Abstract
Glaucoma is one of the chronic progressive disorders of the eye characterized by visual loss, mainly occurring due to a rise in intra-ocular pressure. It is one of the major causes of blindness. The incidence and prevalence in India estimated that there are approximately 11.2 million persons aged 40 years and older with glaucoma in India. The estimated number with primary angle closure glaucoma is 2.54 million. Primary open-angle glaucoma is estimated to affect 6.48 million persons.
Keywords- Glaucoma and Homoeopathy.
Introduction
Glaucoma is one of the chronic progressive disorders of the eye symptomatically visual loss, mainly occurring due to a rise in intraocular pressure. The most important factor which causes rise in intraocular pressure is obstruction of the drainage of the aqueous humor through the angle of the anterior chamber and at the pupil. The intraocular pressure (IOP) refers to the pressure exerted by intraocular fluids on the coats of the eyeball. The normal IOP varies between 10 and 21 mm of Hg.
- Open-angle glaucoma
Open-angle glaucoma is the most common form of the disease. The drainage angle formed by the cornea and iris remains open, but the trabecular meshwork is partially blocked. This causes pressure in the eye to increase. This pressure damages the optic nerve. It happens so slowly that it may loses vision before aware of a problem.
- Angle-closure glaucoma
Angle-closure glaucoma, also called closed-angle glaucoma, occurs when the iris bulges forward to narrow or block the drainage angle formed by the cornea and iris. As a result, fluid can’t circulate through the eye, and pressure increases. Some people have narrow drainage angles, and are at high increased risk of angle-closure glaucoma.
- Normal tension glaucoma
In normal-tension glaucoma, the optic nerve becomes damaged even though eye pressure is within the normal range.
- Glaucoma in children
It’s possible for infants and children to have glaucoma. It may be present from birth or developed in the first few years of life. The optic nerve damage may be caused by drainage blockages or an underlying medical condition.
- Pigmentary glaucoma
In pigmentary glaucoma, pigment granules from the iris build up in the drainage channels, slowing or blocking fluid exiting the eye.
Case Summary
A 50-year-old/male (no K/C/O of any major illness) came with the complaint of difficulty in seeing the object especially the peripheral vision, headache in the frontal region for 2 weeks along with watery discharge & burning in both eyes. Twitching of eyelids since 2 days, letters appeared red. There was edema of the eyelids and pain in orbital bone. Since the complaints started, the patient’s Irritability increased.
Family Details
Father-Hypertension since 20 years on regular treatment.
Past History
Dengue fever at the age of 25 years, recovered with the allopathic Management.
Physical Generals
- Appetite-2 times/day, Hunger Tolerable.
- Thirst-3 liter/day , short quantity long interval.
- Urine-3 times/day ,1 times/night.
- Stool-2 times/day, satisfactory.
- Sleep-6-7 hours/day/refreshing.
Habits/Addiction-Eating of Tobacco for 10 years(2 packets/day)
Diagnostic With Consideration
Ophthalmic examination
| No | Examination | Re | Le |
| 1 | Uncorrected Vision | 6/60 | 6/36 |
| 2 | Corrected Vision / Older Glasses | 6/9 | 6/9 |
| 3 | Bilateral Correction Of Visual Acuity/ Refraction | 6/9 | 6/9 |
| 4 | Bilateral Correction of Near Visual Acuity | N/6 | N/6 |
| 5 | Measurement Of Intraocular Pressure ( mm of Hg) | ||
| 5a | 5a A- NCT | 21 | 21 |
| 5
b |
B- Applanation Tonometry | 22 | 23 |
| 5c | 5c C- Schiotz Tonometry | 20.6 | 21.3 |
| 5
d |
D- Gonioscopy | OPEN
ANGLE |
OPEN
ANGLE |
| 5e | 5e E- CCT | 540 mm | 545 mm |
| 5f | F- Pachymetry | 570 mm | 580 mm |
| 6 | Fundus Examination | ||
| 6a | 6a Retina | WNL | WNL |
| 6b | RNFL | THIN | THIN |
| 6c | Macula | NORMA
L |
NORMAL |
| 6
d |
Optic nerve | WNL | Partially
hyperaemi c |
| 6e | 6e Fovea | WNL | WNL |
| 6f | 6f Disc | WNL | WNL |
| 6
g |
Disc Ratio | 0.6 CDR | 0.65 CDR |
Visual field Test: It can see peripheral vision.
| EYE | ||
| Right | Left | |
| Conjunctiva | Red | Red |
| Sclera | White | White |
| Eyelids | NAD | NAD |
| Pupils | Dilated | Dilated |
Significance of Test
Glaucoma is examined through modern science to measure Intra-Ocular pressure in various categories like Tonometry Examination, Application of Tonometry through Gonioscopic to observe the thickness of cornea via Perimetry to evaluate the visual field defect via projection Perimetry and know the status of the retina ,macula, fovea,optic disk, retinal nerve fiber layer through OCT(Optical Coherence Tonometry) and easy process to examine IOP is NCT (Noncontrol Tonometry) throughout lifetime.
