I would like to present a short, but very interesting and rare case. A 19- year-old girl suddenly lost vision in her left eye. She first felt stitching pain in the eye and shortly after that, she completely lost her vision on the left side. She was hospitalised and examined by ophthalmologists and neurologists.
Ophthalmologists said there was neither any visible pathology in the eye, nor in the optic nerve. Neurologists performed a CT scan of the brain and head and did not find any pathology either. However, they said they believed it could be an inflammation of the optic nerve.
Ophthalmologists did not agree with that and kept saying that the eye itself was free from any apparent pathology. As they were not sure about the diagnosis, they did not prescribe any medication yet.
I investigated what had happened before the incident and found out that the girl had been under tremendous pressure. The loss of vision actually occurred next day after passing her school leaving exam. She had been under stress because of the exams and she had been afraid of not passing it.(3)
But there were also other things to consider. A few months prior to this, she had moved from her parents‘ house to her boyfriend’s flat. However, her boyfriend lost his job so she had to work a lot to support him financially. She had already had some part-time jobs before but after her boyfriend lost his job, she had to work more hours (60 hours a week) and in the evenings after coming home exhausted, she studied for her exam.
The job itself was stressful and she had been living like that for almost 2 months while not eating and sleeping very well.(3) She refused any financial help from her parents. She sometimes cried from all the stress.(3) Before the exam, she was trembling from fear.(2)
Prior to the loss of vision, she also had headaches with vomiting for about a week, usually in the evening around 6 or 7 p.m. (3). The pain was in the forehead and temples.(2) The patient had never had any neurological pathology before and there are no neurological complaints in the family medical history.
Analysis of the case:
I approached this case as an acute case and although there were some chronic symptoms, they were irrelevant to the girl’s current condition. It is interesting and favourable at the same time that according to medical specialists, there was no apparent physical pathology. In fact, the doctors did not reach an agreement, but it rather looked like a functional type of problem.
From that, I derived an assumption that the complaint was most probably caused by overstressing of the nervous system. However, in my opinion, it might have been a forerunner of something more serious which might occur in the future if the patient stresses herself further. I do not tend to make light of these occurrences and take them seriously.
The assumption of the pathology arising from a “mere” overstraining of the central nervous system helped me find the right remedy though. I started focusing on the remedies which have a weak nervous system and are generally overstrained, exhausted and weak.
Selection of symptoms:
- sudden one-sided loss of vision (4)
- ailments from overwork – both, physical and mental (3)
- fear of not passing the exam (3)
- trembling from anticipation, before exam (2)
- ailments from loss of sleep (2)
- exhaustion (3)
- crying from stress (3)
- headaches at around 6 or 7 p.m. (3)
- headaches in forehead and temples (2)
Possible relevant rubrics to use in this case:
Here is a list of relevant and possible rubrics which cover the symptoms of the case. The rubrics come from Synthesis repertory. 1
I did not use all of them in the case.
VISION – LOSS OF VISION – sudden
VISION – LOSS OF VISION – one side
GENERALS – COLLAPSE – overwork; from
MIND – AILMENTS FROM – mental exertion
GENERALS – WEAKNESS
GENERALS – COLLAPSE
MIND – FEAR – failure, of – examinations; in
MIND – ANTICIPATION – examination; before
GENERALS – TREMBLING – Externally – anticipation – from
GENERALS – TREMBLING – Externally – excitement – emotional excitement; after
GENERALS – TREMBLING – Externally
GENERALS – SLEEP – loss of sleep; from
MIND – WEEPING – involuntary – weakness, from
MIND – WEEPING – excitement, from
HEAD – PAIN – evening – 18 h
HEAD – PAIN – evening – 19 h
HEAD – PAIN – Forehead
HEAD – PAIN – Temples
HEAD – PAIN – exertion – agg.
There is no rubric for exhaustion. However, there is a cross-reference for weakness in the repertory. The rubric VISION – LOSS OF VISION – sudden was very helpful in this case and I primarily considered remedies in this rubric and basically used this rubric as eliminatory.
Differential diagnosis of the most probable remedies:
Gelsemium sempervirens is one of the main remedies for stress before examinations and fear of not passing exams. Trembling and weakness are other important keynotes of this remedy. It is a remedy with strong neurological pathology, especially connected with weakness. Sudden loss of vision can be confirmed in Clarke’s Dictionary of practical Materia Medica. It is one of the main remedies for weakness and exhaustion leading to paralysis (together with Cocculus indicus). It is interesting that it can be found in a rather small rubric HEAD – PAIN – evening – 18 h.
