Glaucoma can be treated with Homeopathic constitutional treatment?

How effectively glaucoma can be treated with Homeopathic constitutional treatment? Homeopathic article by Dr Sunitha Devi Vannemreddy M.D (Hom)

drsunithavannemreddy@gmail.com

Glaucoma is the disease of Eye, is one of important sensory organ and for vision. Eye is a complex organ with retina, sclera, iris, aqueous humour and vitreous humour and connected to brain with optic nerve. Structure of eye is well protected with eye lids in the socket of skull. It is one of the sensitive organs in the human body. There are different disease associated with the eye and optic nerve which impact on the eye sight.

Sometimes, person identifies the alteration in the vision, poor visibility which made them to visit the doctor. After the thorough examination, doctor declares that poor visibility due to Glaucoma. So what is glaucoma? How it develops? All are questions and here is the answer for glaucoma and its treatment with Homeopathy. 

Glaucoma is an ocular disorder that results in damage of optic nerve, associated with increased fluid pressure in the eye, i.e. intraocular pressure (IOP).  It affects the vision, first loss of peripheral vision leading to permanent loss of vision, if untreated. Glaucoma often called as “silent thief of sight” because the loss of vision often occurs gradually over the period of time and symptoms only occurred when the disease is quite advance. It is irreversible phenomena, i.e. once vision is impaired it cannot be recovered. So that treatment will be to save optic nerve from further damage. In modern treatment, further prevention is possible than the vision recovery. Glaucoma is second leading cause of blindness, after cataract.

Glaucoma mostly affects in older people than younger, above 50 years of age. If the condition is detected early, it is possible to arrest the development or slow the progression with medical and surgical therapies. 

Types of glaucoma:

Disorder can be roughly divided into, “open-angle glaucoma” and “closed-angle glaucoma”.  

Open-angle glaucoma – it is painless, tend to develop slowly over the time and often has no symptoms until disease progressed significantly.

Closed-angle glaucoma – it is characterised by sudden eye pain, redness, nausea and vomiting and other symptoms resulting from sudden increase in the intra ocular pressure, should be treated as medical emergency. 

Glaucoma and its subtypes are considered to be “optic neuropathy”. The nerve damage involves loss of retina ganglion cells in a characteristic pattern. Raised intra ocular pressure is the most important and only modifiable risk factor in glaucoma.

Ocular hypertension - is the condition; in which high eye pressure for years and never develop damage.

 Low or normal tension glaucoma - is the another condition, in which optic nerve damage associated with visual field loss, nut normal or low intraocular pressure. 

Other variants of glaucoma are;

Exfoliation glaucoma: a common form of open-angle glaucoma that results when there is a buildup of abnormal, whitish material on the lens and drainage angle of the eye. This material and pigment from the back of the iris can clog the drainage system of the eye, causing increased eye pressure. This form of glaucoma responds well to laser treatment.

Pigmentary glaucoma: a condition that typically affects young, nearsighted, Caucasian males. This condition is characterized by the iris bowing backwards, and coming into contact with the support structures that hold the lens in place. This position disrupts the cells lining the back surface of the iris containing pigment, and results in a release of pigment particles into the drainage system of the eye. This pigment can clog the drain and can lead to an increase in eye pressure. This form of glaucoma responds well to laser treatment.

Neovascular glaucoma: an uncommon type of glaucoma is difficult or nearly impossible to treat and is often caused by proliferative diabetic neuropathy or central retinal vein occlusion. It may also be triggered by other conditions results in ischemia of retina or ciliary body. Individuals with poor blood flow to the eye are highly at risk with this condition. Neovascular glaucoma results when new, abnormal vessels begin developing in the angle of the eye that begins blocking the drainage. Patients with such condition begin to rapidly their eye sight. Sometimes, the disease appears very rapidly, especially after cataract surgery procedures.  

