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THE EFFECTS OF PHYSOSTIGMA 30CH AND COMBINED WITH THE BATES METHOD ON THE MANAGEMENT OF MYOPIA By Debbie Smith 9444728 A dissertation submitted to the Faculty of Health and Biotechnology, Technikon Witwatersrand, Johannesburg, in partial fulfilment of the requirements for. the degree: Master in Technology: Homoeopathy. Date ofSubmission: May 2000 Supervisor: Mrs. S. Eagleton Signed: Co-supervisor Mr. J\.,~n Pletzen Signed: Co-supervisor: Dr. M.R.A. Moiloa Signed: DECLARATION I, Debbie Smith, declare thatthis dissertation is my own work. It is being submitted for the Master Degree: in Technology: Homoeopathy in the Faculty of Health and Biotechnology at Technikon Witwatersrand, Johannesburg. It has not been submitted before for any degree or examination in any other institution. ~ y__ day of J UUY...5I..- 2000 \ 11 DEDICATION This study is dedicated to my father, Demetreos and my two sisters, Lelanie and Issie. ... III ACKNOWLEDGEMENTS The author would like to sincerely thank the following people who made contributions to this project and the writing ofthis research report. » My supervisor, Mrs. S. Eagleton of the School of Biotechnology at the Technikon Witwatersrand, for her time, caring and guidance. » Mr. A.I.I. van Pletzen, of the School of Optometry at the Technikon Witwatersrand, who assisted me greatly in the following through and completion ofthis project, for his endless time and insight. » Dr. M.R.A. Moiloa, of the School of Homoeopathy at the Technikon Witwatersrand, for his assistance and homoeopathic ~?wledge in the assistance of this research project. » D. Hayler and G. Garden who gave freely of their time for the optometric examinations. » R. Luwes who had the ability to always manage to organise the research appointments. » To all the subjects who participated in this research project. » To Advanced Cabling for the use oftheir computer facilities. A special thanks to: • My father for believing in me and supporting me throughout my years ofstudying. • My two wonderful sisters for their motivation and support during this research project and during my years ofstudying. • My wonderful companion and friend, Malcolm. • My friends for supporting and encouraging me throughout this study. IV ABSTRACT Spectacles and contact lenses are the most widely used optical appliances to manage myopia. Surgical techniques are an alternative but the outcome of surgery can be unpredictable and the procedures are costly. Myopia, or nearsightedness, is a condition characterised by blurred distant vision. Both a more lasting cure and a more cost-effective alternative solution in the treatment of myopia are desirable. The effectiveness of the homoeopathic remedy, Physostigma 30CH on its own, the Bates method on its own and a combination ofthe homoeopathic remedy and the Bates method in reducing myopia were determined. Thirty suitable myopic subjects between the ages of21 - 34 years were selected. Subjects were paired in terms ofage, race and sex on a double-blind basis. This research was conducted in three stages of thirty days each. During stage one the experimental group performed the Bates method, while the control group performed the modified Bates method. During stage two the experimental group received the .homoeopathic remedy, Physostigma 30CH, whilst the control group received a placebo. During stage three the experimental group performed the Bates method and received the homoeopathic remedy, Physostigma 30CH, whilst the control group performed the modified Bates method and received the placebo. Each subject underwent an optometric examination before and after each of the above­ mentioned stages. During the eye examination, the aided and unaided visual acuity, left and right refractions, accommodative flexibility and accommodation amplitude were determined by a qualified optometrist. After each eye examination a questionnaire was completed to determine the patient's subjective feelings ofthe treatment. The data was analyzed using a 2-sample t-test (incorporating the Levence test) for determining the statistical significance within each different stage of the research. The significant (2-tailed) p-values for the statistical significance between the two groups were obtained in order to indicate whether there was a reduction in myopia in either the experimental or the control group or both. v No significant refractive and accommodative changes were observed in the control and experimental group during any of the three stages of the research. Regarding the questionnaire, no significant differences were detected in the subject's subjective feelings. Further research is required over a longer time duration and the use of different potencies of the homoeopathic remedy, Physostigma, in order to determine the efficacy of the homoeopathic remedy, Physostigma, and the Bates method in the treatment ofmyopia. vi DEFINITIONS OF TERMS 1. Dioptre (D) It is the unit ofmeasurement ofthe refractive power ofthe lens, thus specifying the power of a spectacle lens (Tray & Grosvenor, 1996: 54) or ofan optical system (Millodot, 1985: 40). 