Abstract: 

This case presents a classical instance of Central Retinal Vein Occlusion (CRVO) managed without surgical intervention using homeopathic treatment. The patient, diagnosed with a potentially sight-threatening condition, responded promptly to a carefully selected Secale cornutum. This report highlights the precision of remedy selection based on individualization and pathological correspondence, demonstrating the scope of homeopathy in acute ophthalmic emergencies.

Introduction to Retinal Vein Occlusion:

Central Retinal Vein Occlusion (CRVO) is a serious ocular disorder wherein the main vein responsible for draining blood from the retina becomes occluded. It typically presents as a sudden, painless loss of vision, and if not addressed promptly, may result in irreversible visual impairment.

Conventional management may involve anti-VEGF injections, laser therapy, or even vitrectomy, depending on the type and severity. Known risk factors include hypertension, diabetes mellitus, glaucoma, and hypercoagulable states. This case explores the potential of homeopathy in managing such vascular retinal pathologies.

Case Presentation:

Patient Name: Mr. Mohsin Mohib Asla
Age/Gender: 40 / Male
Date of First Visit: 1^st July 2024

Diagnosis:
– Left Eye (LE): Central Retinal Vein Occlusion (CRVO)
– Diminution of vision (DOV) in the morning lasting ~15 minutes for 5 consecutive days

Chief Complaint:

The patient presented with sudden, temporary dimness of vision in the left eye, occurring each morning for approximately 10–15 minutes. This episode had persisted for five days. The vision loss typically worsened upon rising from bed and improved gradually. No associated pain, redness, or discharge was noted. The patient also reported the appearance of floating spots in vision. His complaints worsened from warmth in general.

History of Present Illness:

The patient was in his usual state of health until five days before presentation. Sudden morning episodes of dim vision began without any known trigger. An ophthalmic consultation in Godhra led to a referral to Vadodara, where a diagnosis of CRVO in the left eye was confirmed via fundus evaluation.

Past Medical History:

– Known diabetic
– Diagnosed hypertensive
– Visual complaint began during the course of antihypertensive and antidiabetic treatment

Family History:

Non-contributory

General Examination: B.P.:150/110 mm hg, Pulse: 78/min R.R.:18/min 

Investigations:

Fundus Examination: Signs consistent with CRVO including retinal hemorrhage, dilated tortuous veins, and optic disc edema in the left eye.

Totality of Symptoms:

– Dimness of vision upon waking.
– Burning pain and cold on touch.
– Spots in vision.
– General aggravation from warmth.
– Comorbid diabetes and hypertension.

             *Single Remedy from the recent Synthesis Repertory 

Prescription:

Rx,

     Secale Cornutum 200, 4 pills × 5 days O.D. then weekly 

•Follow-Up: 

~  20/7/24:  Dimness episode reduced from daily occurrence to occasional,

Intensity and time period of dimness reduced.

Generals improved, mentally he feels much relieved.

Spots size reduced

Rx, Sec cor. weekly O.D.

S.L. B.D. × 4 pills

~  7/8/24: Pt. suffered from dimness attack more severe recently and spots reappeared recently. No relief from medication. Pain as earlier.

Control blood glucose levels, strict dietary regulations.

Rx, Sec cor. 1M single dose

S.L. O.D. × 4 pills

~  10/11/24: Pt. came with normal vision as earlier, no spots, no dimness attack since 2 months. Advised to consult an ophthalmologist for the regular eye check-ups.

~  11/1/25: Pt. came with the reports saying fundus normal.

Response to Treatment:

¤Before Treatment:
– Sudden morning dimness of vision in the left eye lasting 15 minutes
– Confirmed CRVO with visible retinal changes

¤After Treatment:
– Progressive reduction in frequency and duration of visual dimness
– Retinal blood flow improved on follow-up fundus imaging
– Sleep is improved.
– No adverse events or new symptoms
( Within three weeks, the episodes of morning dimness reduced from daily occurrences to occasional and less intense episodes.)

Conclusion:

This case study illustrates how individualized homeopathic treatment can play a complementary and potentially primary role in managing acute vascular ocular conditions such as CRVO. The rapid and sustained response in this case underscores the therapeutic potential of a remedy like Secale Cornutum.

▪︎Reference:

1. Boericke W. Boericke’s new manual of homoeopathic materia medica with repertory. 3^rd rev. aug. ed. Based on 9^th ed. New Delhi: B. Jain Publishers; p. 512.
2. Clarke JH. A condensed homoeopathic materia medica and repertory. Rev. ed. New Delhi: B. Jain Publishers (P) Ltd.; 2001. P. 929.
3. Allen HC. Keynotes rearranged and classified with leading remedies of the materia medica. 21^st reprint ed. New Delhi: B. Jain Publishers; 2021. P. 350.
4. Phatak SR. Materia medica of homoeopathic medicines. 2^nd rev. and enl. Ed. New Delhi: B. Jain Publishers; p. 629.
5. Schroyens F, editor. Synthesis repertory [computer program]. Version 9.1. Belgium: Archibel; [accessed 2024 Apr].
6. Chatterjee BM. Handbook of ophthalmology. 6^th rev. and enl. Ed. Edited by Agarwal LP. New Delhi: CBS Publishers & Distributors Pvt. Ltd.; 2018. Chapter XII – Anatomy and diseases of the retina; p. 208.

▪︎About the Author:

Dr. Samir Memon is a dedicated homeopathic practitioner and Professor, Dept. of H.M.M. at Shree Shamlaji Homeopathic Medical College, Godhra, Gujarat.