Dr Ashwni Gugale
In this study Homoeopathic medicine- Physostigma 30 was prescribed to 30 subjects presented with simple or low myopia and their accessory symptoms. To assist the improvement in this study VISUAL ACUITY i.e. DIOPTER was used. This study includes males and females with 10-30years of age criteria. This study shows Genetic : Environmental Index for myopic development & physostigma30 works well in cases where simple, low myopia is induced due to environmental changes. This study manifest that Physostigma acts well on right eye & almost 29 patients out of 30 showed significant improvement in accessory symptoms of simple low myopia. Dioptric improvement shown totally in 9 subjects; good & moderate improvement shown in 5 & 4 subjects respectively. But when this study analyzed statistically by applying “student ’t’ test”, the null hypothesis accepted that Physostigma 30c does not work in simple low myopia.
This research gives new array to work more for refractive errors. Physostigma 30 reduces accessory symptoms of myopia in 29 subjects out of 30 it means it actually helps to relax ciliary muscles of the eye and may help to regain the normal shape of the retina but it requires extensive research work to prove.
Refractive errors, myopia, physostigma30, visual acuity, genetic : environmental index for myopic development, accessory symptoms of simple, low myopia
Now a days myopia has become major public health problem in Indian school children and adolescent age group.
The interest behind this study is to identify percentage of myopic eyes and cost-effective non- interventional treatment.
Studies suggest myopia or near-sightedness is one of the most common eye disorders. It is more prevalent in Taiwan, Japan, China Korea (East Asia), South east Asia, affecting ~60-80% of young adults.
Recent researchers conclude that Indian population has myopic genes. Study signifies association with increased Axial length even after multiple correction.
Present treatments which are available for myopia: Current treatments which is available to slow down the progression of myopia: 1. Spectacle lenses 2. Contact lenses 3. Pharmaceutical agents like; A) Atropine – but atropine has side effects due to which many Clinicians do not accept long term therapy. B) Pirenzepine -it is just like atropine, is a muscarinic
Many trials and experiments were conducted to slow down the myopic changes, but conclusion occurred that many treatments are effective only in early changes but after the initial months the treatments effects may increase only minimally or not at all.
Long term myopia leads increase in axial length and person land up in irreversible eye problem therefore patients need to take treatment to slow down myopic changes before irreversible changes established.
Therefore, we want to achieve whether homoeopathic preparation of Physostigma30c helps to relax the ciliary muscles which are contracted or in spasm and slow down the progression of myopia.
Simple low myopia is the commonest type of myopia it does not progress much after adolescence. It ranges up to -3.00 D. in this type of myopia no any degenerative changes are seen in the fundus, but in later life peripheral degeneration may seen. Simple low myopia has good prognosis. Signs and symptoms of myopia are not so prominent, majorly blurred objects which are on distance get clearer when they are close to eye sight.
Research question: Does physostigma 30c reduces dioptres in simple low myopia?
Hypothesis: Physostigma 30c does not work in simple low myopia.
Background and justification:
Problem of myopic eye is rapidly growing especially in some specific areas of the glob; and the causes majorly are; gross changes in the environment and genetic predominance. This myopia treated with glasses on primary level to create clear and normal distinct vision, but they have no capacity to cure myopia. if gasses removed blurred distinct vision turns back. Are glasses seriously making myopic eyes worse? This is Hard to answer as many studies show control is the best option for patients. But one way orthokeratology has default treatment for myopia. Nearsightedness always start with pseudo myopia, where muscles are in spasmodic state because of near work for longer time, and it slowly gets relaxed by exercise of eye muscles and some eye drops. When patients use glasses, it means they are not relaxing eye muscles; and spasm sets in and eye become more dependent on glasses. And diopter increases as time flies. Therefore, concave lenses are not final answer to treat myopia.
Treatments which are available for these myopic eyes has not sufficient and satisfactory results and evidence of reduced diopter. Therefore, we are more interested to see the action of physostigma30c in simple low myopia.
AIM: Improve the Refractive errors
- To note the diopter of refractive error at the time of inclusion in the study and note the symptoms after prolonged near vision
- After administrating Physostigma 30 O.D. in every follow up of 15 days
- a) To study the changes in the dioptre of refractive error. b) Simultaneously in each follow up to study for changes in the symptoms of simple low myopia
- To study the improvement in the refractive error by comparing the dioptre of refractive error before giving the medicine and after the medicine in last follow up.
In the 1st phase of the dissertation, I completed theoretical study. Which gives detailed knowledge about Simple and low myopia with the help of extensive literature. From this study I learnt genetic and environmental index. Even studies suggest that eye exercise can help to reduce the diopter in early cases. Outdoor activities are more important to avoid early issues of myopia.
In the 2nd phase practical study was done thoroughly. For this study 30 sample was collected and treated with Physostigma 30 for simple and low myopia.
Dioptric changes before and after the treatment:
Here 5 (no. of cases) i.e. 16% out off 30 cases has been shown ≥ -0.50D change from their previous diopter. 4 (no. of cases) i.e. 13% out of 30 cases shown decrease in diopter by
Predominance of eye:
In this study physostigma treated right eye more prominently than left eye. So we can conclude that physostigma is right sided remedy.
Symptomatically relieved :
In this study Physostigma worked well on myopic accessory symptoms. Observation suggest that around 29 i.e. 96% out of 30 cases showed complete improvement on symptomatic ground..
