.
    2. Sex - Incidence is higher in girls than boys.
    3. Nutrition - Under-nourishment.
    4. Living condition - Overcrowded & unhygienic.
    5. Season - Occurs in all season but incidence is high in spring & summer season.

SYMPTOMS

  1. Mild discomfort in eyes.
  2. Irritation & reflex watering.
  3. Associated with muco-purulent conjunctivitis, due to secondary bacterial infection.

SIGNS: It can presents in 03 forms -----

  1. Simple Phylctenular Conjunctivitis - The most common variety. Characterized by typical pinkish-white nodule surrounded by hyperæmia on the bulbar conjunctiva, usually near the limbus.
  2. Necrotising Phylctenular Conjunctivitis - Characterized by the presence of very large phlycten with necrosis & ulceration, leading to a severe pustular conjunctivitis.
  3. Milliary Phylctenular Conjunctivitis - Characterized by the presence of multiple phylcten, which may be arranged haphazardly or in the form of ring around the limbus and may even form a ring ulcer.

INDICATED HOMEOPATHIC REMEDIES

  1. Antim.Crud.
  2. Aurum Met.
  3. Calc.Carb.
  4. Hepar Sulph.
  5. Conium Mac.
  6. Euphrasia
  7. Kali Bich.
  8. Rhus Tox..
  9. Thuja Occ.

----------------------

CONTACT DERMOCONJUNCTIVITIS: It is an allergic disorder involving conjunctiva & skin of lids - along with surrounding area of face.
It is in fact, a delayed hypersensitivity [Type IV] response to prolonged contact with chemical & drugs. A few common topical ophthalmic medicines may also produce contact conjunctivitis - e.g. Atropine, Penicillin, Neomycin, Soframycin and Gentamycin.

CLINICAL PICTURE

  1. Cutaneous involvement is in the form of weeping eczematous reaction, involving all areas with which medication comes in contact.
  2. Conjuncival response is in the form of hyperæmia with a generalized papillary response affecting the lower fornix & lower palpebral conjunctiva more than the upper.

INDICATED HOMEOPATHIC REMEDIES

  1. Antim.Tart.
  2. Arg.Nitricum.
  3. Apis Mel.
  4. Chamomilla.
  5. Merc. Sol.
  6. Thuja Occ.

============================

GRANULOMATOUS CONJUNCTIVITIS: It is a term used to describe certain specific chronic inflammation of conjunctiva - characterized by proliferative lesions, which usually tend to remain localized to one eye and are mostly associated with regional lymphadenitis. Common Granulomatous Conjunctival Inflammation is :-

  • Tuberculosis of Conjunctiva.
  • Sarcoidosis of Conjunctiva.
  • Syphilitic Conjunctivitis.
  • Leprotic Conjunctivitis.
  • Conjunctivitis in Tularæmia
  • Ophthalmia Nodosa.

PARINAUD'S OCCULOGLANDULAR SYNDROME
The Common causes are - Tularæmia, Cat-scratch disease, Tuberculosis, Syphilis & Lympho-Granuloma Venereum (LGV). It is a name given to a group of condition characterized by :-

  1. Unilateral granulomatous conjunctivitis.
  2. Preauricular lymphadenopathy.
  3. Fever.

OPHTHAMIA NODOSA / CATERPILLAR HAIR CONJUNCTIVITIS
It is a granulomatous inflammation of conjunctiva characterized by the formation of nodule on the bulbar conjunctiva in response to irritation caused by the retained hair of catarpillar. The disease is, therefore, common in summer.

INDICATED HOMOEOPATHIC REMEDIES

  1. Thuja Occidentalis.

============================

OPHTHALMIA NEONATORUM: The name given to bilateral inflammation of conjunctiva occurring in an infant less than 30 days old. It is the preventable disease usually occurring as a result of carelessness at the time of birth. As a matter of fact any discharge or even watering from the eyes in the first week of life should arouse the suspicion of Ophthalmia Neonatorum.

