Clinical Cases

Ophthalmoplegia in a Boy of Five

Homeopathy student Amynah shares a case of ophthalmoplegia in a boy of five. He was born with jaundice and hypoglycemia.

May 8th, 2019 : This was my first child case.  C.T. is a five-year-old boy. His mother was concerned about his eyes and wanted to be seen. He was shy but shook hands while holding onto his mother, almost hiding behind her. Upon asking if he was shy, he smiled and nodded “No”. He is slim and tall for his age. Phosphorus came to my mind right away. I was not sure if eyes and phosphorus had any connections.

C.T. had his red eye glasses on and he said he wears them all the time. His mother said he blinks his eyes a lot and has been seen by an eye specialist who diagnosed ophthalmoplegia (weak muscles) especially in his right eye.

The eye doctor had suggested a patch for a month but she postponed that. His mother was concerned that kids at school will tease him.  I asked C.T. to follow what I am doing and he did. He was able to blink both eyes simultaneously, wink eyes bilaterally, and he denied any pain or having watery eyes. He said he has desire to scratch his eyes even though his mother has not noticed him do so.

His mother had seen him blink quite a bit since returning from a trip to India. He used to watch TV a lot during the trip and has cut down a bit since going to school. There was no family distress during the trip. He has a younger brother. His mother had not noticed any changes in behavior after the sibling was born besides the usual tantrum even before the brother was born.

C.T. used to be clingy with his mother and not accept care from his father.  Now that his mother is back to work, he accepts care from father and grandmother only.

Lycopodium came to my mind when his mother mentioned C.T. was born with jaundice and hypoglycemia. He was kept under photo-therapy after his birth. His liver enzymes were elevated. He was placed on Vitamin D.  He was on iron which was stopped about a year ago.  He suffered with pneumonia in Dec 2018 and was treated with antibiotics.  His mother had gestational diabetes. His mother denied family stress or emotional stress during pregnancy.

She said that he sleeps about 10-11 hours.  He falls asleep easily when tired, otherwise asks to read more stories or discusses things on his mind. He used to wake up if he had bad dreams. He talks in his sleep sometimes.  He keeps the blanket on but moves his body to the cooler side of the bed.

He prefers room temperature. He does not nap during day time, unless he is in the car. He is full of energy as soon as he is awake. I thought about Sulphur and it did show up on my Repertory list.

C.T. is very moody when he is hungry. He likes candies but has no cavities.  He is very particular about his clothing. He does not have any fears. No constipation. He can play in heat of sun for 1-2 hours. He sweats in hair first during summer.

His mother is short with an average healthy-looking body; wears glasses. She denied having any health issues or gestational diabetes with her second child.

These are the rubrics I chose:

  1. Eyes; astigmatism
  2. Eyes; Dryness
  3. Mind; hunger, fasting agg.
  4. Abdomen; chronic complaints, liver region
  5. Abdomen; liver, congestion, chronic
  6. Generalities; food and drinks; fruits; desires; juice
  7. Generalities; food and drinks; sweets; desires

As my first child case I was hesitant to start him with 200CH even though he has great vitality, so I started him with Sepia 30CH 1 pellet split dose, as it was a chronic case of liver, and I was not sure how it will affect the eyes.

First follow up in two weeks:

His mother mentioned C.T. still blinks his eyes and rubs his right eye. Next day after the first dose he was tired and napped after school. He still has tantrums. I asked him how his eyes were and he said “hurts a lot”. It’s not there all the time and it’s a “pinching pain” usually when going to sleep.

Assessment: Potency too low.

Prescription: Sepia increase potency to 200CH twice a week

Second follow up in one month:

His Mother said he is rubbing his eyes but not blinking as much, and tantrums are still the same. He still craves for sugar and carbohydrate food. Energy is still high.  C.T. had upcoming appointment with the optometrist and we wanted to see the result sooner rather than later.

Assessment: There were some good changes.

Prescription: Decided to keep same remedy and potency, to increase the frequency and change dilution method. Continue Sepia 200CH liquid, 5 drops in tablespoon of water once every other day.

Third follow up after three months:

His mother stated C.T. was seen by the optometrist and no patch was needed. She was very pleased. No further rubbing of eyes was noted, eating meals and fruits now, mother had stopped giving him juice and he is drinking water. Still throws tantrum but less often. He still looks for cold spots in bed, otherwise no thermal changes and he is calmer than before.

I chose Sepia and not Lycopodium or Chelidonium for liver or even Sulphur when C.T. clearly looks for cooler place while in the bed.  Farrington wrote in his clinical Materia Medica that, Lycopodium is a worthy rival of Sepia, “The distinction between the two remedies may be given in a very few words”.  Sulphur resembles Sepia in many respects. And as per Boericke pocketbook of Materia Medica, Sepia helps with muscular asthenopia which were the symptoms of his chief complaint. As Hahnemann stated in the Organon “treat what is in front of you” and the “totality of the symptoms”, that tells me that I had found the constitutional remedy for C.T.

About the author

Amynah Hirani

Amynah Hirani, DHOM is a recent graduate from CCHM. She is continuing with her education in BSc of Homeopathy at Centre for Homeopathic Education via Middlesex University in London UK. Amy worked as a nurse since 1996 in vast clinical settings and has also studied reiki, reflexology, Bowen therapy and other healing modalities. Visit her website at

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