Integrative Treatment of the Cornea
Problems in the eye can go from mild to extreme within a day. As a result of this and the pain that often accompanies corneal issues, any corneal abnormality should be seen immediately whenever possible. Once you have the patient in front of you, there are multiple approaches you can use to treat the condition. While we are taught a few specific conventional methods, using drugs and surgery, to treat each corneal ailment, some can be challenging to heal (herpes infections or complications from Cushing’s or other metabolic ailments) or expensive for the clients (surgery for entropion). Holistic options work at a deeper metabolic level as well as topically on the cornea. Given the chance, the cornea can heal quite nicely. Even entropion can often resolve without surgery.
BASICS OF CORNEAL HEALING
Like other epithelia, that of the cornea goes through continuous renewal in order to protect its interior layers of the cornea so it can maintain smooth optical properties and transparency. The outer layer of corneal epithelium has tight junctions between cells and protects the rest of the cornea. Cytokines mediate the stromal-epithelial-immune parts of the healing cascade.1 The stroma, or thick middle layer, contains multiple supportive cells, collagen and nerve fibers. The inner epithelium is a single layer of endothelium, allowing net fluid transport from the corneal stroma to the anterior chamber, offsetting stromal tendency to imbibe fluid and swell (edema). Endothelial fluid transport activity allows maintenance of corneal transparency and thinness. This enables the cornea to clear edema after healing of the surface epithelium.
The primary objectives of treatment are patient comfort, and saving the eye and vision. This often means also addressing the deeper causes of the corneal problem, such as ongoing irritation from foreign bodies or abnormally placed eyelashes, dry eye, glaucoma, uveitis, bacterial or fungal infections which can damage the stroma. Integrative approaches soothe the eye while stimulating deeper immune responses like the healing cascade, so the eye is gently and permanently healed. Often, holistic treatments are sufficient; if not, surgery and drugs can still be used effectively.
INTEGRATIVE TREATMENT OPTIONS
For speedy healing of any corneal injury, homeopathic Cineraria maritima applied topically in low potency is a real winner.
• In the literature, Cineraria is indicated for the treatment of cataracts. While I find it ineffective for cataracts in my patients, it is an excellent remedy for corneal healing. As with any other eye drops, it does not stay in the eye for more than a few minutes, so it is good to give it frequently if possible, especially at the beginning of therapy. I recommend application every two hours the first day after initial trauma, if possible. I have had 24 years of seeing the healing Cineraria stimulates, and it continues to impress me.
• If there is blepharospasm and meiosis, chances are good that the reflex arc from the corneal surface to the brain and back to the muscles of the iris are causing pain to the patient, so topical atropine ophthalmic ointment can be applied every 12 hours in addition to Cineraria. Instill the atropine ten minutes prior to the Cineraria. When using Cineraria and other holistic treatments, it is rarely needed more than a few days. In my clinic, the use of topical antibiotics is neither necessary nor effective, but they do not seem to impede healing when paired with Cineraria.
• When there is mucus, or purulent discharge, significant benefit is gained by gently flushing the eye with saline solutions. You can dispense these to your clients or they can purchase them in human pharmacies. Keeping the animal’s comfort in mind, always warm the saline solution to body temperature. Wait ten minutes after flushing to instill the Cineraria solution. In Paragraph 203 (and elsewhere) of The Organon of the Medical Art, Hahnemann warns against using topical treatments for surface ailments without having internally treated the disease. I have found oral dosing with homeopathic remedies to be a valuable part of the treatment of a variety of corneal ailments, including pigmentation and scarring, foreign bodies, injuries, granulomatous masses, corneal dystrophy, acute or poorly healing corneal ulcers, descemetocoele, KCS (keratoconjunctivitis sicca) and corneal sequestrum. In most cases, I coupled topical Cineraria with the homeopathically-selected internal medicine matching the individual animal’s unique needs.
Remember to alert clients about neovascularization. Often, corneal healing requires an infi ltration by capillaries. We know it is a good sign of healing, but it can be alarming for clients to see all that redness on the cornea if they are not informed. Frequent re-checks are important to assure healing progression.
I rarely need look beyond Cineraria in my practice, but TCVM (Traditional Chinese Veterinary Medicine) and Western herbs can also topically and internally address the deeper causes of corneal problems2. From the TCVM perspective, the eye is connected to the liver. An excess of heat or lack of moisture in the liver can cause dry conditions in the eye, leading to KCS or ulcers. Determining the acupuncture points and Chinese herbs needed to resolve corneal problems depends on identifying which imbalance is present, as well as looking at behavior and concomitant symptoms.
Western herbs can also be useful for eye problems. Euphrasia (eyebright) can be used internally as well as topically by making a tea from the dry herb or tincture. Another useful eye rinse is made from equal parts of marigold, dandelion and chamomile. An astringent eye rinse can help prevent infection when conjunctiva and corneas have been irritated by wind or dust – use raspberry leaf, nettle, Oregon grape and goldenseal. The ingredients in the topical Cineraria drops (Homeopathic Cineraria eye drops for cataract from Natural Ophthalmics) are Cineraria Maritima 5X; Euphrasia 6x; Causticum 6X; Calcarea phosphoricum 10x; Sepia 6X; Calcarea fl ouricum 11X, and Silicea.