ÆTIOLOGY

  1. Source and Mode of Infection - Infection may occur in 03 ways --------
    • Before birth infection is very rare; through infected liquor amnii in mother with ruptured membranes.
    • During birth - It is the most common mode of infection from the infected birth canal especially when the child is born with face presentation or with forceps.
    • After birth - Infection may occur during first bath of new-born or from soiled clothes or fingers with infected lochia.
  2. Causative agent
    • Chemical conjunctivitis - It is caused by silver nitrate or antibiotics used for prophylaxis.
    • Gonococcal infection.
    • Other Bacterial Infection - Staphylococcus Aureus, Streptococcus Hæmolyticus & Pneumoniæ.
    • Neonatal Inclusion Conjunctivitis - It is caused by serotypes D to K of Chlamydia Trachomatis.
    • Herpes Simplex Ophthalmia Neonatorum - It is a rare condition, caused by Herpes Simplex II virus.

INCIDENCE

  1. It is bilateral.
  2. It commonly occurs in the newborns due to maternal infection.

INCUBATION PERIOD: It varies depending on the type of the causative agent as ----

  • Causative agent Incubation period
  • Chemical 4 -6 hours.
  • Gonococcal 2 - 4 days.
  • Other Bacterial 4 - 5 days.
  • Neonatal inclusion Conjunctivitis 5 - 14 days.
  • Herpes simplex 5 - 7 days.

SYMPTOMS

  1. Any discharge from a baby's eye during the 1ST week of life is alarming as tears are secreted only 3 to 4 weeks' after birth.
  2. The conjunctiva is bright-red and swollen, with pouring out of thick yellow pus.
  3. Thick pus accumulates at the lid borders, lashes and canthi.
  4. Sticking together of the lids is a common feature.

SIGNS

  1. Lids are swollen and tense due to dense infltration of the bulbar conjunctiva.
  2. Conjunctiva is markedly congested and chemosed. Lids are separated by lid retractors - to see the cornea - Pseudo-membrane may be present.
  3. Later, the conjunctiva becomes puckered and velvety with free discharge of pus, serum and blood.

INDICATED HOMEOPATHIC REMEDIES

  1. Antim.Tart.
  2. Arg. Nitricum.
  3. Apis Mel.
  4. Chamomilla.
  5. Merc. Sol.
  6. Thuja Occ.

============================

Homoeopathic Therapeutics of Conjunctivitis

Aconitum Napellus

  • INDICATION : In the first stage of any inflammation of the conjunctiva.
  • CAUSES : Traumatic origin; foreign body, exposure to cold & burns.
  • DISCHARGES : Muco-purulent discharges.
  • SENSATIONS : Eyes feel full of sand.
  • CHARACTERS :
    1. Eyes are usually dry & swelled.
    2. Lachrymation moderate.
    3. Marked photophobia with painful inflammation.

Allium Cepa

  • INDICATION : Acute Catarrhal Conjunctivitis.
  • SENSATIONS : As if eye were hanging by string.
  • DISCHARGES : Bland, profuse discharge from the eyes. Tears do not excoriate as they flow down over the cheek.
  • CHARACTERS :
    1. Eyes burns & smart as from the smoke; watery, suffused, capillaries injected with excessive lachrymation.
    2. Extreme Photophobia; with redness of eye ball, sensitive to light; < in evening.
    3. Letter appear smaller; near object seems distant; with yawning.
  • MODALITIES :
    1. Aggravation : warm room & evening.

Alumina

  • INDICATION : Granular Conjunctivitis.
  • ACTION : Alumina is a remedy for Ophthalmia Senillis. It has well known power of producing dryness of mucous membrane.
  • CHARACTERS :
    1. Pressure on the eyes, which render it impossible to open the eye. Pressure as from grains of sand in the corners of eye, especially in the evening. Great dryness of eyes (Nat. Carb, Nat. Sulph).
    2. Sensation of burning, with nocturnal agglutination of lids & diuranal lachyrmation.
    3. Swelling of eyelids & paralysis of upper eyelids.
    4. Photophobia; confuse of sight - as from mist & sparkling before the eyes
    5. Asthenopia; from irritated conjunctiva, granular lids; loss of power of internal rectus (Conium, Ruta, Nat. Mur.).

