-by Dr.Vanija Gautam1 and Dr. Nandini Dadhich2
Blepharitis is characterized by inflammation of the eyelid margins. It can be squamous and ulcerative. It usually presents with recurrent symptoms that may vary over time and involve both eyes. Blepharitis is a clinical diagnosis based on irritation of the lid margins with flaking and crusting of the lashes. The commonest cause in children is poor hygiene and staphylococcus, seborrhea in adolescents and allergic sensitization in adult life. The management of blepharitis includes good eyelid hygiene, elimination of triggers that exacerbate symptoms along with medication. Homoeopathic Materia Medica has a vast range of Homoeopathic Medicines which when appropriately selected help in the treatment of blepharitis.
KEYWORDS: Blepharitis, Homoeopathic Therapeutics
Blepharitis is the most common inflammatory disease of lid margin1.
- Age – common in children, but any age group may be affected.
- External irritants – dust, wind, smoke, cosmetics.
- Unhygienic conditions.
- Eye strain due to errors of refraction.
- Constitutional factors –
- Nature of skin – e.g. tendency to seborrhea
- Metabolic disturbances – e.g. excessive carbohydrate diet
- Toxic factors – e.g. alimentary autointoxication
- Allergic factors – e.g. eczematous condition of skin and septic focus
- Inflammation of neighbouring structures – chronic conjunctivitis, chronic dacryocystitis
- Parasitic infections – phthiriasis palpebrarum due to infection with parasitic Phthirus pubis. The eyelashes are covered with black nits of pediculus pubis & lid margin is red, & irritable3.
Clinically it’s of two types2:
- Squamous Blepharitis1 – it is not essentially an infectious condition. Metabolic causes, hygienic factors, eye strain, seborrhea of scalp usually leads to the development of this condition.
- No pain but discomfort in eyes
- In untreated cases – epiphora develop due to anatomical changes in lid margin, the sharp posterior border tends to be rounded.
Clinical signs –
- Accumulation of white scales like dandruff on the lid margins.
- On removing the scale, the lid margin appears hyperaemic but no ulceration is there.
- Falling of eyelashes, but get replaced quickly without distortion.
- The lid margins may be thickened.
- Ulcerative Blepharitis1 – this condition is due to infection of lid margin with coagulase, the staphylococcus, superimposed are predisposing conditions. There is suppurative inflammation of the ciliary follicles along with glands of Zies &Moli.
- Soreness of lid margins
- Lacrimation, itching & photophobia
Clinical signs –
- Yellow crusts are deposited at the roots of eyelash by which the lobes are glued together
- On removing the crusts, small ulcers appear around the base of lashes which bleeds freely
- Falling of eyelashes which are either not replaced or when replaced become misdirected.
- Chronic papillary conjunctivitis & punctate epithelial erosions of the cornea due to constant irritation.
- Madarosis due to the falling of cilia.
- Trichiasis due to misdirection of eyelashes
- Tylosis due to excessive fibrosis of lid margin.
- Ectropion due to eczema of the lower eyelid
- Epiphora due to disturbed capillary action
General management2 –
- Improvement of general health in children
- A judicious & balanced diet with vitamins especially vitamin A.
- Correction of any error in refraction.
- Treatment of seborrhea of scalp.
- Treatment of associated condition like chronic conjunctivitis, chronic dacryocystitis or louse infection.
HOMOEOPATHIC MEDICINES FOR BLEPHARITIS4,5:
- Aconitum napellus – Lids are swollen, hard and red. Feel dry and hot.
- Alumina – Lids dry, burn, smart, thickened, aggravated in the morning.
- Antimonium crudum – eyes dull, sunken, red, itchy, inflamed, agglutinated, pustules on lids.
- Apis mellifica – Lids are swollen, red, oedematous, everted, inflamed; burn and sting, with hot lachrymation. Sudden piercing pains.