Aconitum napellus is the remedy to think of when any complaints appear suddenly (together with Belladonna). Sudden loss of vision can be confirmed in Clarke’s materia medica and George Vithoulkas‘ Materia Medica Viva. In Aconitum, sudden blindness occurs especially after fright or exposure to excessively cold or hot weather. However, the fear before examination is not typical for this remedy. It rather covers fear arising from horrible shocks and frightful incidents. There are no other keynotes to confirm this remedy in the case.
Nux vomica is the main remedy for collapse from overwork. Ailments from overexertion (esp. mental) represent the main aetiology of this remedy. It is the only remedy in the rubric GENERALS – COLLAPSE – overwork; from. This remedy is suitable for people of workaholic character who surpass limitations and capabilities of their body and very ambitious types of persons who like to prove themselves. The fact, that the girl is refusing financial help from her parents fits the ambitious part of Nux vomica. The remedy can be found in the rubric VISION – LOSS OF VISION – sudden. The remedy also covers ailments from loss of sleep as these people often work until late night hours and do not get enough sleep.
Cocculus indicus is the main remedy for ailments from loss of sleep. Loss of sleep in this remedy is usually caused by a combination of not being allowed to sleep (because of tasks the patient has to do) and worries – usually taking care of sick persons. It has a strong affinity to the neurological system, however, neurological complaints tend to develop slowly in this remedy. Together with Gelsemium, it is a very important remedy for paralysis from exhaustion. Sudden loss of vision cannot be confirmed for Cocculus though. The remedy can be found in the rubrics HEAD – PAIN – evening – 19 h and GENERALS – TREMBLING – Externally – excitement – emotional excitement; after.
Silicea and Argentum nitricum can be found in the rubric for sudden loss of vision and they both can have ailments from anticipation before an exam. Silicea has more fear of being incapable of passing the exam. Argentum nitricum has rather an undefined nervousness before exam. Apart from the fact that Silicea covers headaches from mental exertion, neither of these two remedies can be confirmed further.
Selection of the remedy:
When we put together the collapse state, exhaustion, fear before examination, trembling and probable neurological nature of complaints, the remedy which seems to fit the case the best is Gelsemium. It is very favourable that the main complaint (sudden loss of vision) can be confirmed in a reliable source of our Materia medica – Clarke’s Dictionary of Practical Materia Medica2. If Gelsemium does not work, my second choice remedy will be Nux vomica.
I used repeated dosing in this case as it was an acute situation.
Prescription: Gelsemium 200C 3 times a day
Outcome of the treatment:
The patient took only one dose of the remedy in the afternoon. The same evening, about 3 hours later, she started recognizing some contours and later in the evening she realised her eyesight was really coming back. I told her not to repeat any more doses and wait, because the reaction was obviously already taking place.
Next morning her eyesight was almost normal and within the next few hours it was 100% normal. It took less than 24 hours to regain the full sight after only one dose of the remedy. The ophthalmologists could not believe it and pronounced it a miracle. The problem has never occurred again.
This was one of those miraculous cases where clear and rapid improvement sets in shortly after the remedy. One dose was sufficient to completely reverse the problem. This case also belongs to these mysterious cases where pathology is unclear or not apparent, but symptoms are serious.
Here, the patient benefited from one of the biggest advantages of homeopathy, namely, that a diagnosis is not needed for commencement of the treatment or even for a cure. Conventional medicine is often at a loss when the diagnosis is unclear, because it selects its remedies on the basis of a diagnosis.
As opposed to conventional medicine, homeopathy selects the remedy on the basis of symptoms and it therefore does not have to wait until the diagnosis is established. However, it is always very helpful to understand what is going on in the organism, to understand the pathology itself. It may sometimes help selecting the right remedy.
Pathology-wise, I was considering two possible options in this particular case. It could have been just functional pathology arising from total exhaustion of the organism. However, there is also a possibility that it could have been a warning sign of something more serious, which could occur in the future, possibly multiple sclerosis or some other type of neurological problem affecting optic nerves.
We sometimes come across cases where every medical test of the patient is within the “reference range”, but the patient has symptoms typical for a certain diagnosis. Maybe some people are more sensitive and do not fit in the reference values or their test results are just below the reference line, but they are still sick nevertheless.
I have seen such cases. With this in mind I advised the patient to continue with homeopathic treatment in the future in order to bring her organism to the best possible condition to prevent development of possible serious complaints. I also pointed out the importance of changing her lifestyle so that she does not exert herself over the limits.
 CLARKE, J.H., Dictionary of Practical Materia Medica. Gelsemium [online]. http://www.homeoint.org/clarke/g/gels.htm
 VITHOULKAS, G. Materia medica Viva. Volume 1. London: Homeopathic Book Publishers, 1995. ISBN 0-9522744-69, p. 65