RU2204401C2 - Method for carrying out conservative treatment of blunt injury of the eyeball aggravated with intraocular hemorrhage - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves administering Traumel S preparation combined with classic homeopathy preparation Phosphorus. EFFECT: enhanced effectiveness of treatment; prevented secondary hemorrhages. 4 dwg

Description

 The invention relates to medicine, in particular to ophthalmology, and for the conservative treatment of traumatic eye injuries in children.

 It is known to use various physiotherapeutic methods for blunt trauma to the eyeball complicated by intraocular hemorrhage. General oxygen therapy (B.S. Illarionov, 1968), electrophonophoresis and fibrinolysin (E.S. Weinstein et al., 1975, L.A. Grishatova, 1979), ultrasound (O. O.) are widely used for resorption of concussion hemorrhages. V. Grigorieva, 1972, I.P. Chuistova et al., 1969).

 There is also a method of treating traumatic injuries of the eyeball by prescribing a complex of drugs that promote resorption of hemorrhages, reduce edema, strengthen the vascular wall, reduce the oxidative activity of lipids, promote resorption of exudates and prevent the formation of fibrous strands.

 In particular, E.I. Verigo believes that in the injured eye there is a whole chain of severe changes that occur at the time of the injury and during the entire wound process, on the basis of this, she offers a scheme for treating this pathology with a complex of drugs with the above properties (Verigo E.I. "Dicinon in treatment of post-traumatic complications "All-Russian Congress of Ophthalmologists 3rd: Abstracts - M. 1975. - v.2-p. 148-151.).

 The most commonly used groups of drugs are currently used: they reduce the oxidative activity of lipids - emoxipin, which contribute to the resorption of hemorrhage, reduce edema, extravasates due to increased vascular permeability - dicinone, which facilitate the absorption of exudate in the vitreous body and prevent the formation of fibrous strands - streptodecase. The complex use of these drugs in the treatment of blunt eyeball injury complicated by intraocular hemorrhage is taken by us as a prototype.

 The disadvantage of this treatment is the lack of an individual approach in the treatment of this pathology, the presence of secondary complications, a high percentage of forced surgical intervention, as well as the presence of adverse reactions, in particular allergic ones.

 The aim of the invention is to eliminate these drawbacks, the possibility of creating treatment and rehabilitation programs that allow you to implement an approach to each patient, taking into account its constitutional features, significantly reduce the percentage of surgical interventions and increase the number of positive treatment outcomes.

 This goal is achieved by the fact that, depending on the constitutional type of the child and the child’s predisposition to hemorrhage with a tendency to relapse, a complex homotoxicological drug Traumel S is prescribed in combination with the preparation of classical homeopathy Phosphorus 6, 1 grain for a year of life 1 time per day, after 7 years 7 grains 1 time per day.

 The drugs used by us are prepared exclusively from natural products, in a minimum concentration, are selected according to the principle of similarity and have the maximum therapeutic effect with a minimum pharmacological load.

 The method is confirmed by the following specific examples.

 Example 1

 K., 11 years old, was admitted to the department a few hours after an injury received by a plastic bullet from a spring pistol. The main complaints are: pain in the right eye, decreased visual acuity, headache, floating shadows in front of the eye. Diagnosis at admission: Dull injury to the right eye of 3 degrees.

On examination:
Child from 2 pregnancies, urgent delivery. Born with a weight of 2.5 kg, height 50 cm. Boy asthenic physique, skin is pale, blue-eyed, fair-haired. He likes to draw, goes to the theater studio. From the anamnesis it is also known that diseases in a child occur acutely, with sharp rises in temperature, changes in mood, nasal and subcutaneous hemorrhages are frequent.

An objective examination:
Visual acuity OD-0.3 OS-1.0
OD - the tissues surrounding the eyes are not changed. The mobility of the eyeball is painful. Pronounced mixed injection. Conjunctival hemorrhage in the internal department. Pa endothelium of the cornea are single shaped elements. The anterior chamber is of medium depth, a suspension of blood cells in moisture. Hyphema 2 degrees. The pupil is 3 mm in diameter, its reaction to light is reduced. The iris in color is not changed, the pattern is faded. The lens, vitreous body, fundus are visible behind the fleur. IOP - 15 mm RT. Art.

 An ultrasound scan revealed OD: turbidity is floating, polymorphic, of high density, mainly in the lower half, where they are located preretinally. Turbidity disappears mainly at maturity of 36 db.

 Received as part of complex therapy: the drug Traumel S in the form of subconjunctival (0.3 ml) and intramuscular (1.5 ml) injections, 0.3 ml 5-6 times a day into the irrigation system, 7 Phosphorus preparation 7 grains 1 once a day.

 At discharge after 6 days, we noted the following indicators.

 General condition is satisfactory. The skin is pale, clean.

 The dynamics of visual acuity is shown in FIG. 4 (line with squares).

 The dynamics of resorption of hemorrhage into the anterior chamber (hyphema 2 degrees) is shown in FIG. 1 (line with squares).

 The dynamics of visual acuity and resorption of hemorrhage in the anterior chamber (hyphema 2 degrees) of a child receiving treatment according to the scheme adopted for the prototype is shown in Figs. 1 and 4 (line with triangles).

