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.