- Argentum nitricum – Chronic ulceration of margin of lids; sore, thick, swollen. Unable to keep eyes fixed steadily. Blurred vision. discharge abundant and purulent. Aching, tired feeling in eyes, better closing or pressing upon them.
- Arsenicum album – Lids red, ulcerated, scabby, scaly, granulated. Burning in eyes, with acrid lachrymation. Oedema around eyes. With extreme painfulness; burning, hot, and excoriating lachrymation.
- Aurum metallicum – Extreme photophobia. Great soreness all about the eyes. Double vision; upper half of objects invisible. Feel tense. Pains from without inward.
- Borax Veneta – Lashes turn inward. Eyelids inflamed, lids cut against the eyeball. Entropium.
- Calcarea carbonica – Itching of lids, swollen, scurfy. Lachrymation in the open air and early in the morning. Sensitive to light.
- Chamomilla – Lids smart. Spasmodic closing of lids.
- Clematis erecta – Chronic blepharitis, with sore and swollen meibomian glands. Heat in eyes and sensitive to air; must close them.
- Digitalis purpurea – Mydriasis; lid margins red, swollen, agglutinated in the morning. The blueness of eyelids.
- Dulcamara – Thick, yellow discharge; granular lids.
- Euphrasia Officinalis – Burning and swelling of the lids. The eyes water all the time. Discharge thick and excoriating. Frequent inclination to blink.
- Graphites – Eyelids red and swollen. Dryness of the lids. Eczema of lids; fissured.
- Hepar sulphur – Eyes and lids red and inflamed. Profuse discharge, great sensitiveness to touch and air.
- Kreosotum – Lids red and swollen.
- Mercurius solubilis – Lids red, thick, swollen. Profuse, burning, acrid discharge.
- Pulsatilla – Thick, profuse, yellow, bland discharges. Itching and burning in eyes. Profuse lachrymation and secretion of mucus. Lids inflamed, agglutinated.
- Silicea – Lids of eyes affected. Aversion to light, especially daylight; it produces dazzling, sharp pain through eyes; eyes tender to touch; worse when closed.
- Staphysagria – Margin of lids itch.
- Sulphur – Burning ulceration of margin of lids. Heat and burning in eyes.
- Tellurium – Lids thickened, inflamed, itching.
Blepharitis is an ocular affection, which may be self-limiting or recurrent and may be encountered in all ages. The self-care treatment along with well selected homoeopathic medicine can uproot the underlying cause and not only cure but also prevent the disease and its recurrence rendering mankind a healthy life.
- Nema H.V., Nema Nitin. Textbook of Ophthalmology. 6th New Delhi, India: Jaypee Brothers Medical Publishers (P) Ltd;2012.413,414,415
- Chatterjee B.M. Handbook of ophthalmology. 4th Shahdara Delhi, India: CBS Publishers & Distributors; 1988.258
- Jogi Renu. Basic Ophthalmology. 4th New Delhi, India: Jaypee Brothers Medical Publishers (P) Ltd;2009.405,406
- Boericke W. Boericke’s New Manual of Homoeopathic MateriaMedica with Repertory. Third revised and augmented edition based on 9th Noida, India: B. Jain Publishers (P) Ltd; 2018
- Hering C. The Guiding Symptoms of our Materia Medica. Delhi, India: B.Jain Publishers Pvt. Ltd;1995
- Dr Vanija Gautam M.D.(Hom.), PhD (Hom.), Assistant Professor, Dept. of Materia Medica, Dr.M.P.K.Homoeopathic Medical College, Hospital & Research Centre, Jaipur (A constituent unit of Homoeopathy University, Jaipur, Raj.)
- Dr Nandini Dadhich, MD (PGR), Dept. of Materia Medica, Dr.M.P.K.Homoeopathic Medical College, Hospital & Research Centre, Jaipur (A constituent unit of Homoeopathy University, Jaipur, Raj.)