Preventive Eye Care – An Ayurvedic over view.(compilation work)

Preventive Eye Care  –  An Ayurvedic over view

Dr K Praveen,

 MS Scholar,

Dept. Of Salakya Thantra,

  Govt. Ayurveda College,

Thiruvananthapuram,Kerala.

                                                                                                                    dr.praveen.0088@gmail.com

Eyes are the best among human organs. They can express any kind of emotion. Even one is deaf or dump can express himself through the eyes. Taking good care of such an organ is indeed imperative. Not only in cosmetic front but also from medical point of view it is of paramount importance.

“Ayurveda”- the science of life gives a great importance for netra raksha and paripalana in all its views. The main aim being maintenance of swasthya – as a whole “body and mind”. Achayra explains the nethraraksha step by step including the dinaharya, rathri charya, diets and routines and even care during the seasonal changes. Mind and Body medicine is related to the fact that our general health depends on all the individual parts working together effectively. Eyesight is also dependent upon our total well being which our genetic structure, diet, the work environment and the level of exposure to airborne toxins.

Eyes are the window to our world. Preventive eye care is important in this new era of stress and pollution, since a careless life may rob away the gods gift from us at any time. Many eye and vision conditions such as glaucoma, retinal diseases etc can be treated if they are diagnosed at time. People with diabetes and high blood pressure and with a familial history of eye diseases need to have regular eye tests. This will help to identify any hereditary conditions and symptoms that could affect our vision. Although we use our eyes every day, we rarely pay attention to them until there is some serious problem. If you were asked, "Do you take care of your eyes once a week or at least once a month?", the most common reply would probably be in the negative. The eyes are considered to be the most important organ in our body and yet, people neglect to care for them.

There is much a person can do to help keep themselves healthy. Waiting until something breaks down is a costly way to take care of the body, and often much of the damage is irreversible. Ayurveda advises to take care of health while in a healthy state. You can maintain perfect eyesight for most part of your life by following some simple remedies.

Improper Eye care can result in:

ü  Eye strain

ü  Impaired vision

ü  Watering of eyes

ü  Redness of eyes

ü  Dull and tired eyes

ü  Opacities

ü  Damaged Retinas, Blindness etc

Causes:

               1. Malnutrition and exposure to pollution
               2. Lack of exercises and daily strain full works to eye
               3. Excess of alcohol, coffee, sugar, smoking, refined foods ,hydrogenated oils etc
               4. Stress
               5. Diabetes, hyper tension and other systemic diseases.

PREVENTIVE ASPECTS

1)    Role of pancha mahabhutas:

Netra is said as the pitha sthana and viseshana sthana of alochaka pitha. The thejomayathwa of eye can be understood here. But considering the whole eye, five elements the“pancha mahabhutas”, play a role in maintaining & constituting eye health. Pritwi governs the muscular part of the eye, Agni rules the blood vessels, Vata mahabhuta governs the black area, Jalam the  white area and Akasabhuta the tear ducts and channels

 So the paripalana of all the five in normalcy is a must to maintain the eye care.

2)    Role of agni :

A complete balanced diet is a must in nethra paripalana since it’s the energy source of the whole system. Care should be taken in the selection of diet, the amount and character of food stuffs. Spicy and salty foods do badly to eyes. Also the athimathra or alpamathra asana can cause diseases.

A great importance should be given to agni – the pachakagni and agni sthaanam grahani. Impairment to agni and grahani will cause derangement of whole system and eye being the site of alochaka pitha will show its ill effects early. The fast-food natures of the modern world have led to harvesting of many diseases and also lead to eye diseases even from the birth. Juvenile diabetes is a good example to point out as a bi-product of the cola drinks

3)    Role of antioxidants :

            Antioxidants are free radical scavengers. Our body produces antioxidants to deal with the problem of free radicals. However, our systems can become overloaded by free radicals and cellular damage occurs. Free radicals are derived from many sources, including oxygen, sunlight, ingested foods and drinks. They are highly reactive molecules that can react with the cells in our bodies, causing damage. Much research is being done on free radicals and their contribution to such diseases as cataracts, macular degeneration, cancer, atherosclerosis, Alzheimer's disease, osteoarthritis, etc.

