Author: Dr. Sandeep S. Sathye
Homoeopathic Consultant, Sathye Eye Research Institute for Alternative Medicine
Address for correspondence:
Dr. Sandeep S. Sathye
Plot no. 4, Sadanand Nagar, Anand Nagar,
Hingne (K), Sinhagad Road, Pune 411051, Pune,
Email – sandeepsathye@gmail.com
No.: 9850 818 667
Abstract
Chalazion is a painless, round swelling in the eyelid unless gets infected with pyogenic organisms. It mainly causes a cosmetic disturbance to patient. It is treated usually with intralesional corticosteroid injection or with incision and curetting. However this conventional treatment is associated with chances of recurrence or steroid induced complications. Homoeopathy has mentioned treatment for Chalazion and has been used in clinical practice. A retrospective study from OPD cases of institute was carried out with an aim to know the effectiveness of homoeopathy and biochemic medicines in Chalazion. Total 21 patients registered during the year 2003 to 2006 were studied irrespective of their age, gender and socioeconomic status. 5 cases presented with acute inflamed stage were resolved with homoeopathic Hepar sulphuris 200C. During non-inflamed stage homoeopathic Con., Nat. mur., Silicea and biochemic Calc. flur., Natrum sulph. medicines were used. Out of 21 subjects, in15 (71%) Chalazion has resolved completely without any recurrence. Whereas in 4 subjects (19%) it was reduced but they were lost to follow-up. In 2 subjects (9.5%) there was no change. Thus medicines were found effective in in treating Chalazion in majority of subjects without any recurrence and untoward effects.
Introduction
Chalazion (meibomian cyst) it is a swelling of meibomian gland following an obstruction of its duct, accompanying by a chronic inflammation in the surrounding tarsus. [1] It is actually not a cyst but a chronic inflammatory granuloma of a meibomian gland. The duct of the gland gets obstructed either due to proliferation of its epithelium or by impaction of its secretion. Chalazion occurs in all age groups but it is more common in adults than in children. Chalazion occurs due to some endogenous infection, rosacea, poor lid hygiene, chronic blepharitis, seborrhoeic dermatitis, refractive error etc. however many times no obvious cause is noticed.
Patients presents with either a small, painless, round swelling in the eyelid especially upper one or may present with an acute inflammation of eyelid when it gets infected with pyogenic organisms. Lid swelling may cause a cosmetic disturbance to a patient while a large and centrally located chalazion gives pressure over the cornea leading to blurred vision due to astigmatism.
Although Chalazion is known to undergo spontaneous resolution, most of the Chalazion becomes small after months but complete spontaneous resolution rarely occurs. [2] A Chalazion may sometimes rupture through the tarsal plate and the palpebral conjunctiva and granulation tissue protrudes out causing irritation, watering and even discharge if there is a secondary infection. [3]
Treatment in modern literature includes use of warm compresses and lid hygiene as a conservative treatment for a small painless Chalazion that may result in its resolution within 1 month. Otherwise Intralesional injections of long acting steroids may help in resolution of small chalazion. If it doesn’t resolve or in case of large Chalazion a surgical incision and curettage is the treatment of choice. Recurring Chalazion is treated by a subconjunctival total excision. In an acute stage of inflammation (internal hordeolum) it is treated by meticulous eyelid hygiene together with local and systemic antibiotics. There are some limitations of conventional treatment such as chances of recurrence of Chalazion after incision and curettage surgery, if curetting is not done properly. While with the use of intralesional injection of corticosteroid there are chances of ocular complication such as inadvertent corneal penetration, traumatic cataract and serious complications of corticosteroid injection. If there are multiple and small chalazion they are difficult to remove surgically or with a intralesional corticosteroid injection. [4] Some patients may experience sensitivity or a resistance to a systemic use of antibiotics or anti-inflammatory drugs. So by taking into account above limitations of conventional treatment, a systemic homoeopathy and biochemic medicines were used for this condition.
In homoeopathy different medicines mentioned for Chalazion with their gradation were as follows :
Eyes – Eyelids and margins – Eruptions – Chalazae, tarsal tumors : Ant-t., Calc., Caust., Con., Ferr-py., Kali-i., Platan-oc., Sil., Staph., Thuj., Zinc. [5]
Chalazion – PLATANUS OCCIDENTALIS, STAPH., Thuj., Calc. c., Caust., Con., Hep., Puls., Zinc. [6]
Eye – tumors on lids – nodules in the lids : Con., sil., staph., thuj. [7]
Eyes – Eyelids – Tumours (tarsal) – Arg-n., calc-c., hep., hyds., nat-s., pul., thu. [8]
Eyelids – Tumours – N.M., SIL. [9]
A retrospective clinical study was carried out from records of OPD patients of the institute suffering from Chalazion with an aim to know the effectiveness of Homoeopathic and biochemic medicines in such condition.