Environmental and genetic index:
In my study I found that genetic:environmental proportion is 16 : 14 means environmental background is as important as genetic background to develop myopia.
Improvement criteria :
GOOD ≥ -0.50D= 5 cases i.e. 16%
MODERATE ≥ -0.25D= 4 cases i.e. 13%
POOR < -0.25D= 21 cases i.e. 70%
Statistical analysis :
In this study after applying student t test, the null hypothesis is accepted, that is Physostigma 30c does not work in simple low myopia to improve diopters.
Discussion & conclusion suggest that Physostigma 30 is quite close to cure the myopia though, null hypothesis is accepted. This remedy reduced accessory symptoms of myopia (as it is shown in this study) incredibly then we can say that physostigma may help to reduce the diopters, but to achieve this results further studies need to conduct. Example, use different potencies of physostigma, work on how to repeat the medicine, time period of consumption of the remedy.
Even we should not forget the law of similia & on that basis should study different homeopathic medicines for myopia.
To reach the aim we need to conduct long term experiments to monitor and define the changes in the diopters as well as steadiness in the result.
- D. Chaurasia; Chaurasia’s Human Anatomy Vol.3; CBS publishers # 6th edition; Page no. 269
- Basak k. Samar; Essentials of ophthalmology; current book international; #4th edition; Page : 4,5,6,7,8,9,10,11
- Boricke William; Boericke’s new manual of homeopathic materia medica with repertory; B. Jain publisher (P) Ltd; 3rd revised augmented edition ; page no; 455, 456
- Michael Glynn & William Drake; Hutchison’s clinical methods ; saunders Elsevier; 23rd edition; Page no. 393,394
- Michael Glynn & William Drake; Hutchison’s clinical methods ; saunders Elsevier; 23rd edition; Page no. 395,394
- Murphy Robin; lotus materia medica; B Jain publisher (P) Ltd; 2nd edition; page no. 1355, 1356, 1357
- Murphy Robin; lotus materia medica; B Jain publisher (P) Ltd; 2nd edition; page no.1358, 1359
- Sambulingam K, Sambulingam Prema; Physiology book, Essentials of medical Physiology; JAYPEE publisher; #4th edition; Page no: 902, 903
- Sambulingam K, Sambulingam Prema; Physiology book, Essentials of medical Physiology; JAYPEE publisher; #4th edition; Page no. 878
- https://www.sciencedirect.com/science/article/abs/pii/S0161642020310435 Reducing the Global Burden of Myopia by Delaying the Onset of Myopia and
- Reducing Myopic Progression in Children: The Academy’s Task Force on Myopia;Ophthalmology Volume 128, Issue 6, June 2021, Pages 816-826;
- https://www.sciencedirect.com/science/article/abs/pii/S1367048421001739 Vision-related quality of life with myopia management: A review; Contact Lens and Anterior Eye
- https://pubmed.ncbi.nlm.nih.gov/28552714/ Genetic and environmental-genetic interaction rules for the myopia based on a family exposed to risk from a myopic environment
- https://www.sciencedirect.com/science/article/abs/pii/S0039625721001429 The cause of myopia development and progression: Theory, evidence, and treatment; Survey of Ophthalmology;Available online 25 June 20
- https://www.sciencedirect.com/science/article/pii/S0161642021008174 Efficacy and Safety of 8 Atropine Concentrations for Myopia Control in Children: A Network Meta-Analysis Ophthalmology; Available online 22 October 2021; In Press, Corrected Proof
- https://www.sciencedirect.com/science/article/pii/S2589750021001357 Association between digital smart device use and myopia: a systematic review and meta-analysis; The Lancet Digital Health; Volume 3, Issue 12, December 2021, Pages e806-e818
- https://www.sciencedirect.com/topics/medicine-and-dentistry/myopia Myopia; Wallman, F.A. Vera- Diaz
- https://www.sciencedirect.com/science/article/pii/B978012370585350011X Myopia Pharmacology: Etiologic Clues, Therapeutic Potential RICHARD A.STONE Ocular Therapeutics; Eye on New Discoveries; 2008, Pages 167-196
- https://www.drhomeo.com/homeopathic-treatment/5-best-homeopathic-medicines for-myopia/ Dr Sharma Vikas 5 Best Homeopathic Medicines for Myopia
- https://www.lybrate.com/topic/all-about-myopia-and-its-treatment-in- homeopathy/865ec40769408d54bc4bc4552602d8fc Dr Ghosh Swarup Kumar; All About Myopia And Its Treatment In Homeopathy!
- https://www.researchgate.net/publication/315506252_Pilot_study_on_ultra_high_dilutionof_physostigma_venenosum_for_accommodation_error-myopia Sampath Suresh & Lakshmanan Ganesh; Pilot study on ultra high dilution of physostigma venenosum for accommodation error-myopia
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675264/ Myopia: a growing global problem with sight-threatening complications; Brien A Holden, David A Wilson, Monica Jong, Padmaja Sankaridurg, Timothy R Fricke, Earl L Smith III, and Serge Resnikoff; Community Eye Health.2015;
- https://openscholar.dut.ac.za/bitstream/10321/2704/5/PILLAY_1994.pdf The effect of physostigma venenosum om myopia; Pillay, Bavani
Dr Ashwini Akshay Gugale MD (Hom)