Taking in various antioxidants can help our bodies deal with the free radical, thus reducing the amount of cellular damage. In this case, how can we cut down on the damage done to our eyes over time?  A good dietary thought is needed for the same. A balanced diet is needed for a healthy life. Food supplements will never do good for health .Supplements are just that supplement the balanced diet, they never replace it.

Increasing the daily consumption of fruits and vegetables is very important. Antioxidants found in their natural state are best. Antioxidants as found in fruits and vegetables are more complete than those that are singled out in any given supplement. Most antioxidants are found in the coloured portions of the plants. So green vegetables and fresh fruits can do a lot for eye care .For example, anthocyanin is a phytochemical found in bilberries and is very important in the prevention of macular degeneration. Other plants that contain anthocyanins are: blackberries, blueberries, boysenberries, cherries, cranberries, hawthorn, huckleberries, red grapes, and red raspberries. Getting at least one serving daily can go a long way toward protecting the eyes. (Ref: Preventive Eye Care by Wende Northstar Davis, R.Ph)

4)    Role of vitamins and minerals:

Vitamins and minerals are related with free radical control. The most important ones to consider when dealing with the eyes are: vitamins C & E, beta-carotene, and the mineral selenium.

A)    Vitamin C:

Vitamin C is a water-soluble vitamin and a very powerful antioxidant. The vitamin C content of the eye is many times higher than that of the blood serum. Therefore, getting enough in the daily diet is very important to keep these level up enough to prevent free radical damage. Research shows that it takes at least 1,000mg of vitamin C to boost the levels in the eye.

B)    Vitamn E:

Vitamin E is a fat-soluble vitamin. It works synergistically with selenium to protect against free radical damage. Research has shown that cataract lenses are extremely low in selenium and that supplementation with selenium can greatly reduce the risk of cataracts. Vitamin E is a potent antioxidant for cell membranes. Together, they work better to protect against free radical damage than either one alone.

C)    Beta-Carotine:

Beta-carotene is also a fat-soluble vitamin. It is a powerful antioxidant and also protects against light-induced damage to the lens. It is best to get beta-carotene from natural sources such as carrots, as there are other components in the vegetable that work with beta-carotene that are not available through the supplement. One carrot per day will give plenty of protection at very little cost.

5)    Role of bowel movements:

Normal and regular bowels are a need for a healthy eye. The vitiation of pachakagni and apana vayu may cause deranged bowel and cause harm to eyes. Also dharana of vegas also harms a lot .maintaining of regular and clean bowel movements is a must. Constipation weakens the eyesight. In addition; too much anxiety, mental stress, grief, anger and worry are harmful for the eyes.

6)    Role of pancha karma and netra kriyakramas:

            Panchkarma is the process, which cures the disease from the root by sodhana therapy and maintains the equilibrium of tridoshas. it is not only good for alleviating disease but also beneficial during periods of transition whether it is a change of season or change in your personal  life or a transition into a new phase of your life. This therapy helps to remove the undesired elements from the body, enhance digestion and improve metabolic process through food herbal medicines. Panchkarma means the five therapies:

1) Vamana 2) Virechana 3) Nasya 4) Vasti 5) Raktamoskshana

“Triphala rudhirasrudhir visudhi

Manasonivruthir anjanam sa nasyam

Sakunasanatha sa padapooja

Gruthapanam cha sadaiva nethraraksha”(Ah.Ut)

Eyestrain due to TV, computer, pollution, watering of eyes, dimness of vision, formation of cataract are some of the eye diseases cured by panchkarma.

A)    Nethra aschothana and Anjana:

These are process of applying medicines in eyes. Aschothana and application of anjana in eyes daily is good to increase the eye power. Sauveeranjana is very good for eyes which can be used daily.

B)    Nasya:

The nasal medication also does well to eyes. Prathimarsa nasya kalas best for eyes are explained by Acharyas. Pratimarsa nasya daily helps for improved vison and reduce eye strain.

