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Case Study

A Case of Opthalmoplegia
Madhusudan Adoni.
` Caust

Mrs K C , 65 yrs, working in the fields came on 15/7/93 morning, rushing from her village with a complaint of closure of right eye with inability to move her eyeball. Examination revealed ptosis with complete paralysis of ocular muscles of the right eye. She could not see or move her eye because of ptosis. It was a case of Right-sided Opthalmoplegia.

pathophysiology : Oculomotor (III Cranial nerve ) is affected causing external squint, inability to move the eye upwards and directly downwards and ptosis due to paralysis of levator palpabrae muscles and abducent nerve paralysis causes paralysis of lateral rectus with inability to turn eye outwards beyond midpoint.

Aetiology : She was working in the fields the whole day prior to the attack in drizzling rain with cold atmosphere. Ailments from exposure to cold and rain. She had no other physical symptoms.

Selection of Remedy :.

  1. The keynote symptom Ailments from Exposure to cold.
  2. Paralysis of single nerve.
  3. Paralysis of ocular muscles after exposure to cold.

Analysis of the above three symptoms gives us Causticum, the major nerve remedy, and based on symptom similarity, 1 M potency was chosen.

Management : 2 doses of Causticum 1M for 2 days followed by sac-lac. Advised hot fomentation of eye and adequate protection from rain and cold weather. Remarkable improvement after a week with no ptosis. She could move her affected eye with no difficulty. Causticum 1M another dose was given after a week and now she is completely well with slight improvement in her cataract also. She is now under observation with repeat of Causticum only if necessary.