Antimonium Crudum

  • INDICATION : Phylctenular & Pustular Conjunctivitis.
  • CHARACTERS :
    1. Eyes dull, sunken, red; itchy, inflamed & agglutinated, especially in the morning.
    2. Shooting pain in the eyes.
    3. Pustules on the cornea & lids.
    4. Canthi raw & fissured with soreness (Graphites).
    5. Occurs in children; with pustules on face & moist eruptions behind ears.
    6. Chronic Blepharitis.
  • MODALITIES :
    1. Aggravation : Sun shine & bright light.

Antimonium Tartaricum

  • INDICATION : Gonorrhœal Conjunctivitis and Rheumatic Ophthalmia.
  • SENSATIONS : Shooting, burning & smarting in internal canthi; with redness.

CHARACTERS :

    1. Eyes fatigue; requires sleep & eyes to be firmly closed. Sunken eyes & surrounded by dark circle.
    2. Pain, as if bruised in eyeball - especially on touching it.
    3. In Pneumonia, when the edge of lids covered with mucus.

Apis Mellifica

  • INDICATION :
    1. Acute Catarrhal Conjunctivitis.
    2. Any form of conjunctivitis, with swelling of lids & adjacent cellular tissue (Gels).
    3. Asthenopia; Staphyloma & Strumous Ophthalmia.
    4. Keratitis.
  • CHARACTERS :
    1. Inflammation of eyes with thickening of mucus membrane & lids.
    2. Lids swollen, bluish-red, œdematous, everted; watery-looking semitransparent (Ars. Alb. - pale)
    3. Conjunctiva bright red & puffy.
    4. Lacrymation hot & less acrid (Arsenic - hot, but more acrid).
    5. Stinging pain; sudden piercing pain with great burning.
    6. Marked photophobia.
    7. Piercing itching around the orbit, eyebrows & lids; desire to rub.
    8. Serous exudation with œdema.
    9. Apis has tendency to formation of pus in eyes (Rhus tox.).
    10. It also prevents reccurance of styes.
  • MODALITIES :
    1. Aggravation : evening (Arsenic - night).
    2. Amelioration : cold application (Arsenic - hot application).

Argentum Nitricum

  • INDICATION : Purulent & Granular Conjunctivitis and Ophthalmia Neonatorum.
  • CAUSATION :
    1. Gonorrhoea & Catarrhal condition.
    2. Eye strain from fine needle-work.
  • DISCHARGES : Profuse purulent discharge with intense chemosis.
  • CHARACTERS :
    • Ophthalmia Neonatorum
      1. In young infants, who contacted gonorrhoea during the passage through the birth canal of infected mother.
      2. Profuse purulent discharge with intense chemosis.
      3. Cornea is opaque & ulcerated.
      4. Lids are sore, thick & swollen with agglutination in the morning (Apis, Merc. Sol., Rhus Tox.).
    • Granular Conjunctivitis
      1. Scarlet red like raw beef in appearance.
      2. Eye-strain from needle-work.
      3. Dilated pupil, with dimness of vision & intense photophobia.
      4. The inner canthi are swollen & congested.
      5. Paretic condition of ciliary muscles; defective accommodation.
  • MODALITIES :
    1. Aggravation : worm room, sitting by the side of fire & light.
    2. Amelioration : cold application & dark room.

Arsenic Album

  • INDICATION : Acute & Chronic Catarrhal Conjunctivitis, Keratitis, Trachoma, Iritis.
  • CHARACTERS :
    1. Eyelids are red, ulcerated, scabby, scaly, granulated, swollen.
    2. Great characteristic is burning 'as if from fire'.
    3. Discharge causes burning; relieved by warmth.
    4. External inflammation with extreme painfulness.
    5. Lacrymation hot, burning & excoriating in nature making eyelids & cheek sore. Photophobia.
    6. Everything the patient looks, seen green to him. Hemianopia; can see only lower half of the object.
  • MODILITIES :
    1. Aggravation : night, cold.
    2. Ameoliration : warmth & warm application.
  • All like Apis but without it's stinging pain & relieve by cold application.

