Dear Friends,
It will be quite interesting to know that Ayurveda do contains a
branch known as 'SHALAKYATANTRA' which deals with treatment of eye,
ear, nose ,throat disorders & diseases of head &
neck.'NETRAROGA'(ayurvedic ophthalmology) is a specialised branch of
this Shalakyatantra.

I would like to spread this message of Ayurvedic Ophthalmology
through simple article.So from today I will be sending this article
in parts as a part of Ayurvision Bulletin of my site
www.ayurvision.com

AYURVISION BULLETIN AUG.2004

Article : INTRODUCTION TO AYURVEDIC OPHTHALMOLOGY PART - I

INTRODUCTION TO AYURVEDIC OPHTHALMOLOGY

Dr.Aashish Phadke.

Introduction

"Doctor, please let me know , whether Tina will be able to see
again ?.....",a difficult question was asked to me by Tina's mom….!!
Tina , just completed her 2nd year in microbiology & started
complaining that she could not see properly since last few
weeks, even while looking through the microscopes she was not that
comfortable as
she was before.naturally her parents took her to family doctor & then
he referred her
to an ophthalmologist.He saw her fundus ( retina of her eyes ) &
said she needs to be
visited to a vitreo retinal surgeon ( a super specialist eye surgeon
with the speciality
with retina ), he told that Tina's retina started degenerating, there
are patches on the retina of her both eyes, as well there is a start
of degeneration of macula of one of her
eye, so in nutshell she was diagnosed as a case of `Retinitis
Pigmentosa' (R.P.)of both eyes with `Macular Degenarative changes' in
one of her eye. Also did he mentioned that there is practically no
successful treatment so far to treat this condition of R.P. & let
Tina & her parents accepts this fact soon !
When Tina's mom heard that, there was a great disappointment for
them. When they knew about possibility of treatment with Ayurveda ,
they have brought her to my clinic.
Basically being a post graduate in Ayurveda ( M.D.Ayurveda) & having
qualified in modern ophthalmic sciences I am treating different eye
conditions which are left out by modern ophthalmologist. Only where
there is an absolute requirement of intervention of surgical
procedure then I do recommend those cases to my fellow colleagues
opthalmic surgeons. So when Tina came to my clinic , her vision (
visual acuity ) was less than 4 feet with right eye & 6/60 partial
that means the first line of the vision chart that to be blurred)in
her left eye. Her mom was asking me , "Doc, please tell me know, can
our Tina see again ? Will it be possible to stop the degeneration at
least in her better eye? Can we reverse the changes of her retina due
to R.P?" "Doctor, please don't feel bad, but whether is it true that
Ayurveda has any remedies even for Eye Disorders ?"……
Yes, this is just a representative questions, but similar kinds of
several questions are being asked even by our medico friends,
basically because they are really ignorant about the fact that
Ayurveda not only treats diseases like asthma, diabetes, psoriasis or
arthritis but also speaks in length & treats Eye Disorders ! In fact
there are separate chapters devoted to the description of eye
diseases, about their diagnosis & also about their therapeutic
procedures in different ancient classical texts of Ayurveda. Many of
us might not be aware of the fact that in Ayurvedic curriculum ( of
B.A.M.S.- Bachelor of Ayurvedic Medicine & Surgery course, in the
last year) there is a separate paper on `Netraroga' (Ayurvedic
ophthalmology), along with the second paper on Disaeases of E.N.T. &
Oral cavity and head region ( `Karna nasa mukha & shiroroga')., along
with concerned practicals & case takings ( oral examinations on
patients).




Ashtang Ayurveda

Many a times there is a misconception that Ayurveda doesn't have any
knowledge about surgical disciplines, moreover there is absolutely no
mention about eye disorders, but this is not true.Ayurveda do have
separate specific specialties with references to different eight
disciplines.That is the reason Ayurveda is also known to be Ashtanga
ayurveda.The eight branches constitutes study of the following
disciplines, viz. –
1.Kayachikitsa – General Medicine or Internal Medicine.
2.Balachikitsa – Paediatrics as well as Gynaecology & Obstetrics.
3.Grahachikitsa – Psychiatry & Parapsychology.
4.Urdhwangatantra or Shalakyatantra
– Diseases of Eye, Ear, Nose
Throat & Head region.
(Ayurvedic
Ophthalmology,Ayurvedic Oto-rhino-laringology
& Ayurvedic Neurology. )
5.Shalyatantra- General Surgery, Orthopedic Surgery, Plastic Surgery.
6. Danshtrachikitsa – Toxicology.
7. Jarachikitsa –Geriatrics.
8.Vrishyachikitsa- Including Rasayan & vajeekaran therapy – Prohost
therapy,
Aphrodisiac therapy,
rejuvenation therapy, Immunomodulation
Therapy.

