The covid-19 pandemic initially started in Wuhan, China, and then swiftly spread all over the globe and on March 11, 2020, was declared as a pandemic.[1] Until now, Covid-19 has claimed more than 2.7 million lives worldwide.[2] Since there is no pathognomical symptoms of Covid-19 at the initial stage, concluding its diagnosis is very difficult. Reported symptoms of Covid-19 are not limited to cough, fever, fatigue, sore throat, nasal obstruction, shortness of breath, headache, sputum production, and haemoptysis. Numbers of patients had also showed wider range of gastrointestinal symptoms such as diarrhoea, abdominal pain, low appetite, vomit, and many have shown renal and ocular symptoms.[3] Apart from the gastrointestinal symptoms many has reported variable complications in the eyes. Many patients suffer from post covid symptoms, which is called as long Covid. A retrospective, comparative study had been conducted to find out the manifestation of post Covid syndrome with 100 Covid-19 recovered patients throw some light on this. Full ophthalmological examination, general examination including internal medicine and neurological evaluation done for the assessment. Study has shown that 5% had retinal vascular occlusion, 2% had anterior ischemic optic neuropathy AION, 3% had uveitis and 2% had central serous chorioretinopathy (CSCR).[4],[5] Homoeopathic remedies are reported to remove sequelae of long-lasting acute diseases. Moreover, homoeopathy has an extensive range of remedies to relieve complications of eyes. Hence it is possible that homoeopathy can be helpful to effectively manage the ocular manifestations of long Covid. In this article, we will be discussing the therapeutic indications of the possible remedies for long Covid with the help of repertorization.
Eye symptoms of long Covid
Conjunctivitis, red eye, foreign body sensation, dry eye, photophobia, blurry vision, itching, epiphora, ocular pain, and floaters are the common eyes symptoms reported by the patients of long Covid as per the available data.[6],[7],[8] Few reports suggest that the conjunctiva inflammation was the sign of Covid-19 diagnosis.[9]
Figure: Repertorial analysis of the eye symptoms of long Covid
Possible remedies based on the repertorization and their indications[10],[11],[12],[13]
There are several homoeopathic medicines for the management of post Covid-19 ocular manifestations. We have done the reportorial analysis of the eye symptoms of long Covid. The commonly indicated remedies obtained after repertorisation with RADAR are represented in the figure with their indications. We have used eye irritation as an eliminative rubric since it is a common eye symptom as per Sarkar D et al. 2021; not part of long Covid. There are 88 remedies found in the analysis and the top five remedies are Arsenicum album, Euphrasis officinalis, Calcarea carbonica, Lycopodium clavatum and China officinalis.
Aconitum napellus
Eyes feel dry and hot as if sand in the eyes. Eyelids turn red, hard, and swollen. Complaints begin from exposure to dry, cold winds, reflection from snow, after extraction of cinders and other foreign bodies. Physical and mental restlessness, fright, is the most characteristic manifestation of Aconite. Acute, sudden, and violent invasion of the symptoms. In true sclerotis, acute stage, with contracted pupils, sticking or tearing pains, photophobia, a blue circle around cornea and violent aching in balls. Itching, smarting, and burning in eyes, worse in evening.
Apis Mellifica
Swelling or puffing up of various parts, oedema, red rosy hue, stinging pains, soreness in the eyes. Conjunctiva bright red, puffy. Lachrymation hot. Photophobia. Sudden piercing pains. Keratitis with intense chemosis of ocular conjunctiva. Staphyloma of cornea following suppurative inflammation. Pain in eye are better by cold washing. In general thirstlessness.
Argentum nitricum
Acute granular conjunctivitis, conjunctiva intensely pink or scarlet, discharge profuse, inclined to be mucopurulent. Blepharitis if lids are very red, thick and swollen, especially if complicated with granulations. Photophobia worse in the warm room. Aching tired feeling in eyes, better closing or pressing upon them. Very impulsive wants to do things in a hurry. Pain from brain to eyes during iritis
Arsenicum album
Burning pain in eyes relieved by washing with warm water. Acrid lachrymation from the eyes. Lids red, ulcerated, scabby, scaly, and granulated. Aching, burning, and shooting pains in the eyes, worse by light, as also by the movement of the eyes, accompanied sometimes with a necessity to lie down or with anguish which does not permit to rest in bed. Agglutination of eyelids. Burning pains over orbit, worse at night, with profuse acrid lachrymation during Keratoiritis. Extreme redness of inner surface of eyelids, with an uneasy sensation rather than pain, often obliging one to rub the eyes. Great restlessness and anxiety
Belladonna
Throbbing pain deep in eyes on lying down. Eyes feel swollen and protruding, staring, brilliant. Photophobia from the artificial light. Chronic keratitis, when suddenly eye becomes intensely congested, with heat, pains often sharp, shooting through ball to back of head. Rheumatic iritis in early stages.
Calcarea carbonica
Sensitive to light. Lachrymation in open air and early in morning. Spots and ulcers on cornea. Lachrymal ducts closed from exposure to cold. Chronic dilatation of pupils. Dimness of vision, as if looking through a mist. Lachrymal fistula; scrofulous ophthalmia. Persons of scrofulous type, who take cold easily, with increased mucous secretions, children who grow fat, are large-bellied, with large head, pale skin, chalky look, the so-called leuco-phlegmatic temperament; affections caused by working in water. Averse to work or exertion.
Causticum
Inflammation of eyelids; ulceration. Sparks and dark spots before eyes. Vision impaired, as if film were before eyes. Paralysis of ocular muscles after exposure to cold. Intensely sympathetic. Ailments from long-lasting grief, sudden emotions. Burning, rawness, and soreness in the eyes. Flickering, sparks or black points before eyes. Sensation of heaviness in upper lid, as if he could not raise it easily, or as if it was agglutinated to lower lid, and could not be easily loosened. At first dryness of eyes in morning, and stiffness, followed by lachrymation.
