In May, 1885, Geo. H., age thirty-seven, came to me from Indiana,
with the following history: He had been very nearsighted all his
life, but had never worn glasses. His eyes had never troubled him in
any other way, until a few days before he came. He then noticed a
few floating white spots before his left eye. This gradually
increased, and the vision of this eye, by degrees, grew less and
less until after four days the sight of the left eye was gone. There
was no pain in either eye.
Examination showed vision of the right eye was 4/200; with a — 13
Ds. glass, 15/200. With the left eye he could just distinguish light
in the outer upper field of vision. With the ophthalmoscope only the
lower fundus of the left eye could be made out, where the retinal
vessels were seen up to the lower edge of the optic disk. The disk
itself could not be made out, but above it a bulging, detached
retina was prominent, with a hemorrhagic spot at its inner margin.
In the upper outer fundus another separate bulging detachment of the
retina could be plainly seen.
The right eye was highly myopic, with a myopic arching around the
disk, and the entire fundus was mottled with small choroidal
pigmentation spots, clearly of long standing.
The nature of his trouble was explained to him. He was kept quiet,
and all forms of tobacco and stimulants were forbidden. He was
placed on kali hyd. 3d, three times daily. In one week’s time a
remarkable change for the better had taken place. The detachment was
much reduced. The wavy retinal vessels were seen climbing over its
edges. The optic disk was visible. In two days more he could count
fingers with the left eye at two feet. The improvement continued. On
June 24 vision of the left eye was 15/200; right eye, 15/100. He
then went home for a few days; the kali hyd. being kept up. July 13
he returned, saying that the improvement had gone on by slow
degrees, until, suddenly, the vision of the left eye was again lost,
on July 12. He was then placed on 5‒grain doses of kali iod. 3d,
three times daily, which was followed by very slow improvement, so
that in three weeks he could again count fingers with the left eye
at two feet, and the detachment, which had resumed its former
dimensions, was somewhat reduced. I then went back to kali hyd. 3d,
three times daily, which was again followed by improvement for some
months after his return home. This, with some intercurrent
medication, was kept up from time to time for a year, gradual
improvement being reported until the sight of both eyes seemed about
as it was in former years.
May 3, 1899, fourteen years after his first visit, he again came to
me, reporting that his eyes had gotten along very well, with no
particular trouble until in 1897, when he took a severe cold, which
settled in his left eye, which became badly inflamed. He went to St.
Louis, but did not find me, as it was during my summer vacation.
Returning home, he consulted Dr. Knapp of Vincennes, Ind., who
advised the removal of the left eye, as it seemed hopelessly
involved by that time. This was done, and he progressed nicely, the
vision of the right eye remaining about the same, though
occasionally its vision seemed not quite so clear.
This was the situation until two weeks before his visit, when the
sight of the eye began to grow dimmer. There was no pain present at
any time, but vision gradually grew worse and worse.
Examination: V. R. = 8/200; where it had before been 15/100.
Ophthalmoscope revealed some increase of the old choroidal atrophic
mottling, with a red blurry optic disk.
He was placed on gels. θ, three times daily, for a few days, with
evident improvement of the optic nerve congestion. He was then given
kali hyd. 3d, four times daily. He returned home in a week, keeping
up the same remedy. In three weeks he returned to me again, when
examination showed decided improvement; with — 13 Ds., V. = 15/100
once more; still keeping up the kali hyd. 3d.; thus having been
brought back to the condition which followed the treatment in 1885,
and which had remained in _statu quo_ for fourteen years.
Detachment of the retina is always a serious condition. It is not an
unfrequent complication in high degrees of myopia. In three hundred
cases collected in Horner’s clinic, 48 per cent. were in myopic eyes.
Its progress is generally unfavorable. It is usually treated by perfect
quiet, rest of patients, after confining them to bed for some weeks,
giving infusions of jaborandi and hypodermics of pilocarpin mur.
Puncture through the sclera at the points of detachment, allowing escape
of the fluid, has been advocated and performed by various well-known
authorities, but has not been successful enough to ensure its general
adoption. In rare cases spontaneous recovery has been observed, but I
cannot think that the case here presented belongs to this class, for the
original attack was in 1885, and was of such a degree that the vision of
the left eye was reduced to mere perception of light in the outer upper
field of vision. Under kali hyd. 3d, remarkable changes and rapid
improvement took place. A relapse followed on his return home, after a
couple of weeks. This again yielded to the same treatment, the vision of
the left eye regained what it had lost, and remained in this condition
for twelve years, when a severe general inflammation of the left eye
necessitated its removal. Then, in a couple of years, the vision of the
right eye became suddenly involved. Rapid improvement again followed the
same remedy, and it was restored to its original condition. Hence, I
cannot regard the improvement as either spontaneous or a coincidence,
but think I am justified in attributing it to the direct result of the
remedy given.
In the old school iodide of potash, in large and repeated doses, is a
very common remedy in all intraocular diseases, and the more obscure the
case, the more frequently and persistently it is used. Some cases are
benefited by it, others not. The points I wish to make are, first to
demonstrate the homeopathic possibilities of treatment in this serious
disease; that when you have a homeopathic kali hydriodicum case, kali
hyd. will probably help it, whether you give it in the third trituration
or in more appreciable doses. In the case here reported kali hyd. 3d was
certainly more potent than the 5‒grain doses used for one week and then
changed to the 3d trituration again.