What is Shalakyatantra ?

According to the definitions of `Vagbhatacharya'
& `Sushrutacharya',Shalakyatantra can be defined as that branch of
Ayurveda, in which there is a provision for management of disorders
of the parts situated above the level of the clavicles
(urdhwajatrugata vikara ), namely that of Ear- Nose – Throat
(Shravana – vadana ghranadi ) i.e.Otorhinolaryngology & Eyes
(Nayanadi ). At other rference it has been stated by Dalhanacharya,
that this branch is known to be Shalakyatantra , because while doing
the examinations of these regions as discussed before , one need to
take help of a small instrument – a probe or thin metallic structure
known to be Shalaka, & hence the name of the branch is Shalakyatantra.
Synonyms Of Eye
Various synonyms of eye have been discussed in Ayurveda , they are as
follows – Nayana, Netra, Budbuda, Akshi, Chakshu, Netragolaka etc
Concept of Anatomy & Physiology of Eye in Ayurveda
In certain texts of Ayurveda, like in Sushrut samhita, anatomy &
physiology of eye has been discussed in great details. They have
mentioned thousands of years before that the shape of eye is oblong &
not a perfect round , ( Gostanakaram ) thickness of the eyeball is
close to the thickness of ones own thumb ( swangushthdara
sammitam ) , they have even discussed about different coats / layers
(patal) , various junctions( sandhi), about pupil (drishti) , inner
canthus(kaninak), outer canthus(apanga) , about lens, eye lids, eye
lashes & many more such relevant things in Ayurvedic anatomy of
eyeball(Netrasharira).

While discussing about Ayurvedic physiology of eye , they have
mentioned that the main dosha that is responsible for the very basic
function of eye that is nothing but sight, to see , is no other than
Pitta & that to again a subtype of Pitta known as `Alochaka Pitta'.I
am sure all of us would salute to our ancient masters who knew that
there were two distinctive components were responsible for the act of
seeing , one in the eye itself ( may be in the retina ) & other in
the brain as a optic centre, which they have clearly mentioned then
as the `Chakshurvaisheshika Alochaka Pitta' & `Buddhirvaisheshik
Alochaka Pitta' respectively.
The clinical application of this anatomical background of eye was
reflected clearly in the area of classification of eye diseases
mentioned in those days by `Sushrutacharya' in his samhita.One may
see description as Pakshma roga ( Diseases of Eye lashes ),
Vartmaroga ( Diseases of Eye lids ),which is having a striking
similarity with the that of the classification of eye disorders being
accepted by the contemporary modern ophthalmology !
Etiology Of Eye Disorders (In General)
(Netraroga, Samanya Hetu)

Ushnabhitaptasya Jalapraveshat
Dooreshanat swapnaviparyayat chal I
……………………………………….
Bashpagrahat Sookshma Nirikshanat chall
Netre vikaran janayanti ghoran II Ref.
(Su.Samtita / Uttar ; Ch 26/4)
- Ushnabhitaptasya Jalapraveshat -After coming from (hot
environment) outside especially in the afternoon, and to jump in a
river / water / for swimming, on in today contest to take cold water
bath / shower on even a step ahead, one may interpret it, as a sudden
change of temperature zone. eg. from heat zone, if one enters
suddenly to a Air- Conditioned chilled chamber.
- Dooreshanat -means to see object at for constantly eg. in
professions like astronomers / Scientists in the observatories,
personnel from military at boarder, personnel from Railway Merchant
Navy to see signals.
- In all these cases, one may have increased strain on eyes,
leading to ocular disorder.
Swapnaviparyayat cha:- means alteration of the pattern of sleep.
Usually seen with those on shift duties. Workers, Engineers, Nurses &
even Doctors on well by everyday havit of sleeping at daytime
biorhythm & can leads to strain on eyes leading to ocular disorders.
Prasakta, Samrodan, Kopa, Shoka, Klosha
By taking too much of tensions for crying for a longer period, by
becoming very angry on by taking excessive efforts out of capacity
all these things may lead to increase in vitiated Vata Dosha leading
to ocular disorders.