Conium maculatum
Photophobia and excessive lachrymation. Corneal pustules. Dim-sighted; worse, artificial light. On closing eyes, he sweats. Paralysis of ocular muscles. The slightest ulceration or abrasion will cause the intense photophobia. In superficial inflammations, as in phlyctenular conjunctivitis and keratitis. Aversion to light, without inflammation of eyes. Cannot read long without letters running together; burning pain deep in eyes, with hot flushes, cannot bear either light or heat.
Euphrasia officinalis
Indicated in inflammation of the conjunctival membrane especially, producing profuse lachrymation. Pain in eye better by cold washing. Profuse acrid lachrymation and bland coryza; worse, evening. Catarrhal conjunctivitis; discharge of acrid matter. Burning and swelling of the lids. Frequent burning biting in eyes, obliging frequent winking.
Gelsemium sempervirens
Double vision. Disturbed muscular apparatus. Orbital neuralgia, with contraction and twitching of muscles. Deep inflammations, with haziness of vitreous. Swimming black specks before eyes, vision dim, can neither read nor write, words run together, cannot recognize one across room, with heat in eyes extending to forehead. etachment of retina dependent upon an injury, with diffuse haziness of vitreous and serous inflammation of choroid and retina. Dizziness, drowsiness, dullness, and trembling in general. Thirstlessness.
Lycopodium clavatum
Right eye is generally affected. Flickering and black spots before the eyes. Dim, hot eyes. The eyes are wide open, insensible to light, fixed. Dryness of eyes, in evening. Sparks before the eyes, especially in the dark. Drawing pain in the cervical muscles. Eye symptoms may accompanied with flatulence and heartburn, worse at afternoon especially 4-8 P.M.
Natrum muriaticum
Eyelids heavy. Muscles weak and stiff. Fiery, zigzag appearance around all objects. Burning in eyes. Give out on reading or writing. Stricture of lachrymal duct with suppuration. Lachrymation, burning and acrid. Tears stream down face on coughing. Pain in eyes when looking down. Great weakness and weariness especially felt in the morning in bed. Oversensitive to all sorts of influences.
Phosphorus
The occiput and nape of the neck are painful and very stiff. This pain extends till coccyx. Sleeplessness due to overuse of computers. Slightest noise disturbs. Paralytic weakness in the small of the back and extremities with tremor from prolonged sitting. Patient may have logging of cold food, ice cream, excessive salt, and thirst for cold water.
Pulsatilla
Itching and burning in eyes. Profuse lachrymation and secretion of mucus. Lids inflamed, agglutinated. Dryness of eyes and lids, with sensation as if darkened by mucus, which ought to be wiped away. It seems dark before eyes in morning, on rising from bed. Loss of vision at night, as if eyes were tightly bound by a cloth, with menstrual disturbances. Iritis with dry burning heat in and about eye. Burning, itching in eyes, provokes rubbing and scratching relieve by washing with cold water, cold application, and open air. In general patient is thirstless, mild, and weeping disposition.
Ruta greveolens
Eyes-strain followed by headache. Eyes red, hot, and painful from sewing or reading fine print. Disturbances of accommodation. Weary pain while reading. Pressure deep in orbits. Feeling of intense lassitude, weakness and despair. Overstrain of ocular muscles. Eyes feel hot like balls of fire.
Sangunaria canadensis
Neuralgia in and over right eye. Blepharadenitis : with a feeling of dryness under upper lid and accumulation of mucus in eye in morning ; blepharitis and catarrhal conditions of conjunctiva, with burning in edges of lids, worse in afternoon ; dependent on stricture of lachrymal duct. Acute conjunctivitis, with excessive redness and numerous ecchymosis in conjunctiva, tending toward trachoma, with moderate discharge and some pain in eye.
Sulphur
Burning ulceration of margin of lids. Heat and burning in eyes Black motes before eyes. First stage of ulceration of cornea. Chronic ophthalmia, with much burning and itching. Cornea like ground glass. Ebullitions of heat, dislike of water, dry and hard hair and skin, red orifices, sinking feeling at stomach about 11 am, and cat-nap sleep; always indicate Sulphur homoeopathically. General offensive character of discharge and exhalations.
Conclusion
Homoeopathy can be effectively used for eye symptoms of long Covid. Reportorial analysis throws 88 remedies with Arsenicum album, Euphrasis officinalis, Calcarea carbonica, Lycopodium clavatum and China officinalis at the top.
References
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[9] Mahayana IT, Angsana NC, Kamila A, Fatiha NN, Sunjaya DZ, Andajana W, et al. Literature review of conjunctivitis, conjunctival swab and chloroquine effect in the eyes: a current updates on COVID-19 and ophthalmology. J Med Sci 2020;52:21–28.
[10] Hering’s Guiding Symptoms of our Materia Medica By Calvin B. Knerr, M. D. B Jain Publishers Pvt Ltd;New Delhi
[11] F. Schroyens, Synthesis Treasure Edition 2009V, RadarOpus 1.33 (Homoeopathic Software), Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
[12] W. Boericke, New Manual of Homoeopathic Materia Medica & Repertory [with Relationship of Remedies], Second Re-Augmented & Revised Edition Based on Ninth Edition, Reprint Edition 2002, B. Jain Publishers, New Delhi.
[13] J. H. Clarke, Dictionary of Practical Materia Medica, Reprint Edition 1992, B. Jain Publishers, New Delhi.