Toxic glaucoma: it is open angle glaucoma with an unexplained significant rise in intraocular pressure flowing unknown pathogenesis. Intraocular pressure can sometimes reach 80 mmHg. It is characteristically manifests as ciliary body inflammation and massive trabecular odema that sometimes extends to Schlemm’s canal. This condition is differentiated from malignant glaucoma by the presence of a deep and clear anterior chamber and a lack of aqueous misdirection. Also, the corneal appearance us not as hazy. A reduction in visual acuity can occur followed neurological breakdown. Associated factors include inflammation, drugs, trauma and intraocular surgery, including cataract surgery and vitrectomy procedures.

Glaucoma can be classified in to specific types:

1)      Primary glaucoma

2)      Secondary glaucoma

3)      Developmental glaucoma

4)      Absolute glaucoma

Primary glaucoma

• Primary open-angle glaucoma, also known as chronic open-angle glaucoma, chronic simple glaucoma, glaucoma simplex

·         High-tension glaucoma

·         Low-tension glaucoma

• Primary angle closure glaucoma, also known as primary closed-angle glaucoma, narrow-angle glaucoma, pupil-block glaucoma, acute congestive glaucoma

·         Acute angle closure glaucoma

·         Chronic angle closure glaucoma

·         Intermittent angle closure glaucoma

·         Superimposed on chronic open-angle closure glaucoma ("combined mechanism" – uncommon)

Variants of primary glaucoma

• Pigmentary glaucoma
• Exfoliation glaucoma, also known as pseudoexfoliative glaucoma or glaucoma capsulare
• Primary juvenile glaucoma

Developmental glaucoma

• Primary congenital glaucoma
• Infantile glaucoma
• Glaucoma associated with hereditary of familial diseases

Secondary glaucoma

• Inflammatory glaucoma

• Phacogenic glaucoma
• Glaucoma secondary to intraocular hemorrhage
• Traumatic glaucoma
• Neovascular glaucoma
• Drug-induced glaucoma

• Glaucoma of miscellaneous origin

·         Associated with intraocular tumors

·         Associated with retinal detachments

·         Secondary to severe chemical burns of the eye

·         Associated with essential iris atrophy

·         Toxic glaucoma

Absolute glaucoma

Absolute glaucoma is the end stage of all types of glaucoma. The eye has no vision, absence of pupillary light reflex and pupillary response, and has a stony appearance. Severe pain is present in the eye. 

Warning signs for glaucoma:

• Unusual trouble adjusting to dark rooms
• Difficulty focusing on near or distant objects
• Squinting or blinking due to unusual sensitivity to light or glare
• Change in color of iris
• 
  
• Red-rimmed, encrusted or swollen lids
• Recurrent pain in or around eyes
• Double vision
• Dark spot at the center of viewing
• Lines and edges appear distorted or wavy
• Excess tearing or "watery eyes"
• Dry eyes with itching or burning; and
• Seeing spots, ghost-like images
• Sudden loss of vision in one eye
• Sudden hazy or blurred vision
• Flashes of light or black spots
• Halos or rainbows around light

Causes for glaucoma:

There are no specific causes for glaucoma is identified. No specific dietary factors are seen in causing glaucoma. But caffeine causes increase in intra ocular pressure in those has glaucoma but not seen affect in normal persons.

Positive family history is a risk factor in glaucoma. A relative risk of developing primary open angle glaucoma is four fold in siblings of glaucoma patient. 

Secondary glaucoma, caused by prolonged use of steroids (steroid induced glaucoma), the conditions that severely restrict the blood flow to eye such as severe diabetic retinopathy, central retinal vein occlusion (neovascular glaucoma), ocular trauma (angle-recession glaucoma) and uveilitis (uveilitic glaucoma).

Persons who are at risk for glaucoma:

 high ocular pressure alone is not deciding factor that person have glaucoma, but also the risk factors will decide the affect of glaucoma on person.

The most important risk factors include:

• Age
• Elevated eye pressure
• Thin cornea
• Family history of glaucoma
• Nearsightedness
• Past injuries to the eyes
• Steroid use
• A history of severe anemia or shock

Individuals with diabetes and hypertension may also have an increased risk of developing open-angle glaucoma. 

