A 6 year old boy was expected to undergo strabismus surgery for a symptomatic decompensating fully accommodative esotropia. He reported increasingly troublesome double vision.
With low hypermetropic correction, his visual acuity was 0.02 right eye and 0.04 left eye, his stereoacuity 85 seconds of arc, he had an 18 PD near esophoria and 8PD distance esophoria. Uncorrected, his visual acuity was 0.12 in both eyes with a 30 PD right esotropia at near and 20 PD at distance.
Whilst considering squint surgery, his mother, who is studying homeopathy, initiated treatment with an individualised homeopathic remedy of 30c nitric acid administered once a day on a sugar-coated dissolvable tablet. He completed an initial one-week course with success, although the effect was short lived with diplopia returning after one week. He proceeded with an additional two-week course which allegedly improved his symptoms and ocular alignment.
One month following this self-medicated treatment, our patient attended his scheduled outpatient review, to our surprise without diplopia and without spectacle correction. His unaided visual acuity was 0.04 in both eyes and he controlled a 20 PD esophoria for both near and distance fixation. Strabismus surgery was therefore postponed and active monitoring has resumed. At two months, Mum reports he remains asymptomatic.
This is the first case described where individualised homeopathic treatment has demonstrated an apparent resolution of a fully accommodative esotropia. The longevity is yet to be determined but as homeopathy becomes ever more popular, Paediatric Ophthalmologists may require some basic awareness of such fascinating cases.
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