From styes to conjunctivitis, community pharmacist Carol Jackson advises on the most appropriate treatment
Maybe you have seen the television adverts for a “new” eye drop available over-the-counter for conjunctivitis. The active ingredient is chloramphenicol, a bacteriostatic which means it prevents the growth, but does not kill, a number of the bacteria known to cause conjunctivitis. It’s a useful addition to the repertoire of conventional medicine available to a pharmacist, but of the patients I’ve seen so far only a few would have benefitted from the drops. The uses for homeopathic remedies are far more wide-spread.
Let’s first note the signs that would indicate when self-treatment should not be attempted:suspected or known presence of a foreign body (though, in this instance, a dose of Silica would aid the removal of said “body” by an appropriate practitioner); pain or swelling round the face not associated with obvious trauma to the area, eye movement is restricted (indicating cerebral involvement); vision affected or there is nausea and vomiting (as above);
the eye is “damaged”: the pupil is torn, irregular or not reactive to light; the cornea is cloudy; patient has glaucoma or you suspect glaucoma; patient has had recent eye surgery or laser treatment.
The conditions I will consider for self-treatment are mostly acute and therefore I’ve limited myself to a few remedies reasonably easy to obtain on the high street.
Conjunctivitis comes in four varieties: viral, bacterial, allergic and as a result of a foreign body causing abrasions. Physically the signs are often difficult to distinguish. Allergic conjunctivitis would be bilateral, produce watery discharge and be accompanied by itching. The other conditions would probably start in one eye, the discharge would be thicker and more sticky and the pain would be more burning and stinging. But we mustn’t over-generalise and indeed the cause is not so important from a homeopathic point of view.
The eyes have a great ability to heal themselves and conjunctivitis is more often than not self-limiting. It helps to bathe the eyes as often as possible with salt water ( a teaspoon to a pint of boiled and cooled water), or, if the eyes are especially “sticky”, a mixture of half milk to water, “sterilised” as above. Contact lenses should be removed and discarded if possible or at least thoroughly cleaned to prevent re-infection.
Apis mel is useful for allergic conjunctivitis. The conjunctiva are bright red and very swollen, there seem to be water bags under the eyes which leak excess hot fluid. There may be sudden piercing pains. Both eyes are normally affected.With Arsenicum alb the conjunctiva is red, swollen and infected. There is purulent discharge and a burning sensation, but warm compresses ease the pain. The lids may be “crusty” and eyelashes could fall out. The patient is often panicky and not easily reassured.Argent nit presents a similar picture. The inner canthi of the eye are particularly affected, becoming red and swollen. The patient will be more worried than panicky and will feel better for closing the eyes and pressing them.Belladonna on the other hand presents with a very hot, red, swollen but essentially dry eye. The condition may have come on very suddenly and any pain associated is throbbing. Characteristically the pupils are dilated, staring and brilliant. The patient will be more cross than panicky.Euphrasia and Allium cepa are normally associated with hay fever or colds. They work almost as opposites. I remember which is which by thinking of the affects of peeling strong onions. Burning nasal discharge, but bland copious tears (even though the eyes themselves will burn), that’s Allium or onion. Euphrasia is the other way round; bland nasal discharge but burning tears which leave a “varnish” on the face. In practice, if people aren’t sure of their symptoms I tell them to try one and if it doesn’t work use the other. Not very scientific but effective in an emergency!
The above remedies are the most common ones I recommend. But there are special occasions when others are more appropriate. I’m thinking of Nux vom for the “hangover” type of conjunctivitis; Rhus tox for conjunctivitis associated with a rheumaticy cold, or Pulsatilla when there is a general cold with bland yellowy discharges and the patient feels better for rubbing the eyes, whether because of the pain or because they are a mite weepy! Hepar sulp is indicated for severe purulent discharge and pain such that the patient can’t even stand drafts to their eyes; but very severe pain could also indicate a more severe condition which should be referred. I usually recommend 30c potency to be taken every two hours, if necessary for up to two days. Some patients prefer to apply something directly to the eyes, in which case the tablets or pills can be dissolved in a little suitably sterilised water and used as a wash. I don’t think they work any better this way but there may be a psychological advantage. If the condition is no better after two days the patient should seek further advice from an appropriate practitioner.
Cleaning the eyelids helps to release the blocked duct. Obviously one must be careful, but my optician recommends gently wiping a cotton bud soaked in a solution of baby shampoo. It sounds frightening and stingy, but it works a treat. Remember it must be baby shampoo (it is alkaline as are the surfaces of your eyes).
The classic remedy would be Graphites. It is linked to in-growing eyelashes, blephritis (inflammation of the eyelids) and eczema; all common causes of styes. But it is not a remedy you are sure to find in your chemist or health food store. If you are prone to styes it may be as well to acquire some from a specialist homeopathic supplier. Having said that, Staphysagria is the remedy for recurrent styes.Sulphur is indicated for styes which are swollen and red, causing burning and itching. The lids in this instance would be more oily than dry. Pulsatilla styes are bland, pussy yellow affairs that cause little pain and are usually associated with colds and general “un-wellness”.
Make sure that there are none of the danger signs as at the beginning of this article. A cold compress well help to prevent swelling, or better still a compress of witch hazel lotion (Hamamelis).
Of course Arnica is the gold standard for trauma injuries, and certainly if that’s what you have, give it; however eye injuries respond better to Hamamelis for the bruising and Ledum if the skin has been cut. Again these are not that easily found, but if you are expecting to have eye surgery they can be taken as prophylactics. This includes use for cosmetic surgery, as a colleague of mine will attest to!
Don’t do too much and whatever you’re doing, do it in good light! If you suffer from eye strain regularly it’s important to have your eyes checked by an optician in case you need glasses or are not wearing the correct prescription. The ones you can buy in many chemists etc are for short term use only. They do not replace the need for proper optical assessment.
As for all muscular strains Ruta grav would be the remedy of choice. Twice daily dosing should be sufficient and it should not be used long term.
Just a brief note about contact lenses: they should be removed whilst treating any eye conditions, though the remedy itself will not damage them.I have contact lenses myself and don’t like having to do without them, but there are some particularly nasty bacteria associated with long-term wear. If you have an infection associated with contact lenses it should be treated with antibiotics.Particles stuck under a lens and rubbing the cornea can quickly lead to corneal ulcers. The lens should be taken out as soon as possible. Calendula can be used to soothe these minor irritations. The lens should be left out for at least a week to allow the corneal surface to repair. Any major irritations, or where the lens was not removed quickly, need to examined by an optician.And for those horrid occasions when a soft lens folds itself up and hides under the upper lid, causing jammed-shut eyes, sweating and panic – if you can see to find your remedies, use high potency Aconite. Failing that, in my experience, sitting on the side of the bath and singing to yourself usually works!