Aurum Metallicum

  • INDICATION : Scrofulous ophthalmia, Glucoma, Iritis.
  • CHARACTERS :
    1. Ophthalmia with great vascularity & profuse lachrymation.
    2. Hemiopia; half sight - patient can seen only the lower half of the object
    3. (Lycopodium & Muriatic acid - Lateral half cut off).
    4. Opacity & ulcer on the cornea with great congestion.
    5. Syphilitic Iritis; sore & bruise congestion around eyes, with violent pain in bones around the eye.
    6. Extreme photophobia with double vision.
  • MODALITIES :
    1. Aggravation : cold air.
    2. Amelioration : warmth.

Atropha Belladonna

  • INDICATION : Early stage of Catarrhal Conjunctivitis, Iritis.
  • CHARACTERS :
    1. Great dryness of eyes. Right eye mostly affected. Red, hot burning eye with dimness of vision. Half open protruding eyes.
    2. Total absence of lachrymation.
    3. Great intolerance of light; marked photophobia.
    4. Sudden attack of congestion with severe & violent spasmodic pain. Pain comes suddenly, lasts indefinitely & goes suddenly.

Calcarea Carbonica

  • INDICATION : Phlyctenular Conjunctivitis, Trachoma, Eye strain (Onosodium). Calc. Carb. is indicated in fatty & flabby constitution - where cold settles in eye & produces inflammation.
  • CAUSATION :
    1. Exposure to the wet & cold air.
    2. Foreign body.
  • SENSATIONS : Sensation of coldness in eyes.
  • DISCHARGES : Profuse, purulent, thick, whitish-yellow & excoriating in nature.
  • CHARACTERS :
    1. Eyelids are red, swollen; with pain & itching.
    2. Ulcer and opacity of cornea.
    3. Dim vision & photophobia.
    4. Calc. is an excellent remedy for eye strain caused by exertion like reading & looking steadily one thing etc.(Onosmodium).
    5. Lachrymation especially in morning & in open air.
    6. Chronic dilatation of pupils.
  • MODALITIES :
    1. Aggravation : exertion of eye & taking cold.

Matricaria Chamomilla

  • INDICATION : Ophthalmia Neonatorum.
  • CAUSATION :
    1. After exposure to cold while bathing & washing.
    2. During dentition.
  • DISCHARGES :
    1. Profuse, acrid, yellow, purulent discharge.
    2. Oozing of bloody water from the eyes of newborn infant.
  • CHARACTERS :
    1. Inflammation of margins of eyelids, especially lower, which becomes swollen & puffed.
    2. Yellow colour of sclerotica.
    3. Ecchymosis & hæmorraghes in eye.
    4. Shooting, burning pain & violent pressure in orbit.
    5. Irritable temperament; child cries, must be carried.

Conium Maculatum

  • INDICATION : Phlyctenular & Scrofulous Conjunctivitis
  • SENSATIONS : Cold & burning sensation in eyes, when walking in open air.
  • CHARACTERS :
    1. Intense photophobia & excessive lachrymation from slightest inflammation or even not at all.
    2. Defective accommodation & visual disturbance on watching moving object.
    3. Pain burning, cutting & shooting pain in the eyes when reading.
    4. Yellow coloured sclera.
    5. Sweat on head, face & neck.
  • It is very useful remedy in Diplopia, Myopia & Presbyopia.

Euphrasia Officinalis

  • INDICATION :
    1. Catarrhal, Purulent, Phlyctenular Conjunctivitis.
    2. Blepharitis, Photophobia, Rheumatic Iritis.
    3. Opacity & Ulceration of Cornea.
    4. Ambylopia.
  • CAUSATION : Exposure to cold & during first stage of measles.
  • SENSATIONS : Gnawing sensation in the eye as if sand in the eye.
  • DISCHARGES : Thick, acrid, profuse, yellow discharge; which excoriates the cheek & make the lids sore (Merc. Sol., Nat. Mur.).
  • CHARACTERS :
    1. Eyelids become red & injected, particularly on inner surface. They become puffed red or even dark. Swelling of eyelids especially lower.
    2. Photophobia is marked & the person cannot bear sunlight or artificial light.
    3. Intense itching with constant rubbing the eyes.
    4. Little blister forms on or near the phlyctenule.
    5. A film of mucus seems to collect over cornea causing difficulty in vision.
    6. Scar from ulcer & specks on cornea.
    7. Wiping & winking the eyes relieve blurred vision.
  • 12x is very useful
  • MODALITIES :
    1. Aggravation : open air.
    2. Amelioration : warmth.