Diagnosis of glaucoma:

Regular eye examinations by your ophthalmologist are the best way to detect glaucoma. Your ophthalmologist will measure your eye pressure with Tonometry. Inspect the drainage angle of your eye with Gonioscopy. Evaluate your optic nerve with Ophthalmolscopy and test the visual field of each eye with Perimetry. Optic nerve evaluation and visual field testing are performed at regular intervals to monitor the effects of glaucoma. The information from these tests provides an indication of the effectiveness of the treatment being used and whether further treatments may be necessary.

Glaucoma tests:

Sr No	Test	What it examines	How will test done
1	Tonometry	Inner eye pressure	The eye is numbed via eye drops. The examiner then uses a tonometer to measure the inner pressure of the eye through pressure applied by a puff of warm air or a tiny tool.
2	Opthalmoscopy	Shape and color of optic nerve	The pupil is dilated via the application of eye drops. Using a small magnification device with a light on the end, the examiner can examine the magnified optic nerve.
3	Perimetry	Complete field vision	The patient looks straight ahead and is asked to indicate when light passes the patient's peripheral field of vision. This allows the examiner to map the patient’s field of vision.
4	Gonioscopy	Angle in the eye where iris meets the cornea	Eye drops are used to numb the eye. A hand-held contact lens with a mirror is placed gently on the eye to allow the examiner to see the angle between the cornea and the iris.
5	Pachymetry	Thickness of cornea	The examiner places a pachymeter gently on the front of the eye to measure its thickness.
6	Nerve fibre analysis	Thickness of nerve fibre layer	Using one of several techniques, the nerve fibers are examined.

Treatment

The treatment for glaucoma depends upon the nature and severity of each case. In general, glaucoma cannot be cured, but it can be controlled. Eye drops, pills, laser procedures, and surgical operations are used to prevent or slow further damage from occurring. With any type of glaucoma, regular eye examinations are very important to detect progression and to prevent vision loss.

Medicines: Glaucoma is often treated with eye drops taken regularly several times a day, sometimes in combination with pills. These medications will alter the circulation of eye fluid and lower eye pressure, either by decreasing the production of fluid within the eye, or by increasing the flow leaving the drainage angle. Side-effects from some eye drops may include a stinging sensation, red eyes, blurred vision, headaches, or changes in pulse, heartbeat or breathing. Side-effects from pills may include tingling of fingers and toes, drowsiness, loss of appetite, bowel irregularities, kidney stones, anemia or bleeding disorders.

Laser Surgery: Laser surgery is also effective for glaucoma treatment. Trabeculoplasty is laser treatment to enhance the eye drain age function to control eye pressure within the eye when treating open-angle glaucoma. Iridotomy is laser treatment to create tiny holes in the iris to improve the flow of eye fluid to the drain when treating narrow angle glaucoma.

Operative Surgery: Surgery will be recommended only if your ophthalmologist feels the benefit of a lower eye pressure achieved with an operation outweighs possible complications and/or further progression of optic nerve damage.

Homeopathic treatment for glaucoma:

Homeopathic constitutional treatment will take good care of glaucoma cases. As glaucoma is progressive destructive disease, with homeopathic medication complaints will reduce and it will arrest the further progression of disease without any side effects.

In allopathic treatment for glaucoma, they use tropical adnergic agonists, cholinergic agonists, beta blockers and prostaglandin analogues. With this medication, always there will be side effects. Even the beta blockers used in eye drops, causes bradycardia, hypotension, bronchospasm, heart block and even impotence and depression.

Main aims and criteria of homeopathic classical treatment is,

1)      It is safe and alternative mode of treatment which can be used alone or along with allopathic medication like eye drops prescribed by ophthalmologist.

2)      It will arrest the further progression of disease, in advanced cases.

3)      It will prevent and arrest the disease if diagnosed and treated early.

4)      It prevents progression of disease for another eye, if treated early.

5)      As homeopathic treatment acts in person as a whole, constitutionally, it will reduce the intraocular pressure.

6)      It corrects the hypertension glaucoma and reduces the symptoms.

7)      It will reduce and cures the symptoms like, redness, swelling, clarity of vision.

8)      It improves the visual quality and halo vision and diplopia.

9)      In case of family history, it will reduce the effect of disease if treated prior.

10)   Genetic predominance will be reduced.