C)    Akshitarpana:

            Akshi’ means eyes, Tarpana means nutrition. This is a process where medicated Ghee is poured over the eyes and retained within a fresh black gram paste pad. It is one of the therapeutic processes for the treatment of eye. It cleanses eyes by rejuvenating them using pure medicated ghee. It gives a cooling effect to the eyes and strengthens nerves thus improving eyesight

D)    Abyanga:

            Abyanga is the application of medicated oil over the body. The oleation therapy over the foot do a great job in the preservation of eye sight.Vagbadacharya explains the same in the dhinacharya adhyaya as-

“Abyangamachareth nithyam sa: jarasrama vataha

Drishtiprasadana.....”(Ah.Su)

E)    Padaksalandhikriya:

            Kriyas over the foot helps a lot to increase eye sight.As Acharya says

“Dwe padamadhye prithusannivesha

Sire gathe the bahudha cha nether

Tha mrigshnodwarthanaalepanadheen

Padaprayuktha nayanam nayanthy”(Ah.Ut-65/16)

F)     Dhara

              Dhara is the pouring of warm medicated oil or an herbal decoction over the body. Dhara with oil is one among the major oil therapies. While in Shirodhara oil is poured only on the forehead, in Sarvangadhara, it is poured all over except on the head. However, any dhara with oil is generally called Snehadhara.

When medicated buttermilk replaces oil (Sneha), the therapy is called Takradhara. If medicated milk is used instead of medicated oil, then the process is called 'Ksheeredhara'. All types of dhara are useful for eye diseases. Extracts of herbs that possess preventive and curative properties are used for Netradhara.

G)    Shirovasti

            Shirovasti is considered more of a palliative (Shamana) Treatment than an eliminative (Shodhana) and Sudation (Swedana).The oil commonly used is Ksheerabala or Dhanwantaram. The duration is determined by the severity of the disease.

In Ashtanga Hrudaya Acharya has explained the importance of nethra raksha.

“Chakshurrakshayam sarvakalam manushyair

Yathnaha karthavyo jeevithe yavad icha

Vyartholokoyam tulyam rathrimdivanam

Pumsam anthanam vidyamaane api vithe” (AH-98/14)

7)    Cataract – can it be prevented?

Cataract is one of the leading causes for blindness today. Almost 42% of all persons who lose their sight later in their lives do so because of the onset of cataract. It is an age-related disease and is actually a very simple disorder to diagnose and treat. Still, a large number of people are neglecting the issue. Ignoring the symptoms of early cataract can lead to a large number of complications in the future. The most dangerous of the complications is that cataract can cause total blindness if left untreated. Statistics show that, within 10 years, most untreated cataracts can convert into total blindness of one or both the eyes.

A)    Prevention of Cataract :

Since the most important cause of cataracts is advancing age, it is not possible to prevent them totally. However, some steps can be taken in order to reduce the chances of contracting cataracts:-

·         Have a regular eye check-up done. Especially after  the age of 60 years.

·          Excessive exposure to the heat and sunlight must be avoided by people of all ages. This can cause excessive wear and tear of the eye lens.

·         Stop smoking. Smoking is a leading cause of cataracts in the old age.

·         People who have conditions like diabetes should adhere quite diligently to the mode of treatment given by the doctor.

·         Avoid direct contact with toxic fumes and do not continue eye medications for prolonged periods of time.

·         Do not expose your eyes to X-rays, microwaves and infrared radiation.

·          Never stare directly at any source of light. Adjust the lighting in your homes in such a manner that the source of light is not seen directly. Use white and milky sources of light rather than incandescent bulbs, as their filaments become too luminous to the human eye.

·         Wear proper and genuine protective eye glasses especially in sunny weather.

·         Pregnant women must take all precautions to prevent the affliction of German measles

B)    Diet during Cataract :

A proper diet can go a long way in the prevention of cataract. The following are some guidelines:-

·         Vitamin A foods are very important to maintain normal ocular health and vision. This is due to the presence of beta carotene, the precursor of vitamin A. Carrots are the best sources of vitamin A for maintaining ocular health.