Graphites Naturalis

  • INDICATION : Phlyctenular & Chronic Catarrhal Conjunctivitis, Blepharitis & Styes.
  • SENSATIONS : Sensations of cobweb on the face; tries hard to brush it off.
  • DISCHARGES : Muco-purulent discharge from the eye; excoriating.
  • CHARACTERS :
    1. Eczema of lids; eruptions moist & fissured; margin of lids are covered with scales & crusts.
    2. Graphites leads all remedies for eczematous eruption of lids (Staph., Sulph.)
    3. Scrofulous Ophthalmia; cornea is apt to be covered with superficial ulcers.
    4. Blepharitis; < in the angles of eye in the canthi.
    5. Hardened styes may appear along the edges of lids.
    6. Letter appears double when writing & run together when reading. He also sees fiery zig-zags around his field of vision.
    7. Intense photophobia in the sunlight with copious lachrymation.
    8. No remedy has marked photophobia more than Graphites. If there is a tendency for the edges of the lids to crack & bleed, Graphites is sure sort remedy
  • MODALITIES :
    1. Aggravation : morning & cold air.
    2. Amelioration : open air.

Hepar Sulphuris Calcareum

  • INDICATION : Purulent Conjunctivitis
  • CAUSATION : Exposure to cold air & suppressed eruption.
  • DISCHARGES : Bloody, offensive discharge; yellowish-white in colour.
  • CHARACTERS :
    1. Eyelids thick & swollen. Excessive soreness & sensitiveness of lids. Little point of pus appear at the root of cilia.
    2. Oversensitiveness of lids; spasmodically closed; bleed easily upon any attempt to open them & very sensitive to touch.
    3. Intense photophobia with lachrymation & great redness of eye.
    4. Throbbing, aching, shooting pain; worse by warmth.
    5. It is speedly absorbes hypopyon & abscess of cornea. No other remedy is required. Therefore it is called as "King of Remedies in Ulceration of Cornea".
    6. Suppurative styes. It is very useful in suppurative forms.
  • MODALITIES :
    1. Aggravation : cold air & cold application.
    2. Amelioration : warmth.
  • 'Hepar is our best remedy for conjunctivitis, especially in the cases that do not yield to Aconite or Belladonna, following this remedy well'

Kali Sulphuricum

  • INDICATION : Ophthalmia Neonatorum & Gonorrhœal Conjunctivitis. Abscess in cornea.
  • DISCHARGES : Thin, watery, yellow discharge.
  • CHARACTERS : Purulent & yellow mucus discharge. Yellow crusts present on the margins of eyelids.
  • MODALITIES :
    1. Aggravation : warmth.
    2. Amelioration : cold things & open air.

Kali Bichromicum

  • INDICATION : Conjunctivitis of Scrofulous/Syco-Syphilitic origin. Diphtheritic Conjunctivitis. Trachoma.
  • CAUSATIONS : Hot weather; Autumn and Spring
  • DISCHARGES : Thick, stringy, yellow matter.
  • CHARACTERS :
    1. Lids are swollen & agglutinated especially in the morning.
    2. Little photophobia with marked indolence; eyes are not very red.
    3. In chronic cases, there is tendency to formation of ulcers which progresses slowly.

