Macular degeneration symptoms and treatment options you can use

Even though homeopaths recognize macular degeneration symptoms and can suggest different treatment choices, a majority of these same homeopaths are reluctant to treat age related macular degeneration for several reasons. First there is a poor understanding of the pathology and its affect on the visual system. This means the cause of macular degeneration must first be identified. Second is the belief that only a specialist should treat this serious disorder, and lastly is the belief this condition will not respond to homeopathy- it is an incurable state.  Since there is no effective allopathic treatment why not try homeopathy? The homeopathic treatment of macular degeneration is a unique opportunity for homeopaths.  I would like to share my experiences using homeopathy in the treatment of this disorder.

Definition of age related macular degeneration (ARMD)

Macular Degeneration is a pathological condition that occurs in the macular area of the retina. The macula is the area of the retina responsible for central vision or that, which gives us the greatest detail in our sight.  The pathological changes primarily occur in the choroid (the vascular layer of the eye which lies between the sclera and the retina) and pigmented retinal epithelium (RPE- the layer separates the choroid from the retina). These changes may lead to fluid accumulation, hemorrhage and scar tissue. Loss of central vision occurs, but this rarely produces total blindness because the peripheral vision is preserved.

Macular Degeneration affects 13 million Americans. Most of them are over the age of 65, but certain hereditary conditions may cause it to develop in younger individuals. Persons over the age of 75 have a 30% chance of developing ARMD; it rarely affects anyone younger than 55 years old. Caucasians tend to develop it more than persons of pigmented skin  due to the fact  they have less pigment in the retina, especially if they have blue, gray, or green eyes. It affects men and women equally. People who are nearsighted (myopic) have a greater chance of developing the condition as do people who work or spend a lot of time out of doors and are exposed to ultraviolet radiation from sunlight.

Symptoms of ARMD

When a patient has ARMD, vision in the center of the visual field gets fainter and fainter until finally there is hardly any way to see objects in the center of the visual field. The first thing most people will notice is a lessening of their sight as they look straight ahead at things, like print or faces or clocks. This may be a dimming, a blurring, or actual ‘holes’ or black spots in the vision. Extreme light sensitivity and poor night vision also precede ARMD in many cases. Light-to-dark adaptation, the ability to find a seat in a movie theatre is also apt to be very slow.  ARMD rarely leads to total blindness. Instead, worsening symptoms include a loss of central vision and a diminished ability to see things straight ahead. Looking at a clock or a face becomes more and more difficult. People with ARMD will rely more and more on peripheral vision. Sometimes, in the early stages, there are holes in the  vision, called scotoma.  These are areas where you cannot see anything. Most people with ARMD become unable to drive and are eventually declared legally blind.

Types of ARMD

There are two main types of macular degeneration, wet and dry. The dry or areolar type consists of degeneration of the retinal pigment cells resulting in drusen (small wart like growth) hyper and hypopigmented areas in the retina with loss of rods and cones and generalized atrophy. Dry ARMD, which affects 90% of persons with ARMD ,results from a buildup of cellular waste product called drusen, in the back part of the inner eyeball where the retina and macula are. Drusen is from the German word druse meaning bump or gland. It refers to the earliest changes that are observed in ARMD. A drusen or bump develops on Bruch’s membrane. This occurs when the retinal pigment epithelium becomes overloaded with undigested discs from the cones. This material collects on Bruch’s membrane producing thickened areas, which look like little bumps or warts.

The wet type or exudative type presents as vascular leakage with exudates and a detachment of the retina with loss of vision. . In addition when the retinal pigment epithelium becomes overloaded, the RPE cells begin to degenerate. Debris begins to accumulate at the base of these cells. These cells lose their attachment to Bruch’s membrane and fluid begins to accumulate under the cells. Soon there are breaks in Bruch’s membrane leading to growth and leakage of blood vessels from the choroid. This leakage and new blood vessel growth into the retina lead to the wet stage of macular degeneration. A small percentage of these cases can be treated successfully with the argon laser. There is another type of wet macular degeneration that occurs in people who are diabetic. This results from leakage of small blood vessels, which leads to fluid accumulation under the retina and loss of central vision.