Some of the important rubrics which help in glaucoma treatment are, 

Eye, anaemia of, optic nerve

Eye, atrophy of, optic nerve

Eye, blinking, looking at bright object

Eye, bloated lids

Eye, congestion

Eye, crooked, objects seems

Eye, dimness

Eye, discoloration, redness

Eye, edema

Eye, fiery

Eye, fire, darting out, as if

Eye, glaucoma

Eye, glazed

Eye, heaviness

Eye, hypertensive retinopathy

Eye, inflammation

Eye, intoxication, appearance of

Eye, sensitive

Eye, swelling

Eye, tension, increased

Eye, water

Vision, approach, objects seems to then reduce

Vision, blurred

Vision, circles, rings

Vision, confusion of colors

Vision, dazzling

Vision, diplopia

Vision, field of vision, contracted

Vision, film before eyes, as if

Vision, impaired

Vision, loss of vision

Vision, smoky

Vision, twinkling before eyes

Vision, vanishing sight

Vision, weak

Some of important Homeopathic Medicines which help in treatment of glaucoma are:

For Acute complaints:

Aconite, Apis, Ammonium, Arnica, Asafoetida, Atropinum, Belladonna, Bryonia, Chelidonium, Coffea, Colo cynth, Gloninum, Grindelia, Ipecac, Jaborandi, Ranunculus bulbosus, Sanguinaria, Secale, Spigelia, Tabacum.

For Chronic complaints:

Aristolochia, Aurum met, Aurum muriaticum, Calcarea calb, cauticum, Cedron, Gelsimium, Iodum, Lachesis, Natrum mur, Prunus, Nux vomica, Pulsatilla, Osmium, Phosphorus, Pysostigma, Plumbum, Sulphuric acidum. 

Some of the indicated drugs:

OSMIUM: A homoeopathic drug that is useful for glaucoma with iridescent vision. Green colors surround the objects esp. candlelight. They have violent neuralgic pains above and below the eyes with watering of the eyes. There is an increase in the intra- ocular tension, with a dim sight and photophobia.

PHOSPHORUS: Indicated for a green halo about the candlelight like Osmium.   Letters appear red.  Sensation as if everything were covered with a mist or veil, or something pulled tightly over eyes. The patient sees well by shading eyes with the hand.  There is a fatigue of the eyes and head even without much use of the eyes.  Degenerative changes in the eyes with soreness and curved lines are seen in old people. It is also a good drug for retinal trouble with lights and hallucination of vision. Black points seem to float before the eyes.  There may be an atrophy of the optic nerve and partial loss of vision from abuse of tobacco or a thrombosis of retinal vessels and degenerative changes in retinal cells.

COMOCLADIA DENTATA: It is to be considered when there are throbbing pains worse by heat. There is a ciliary neuralgia with the eyes feeling large and protruded, especially RIGHT, which is worse, near warm stove.  Sees only a glimmer of light with the left eye.   Glaucoma, with a sense of fullness; eyeball feels too large. Eyes feel as if pressed outward.  Motion of eyes aggravates.

PHYSOSTIGMA: It is another drug for glaucoma with flashes of light and partial blindness.There is a contraction of the pupils and twitching of ocular muscles. There is also a spasm of the ciliary muscle in the eye, with irritability after using the eyes.  It is an important drug for patients with an ncreasing   myopia. Other eye conditions where this drug is useful are: night-blindness, photophobia, floaters, paresis of accommodation and astigmatism.

PRUNUS SPINOSA: Useful for glaucoma with a sudden pain in left eye as if it would burst, better by lachrymation. There is sometimes also a bursting pain in the right eyeball, shooting like lightning through the brain to the occiput. It is also useful for ciliary neuralgia, irido-choroiditis and opacity of the vitreous humor.

SPIGELIA: Glaucoma with a sensation in the eyes as if they are too large. There is a severe pain in and around the eyes, extending deep into the socket. There is also a pressive pain on turning them. There may be a pain from beneath the eminence of the forehead and temples, extending to the eyes. It is felt as a semi-lateral headache, involving the left eye; the pain is violent and throbbing; worse, making a false step. The pupils are dilated.

Homeopathic constitutional treatment offers safe and effective treatment for glaucoma.