·         Vitamin C is vital to the health of the eye as it is present in high concentrations in the eye lens. Vitamin C is an antioxidant; it prevents the oxidative damage of the lens. Foods such as amla, oranges, limes, etc. that are rich in vitamin C must be included in the diet.

·         Vitamin E is also an antioxidant and must be included in the diet. Almost all foods contain vitamin E.

·         Oils must be avoided.

·         The diet must contain copious amounts of grains and legumes as they provide the necessary amino acids (proteins) for the health of the eye lens.

8)    Tips to protect eye:

            A lot has been explained in Ayurvedic texts for nethra paripalana while describing the dhina and rithu charya. A detailing of all these including  rathricharyas are given by Laghuthrayis.

“Varjayeth vegasamrodha ajeernam adyasanadhi cha

Sokakrodha divaswapna nishajagaranany cha

Vidhaha vishtambhakaram yacheshtaahara beshajam”

I like to point out some which can be brought into our routine life

ü  Each morning on waking up at Brahma muhurtha , after dandadhavana kabala or     gandoosha can be done. fill mouth with luke warm water or triphala jala and hold for a few seconds with your eyes closed. Spit it out and repeat 2-3 times. It can be done twice a day.

ü  Splash your eyes and face with cool or slightly warm
water 10-15 times. Repeat again in the evening.

ü  Application of collirium in the in the eye after mouth wash is good to remove the kapha dosha in the eye in the morning time and netra kshalana with sreshta jalam.

ü  Daily Siroabyanga and padaabyanga is a must for eye care. Tila taila or medicated oils can be used.

ü  Exercise daily. Eye exercises help remove toxins and congestion from eyes

ü  Regular eye exercise maintains perfect eyesight. One simple method of exercise is moving the eyeball - right and left; upwards and downwards and rotating it in the clockwise and anti-clockwise directions.

ü  Another simple way of protecting of eyes is through 'palming'. Rub the palms of both hands for about 30 seconds, close the eyes and gently place the warm palms over the eyes.

ü  Avoid reading or working in either dim light or in bright sunlight.

ü  Wear sunglasses to protect your eyes in bright sunlight, but not to drive or read with, as this will cause strain.

ü  Manage your stress. Meditation, nature walks and yoga helps to relieve stress.

ü  One of the biggest enemies of the eyes is lack of sleep. Sound sleep at least for five hours daily at night is a must.

ü  Blink your eyes periodically.

ü  Look away at short intervals to keep from straining the eyes

ü  Drink plenty of water throughout the day.

ü  Do not wash the eyes or face when the body is sweating, especially after hard physical exercise or after being exposed to heat and sun.

9)    Diet tips:

ü  Triphala is an important medicine for eye health, especially blurred vision or to prevent the development of cataract. Intake of triphala along with honey and ghee improves eye sight.

ü  Drink lots of water as constipation has adverse effect on eyes.

ü  Eat food rich in vitamin C and E and minerals like sulphur and magnesium. Recommended foods are garlic, onions, beans, spinach, celery, turnips, yellow and orange vegetables, green leafy vegetables, seaweed, apples, oranges, tomatoes, nuts, seeds and soy products.

ü  Avoid alcohol and caffeinated drinks.

ü  Remove the seed from dhathree mix it with tablespoon of honey. Chew thoroughly to the strengthen vision.

ü  Almond is ideal for eyes; it strengthens the vision, and calm mental stress.

Try these tips daily and keep your eyes healthy and beautiful. These remedies can be used by everyone, including those having weak eye sight. This can even improve the eyesight and make your eyes healthy.

“Prevention is better than cure”

An analytical survey on patients with increased IOP to find out the dosha predominance.

Back ground of the study:

Increase IOP conditions were not mentioned in our classical text books.In our OPD this condition is common, and every patient presented somewhat similar symptoms, and most are not with pre diagnosed reports about the IOP. We don’t have any idea about the dosha predominance of this condition, and what treatment principle has to apply. So I found it necessary to conduct a survey on this topic to    analyze the dosha predominance of symptoms in order to choose a better treatment modality.