Summary of the types of Macular Degeneration
Dry Stage of Macular degeneration

1. Development of Drusen
2. Degeneration of Retinal Pigment Epithelial cells

Wet stage of macular degeneration

1. Breaks in Bruch’s membrane leading to growth and leakage of blood vessels
2. Absorption of blood with the development of scar tissue

Traditional treatment-

There have been many studies that have shown that the antioxidants, Vitamins  A, C, E and zinc and selenium can retard the progression of this disorder.

One of the treatments for wet ARMD uses laser surgery to cauterize the leaky blood vessels. This measure may preserve more vision in the long run, but usually results in worse vision in the short run because healthy tissue is almost always destroyed along with the diseased vessels. Laser treatments are only indicated for the wet type of degeneration and in fact only a small percentage of patients with the wet type will actually qualify for laser treatment.

Homeopathic approach-

Macular Degeneration can be treated homeopathically just like any other disease state of the body.  The constitutional approach works best , the goal being to find the totality of the case.  In some cases, when the remedy is not clear or the patient is not willing to under go constitutional treatment, a more lesional approach can be used.

Rubrics for Macular degeneration:
INFLAMMATION – Choroid
EYE – INFLAMMATION – Chorio-retinitis
EYE – ATROPHY – CHORIOD, Atrophic spots
EYE – INFLAMMATION – Retina – pigmented
EYE – INFLAMMATION – Retina – punctata albescens
EYE – INFLAMMATION – Retina – syphilitic
EYE – INFLAMMATION – Retina
VISION – DIM
VISION – FOGGY
VISION – LOSS OF VISION – vanishing of sight
VISION – LOSS OF VISION – colors; for
VISION – SCOTOMA
VISION – SCOTOMA – central

Constitutional approach

Miasms:
I first try to uncover the miasm stages in these cases to limit the remedies under consideration. The exudative type of degeneration represents the sycotic miasma. The dry or atrophic type of macular degeneration probably represents the syphilitic miasm.

Psoric Stage- This is the earliest presentation with minimal pigmentary changes and a loss of the foveal light reflex. The foveal light reflex is produced when healthy cones reflect the light, which enters the eye. As the cells become weakened with age and disease, they loose this ability to reflect light.

Sycotic Stage- There is a hyperproliferation of tissue in the macular area. This  can manifest as excessive pigment which has the appearance of dark pepper like specks in the macular area.  Another presentation can be Drusen. These are wart like growths, which extend from the inner layer of the retina called bruchs membrane. These drusen cause a weakening of the retina and can lead to death of the photoreceptive cells. This weakness can also cause tiny blood vessels to grow into the retina. These vessels can leak fluid or bleed and cause a sudden loss of vision (Wet Macular degeneration).

Syphilitic Stage- There is more destruction of tissue with atrophy and destruction of the retina.

Description of lesion

Characteristics of the macula can be very useful in remedy differentiation. Is the lesion wet or dry? Is there hyperpigmentaion or hypopigmentation? What color is the exudate? Yellow, white, or  orange? Is there blood present? What color is the blood?

As an Ophthalmologist I have the unique ability to observe the changes inside the eye and to use these physical findings to select the remedy,but you can ask the patient to bring in retinal photos of the macular degeneration so you can study these characteristic features.   I often will look at the skin and generality section to select the proper remedy. Some rubrics that I have found to be helpful in treating macular degeneration are:

SKIN – CICATRICES
SKIN – DISCOLORATION
SKIN – EXCRESCENCES
SKIN – ERUPTIONS
SKIN – FRECKLES
SKIN – INFLAMMATION
SKIN – WARTS
GENERALS – ARTERIOSCLEROSIS
GENERALS – ATROPHY
GENERALS – HEMORRHAGE
GENERALS – INDURATIONS
GENERALS – INFLAMMATION
GENERALS – STASIS of the venous system
GENERALS – TUMORS

Remedies that have an affinity to the eye

Retinal Atrophy
Carboneum Sulpuratum
Cina Maritima
Haliaeetus leucocephalus
Kalium Chloricum
Phosphorous
Santoninum
Senecula
Tabacum
Vanadium

Choroidal Atrophy
Cina Maritima
Kalium Chloricum
Kali Iodatum
Santoninum
Veratrum viride

Lesional approach
Some prescribers have had experience with a more lesional approach to this disease. I use this approach when the patient is not interested in undergoing constitutional treatment.