2. Homoeopathic remedy A remedy or medicine made according to the principles of homoeopathy which includes dilution and succussion (Eizayaga, 1991 : 176 - 186). 3. Myopia Myopia is defined as an error ofrefraction, causing parallel rays oflight to be focused in front ofthe retina (McDonough, 1993 : 666). The result ofthis is blurred vision. 4. Potency(ies) A stage ofdilution and succussion ofthe homoeopathic remedy or medicine (Eizayaga, 1991 : 177). 5. Potency scale A scale or series of homoeopathic dilutions and succussion of the remedy or medicine (Eizayaga, 1991 : 177). 6. Physostigma venenosum This is a great twining climber plant belonging to the family Leguminosa. Its common name is the calabar bean. The chiefconstituent is the alkoloid physostigmine (Lockie, 1989 : 156). 7. Refractive power The change in vergence that occurs when light passes through a lens (Troy & Grosvenor, 1996, : 54). vii 8. Retinoscopy An instrument for determining objectively the refractive state of the eye (Millodot, 1985 : 229). viii TABLE OF CONTENTS Page Declaration 11 Dedication 111 Acknowledgements IV Abstract V Definition oftenns Vll Table ofcontents IX List oftables Xll List offigures XIll List ofappendices XIV 1.0 LITERATURE REVIEW 1 1.1 AIM OF RESEARCH 2 1.2 INTRODUCTION 2 1.3 INCIDENCE OF MYOPIA 3 lA AETIOLOGY OF MYOPIA 3 1.5 MANAGEMENT OF MYOPIA 5 1.5.1 Allopathic treatment ofmyopia 5 1.5.1.1 Spectacles 6 1.5.1.2 Contact lenses 7 1.5.2 Refractive eye surgery 9 1.5.2.1 Radial keratotomy 10 1.5.2.2 Photorefractive keratectomy (pRK) 12 1.5.2.3 Laser in-situ keratomileusis (LASIK) 12 1.5.2.4 Refractive keratoplasty 13 1.5.3 Natural vision therapies 13 1.5.3.1 The Bates method 13 1.5.3.2 Progressive optometry 14 1.5.3.3 Eclectic school 15 IX 1.5.3.4 Other less well known treatments 15 1.5.4 Homoeopathic treatment 16 1.5.4.1 Principles ofhomoeopathy 16 1.5.4.2 The homoeopathic treatment ofmyopia 16 1.6 SUMMARY 17 2.0 MATERIALS AND METHODS 19 2.1 HYPOTHESES 20 2.2 ASSUMPTIONS 20 2.3 METHODOLOGY 21 2.3.1 Stage one 21 2.3.2 Stage two 21 2.3.3 Stage three 22 2.3.4 Questionnaire 22 2.3.5 Optometric eye examinations 22 2.4 STATISTICAL ANALYSIS 23 2.4.1 T-test 23 2.4.2 Levence's test 23 2.4.3 Significant p-value (2-tailed) test 23 3.0 RESEARCH ANALYSIS AND RESULTS 25 3.1 GRAPHS 27 3.1.1 Unaided visual acuity 27 3.1.2 Refraction ofright eye 28 3.1.3 Refraction ofJeft eye 29 3.1.4 Accommodative flexibility 30 x 3.1.5 Accommodation amplitude 31 3.1.6 Questionnaire 32 3.2 ANALYSIS OF RESULTS 33 3.3 .1 Stage one 33 3.2.2 Stage two 34 3.2.3 Stage three 36 3.2.4 Summary 37 4.0 DISCUSSION OF RESULTS AND RECOMMENDATIONS 38 4.1 STAGE ONE 39 4.2 STAGE TWO 40 4.3 STAGE THREE 40 4.4 OTHER VARIABLES 41 4.5 POSSffiLE REASONS FOR THE OUTCOME OF THE RESEARCH 41 4.6 RECOMMENDATIONS 42 . Xl LIST OF TABLES 3.1 T-values for stage one 33 3.2 Levence's p-values for stage one 34 3.3 Significant p-values for stage one 34 3.4 T-values for stage two 35 3.5 Levence's p-values for stage two 35 3.6 Significant p-values for stage two 35 3.7 T-values for stage three 36 3.8 Levence's p-values for stage three 36 3.9 Significant p-values for stage three 37 3.10Significant p-values (2-tailed) for independent two sample test 37 .. Xli LIST OF FIGURES 3.1. Mean unaided visual acuity for both eyes for the initial consultation and for each stage 27 3.2 Mean unaided visual acuity for both eyes for the final findings for each stage 27 3.3 Mean refraction ofright eye for the initial consultation and for each stage 28 3.4 Mean refraction ofright eye for the final firidings for each stage 28 3.5 Mean refraction ofleft eye for the initial consultation and for each stage 29 3.6 Mean refraction ofleft eye for the final findings for each stage 29 3.7 Mean accommodative flexibility for the initial consultation and for each stage 30 3.8 Mean accommodative flexibility for the final findings for each stage 30 3.9 Mean accommodation amplitude for the initial consultation and for each ~age 31 3.10Mean accommodation amplitude for the final findings for each stage 31 3.11 Mean questionnaire total for the initial consultation and for each stage 32 3.12 Mean questionnaire total final findings for each stage 32 ..