ayurvedic ocular therapeutics

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ISSUE 5 (2014) INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE eISSN

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Manisha Y. Dehankar et. al., Kriyakalpa: Ayurvedic Ocular Therapeutics - A Review, Int. J. Ayu. Alt. Med., 2014;2(5):1-4

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REVIEW ARTICLE eISSN 2348- 0173 Global Impact Factor (GIF) – 0.187 (2013)

KRIYAKALPA: AYURVEDIC OCULAR THERAPEUTICS - A REVIEW

Manisha Y. Dehankar1*, Ashish Y. Gotmare 2

1. Asst. Professor, Dept. of Shalakyatantra, M S Ayurved Medical College, Gondia, M.S Mobile no. – 9272737355, Email id – [email protected]

2. Asst. Professor, Dept of Rognidan-Vikriti Vigyan, Shri Ayurved College, Nagpur, M.S. Mobile no. – 9823453929, Email id – [email protected]

Article Received on - 24th Aug 2014 Article Revised on - 9th Sept 2014 Article Revised on - 28th Oct 2014 Article Accepted on - 30th Oct 2014

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REVIEW ARTICLE eISSN 2348- 0173 *Corresponding Author Manisha Yuvraj Dehankar C/o Dr. Ashish Y. Gotmare 597, Near KDK College, Darshan Colony, Nandanvan, Nagpur – 440009 Maharashtra, India, Mob. - 9272737355 Email - [email protected] QR Code IJAAM

ABSTRACT: Now days there are various advances in the field of ophthalmology. With these

advances modern ophthalmologists and scientists have successfully convinced the new generation about the need of regular eye care and the remedies to be followed for healthy vision for long time. But along with these advances the modern ophthalmologists have some challenges compelling them to find the field of medical knowledge which is present in ancient medical manuscripts. Some people are known / aware about the various eye ailments and remedies. But the significance of Ayurvedic treatments for these ailments is not that much recognized by modern medical faculty and general public. Kriyakalpa is the main ocular therapeutics in Ayurveda. In this article various Kriyakalpas and their indications and possible mode of action is discussed.

Key Words: Kriyakalpa, Ocular pharmacology, Opthalmology, Ayurved

INTRODUCTION The Eye is the main sense organ gifted by God to human beings. It’s very much needed organ for physical, social and intellectual development of a person. Without vision the whole world is a dark place. Ayurveda has stated the importance of an eye with quote “Sarvendriyanam nayanam pradhanam”[1] i.e. eye is the prime sense organ among the all sense organs. Shalakyatantra is one of the branch of Ashtang Ayurveda which deals with the diseases above the Jatru i.e. clavicle. Its founder is said to be Acharya Nimi, whereas the whole Shalakyatantra is explained by Acharya Sushruta in Uttartantra in 26 chapters. Out of these 19 chapters contains the details about the Netra i.e. the eye with its Anatomy, Physiology, various diseases of eye and its management. The theoretical review of the kriyakalpa is explained as follows Kriyakalpa Kriyakalpa are the special procedures indicated in various ocular conditions. The word Kriyakalpa is made up of two words ‘kriya’ and ‘kalpa’. Kriya means the various procedures done to treat the eye problems/diseases. And Kalpa means the modes of treatment. It is the possible way of using various drugs in various procedures to cure the disease. The Kriyakalpa means the specific procedures in which the various prepared drugs are applied to the eye in various manners.[2] Acharya Sushruta has stated 5 types of Kriyakalpa, it includes Tarpan, Putpaka, Seka, Aschyotana and

Anjana.[3] Whereas Acharya Sharangdhara[4] has added Pindi and Vidalaka in Kriyakalpa. Definition and Indications of Kriyakalpa – TARPAN – Medicated Ghrita is placed in the eye with Tarpan goggle. Indication – Tarpan is indicated in Vata-Pitta predominant persons suffering from eye disease.[5] It’s done in dry eyes, patients with photophobia (light sensitivity), madarosis (falling of eye lashes), difficulty in visualizing distant object[6] night blindness.[7] It is soothing procedure for eye, so can be done by healthy person with healthy eyes also. PUTPAKA – Plant extract prepared by ball of medicine rapped by green leaves and the layer of mud getting after combustion is used like Tarpan.[8] It’s indicated after Tarpan procedure when the eye gets fatigued. It rejuvenates the eyes and helps the eyes to overcome the fatigue stage. It strengthens the eye sight. As it’s suggested after Tarpan, it has same indications like Tarpan.[9] PARISHEK/SEKA - In this procedure decoction or extracts of various medicines is allowed to flow constantly on the closed eyes.[10] It’s generally indicated in the acute conditions of the eye diseases.[11] ASHYOTANA Acharya Vagbhata has stated Aschyotana as the first (prime) procedure for all eye diseases.[12] In this procedure 10-12 drops of decoction or juice of