Visual acuity OD-1,0 OS-1,0
OD - calm eyeball. Eye mobility in full. The cornea is transparent, spherical, mirror-like. Iris - pattern and color are not changed. The anterior chamber is of medium depth, moisture is transparent. The pupil is 3 mm in diameter, satisfactorily responds to light. The crystalline lens is transparent. In the vitreous body, single floating opacities not associated with the inner membranes. The fundus is a satisfactory reflex from the fundus. D3N - pale pink, the contours are clear. The course and caliber of vessels without features. Macular and foveolar reflexes are satisfactory. Retinal periphery without features - IOP-19 mm Hg

 During the examination one month after the discharge of OD, the main visual functions and the condition of the eye are satisfactory.

 When conducting ultrasound, the vitreous body is transparent.

 Thus, early positive dynamics in a child with the claimed method of treatment appeared earlier for 3-4 days compared with a patient who received treatment according to the traditional scheme. The terms of resorption of hemorrhage were 5-6 days in our patient compared with the patient who received traditional therapy - 7-8 days.

 The maximum visual acuity was achieved on days 5-6 compared with 7-9 days in a patient with a traditional method of treatment.

 Example 2

 O., 9 years old, was admitted to the department 6 hours after a left eye injury with a diagnosis of Dull left eye injury of the 2nd to 3rd degree. Injury caused by a bullet from a toy air gun.

On admission:
A boy from the first normal pregnancy, the first independent birth. Birth weight 3 kg, height 50 cm. Early development without features. The child is red-haired, pale, with blue eyes. Easily makes contact with a doctor in the presence of parents. According to his parents, he likes to draw, has an artistic nature, a desire to like. But periodically feels a sense of fear and anxiety in the event that not all relatives are at home. A superficial dream with frequent awakenings is noteworthy. Before the injury, slight bruising was noted, and after the bleeding joined, which was observed mainly in the full moon. Food preferences: drinks a lot of cold water and milk, likes eggs, pickles, smoked meats.

 The appearance of the child, anamnesis and eating habits testify to his belonging to the constitutional type Calcarea phosphorica.

Visual acuity OD-1.0 OS-0.2
OD-calm, healthy.

 OS photophobia. Tissues surrounding the eye without features. Superficial injection of the conjunctiva, in the area of the outer corner of the eye, extensive hemorrhage under the conjunctiva. On the corneal endothelium, thick deposition of shaped elements, hyphema 3 degrees. The iris is swollen, the pupil is 2 mm, sluggishly reacts to light. The lens and vitreous body are visible behind the fleur. The fundus is a dull reflex, details are visible behind the fleur.

 IOP-14 mmHg

 Received as a complex therapy: the drug Traumel S in the form of subconjunctival (0.3 ml) and intramuscular (1.5 ml) injections 5, the drug Phosphorus 6, 7 grains 1 time per day 7.

 At discharge, after 7 days, we noted the following indicators: general condition is satisfactory, the child became calmer, constant anxiety about the absence of loved ones decreased, began to sleep calmer.

 The dynamics of visual acuity is presented in figure 3 (line with squares).

 The dynamics of resorption of hemorrhage into the anterior chamber (hyphema 3 degrees) is shown in FIG. 2 (line with squares).

 The dynamics of visual acuity and resorption of hemorrhage into the anterior chamber (hyphema 3 degrees) of a child receiving treatment according to the scheme adopted as a prototype is shown in Figs. 3 and 2 (line with triangles).

Visual acuity OD-1,0 OS-1,0
OS-eyeball is calm. Eye mobility in full. The cornea is transparent, spherical, mirror-like. Iris - pattern and color are not changed. The anterior chamber is of medium depth, moisture is transparent. The pupil is 3 mm in diameter, satisfactorily responds to light. The lens and vitreous are transparent. The fundus is a satisfactory reflex from the fundus. DZP - pale pink, the contours are clear. The course and caliber of vessels without features. Macular and foveolar reflexes are satisfactory. Retinal periphery without features.

 IOP - 20 mmHg

 After 1 month after the injury - a second consultation, the condition is satisfactory, is engaged in 2 schools, the constant anxiety for loved ones disappeared. Parents did not report nasal and subcutaneous hemorrhages.

 Basic visual functions and eye condition without negative dynamics.

 Conclusion: as a result of the analysis, we noted an earlier positive dynamics (by 4-5 days), a decrease in the time of resorption of hemorrhage (by 4-5 days), a faster restoration of visual acuity (by 5 days) in a patient who received the Traumel complex homotoxicological drug S and the preparation of classical homeopathy Phosphorus 6, compared with the patient who received the treatment regimen, which we claimed as a prototype.

 Despite the rather long existence of the homeopathic treatment method for ophthalmologists, who are usually prone to allopathic medicine, there is a strong belief that homeopathic treatment is inapplicable in the case of acute injury, especially complicated by hemorrhage. Many of these patients undergo surgical methods due to the ineffectiveness of the treatment used.

 The claimed method of treatment was effective and is currently used in the clinic as a method of choice in the treatment of this pathology. The method is extremely simple to implement, allows you to take into account the constitutional features of the child and thereby largely predict the outcome, significantly reduce the percentage of surgical interventions for this pathology, reduce treatment time.

 The claimed method of treatment is very simple, but it is completely not obvious to ophthalmologists working in pediatric practice, and we applied it for the first time.

 In addition, the method used in the application will allow in some cases to maintain visual functions, to prevent the occurrence of secondary complications.

Claims (1)

 A method for the conservative treatment of blunt eyeball injury complicated by intraocular hemorrhage, characterized in that when the child is prone to hemorrhage with a tendency to relapse, he is prescribed a complex homotoxicological drug Traumel S in combination with the drug Phosphorus classical homeopathy.

Images