Acute angle closure glaucoma precipitated by homeopathic eyedrops containing Atropa belladonna

Acute angle closure glaucoma is a sight-threatening condition that may lead to blindness. This is a case report of a woman who presented to the emergency department (ED) with acute angle closure glaucoma following use of an over-the-counter (OTC) homeopathic eye drop containing atropa belladonna (deadly nightshade). A 55-year-old woman presented to the ED with a 5-day history of left eye redness, swelling, tearing, and foreign-body sensation that had acutely worsened in the last two days. Her exam revealed mild left conjunctival injection with watery tearing and a hazy appearance of her left cornea. Fluorescein staining was negative, while tonometry revealed elevated intraocular pressure on the left, suggestive of acute angle closure glaucoma. She was urgently referred to ophthalmology. The etiology of the acute angle closure glaucoma was initially unclear however, with additional prompting, she revealed that two days prior she had started using homeopathic OTC eye drops. Inspection of the eyedrop's ingredients revealed that atropa belladonna was the primary ingredient and likely precipitated her isolated episode of acute angle closure glaucoma. A high level of clinical suspicion and focused ophthalmic exam including tonometry is essential to identify acute angle closure glaucoma in the ED. We present a case report of acute angle closure glaucoma associated with the use of homeopathic belladonna-containing eyedrops. Our report reinforces the necessity to perform thorough medication and supplement history given the prevalence of physiologically active substances available in OTC medications.

Anisocoria Secondary to Anticholinergic Mydriasis from Homeopathic Pink Eye Relief Drops

A woman, aged 70 years, developed anisocoria after applying homeopathic eye drops (Similasan Pink Eye Relief) to her left eye. Her pupil was dilated for two weeks and did not respond to light or near stimuli for one week. Both 0.1% and 1% pilocarpine failed to constrict her left pupil, and magnetic resonance imaging of her brain did not reveal any abnormality. The eye drops she had used contain belladonna extracts which have a natural atropine component. This case demonstrates the importance, when evaluating a patient presenting with anisocoria, of knowing the chemical ingredients of the homeopathic eye drops, which often are not listed.

Homeopathic treatment as an alternative prophylactic to minimize bacterial infection and prevent neonatal diarrhea in calves

Bovine neonatal diarrhea is common due low immunity in newborn calves, poor management (or absence) of sanitary barriers, and other factors. Newborn calves with diarrhea in the first days of life suffer failure to thrive and may die if left untreated. The aim of this study was to evaluate whether prophylactic administration of a homeopathic product (Dia 100^®) can control bovine neonatal diarrhea in calves born on a farm with substantial sanitary challenges. We counted total bacteria and protozoan parasites in fecal samples. We measured serum glucose, total protein, globulin, albumin, cholesterol and triglycerides on days 1, 7 and 14 of life. Twenty newborn calves were maintained in individual stalls, and were divided in two groups: ten untreated animals (control) and ten animals treated with Dia 100^®. Fecal consistency was evaluated daily. We diagnosed diarrhea in five animals in the treated group, and in all animals from the control group. Infections with Escherichia coli and Giardia duodenalis were identified as the responsible organisms. The E. coli count was low in the treatment group on day 7 of life compared with the control group. Antibiotics were given to eight animals in the control group, and to two animals in the treatment group. On day of life 7, serum levels of total protein and globulins were higher in the control group, but were lower on day 14. Serum levels of glucose and triglycerides were greater in treated animals on days 7 and 14, suggesting that the homeopathic product contributes to improvement of intestinal health and absorption and nutrients. We conclude that Dia 100^® controls diarrhea with 50% of efficacy, and reduces antibiotic utilization.

Complementary and alternative medicine among hospitalized pediatric patients

OBJECTIVES

To estimate the prevalence and describe the characteristics of complementary and alternative medicine (CAM) use among hospitalized children, and to discover the awareness of medical staff regarding CAM use.

DESIGN/SETTING

Parents of children aged 0-18 years admitted to the Pediatric Division at Assaf Harofeh Medical Center in Israel between January and July of 2015 (n=146) were provided a questionnaire regarding socio-economic status and evaluating the CAM use. The medical charts of the participants were reviewed in order to establish whether or not CAM use was documented.

RESULTS

Of those who completed the questionnaire, 78 (54.3%) were using CAM. The major indications for CAM use were colic and teething. CAM use was advised by the family in 44.9%, physician 34.6%, pharmacist 34.6%, friends 30.8%, previous experience 23.1, advertisements 18%, nurses 6.4%, and homeopaths 2.6%. The family physician was aware of CAM use was in 42%. During the admission, only 5 patients were asked about CAM use (3.4%) by the medical staff. Reviewing the medical charts revealed there was no documentation of CAM use in any of the participants. Socio-demographic analysis of our population revealed no differences between users and non users of CAM, but significant differences in belief in CAM (p=0.018) were found. CAM use was age related; the older the child the less the use (p=0.010).

CONCLUSION

CAM use is common among hospitalized pediatric patients and is often overlooked by the medical staff. CAM use should be included in the medical history.