Ques. 1 What are the common causes of watering of eyes?
Ans. Common causes of watering from the eyes are – Conjunctivitis, scleritis, iritis, etc.
Classification of Conjunctivitis :
(A) Infective bacterial Conjunctivitis –
- Purulent, e.g. gonorrheal, ophthalmia neonatorum.
- Acute catarrhal of muco-purulent conjunctivitis, e.g. acute (commonest), Sub-acute, chronic.
Viral conjunctivitis –
- follicular, e.g. acute and chromic,
- conjunctivitis in measles; varicella (chicken pox, variola of small-pox, mumps, influenza, vaccinia; yellow-fever and dengu fever; herpes zoster ophthalmicus).
Conjunctivitis due to specific infection, e.g. tuber-culous, Tularensis, Parinaud’s and in leprosy. Conjuctivitis associated with skin disease.
Allergic conjunctivitis, e.g. simple allergic, Vernal or spring catarrh.
Conjunctivitis due to Bedsonia group of organisms , e.g. Swimming-bath conjunctivitis, trachoma, inclusion blennorrhoea of newborn.
Ques. 2 What is Acute conjunctivitis?
Ans. Commonest organism is Koch Week’s Bacillus. Other organisms are pneumococci, staphylococci, influenza bacilli. Incubation period is 3-4 days. Age – any age. Sex- any sex. (bad hygienic conditions and dirty habits help infection to establish as disease is highly contagious). It is an acute inflammation of the conjunctiva associated with redness and discharge. It is due to infection of the conjunctiva by various micro-organisms.
- Tissue changes – The desquamated cells often contain hundreds of bacteria and marked increase of lymphocytes in adenoid layer. The epithelial cells undergo degeneration & exfoliation either individually or in sheets leaving raw areas.
- Vascular changes – The exudates, after producing tissue-oedema, filters though conjunctival epithelium and mingling with the tearm and secretion of conjunctival glands, constitutes the discharge of conjunctivitis. Hyperamia, exudation of cells and fibrin-rich oedematous fluid into tissue space.
Clinical Features : Symptoms –
- Foreign – body sensation in the eyes.
- Mucoid or muco-purulent discharge.
- Sticking together of the lids with discharge on waking.
- Marked redness of the eyes, usually bilateral.
- Watering and photophobia.
- Muco-purulent discharge on the lid-margins and in the fornices.
- In severe cases, chemosis and small punctuate conjunctival haemorrhages may be present.
- Palpebral conjunctiva and fornices are bright red in colour and swollen.
- Bulbar conjunctiva relatively less congested.
Course : Even without treatment, disease clear up within a week of two.
- Conjunctival type of congestion.
- Presence of muco-purulent discharge.
- History of sticking together of the eye lids during sleep.
- Rarely chronic dacryocystitis.
- May pass on to chronic stage.
- Corneal ulcer.
Differential Diagnosis :
- Keratitis – watering, dimness of vision, haziness of cornea.
- Glaucoma – severe pain in eye and headache, raised intra-ocular, cupping of optic disc.
- Refractive error –the patient cannot see the objects of either near of distance.
- Iritis – ciliary type of congestion, muddy colour of iris, pupil constructed, pain in eye and headache.
Management : (A) Prophylaxis –
- Protection of the unaffected eye if unilateral.
- Patient should lie on the affected side if the disease is unilateral.
- For others- isolation.
- Towels and other articles of the patient should not be used by other members of family.
(B) Curative –
- No rubbing.
- Antibiotic and chemotherapeutic drops and ointment.
- Wash – the eyes should be washed with lotio normal saline (0.9%) thrice daily.
- For other eye – (a) sealed, (b) should lie on affected side.
Ques. 3 Which Homoeopathic Remedies are important in this case?
Ans. Homoeopathic Remedies : -
- ACONITE – First stage of inflammation, prior to exudation, cornea or iris, or after surgical operations, or if there be great redness, chemosis and profuse purulent discharge with swelling and redness of lids & much burning heat in eye; excessive painfulness and photophobia; feeling as if it would be forced out of orbit, making lids tense.
- ALLIUM CEPA – Acute catarrhal conjunctivitis, associated with a similar condition of the air-passages; lachrymation excessive, but not excoriating, burning esp. in margin of lids. Panophthalmia after operation of trauma with great pain.
- EUPHRASIA – Blepharitis, lids red, swollen and with thick, yellow, acrid discharge, often mixed with the profuse, acrid, which excoriate lids and cheeks, conjunctivitis and keratitis catarrhalis and scrofulosa, photophobia, dimness of aqueous, discoloration of iris.
- NATRUM PHOS – Conjunctivitis with discharge of yellow creamy matter; lids glued together in morning, burning lachrymation.