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medicines is instilled in the eye. It’s indicated in the initial stage of eye diseases (i.e. in alpa dosha prakopa condition).[13] ANJAN – In Anjan Liniment of various drugs is applied over the lower lid. Anjan is done in healthy eyes to maintain the healthy vision (for healthy vision a person should use Rasanjana once in 5 days or 8 days)[14] and in diseased eyes to cure the diseases. Generally it is indicated in Kapha predominant eye diseases.[15] It’s especially useful in some eye conditions like vedana (pain), daha (burning), shotha (oedema), Rag (redness). Anjan has lekhan property which helps in flushing out the debris and unwanted tissues.[16] PINDI It’s also called Kawalika.[17] In this procedure poultice of medicines is put on the eye It’s indicated in various stages of Abhishyanda (conjunctivitis).[18] VIDALAKA Medicated paste is applied over the eyelids. It’s indicated in early stages of eye diseases.[19] MODERN VIEW Mode of administration of drugs In modern sciences the ocular therapeutics includes the medicines in the form of drops, ointments, gels and ocuserts. These are the modes of topical installations of medicines in the eye. Whereas there are some periocular routes of drug administration like subconjunctival injections, subtenon injections, retrobulbar injections and peribulbar injections. Some injectable medicines are given in the form of intraocular injections. Systemic route of drug administration is also needed in some ocular diseases in the form of tablets/capsules. Here focus is given on topical route only. Eye drops are the easiest and most convenient method of topical application. Aqueous solutions and aqueous suspensions are the two forms of drug instillation in eye. In aqueous solution form the drug is totally dissolved, so the drug is completely available for immediate action. But it gets quickly diluted by tears and drains through naso-lacrimal duct. Hence, it causes low tissue contact time. Whereas in suspension forms the drug is present as small particles suspended in aqueous medium and these do not leave the eye as early as solution. Hence it increases the tissue contact time.

Ointments and gels have more bioavailability of drug which increases tissue contact time and prevents dilution and early absorption. Ocuserts are placed in upper and lower fornix for up to one week and allows a drug to be released at a constant rate. The drug is delivered through a membrane. The systemic route includes oral tablets intramuscular and intravenous injections. The intraocular penetration of systemically administered drugs depend upon the blood aqueous barrier which is influenced by the molecular weight of drug and its lipid solubility i.e. only low molecular weight drugs can cross the blood aqueous barrier. In cornea the epithelium and endothelium is lipid permeable i.e. lipophilic whereas stromal layer is hydrophilic. Hence the lipophilic and hydrophilic drugs are effectively delivered to cornea, whereas the drug permeability across the sclera depends upon the molecular size and weight of the drug. DISCUSSION – Various ocular procedures done in Kriyakalpa has its own mode of action which helps in treating eye diseases. These can be explained as fallows –The drugs used in Tarpan procedure is the combination of Ghrit and decoction of medicines , hence the drug can easily cross the corneal epithelium (being lypophilic)and endothelium (being hydrophilic ) .Also due to more contact time the active component of drug used in Tarpana will be absorbed more to cure the disease. The drug used in Putpaka is in aqueous solution form and has higher active component concentration. It helps for rapid cure of disease. The drug used in Seka is in the form of aqueous extract poured on closed eye, hence drug is absorbed through the skin of lids. In Ashchyotana drug is used in the form of aqueous extract and has very low tissue contact time and the drug is diluted easily with tears. The liniment of drug used in Anjana has more tissue contact time which leads to more bioavailability. In Pindi drug gets absorbed through the skin of eyelids. Because of heat of poultice local vasodilatation occurs which drains toxins from lesion site. Drug used in Vidalaka is absorbed through the skin of eyelids and the mechanical pressure causes vasodilatation and aqueous drainage which help to reduce intra-ocular pressure.

