Case Study of Paediatric Glaucoma and The Effects of Homoeopathic Medicine.

Objective: The objective of this study is to assess the therapeutic effect of homeopathic remedies on pediatric glaucoma patients in terms of reducing intraocular pressure, stabilizing optic nerve health, and improving overall visual function. The specific objectives are:

1. To evaluate the degree of intraocular pressure reduction in pediatric glaucoma patients undergoing homeopathic treatment.
2. To assess changes in optic nerve health, as indicated by optic nerve head and retinal nerve fiber layer (RNFL) thickness.
3. To monitor improvements in visual acuity in children receiving homeopathic care.
4. To document any changes in the quality of life as reported by patients and caregivers.
5. To compare the outcomes of homeopathic treatments with those observed in conventional glaucoma management.

Methodology:

The patient were divided into 2 groups 

Group 1: Homoeopathic medicine            

Group 2: Homoeopathic with conventional medicine.

All were examined for routine ophthalmic check with special attention to the following:

• Fixation for detecting exotropia, nystagmus.
• Sclera for bluish discoloration.
• Cornea for size more than 12mm, striation indicating breaks and tears, edema.
• A deep AC.
• Iris for atrophy, Iridodonesis. 
• Disc for glaucomatous cupping.

Study Design

This was a prospective, observational open label conducted over a 6 month period at a Sat Kaival eye hospital . Twenty patients with confirmed diagnoses of pediatric glaucoma were recruited for the study. These patients were followed for a period of 6 months, during which they received individualized homeopathic treatments in addition to any conventional care they had been receiving. The study protocol was reviewed and approved by the hospital’s ethical review board, and informed consent was obtained from all caregivers.

Patient Selection

Inclusion Criteria:

Children aged 6 months to 15 years with a confirmed diagnosis of primary congenital or juvenile glaucoma.

Patients who had undergone prior glaucoma surgery or were on conventional medical therapy but had not achieved satisfactory IOP control (defined as IOP ≥ 21 mmHg).

Patients with documented progression of optic nerve damage or visual impairment despite conventional treatment.

Patients whose caregivers sought homeopathic treatment as an adjunct or alternative to ongoing conventional therapy.

Exclusion Criteria:

Patients with secondary glaucoma caused by trauma, inflammation, or systemic conditions such as retinopathy of prematurity.

Patients who had undergone glaucoma surgery within the previous six months or were scheduled for surgery during the study period.

Patients with systemic conditions (e.g., diabetes, severe asthma) that could confound the study results.

Patients whose caregivers refused or were unable to comply with follow-up visits.

Intervention

Homeopathic treatment was administered by a certified homeopathic physician who followed classical homeopathic principles. A detailed case history was taken for each patient, including physical, mental, and emotional symptoms. Based on this information, a personalized homeopathic remedy was selected for each patient. Common remedies used included:

1. Physostigma: Creating a twisted feeling in the eyes. When shifted from side to side, the eyes become sore and painful. Intense discomfort in both orbits. Sharp, searing pain in the eyes. After use, there is a dull ache over or between the eyes. Eyes are sharp; lids are painful and heavy. Aching in the back of the orbit, extending into the brain, exacerbated by reading, which produces nausea. Light sensitivity in the eyes; feeling frail. Accommodation spasm, which can be irregular and produce astigmatism. Blurred vision, as if a picture was playing in front of the eyes. 

2. Sarothamnus Scopanarius: Glaucoma that is chronic. Choroiditis. Iritis. Burning and burning sensations, particularly behind the left eye. Moving the eyelids causes pain. When viewing a light source, the brightness of the light and the rainbow colours of the halo appear more vivid. 

3. Cedron: Cedron is the remedy if the symptoms have a distinct pattern. Red eyes. Burn brightly. Shooting across the left eye. Scalding lachrymation, severe pain in the eyes with radiating pains around the eye. Supraorbital pain on a regular basis. Sex is made worse by ocular pain. The eye is inflamed. Objects are red at twilight and yellow during the day. 

4. Comocladia Dentata: Right eye is extremely painful, feeling much bigger and protruding than the left. Being near a warm furnace aggravated the situation. The balls of the eyes feel heavy, as if something is resting on top of them, pushing them downward and outward. Motion aggravates the situation. The eyeball hurts a lot.

