A rabbit with an eye injury: a case of Physostigma

Snout is a rabbit family pet. He escaped into the garden when the children were not watching, and was only found two days later. He had an injury to his right eye, perhaps from old barbed wire or from another animal. His owner disinfected the eye with a salve and observed the situation for a day, then brought him in to the practice. Snout’s eye was discharging. He was very quiet and did not want to eat; the family was very concerned. When he was brought in to the practice, there was an ulcer of the cornea, a perforation of the anterior eye chamber, glaucoma, and white pus oozing from the eye. His eye was enormously swollen, even to the top of his head, and he could not shut it. His left ear was hanging down. A swelling like that is very painful and it was no wonder that he was “a bit quiet”.

Could this eye be saved or should it be surgically removed? Or should the rabbit be euthanized? Usually, the only option would be to remove they eye or to euthanize the animal. The owners did not want to spend any money on it but they also wanted to wait a few days until the children would be away at a camp, hoping that it would be less painful for them. They asked for pain relief, but this is difficult for rabbits, since it is very toxic for them. The remaining option was homeopathy. An important sub-rubric turned out to be “Eye, glaucoma, injuries, after”, with only one remedy: Physostigma. In his Dictionary, Clarke writes: “In glaucoma, it has been used with signal success to diminish intraocular tension, and especially when glaucoma has been the result of injury.” Phatak writes: “Glaucoma, especially after injury.” Further study of the Materia Medica says the following about Physostigma: “Diminished accommodation, tension of the eyelids, cannot shut the eyelids. Continual pain on the top of head.” (We cannot ask this of course…) Also “Pain above the eyes” and “contraction of the pupils and ciliary muscles”. Additionally, I studied all the larger rubrics concerning eye injuries: “Eye, injuries after”; “Eye, glaucoma, injuries after”. The following remedies presented themselves as possibilities: Aconitum, Arnica and Physostigma, of which Physostigma seemed to be the most appropriate.

Prescription: Physostigma 30K

Note:  these days, I usually give fairly low potenties, not higher than 6K or 12, so that I can repeat the remedy more often.

Follow-ups
Next day: Snout is eating again and moving more; he is not just sitting quietly in his corner. The swelling on his head has diminished. The eye is still cloudy, swollen, and still discharging white pus. Physostigma 30K was repeated.

Next day: the eye is less swollen, it looks like a watery bag of jelly. The swelling on top of the head has disappeared. Physostigma 30K is repeated. His eye continued to improve: less swelling, and he is more lively. The eye is still cloudy.

In the following days the glaucoma decreases. Snout is lively and eats well, so the thought of euthanasia has been dismissed. A new remedy was sought for the remaining complaints, choosing the following rubrics: “Eye, ulceration, cornea”; Eye, ulceration cornea deep”; “Eye, ulceration, cornea, scars from”. This last rubric gives us the following remedies: cadm-s, Euphr, sil.

In Clinical Therapeutics, T.S.Hoyne writes of Euphrasia: “Opacity of the cornea after injuries of the eye. The patient may often complain that, after injuries to eyes, opacity of the cornea has developed. In the case of Euphrasia, conjunctivitis is inflammatory in origin and associated with acrid and purulent discharge from the eyes, while Arnica is a good remedy for conjunctivitis that follows any injury, and is commonly associated with a bruised sensation.

After a few days, I gave two remedies in alternation, Euphrasia for two days, then Mercurius corrosivus, back and forth, using the rubric “Eye,  ulceration, cornea, deep: ars, euphr, Kali-bi, Merc-c; merc-i-f, merc-i-r, sil.” The reaction was very good. The discharge decreased, a crust formed on the wound and Snout could finally close his eye.

A red ring of capillaries was forming around the pupil, a sign of renewed circulation, showing that the healing was proceeding in the right direction.

Snout is clearly improving but his ear is still drooping. After a few weeks of alternating Euphrasia and Mercurius corrosivus, a few times of each remedy, both ears are upright. The ulcer is much smaller, ringed with capillaries, and the eye is now blue.

After a month, the ulcer has disappeared completely; there are still some visible capillaries. The cornea is still cloudy. Several weeks later, though, his eye has completely cleared up. He has a pupil reflex, indicating that he can see with that eye. One happy bunny!

Photo
Shutterstock: lion head rabbit; Viorel Sima