Mercurius Solubilis

  • INDICATION : Gonorrhœal & Purulent Conjunctivitis. Ophthalmia Neonatorum
  • CAUSATIONS : Conjunctivitis from cold or in those who works about fires.
  • DISCHARGES : Mucopurulent, thin & acrid.
  • CHARACTERS :
    1. Violent inflammation & redness of eyes.
    2. Cutting & burning pain & pressure in eye - as if from sand.
    3. Great sensitiveness of eye to glare of fire or light.
    4. Vesicles & pimples on sclera with purulent discharge.
    5. Pustules & scruffs around the eye & on the margins of lids.
  • MODALITIES :
    1. Aggravation : Pain are always aggravated at night.

Natrum Sulphuricum

  • INDICATION : Granular & Scrofulous Conjunctivitis.
  • CAUSATIONS : Damp weather.
  • DISCHARGES : Greenish, thick, catarrhal discharge.
  • CHARACTERS :
    1. Intense photophobia, even patient cannot open his eyes in light and causes headache.
    2. Burning of lids with lachrymation.
    3. Chronic conjunctivitis with large blister like granulation.

Pulsatilla nigricans

  • INDICATION : Purulent, Catarrhal & Phlyctenular Conjunctivitis. Trachoma.
  • CAUSATIONS : Cold or accompanying Measles.
  • ACTIONS : Pulsatilla Nig. has special affinity for lids - inflaming them & increasing Meibomian gland's secretion - which agglutinate the lids.
  • DISCHARGES : Profuse, thick, bland & yellowish-white or yellowish-green in colour.
    1. Discharges worse at night.
  • CHARACTERS :
    1. Agglutination of lids especially in the morning. Lids become swollen & itchy. Fine granulation on the lids.
    2. Profuse lachrymation & secretion of mucus; worse in the evening.
    3. Styes, especially on the upper lids - from eating greasy, fatty food. Repeated highly inflammed styes.
    4. Conjunctiva becomes full of minute pustules.
    5. Pulsatilla Nig. is especially serviceable for mild, passive, lymphatic temprament and locally profuse, thick, bland discharges, with not much pain or photophobia.
  • MODALITIES :
    1. Amelioration : cold & open air.

Rhus Toxicodendron

  • INDICATION : Catarrhal, Purulent, Phlyctenular Conjunctivitis. Scrofulous Ophthalmia. Iritis.
  • CAUSATIONS : From getting wet. Rheumatic subjects, from exposure to the damp weather.
  • ACTIONS : It corresponds to the chemosis & produce a great tendency to formation of pus.
  • DISCHARGES :
    1. Copious, purulent mucus discharge, yellow in colour & acrid in nature.
    2. Tears hot & scalding.
  • CHARACTERS :
    1. Eyelids inflamed; spasmodic closure of eyelids & gushing forth of yellow pus on forcing the lids apart.
    2. Eyes are red & agglutinated, especially in the morning.
    3. Conjunctivitis on getting wet & rheumatic iritis with great intolerance of light; inflammation extending to & involving choroids.
    4. In Iritis pains are shooting through the eyes to the back of head; worse at night & in damp weather.
    5. Tears hot & scalding - causes pimples on the parts bathed in them.
  • MODALITIES :
    1. Aggravation : during rest, after midnight, damp weather.

Sepia

  • INDICATION : Vernal, Recurrent, Follicular Conjunctivitis. Trachoma.
  • CAUSATIONS : Uterine disease and Seminal loss. Hot weather.
  • DISCHARGES : Muco-purulent discharge, especially in the morning.
  • CHARACTERS :
    1. There is dryness of eyes in the evening. The lids may be scaly & there will dropping of the lids; worse in the morning, evening & in hot weather.
    2. In asthenopia from uterine disease Sepia is especially indicated.
    3. There is blurring of sight & asthenopia due to seminal losses.
    4. It is perhaps the chief remedy in vernal conjunctivitis; morning & evening aggravation is its great characteristic.
    5. Acute Catarrhal Conjunctivitis with drawing sensation in external canthus & smarting in the eyes; amelioration by bathing in cold water.
    6. Follicular & Trachomatous Conjunctivitis during summer; always aggravate in hot weather, especially from abuse of tea.
  • MODALITIES :
    1. Aggravation : morning, evening & in hot weather.
    2. Amelioration : cold bathing.