5. Aconite: Eyes burn, feel dry, and are susceptible to light. There was a lot of pain and heat. Pain that is intensely searing and shooting. The ball, particularly the upper portion, is sensitive when moved. Looking down or turning the eyes; the ball appears to be enlarged, as if protruding, causing the lids to tense; appears to be pushed out of the circle. The eyes are puffy. They have the appearance of grit in them. Photophobia. Faces are difficult to discern because vision is as if through a veil. Sparks appear in front of the irises, they flicker. The aconite patient exhibits extreme anxiety, dread, restlessness, and thirst. The initial stage of inflammation or trauma to the eye, conjunctiva, sclera, and lids. The standard treatment for ocular trauma or injuries caused by foreign bodies, wounds, or operations, as well as neuralgia caused by exposure to a cold dry breeze.

6. Phosphorus: Glaucoma. Retinal vessel thrombosis and degenerative alterations in retinal cells. In the elderly, degenerative changes such as pain and curved lines can be seen. Light sensitivity and distortion of vision are symptoms of retinal disease. Black points appear to hover in front of the eyes. The patient improves his vision by shading his eyes with his palm. Eye and brain fatigue even when not using the eyes much. 

7. Osmium: Glaucoma accompanied by shimmering vision. Violent supra- and infra-orbital neuralgia, as well as discomfort and lachrymation. Green hues envelop candlelight. Conjunctivitis. Increased intraocular strain, blurred vision, and photophobia.

8. Spigelia Anthelmia: Sensation as if eyes are too big; pressive discomfort when turning them. Pupils enlarged; photophobia; rheumatic ophthalmia. Severe discomfort in and around the eyes that extends deep into the socket. A real neuritis is iliary neuralgia. 

9. Prunus Spinosa: Prunus Spinosa is an excellent natural remedy for treating sudden discomfort in the right eye caused by Glaucoma. Prunus Spinosa is most effective for right eye discomfort. The pain in the eye is so intense and violent that it causes a bursting feeling in the eyeball. 10. Belladonna: It is most effective for severe Glaucoma symptoms. The primary symptom is a sudden increase in vision dimness. The eyes look to be red. This is followed by excruciating pain in the eyes and head. The agony has a very violent personality. Nausea and vomiting are also possible side effects.

10. Calcarea carbonica – for children with poor physical development, often indicated in patients with constitutional weakness and slow development.

11. Silicea – typically prescribed for chronic conditions where the body struggles to eliminate toxins, believed to support the drainage system of the eye.

11. Pulsatilla – used in children with fluctuating symptoms, including intermittent pain and variable IOP, often associated with emotional sensitivity.

13. Belladonna – for acute episodes of raised IOP accompanied by inflammation, dilated pupils, or visual disturbances.

Remedies were prescribed in potencies ranging from 30C to 200C, depending on the patient’s condition and response to treatment. Follow-up appointments were scheduled every 4-6 weeks, during which the homeopathic prescription was adjusted as needed based on the patient’s progress.

Outcome Measures

The primary outcomes of the study were changes in intraocular pressure and optic nerve health. Secondary outcomes included visual acuity, quality of life, and adverse effects.

1. Intraocular Pressure (IOP): IOP was measured using Goldmann applanation tonometry at baseline and at each follow-up visit. A clinically significant reduction was defined as a decrease of ≥20% from baseline.

2. Optic Nerve Health: The health of the optic nerve was assessed using optical coherence tomography (OCT) to measure retinal nerve fiber layer (RNFL) thickness. Progressive thinning of the RNFL is a marker of glaucoma-related optic nerve damage.

3. Visual Acuity: Visual acuity was assessed using age-appropriate methods, such as the Snellen chart for older children or visual fixation behavior for infants.

3. Adverse Effects: Any adverse reactions to homeopathic treatments were documented, including aggravation of symptoms or new symptoms.

Statistical Analysis

Data were analyzed using SPSS software (version 25.0). Paired t-tests were employed to compare baseline and post-treatment IOP and RNFL thickness. Wilcoxon signed-rank tests were used to analyze changes in visual acuity, as these data did not follow a normal distribution. Descriptive statistics were used to summarize quality-of-life scores and adverse events. A p-value of <0.05 was considered statistically significant.

Results:

Patient Demographics

The study included 20 pediatric glaucoma patients, of which 12 (60%) were male and 8 (40%) were female. The mean age of patients was 11.3 (range: 6 months to 12 years). Twelve patients (60%) were on solely homoeopathic medication. The remaining 8 patients (40%) were receiving conventional medical therapy, including beta-blockers or prostaglandin analogs, but were either non-responsive or experienced adverse effects and thereafter taken on homoeopathic medication with allopathic treatment continued .