Literary review:-

            Intraocular pressure is mainly determined by the coupling of the production of aqueous humor and the drainage of aqueous humor mainly through the trabecular meshwork located in the anterior chamber angle. Intraocular pressure is measured with a tonometer. Ocular hypertension (OHT) is defined by intraocular pressure being higher than normal, in the absence of optic nerve damage or visual field loss. Current consensus among optometrists and ophthalmologists define normal intraocular pressure as that between 10 mmHg and 20 mmHg

The average value of intraocular pressure is 15.5 mmHg with fluctuations of about 2.75 mmHg. Intraocular pressure varies throughout the night and day. The diurnal variation for normal eyes is between 3 and 6 mmHg and the variation may increase in glaucomatous eyes. During the night, intraocular pressure usually decreases due to the slower production of aqueous humour. Intraocular pressure also varies with a number of other factors such as heart rate, respiration, exercise, fluid intake, systemic medication and topical drugs. Alcohol consumption leads to a transient decrease in intraocular pressure and caffeine may increase intraocular pressure.

An important quantitative relationship is provided below: IOP = F / C + PV Where, F = aqueous fluid formation rate,C= outflow rate, PV = episcleral venous pressure. The above factors are those that drive IOP. In the general population, IOP ranges between 10 and 21 mm Hg with a mean of about 15 or 16 mm Hg (plus or minus 3.5 mm Hg during a 24-hour cycle).

Ocular hypertension is the most important risk factor for glaucoma.

A difference in pressure between the two eyes is often clinically significant, and potentially associated with certain types of glaucoma, as well as iritis or retinal detachment.

Intraocular pressure may become elevated due to anatomical problems, inflammation of the eye, genetic factors, as a side-effect from medication, or during exercise. Intraocular pressure usually increases with age and is genetically influenced.

Hypotony, or ocular hypotony, is typically defined as intraocular pressure equal to or less than 5 mmHg. Such low intraocular pressure could indicate fluid leakage and deflation of the eyeball.

Glaucoma refers to a group of diseases that affect the optic nerve and involves a loss of retinal ganglion cells in a characteristic pattern. It is a type of optic neuropathy. Raised intraocular pressure is a significant risk factor for developing glaucoma (above 22 mmHg or 2.9 kPa). One person may develop nerve damage at a relatively low pressure, while another person may have high eye pressure for years and yet never develop damage. Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.

Glaucoma can be divided roughly into two main categories, "open angle" and "closed angle" glaucoma. Angle closure can appear suddenly and is often painful. Visual loss can progress quickly but the discomfort often leads patients to seek medical attention before permanent damage occurs. Open angle, chronic glaucoma tends to progress more slowly and the patient may not notice that they have lost vision until the disease has progressed significantly.

Glaucoma has been nicknamed the "sneak thief of sight" because the loss of vision normally occurs gradually over a long period of time and is often only recognized when the disease is quite advanced. Once lost, this damaged visual field can never be recovered. Worldwide, it is the second leading cause of blindness. Glaucoma affects 1 in 200 people aged fifty and younger, and 1 in 10 over the age of eighty. If the condition is detected early enough it is possible to arrest the development or slow the progression with medical and surgical means.

In India glaucoma (of all types combined) ranks as the second important cause of blind­ness, it is reported that 32.4 per cent blindness was due to catract and 25.4 per cent due to glaucoma

Design: cross sectional study on patients with Increased Iop

Materials and Methods: Patients with increased IOP is grouped in to two group

A) Patients with IOP 20mm of Hg to 30 mm of Hg

B) Patients with IOP 30 & above

Their signs & symptoms recorded, & analytical study is done to find out the dosha predominance according to our thridosha theory. Data are statistically evaluated & made conclusion.

Results: It is found that majority of symptoms are V or VK.

Conclusions: By analyzing the result we can find that increased IOP condition can be treated with V K hara treatment.