CONCLUSION The main aim of any pharmaco-therapeutics is to get the proper response of the drug by attaining the effective concentration at the site of action for sufficient period. In day-to-day practice all Kriyakalpas are found to be therapeutically effective. It depends how we correlate the findings

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with scientific explanation. In this review article, it is being tried to correlate the Ayurvedic ocular therapeutics i.e. Kriyakapa on the basis of modern pharmaco-therapeutics. By the guidelines of above principles of the modern pharmacology all the Ayurvedic ocular therapeutic procedures are relevant as such. Only the drugs needs to be selected according to stage and type of diseases and the various Kriyakalpa are to be used as per need. REFERENCES 1. Aachary Manik, editor. Chanakya Neeti. Azadpur, Delhi:

Sadhana Publication; 2004.p.86. 2. Jadavaji Trikamji Acharya, Narayana Ram Acharya,

editors. Sushruta Samhita Dalhana Comm. Nibandhasangraha, Gayadasacharya comm. Nyayachandrika Panjika on Nidanasthana. Uttara Tantra 18/1-2. Varanasi: Chaukhamba Surbharati Prakashana; 2012.p.633.

3. Jadavaji Trikamji Acharya, Narayana Ram Acharya, editors. Sushruta Samhita Dalhana Comm. Nibandhasangraha, Gayadasacharya comm. Nyayachandrika Panjika on Nidanasthana. Uttara Tantra 18/4. Varanasi: Chaukhamba Surbharati Prakashana; 2012.p.633.

4. Brahmanand Tripathi editor. Sharagdhar Samhita. Uttarkhanda 13/1. Varanasi: Chaukhamba Surbharati Prakashan; 2001.p.424.

5. Vd. Yadunandan Upadhyay editor. Ashtanga Hridaya. Sutrasthana 24/1. Varanasi: Chaukhamba Surbharati Prakashana; 2005.p.137.



8. Vd. Yadunandan Upadhyay editor. Ashtanga Hridaya. Sutrasthana 24/17-18. Varanasi: Chaukhamba Surbharati

Prakashana; 2005.p.138,139. 9. Vd. Yadunandan Upadhyay editor. Ashtanga Hridaya.

Sutrasthana 24/18. Varanasi: Chaukhamba Surbharati Prakashana; 2005.p.139.

10. Indradev Tripathi and Dr. Daya Shankar Tripathi editors. Yogratnakar with Vaidyaprabha Hindi Comm. 1st ed. Netrarog Nidan-Chikitsa Prakaranam, Sutra No. 336. Varanasi: Krishnadas Academy Publishers; 1998.p.792.

11. Jadavaji Trikamji Acharya, Narayana Ram Acharya, editors. Sushruta Samhita Dalhana Comm. Nibandhasangraha, Gayadasacharya comm. Nyayachandrika Panjika on Nidanasthana. Uttara Tantra 18/44. Varanasi: Chaukhamba Surbharati Prakashan; 2012.p.635.



14. Vd. Harish Chandra Singh Kushwaha. Editor-Translator. Charak Samhita Ayurved Dipika Ayusi Hindi Comm. First Part, Sutrasthana 5/15. Varanasi: Chaukhamba Orientalia Publishers; Reprint Edition; 2011.p.77.

15. Vd. Harish Chandra Singh Kushwaha. Editor-Translator. Charak Samhita Ayurved Dipika Ayusi Hindi Comm. First Part, Sutrasthana 5/16. Varanasi: Chaukhamba Orientalia Publishers; Reprint Edition; 2011.p.77.


17. Brahmanand Tripathi editor. Sharagdhar Samhita. Uttarkhanda 13/21. Varanasi: Chaukhamba Surbharati Prakashan; 2001.p.427.

18. Indradev Tripathi and Dr. Daya Shankar Tripathi editors. Yogratnakar with Vaidyaprabha Hindi Comm. 1st ed. Netrarog Nidan-Chikitsa Prakaranam, Sutra No. 344. Varanasi: Krishnadas Academy Publishers; 1998.p.793.

19. Vd. Harish Chandra Singh Kushwaha. Editor-Translator. Charak Samhita Ayurved Dipika Ayusi Hindi Comm. 1st ed. Chikitsasthana 26/231. Varanasi: Chaukhamba Orientalia Publishers; Reprint Edition; 2009.p.710.

.CITE THIS ARTICLE AS – Manisha Y. Dehankar et. al., Kriyakalpa: Ayurvedic Ocular Therapeutics - A Review, Int. J. Ayu. Alt. Med., 2014;2(5):1-4 Source of Support – Nil Conflict of Interest – None Declared

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ayurvedic ocular therapeutics

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