Tissue salts
Tissue salts can also be useful in the treatment of macular degeneration. The follow salts have found to be helpful in the treatment of ARMD.
Calc-f  8X- The tissue strengthener
Calc-p 6X -The cell builder.
Kali-p 6X -Nerve nutrient
Nat-m 6X -The fluid distributor. Dryness or excessive moisture in any parts of the body. Can be helpful in cases of wet macular degeneration.

Carb-s

Andrew Lange has reported success in early macular degeneration using Carboneum Sulphuratum. He uses 30C everyday and has seen resolution of drusen and pigmentary changes.

Secale
Dr. Johann A. Müller has had good success with Secale in the treatment of macular degeneration. Secale is used in low potency when the patients have some general signs compatible with Secale. Modalities such as burning and heat and worse heat. Amelioration from cold. Circulatory problems and hemorrhagic tendencies are not very sympathetic.

Senecula and Vanadium
Dr. A. U. Ramakrishnan has used Senecula in cases of macular degeneration with the symptom of wavy vision. He has also used Vanadium 200C every month for the treatment of macular degeneration.

Sarcode- Human Retina 5C
Max Tetau has reported the affects of 5C, 7C and 9 C sarcodes on the tissue that was prepared. 5C Stimulates activity from tissue it was derived.  7C normalizes tissue activity and 9C suppresses tissue activity. Human retina 5C has been used with some success in stimulating the activity of the failing macula.

Cases

1) DS 76 year old female
Prominent look of suffering on her face during the interview. Recent episode of a hypertensive crisis- 220/146- she is very anxious about getting her vision back- over 10 laser treatments in both eyes.

She is worried down the road? What is going to happen? She needs to know more information.  She needs the information so she can do what will help her. She has to be sold on it for the best avenue. She is a skeptical person
She owns a health care agency.

She sleeps with the light on all night. She was robbed as a child. Fear of robbers. A man coming up through a trap door. Her parents’ home was large with 14 rooms. She and her sister would take turns staying up at night.

Fear that someone is in the room. She is on guard.  She sleeps facing the door on her left side. She also has a gun. A small ladies gun which is loaded.

She will sleep for a couple of hours and then wake at 2:00 to 3:00 AM.
Fear is worse when she is alone. She stayed up all night when her husband was in the hospital. She could solve this problem if she had a dog. The dog would be on guard instead of her.

PE
5/100 right eye, 5/10 left eye
Cataracts OU
Central scarring right eye from laser treatment
Retinal pigmentary changes with large drusen (Tumors/ Warts) in the left eye

Diagnosis
ARMD
Cataracts
Hypertension
Anxiety

Rubrics
FACE – EXPRESSION – suffering
MIND – FEAR – alone, of being
MIND – ANXIETY – health; about – own health; her/his
MIND – ANXIETY – night
GENERALS – TUMORS

She escapes by reading books about the simple life. Small town, a quite place, the neighbors visiting each other. She likes the feel of soft clothes. Desires creature comforts. She wants a simple dog, a dog to stay on guard at night.

There are many aspects of Calc. Issues of security in the home, enjoying the simple pleasures of life. There is also the fear and anxiety element of Ars.

Calc-a LM1

Follow up one year later
It took her 2 months before she started the remedy- strong fears of an aggravation

• She feels good. Lots of energy.  She can relax easily.
• She has a lot more energy in her business.
• She is getting a lot of compliments on her skin since taking the medication.
• Her fears are greatly improved. She does not have the fear of being robbed. Her fears at night have greatly improved.
• Happier and more relaxed. What more could you want!
• Vision has improved two lines on the chart!
• PE 5/100 in the right eye, 5/10 in the left eye

2) RR  78 year old female
Chief complaint is macular degeneration, cataracts and a balance problem.

She has noticed her vision decreasing since her last eye exam when she was told that she had macular degeneration and cataracts. Vision is very dim and she has trouble reading.

The vertigo comes on suddenly and she then goes down like a rock. Room spins from left to right. She is debilitated. She is like a quivering old lady. She is so weak that her arms and legs shake. Twice it happened at 7:00AM when she woke up from bed. She pulled herself up with great effort. She lives in fear that this attack will come back again when she is under stress. She works as a real estate broker. When she is in a stressful conversation she can feel her balance leave her. She feels that the bottom is dropping out of her stomach and experiences light-headedness.