Abhigatat (i.c. due to traumatic injury)
These exists seven ocular emergencies.
Atimaithunat Cha :- By having excessive sex, again these will be
vitiation of essential vital tissue Shukra & even of Ojas & will be
increase in vitiated Vata leading to ocular disorders.
Shukta, Aranal, Amla - are all sour preparations having them in
excess may lead increase of vitiated Pitta & Rakta leading to ocular
disorders.
Kulatha, Masha- these again leads to increase in vitiated Vata dosha,
leading to ocular disorders.
By controlling essential urges (Vega vinigrahana) like passing urine,
or defecating stools, (these are 13 such urges which should not be
controlled as per Ayurveda)
By taking increased amount of Sudation( swedan) : eg. to sit more in
a Saunna bath.
Dhoomranishevana : By smoking excess is one way of interpreting if &
other way may be contact of eyes to Gas / Fumes / eg. pollutant on
roadways / industries etc.
Having excessive procedures in Purificatory measures (Panchakarma)
viz. Vamanatiyogat Excessinve induced emesis (Vamanatiyogat)etc.
Sookshma Nirikshanat cha-means to observe microscopic objects for a
longer period. May lead stress eyes, leading to ocular disorders e.g.
Pathology technicians, Diamond Cutter, Wrist watch repairers etc.
In a current situation, in 21st century more & more number of people
are getting introduced to Personal Computers, even starting from
school going children to the office attending executive, has to work
in front of computer screen for a longer period , similarly kids/
teenagers one spending hours together staring at computer screen
while playing with computer games also in front of television screen
all these also can be considered to be modern hetu (Reasons) for
increasing ocular disorders.
In Traumatic Eye Disorders Aghatajanya Netravyadhi ,there exists
traumatic lesion first, & the doshasushti latter (Vitiation of dosha
follows thereafter.)

How do these Eye Disorders takes place ? ( Samanya Samprpapti –
Pathophysiology of Netraroga)
According to Sushrutacharya -
Due various reasons, dosha gets vitiated & increased (Prakopa)
leading to their way upwards towards eye, & gets entered in different
Channels / Vessels( sira) of Eye, creating
vitiation (Dooshti) of different organels of an eye. In this way
there exists eitiopathogenesis of an eye disorders in general.
Total number & the classification of Eye Disorders
Discussion with regards to classification of an eye disorders
according to different scholars of Ayurvedic Opthalmology number of
eye disorders mentioned according to different masters ( Acharyas)
are as follows -
Sushrutacharya & Vagbhatacharya 76 types
of Eye diseases
Charakacharya 96 types of
Eye diseases
Madhav Nidanakar
78 types of Eye diseases
Different Approaches of the classification of an Eye disorders
according Ayurveda.
- A. Based on Dosha type
- B. Based on Therapeutic approach.
- C. Based on Anatomical Approach.

Out of which the last option i.e. based on anatomical approach is
still followed by contemporary ophthalmologist in their standard
texts on ophthalmology (eg. Diseases of lids, disease of cornea,
diseases of sclera etc.,)
A. Classification of eye disorders according to Dosha type.
In this approach surprisingly a great efforts have been taken to sub
classification of diseases ,according to their tentative prognostic
values ,such as easily manaageble/completed curable ie. Sadhya,
difficult as treat ie, Yapya & Untreatable ie. Asadhya apat from its
doshik classification such as Vataj, Pittaj, Kaphaj etc.
B. Classification of eye disorders based on Therapeutic Approach
1) Cheddya ( to be incised) - 11 4) Vedhya ( to be
punctured -15
2) Lekkhya ( to be scraped ) - 9 5) Asadhya ( Non treatable)
-24
3) Bheddya ( to be punctured ) -5 6) Shamanarha(conservative line
of therapy)1-

( Next part will be mailed latter)
Please do communicate with your views
With warm regards,
Prof.Dr.A.S.Phadke,India