Analysis of Symptoms
| SR
NO |
SYMPTOMS | TYPE OF
SYMPTOMS |
| 1 | Difficulty in seeing object . | Physical Particular
Common |
| 2 | Headache in the frontal region. | Location Physical
Particular Uncommon |
| 3 | Watery discharge. | Physical Particular
Common |
| 4 | Burning in both eyes. | Location Physical
Particular Uncommon |
| 5 | Twitching of eyelids. | Location Physical
Particular Uncommon |
| 6 | Letters appear red. | Physical Particular
Common |
| 7 | Pain in orbital bone. | Location Physical
Particular Uncommon |
| 8 | Oedema of Eyelids. | Location Physical
Particular Common |
| 9 | Irritability. | Physical Particular
Uncommon Concomitant |
| 10 | Complaints ameliorated by washing . | Physical Particular
Uncommon Ameliorating Characteristic Modality |
| 11 | Tobacco Addiction. | Physical Uncommon |
Totality Of Symptoms
- 1-Difficulty in seeing an object. 2-Headache.
- 3-Watery Discharges,
- 4-Burning in both eyes.
- 5-Twitching in both eyes. 6-Odema in eyelids.
- 7-Pain in the orbital bone.
- 8- Ameliorated by washing 9-Irritability during complaints. 10-Tobacco Addiction.
Repertorial Result
PHOS- 38/11, SULPH:35/10, ARS.ALB 33/1O, BELLA-31/09,NAT-M 30/10, SPIG 30/10.
Case Analysis
After a complete analysis and evaluation of symptoms, Totality was constructed based on the difficulty in seeing or an object, Headache, Watery discharges, Burning and Twitching, edema, pain in the orbital bone, complaints better by washing, Irritability during complaint, and Tobacco addiction. According to Hahnemann’s classification of diseases, it comes under local surgical diseases, which comes under dynamic diseases given in aphorism 192, all the changes and symptoms are collected to form the totality of symptoms. After doing Repertorisation from the complete repertory Phosphorous was finally selected as a similimum. Based upon age, susceptibility, and pathology 200 potency was given and frequent repetition was given till the objective and subjective symptoms were relieved.
Treatment Approach
While going through the case after a detailed examination, physical particular qualified characteristics are prominent in the case which helps in choosing complete and reference to Materia Medica, Phosphorous covers the qualified physical particulars symptoms along with the objective symptom hence prescribed the medicine.
RESULT
| DATE | IOP MEASUREMENT (mm of Hg) NCT | PRESCRIPTION | |
| RT EYE | LT EYE | ||
| 17/03/2024 | 20.6 | 20.6 | PHOSPHORUS 200 BD For 15 Days |
| 02/04/2024 | 17 | 19 | PHOSPHORUS 200 BD For 15 Days |
| 18/04/2024 | 18 | 21 | PHOSPHORUS 200 BD For 15 Days |
| 03/05/2024 | 20 | 22 | PHOSPHORUS 200 BD For 15 Days |
| 19/05/2024 | 23 | 21 | PHOSPHORUS 200 BD For 15 Days |
| 04/06/2024 | 20 | 18 | PHOSPHORUS 200 BD For 15 Days |
| 20/06/2024 | 17 | 15 | PHOSPHORUS 200 BD For 15 Days |
| 02/07/2024 | 18 | 17 | PHOSPHORUS 200 BD For 15 Days |
Discussion
This study concerns the community through long-lasting medicine from modern medical science in some categories at are very high rate. So effectively of Homoeopathic medicine through easy to administer and very low rate ,so anybody can afford and prevent their vision.
Conclusion
The description and discussion regarding this study are going towards the prevalence ratio of the vision in the community. Different medicines are liable control IOP, to prevent retinal blindness, to maintain the optical status and functional condition of Glaucomatic structure, prevention of complications after Glaucoma diagnosis.
References
- Sihota Ramanjit, Tondon Radhika; Parson’s diseases of eyes; 21st edition; 2011; Elsevier India Pvt Ltd.
- https://www.homeobook.com/homoeopathy-and-glaucoma/
- Boericke William. Pocket manual of homoeopathic Materia Medica and repertory; Student edition 2012; B. Jain Publisher, New Delhi
- Allen. H.C. keynotes rearranged and classified with leading remedies of Materia Medica and bowel nosodes; Student edition 2011; B. Jain Publisher, New Delhi.
- B.M Chatterjee; Handbook of Ophthalmology;6th Edition, CBS Publishers and Distributors Pvt Limited.