Sulphur

  • INDICATION : Acute & Chronic Catarrhal Conjunctivitis. Phylctenular Conjunctivitis.
  • CAUSATIONS : Foreign body.
  • SENSATIONS : Feeling as if sand were in eyes. Sensation as if splinter of glass in eyes.
  • DISCHARGES : Acrid discharges. Hot tears flow out on opening the eyes (Rhus tox.).
  • CHARACTERS :
    1. Scrofulous Ophthalmia; pustular inflammation of conjunctiva with marked lachrymation.
    2. Sulphur patient has a tendency to congestion.
    3. The pain vary - though usually of a sharp, lancinating character - as if a needle were piercing the eye; there may have sharp shooting pain going through the eye back into the head from 1 to 3 am.
    4. Eyes are red & injected. Edges of the lids are thickened & ulcerated.
    5. Itching & burning in the eyes & eyelids; aggravated by moving or exposing them to the light.
    6. All symptoms are aggravated by bathing the eye; so that the child can not bear to have any water touch them.
  • MODALITIES :
    1. Aggravation : hot weather & by bathing.
  • "Sulphur works when the Aconite fails".

Thuja Occidentalis

  • INDICATION : Chronic Catarrhal & Phylctenular Conjunctivitis. Ophthalmia Neonatorum. Trachoma. Warts like excrescene on iris. Vascular tumour on cornea. Fungous tumour in orbit.
  • DISCHARGES : Purulent in nature.
  • CHARACTERS :
    1. Inflammatory swelling of lids with hardness. Granular lids, with warts like granulation. Red & painful nodosities on the margins of lids. Dry & branny lids.
    2. Styes, Tarsal tumour, Chalazæ; thick & hard knots.
    3. Lachrymation especially in the left eye, when walking in open air. The tears do not run off, but stand in the eyes.
    4. The eyes must be warmly covered; pain when uncovered.
  • MODALITIES :
    1. Aggravation : night.
    2. Amelioration : warm covering.

============================

After Operations on the Eyes

  • Aconitum Napellus : Principal remedy.
  • Ignatia Amaara : Violent pains in temples.
  • Rhus Toxicodendron : Pains shooting into head.
  • Bryonia Alba : Pains in head accompanied by vomiting.
  • Asarum Europeum : Jerking pains, with vomiting & diarrhœa.
  • Crocus Cacti : Hammering and jerking in eye.
  • Thuja Occidentalis : Stinging pains in temples.
  • Senega : Promotes the absorption of lens debris.
  • Strontia Carbonicum : Objects appear, as if tinged with blood.

============================

An abridged repertory of Conjunctivitis

Aggravation:

  • Morning : Sepia.
  • Evening : Pulstilla, Sepia.
  • From evening till midnight : Merc. Sol.
  • Night : Merc. Sol., Sulphur.
  • After midnight : Sulphur, Thuja Occ.
  • In warm room : Arg. Nit., Merc. Sol, Pulsatilla.
  • In cold air : Aconite, Merc. Sol.
  • During damp weather : Calc. Carb.
  • Water& washing : Sulphur.
  • From reading : Pulsatilla.

Amelioration:

  • From external warmth : Hepar Sulph.
  • In open air : Arg. Nit., Pulsatilla.
  • When lying on face : Kali Bich.

Causes :

  • Pieces of steel or cinder : Aconite.
  • Getting wet : Calc. Carb, Rhus Tox.
  • Working in water or in Clay-modellers : Calc. Carb.
  • Bathing & washing of infants : Chamomilla.
  • Sharp cold winds : Aconite, Hepar Sulph.
  • Exposure to cold winds & during first stage of Measles : Euphrasia.
  • During dentition : Chamomilla , Calc. Carb.
  • After vaccination : Thuja Occ.
  • Gonorrhœal poisons : Pulstilla.
  • Syphilitic infection : Merc. Sol.
  • Mercurial & Syphilitic poisons : Hepar Sulph.