She has also developed ringing in her ears associated with the vertigo.

An important aspect of her life was Ballroom dancing. She has achieved a silver level in ballroom dancing. She is very depressed because now she can’t compete.  She feels hopeless and withdrawn.

Her sexual drive was never very high and she is not in a relationship. She states there is a lot of sexuality in dancing. She enjoys the provocative aspects of the Latin dancing.

PE
20/300 right eye, 3/100 left eye
Advanced cataracts in both eyes
Myopic degeneration with atrophic changes in her retina

Diagnosis
ARMD
Vertigo
Cataracts

Rubrics
EYE- CATARACT
VERTIGO – ACCOMPANIED by – staggering
VERTIGO – SUDDEN
EAR – NOISES in – ringing
MIND – DANCING
FEMALE GENITALIA/SEX – SEXUAL DESIRE – diminished

According to A. B. Norton in his article “The Homeopathic Treatment of Incipient Senile Cataract, with Tabulated Results of One Hundred Cases” Sepia is the number one remedy to think of in females with advanced cataracts.

Sep LM1

8 month follow up

• She can read the menu! 70% improvement in her vision
• Street signs are becoming clearer- colors are vivid
• No more dizziness- stronger and confident walking
• No more ringing in her ears
• PE- vision is now 20/200 OU

3) EA 78 year old female
2 years ago developed cloudy vision in the left eye- vision very dim and letters run together while reading.

Biggest rift has been with her daughter. She has cut her off from the family. She will not return her letters and she will hang up the phone when she calls. It is such a big disappointment in my life.

Told lies about my husband and me.   “You know mother you are a slob” She wanted to cry but she could not cry. How could she be so hurtful? They would go for hours not talking to each other. Her daughter would not appreciate anything that she did. “I wanted to tell them to go to hell” but she did not because she did not want to exacerbate it.

She blows and she gets angry very quickly. She shouts and she quite throwing things years ago. Sometimes a silly little thing will irritate her. She was eating her salad and they brought out the main course. It was cold and she became extremely upset.

PE- retinal pigment atrophy in the left eye
Vision 10/10 right, 1/70 left eye

Diagnosis
ARMD
Hypertension

Rubrics
MIND – CONTRADICTION – intolerant of contradiction
MIND – ANGER – trifles; at
MIND – ANGER – violent
CHEST – PALPITATION of heart – anger
VISION – RUN together – letters

Staph LM1

7 month follow up

• Peripheral vision is better on left eye- the right she has noticed an overall improvement
• Colors are much brighter- she has a dress that she thought was gray and now it looks lavender!
• She is not getting angry as easily or as often-
• She called her daughter and asked her if she wanted to meet her- she said yes- it was a good meeting- at the end she said that they had 3 wasted years-

Vision has improved 3 lines in the left eye-
10/10 in the right eye
1/40 in the left eye

Homeopaths should not view macular degeneration as an incurable disease that will not respond to homeopathic treatment. I hope that all homeopaths will welcome the opportunity to help people who are suffering from the effects of macular degeneration. Do not tell them- what so many eye doctors have told them- “Nothing can be done”- Yes homeopathy can help and begin to look for the similimum that will improve their vision and their life.

1. Jeffery Berger, MD. Age Related Macular Degeneration. St. Louis, MO Mosby, 1999
2. Samuel Hahneman, MD The Organon of the Medical Art. Redmond, WA Birdcage Books, 1996
3. Edward C. Kondrot, MD. Healing the Eye the Natural Way: Alternative Medicine and Macular Degeneration. Berekley, CA North Atlantic Books: 1999.
4. Frederik Schroyens, MD. Synthesis, Repertorium Homeopathicum Syntheticum. London, England Homeopathic Book Publishers, 1997
5. Todd Rowe, MD Homeopathic Methodology. Berekley, CA North Atlantic Books: 1998
6. Frans Vermeulen, MD Concordant Materia Medica.  Haarlem, Netherlands Merlijin Publishers, 1994

For more information on macular degeneration symptoms contact Dr. Kondrot:

Correspondence
Edward C. Kondrot, MD, CCH
1-800-430-9328
www.healingtheeye.com
drkondrot@healingtheeye.com

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