Conjunctiva :

  • Inflammed; with dryness, burning & heat in the eye : Aconite.
  • Dark, violet colour : Arsenic.
  • Dull red colour; with some photophobia & swelling of lids; aggravation in the morning : Sepia.
  • Persistent redness of inner angle, after Keratitis; aggravation in the evening & open air : Hep-s.
  • Blood shot : Chamomilla, Conium Mac.
  • Chemosis : Apis Mel., Arg. Nitricum, Hepar Sulph.
  • Granulated, with pannus : Merc. Sol.
  • Granulated, like warts : Thuja Occ.
  • In tearsful females : Pulsatilla.
  • Phlyctenules : Pulsatilla.
  • Phlyctenules on boundary of sclera & cornea : Sepia.
  • Pustulous, ulcerated, raw & suppurating : Arsenic.
  • Like a piece of raw flesh : Lycopodium.

Discharge:

  • Acrid, Excoriating & Thin : Arsenic, Graphites, Merc. Sol.
  • Acrid, Excoriating & Thin with burning pain, restlessness & < night : Arsenic.
  • Acrid, Thick & yellow; excoriating lids & cheeks : Euphrasia.
  • Bland, Profuse & Whitish : Pulsatilla.
  • Profuse, Yellowish-white : Calc.carb.
  • Profuse, Yellowish-white tears gush out of eyes : Rhus tox.
  • Purulent : Arg. Met., Arg. Nit., Hepar Sulph., Lyco.
  • Muco-purulent; dry in evening : Sepia.
  • Stringy : Kali Bich.

Forms:

  • Acute : Graphites, Merc. Sol., Sulphur, Aconite, Belladonna.
  • Chronic : Graphites, Merc. Sol., Pulsatilla.
  • Ophthalmia Neonatorum : Chamomilla, Lycopodium, Pulsatilla, Merc. Sol.

Lachrymation:

  • Acrid, Excoriating : Euphrasia, Merc. Sol.
  • Hot & Burning : Arg.met.
  • Hot & Burning with dryness of eye : Belladonna.
  • Hot & Burning with photophobia : Apis Mel.
  • Profuse : Euphrasia, Rhus Tox.

Lids:

  • Bulging from pus beneath or from sub-conjunctival tissue & not from infiltration : Lycopodium, Arg. Nitricum.
  • Puffed & swollen : Apis Mel., Chamomilla, Hepar Sulph., Merc. Sol., Sepia.
  • Œdema : Calc. carb., Apis, Rhus tox.
  • Œdema of adjacent cellular tissue; with redness, heat & sensitiveness to external covering : Apis.
  • Œdema of conjunctiva : Rhus Tox.
  • Affection of Meibomian glands and lids sensitive to touch : Hepar Sulph.
  • Drawing-in of edges when trying to separate them : Arg. Met.
  • Spasmodically closed : Arsenic, Hepar Sulph., Merc. Sol.
  • Bleeding on attempting to open them : Chamomilla, Hepar Sulph.
  • Everted villous : Apis Mel.
  • External canthi cracked & bleed : Graphites.
  • Internal canthi more inflamed : Nux Vom.

Pain:

  • Aching on lying down to sleep : Conium Mac.
  • Burning, Stinging : Apis Mel.
  • Cutting through the eyes : Arum Met.
  • Sensitive to touch : Merc. Sol.
  • Sharp, piercing, like pins through eye into the head; < 1 to 3 am., waking from sleep : Sulphur.
  • Throbbing : Belladonna.
  • Absence of pain; photophobia & redness : Kali Bich.

Photophobia:

  • Intense : Belladonna, Graphites, Hepar Sulph., Merc. Sol.
  • With intense Inflammation : Rhus Tox.
  • Without much inflammation : Conium Mac.
  • With Hot Lachrymation : Apis Mel.

Sides:

  • Right eye : Belladonna.
  • Left eye : Rhus Tox.

Sight:

  • Blurring of vision, > by winking : Euphrasia.
  • Everything appears slightly red : Kali Bich.
  • Everything appears slightly green : Arsenic.

 

Relation of different remedies:

  • Arg. Nitricum antidoted by : Arsenic,
  • When other remedies fail : Sulphur.
  • When Sulphur & Calc. Carb fails : Arg. Metallicum

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