Adhimantha / Vātānubandha Abhishyanda – An Ayurvedic Insight into Glaucoma
🔬 1. MODERN MEDICAL PERSPECTIVE:
Definition:
Glaucoma refers to a group of eye diseases that damage the optic nerve, usually due to increased intraocular pressure (IOP).
🔍 Types of Glaucoma:
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Primary Open-Angle Glaucoma (POAG): Most common, slow, silent vision loss
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Angle-Closure Glaucoma (ACG): Acute, painful, sudden increase in IOP
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Normal-Tension Glaucoma: Optic nerve damage with normal IOP
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Secondary Glaucoma: Due to trauma, steroids, uveitis
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Congenital Glaucoma: Present at birth
🧪 Signs and Symptoms:
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Gradual peripheral vision loss (POAG)
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Eye pain, headache (ACG)
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Halos around lights
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Red eye, nausea, vomiting (in acute attacks)
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Optic disc cupping on fundus exam
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Elevated IOP (>21 mmHg in most types)
📜 2. AYURVEDIC CORRELATION:
Glaucoma is most closely correlated with the following Netra Rogas:
✅ a. Adhimantha (अधिमन्थ)
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Acute, painful eye condition
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Involves all three doṣas
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Leads to Linganāśa (blindness) if untreated
✅ b. Vātānubandha Abhishyanda
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A type of Abhishyanda (conjunctival discharge/inflammation)
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Dominated by Vāta, with associated Kapha or Pitta symptoms
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Chronic inflammation with pain, discharge, heaviness
✅ c. Timira progressing to Linganāśa
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If left untreated, Timira (blurring) progresses to Linganāśa (blindness) due to vitiated Vāta affecting the 4th patala (deep ocular structures)
🧬 3. DOṢA–DUṢYA–SAMPRĀPTI:
Factor | Detail |
---|---|
Doṣa | Vāta (predominant), associated with Kapha or Pitta |
Duṣya | Rakta, Rasa, Majjā Dhātu |
Srotas | Netravaha srotas, Majjavaha, Raktavaha srotas |
Samprāpti | Vitiated Vāta causes obstruction of ocular channels, increases pressure, leading to optic nerve damage (gradual or acute) |
📚 4. CLASSICAL ŚLOKA REFERENCES:
🕉 Suśruta Saṁhitā – Uttara Tantra 11/1–2:
त्रिदोषैर्भवति व्याप्तं नेत्रं यस्मिन् स तीव्ररुक्।
अधिमन्थस्तु स विज्ञेयः स सदा लिङ्गनाशनः॥
Translation:
Adhimantha occurs when all three doṣas infiltrate the eye, causing intense pain and ultimately leading to blindness.
🕉 Suśruta – Uttara Tantra 7/22:
तत्र चतुर्थपटलगते दोषे तु लिङ्गनाशनं॥
Meaning:
When doshas reach the fourth patala (deep retinal/optic area), permanent vision loss occurs.
🧪 Modern-Ayurvedic Correlation Table:
Modern Type | Ayurvedic Equivalent | Dominant Doṣa |
---|---|---|
Open Angle Glaucoma | Vātānubandha Abhishyanda | Vāta + Kapha |
Angle Closure Glaucoma | Adhimantha | Tridoṣa (esp. Vāta) |
Chronic optic nerve degeneration | Linganāśa via Timira progression | Vāta-Majjā kṣaya |
🌿 5. AYURVEDIC MANAGEMENT OF GLAUCOMA
🔸 A. Local Therapies (Kriyākalpa):
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Āśchyotana (Eye Drops):
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Triphala decoction
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Daruharidra + Yashtimadhu Kashaya
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Anjana (Collyrium):
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Chandrodaya Varti (with ghee)
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Krimighna Rasakriyā if recurrent inflammation
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Netraseka (Irrigation):
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With Chandana-Bala-Lodhra Kashaya
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Tarpana (Eye ghee retention – post-acute phase):
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Jeevantyadi Ghrita or Triphaladi Ghrita
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Rejuvenates optic nerve and eye tissues
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🔸 B. Internal Medicines:
Formulation | Dose & Role |
---|---|
Saptamrita Lauha | 250 mg with honey + ghee – Chakshushya + Majjā poshaka |
Punarnavadi Kashaya | 15 ml BID – reduces intraocular congestion and oedema |
Pathyadi Kashaya | 15 ml BID – headache, eye strain |
Triphala Ghrita | 5–10 ml HS – Rasayana for vision |
Yogendra Rasa / Vasantakusumākara Rasa | Nerve tonic (if diabetic or chronic case) |
Ashwagandhādi Churna | 3–5 gm BID – Majjā nourisher |
Chandraprabha Vati | 500 mg BID – for systemic support and Vata-Kapha balance |
🔸 C. Pañcakarma Therapies:
Panchakarma | Details & Benefits |
---|---|
Nasya | Anu Taila or Shadbindu Taila – clears head channels, optic nerve tonic |
Virechana | Trivrit Lehya or Avipattikar – Pitta-Vāta shodhana |
Basti | ✅ Tikta Ksheera Basti – Best for Majjā dhātu kṣaya (optic degeneration) |
✅ Dashamoola Niruha Basti for systemic Vāta-Kapha involvement
| Raktamokṣa | In selected Kapha-Pitta cases with headache/congestion (especially if associated with Raktadushti or raised IOP)
🔸 D. Rasāyana Chikitsā (Rejuvenation):
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Triphala Rasayana
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Guduchi + Haridra capsules
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Chyawanprash / Amla Rasayana
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Ashwagandha + Brahmi + Shatavari Ghrita
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Shilajatu (if diabetic associated glaucoma)
🔸 E. Pathya-Apathya (Diet & Lifestyle):
✅ Pathya (Recommended):
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Ghee, amla, barley, green gram soup
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Cow milk, wheat, soaked raisins
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Daily eye washing with Triphala water
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Gentle yoga and meditation
🚫 Apathya (To Avoid):
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Day sleep, late nights
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Heavy, spicy, sour foods
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Screen overexposure
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Stress and emotional triggers
📚 6. INTEGRATIVE & RESEARCH-BASED NOTES:
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Studies show Triphala Ghrita and Saptamrita Lauha improve ocular perfusion and optic nerve nourishment
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Basti chikitsā improves systemic Vāta disorders contributing to optic nerve ischemia
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Tarpana therapy has been traditionally indicated for Timira and Linganāśa – similar to early optic degeneration and glaucoma
📝 7. AYURVEDIC PROTOCOL FLOW (Clinical Steps):
Phase | Protocol |
---|---|
Early Stage (POAG) | Virechana → Nasya → Saptamrita + Triphala Ghrita → Netraseka + Āśchyotana |
Moderate Stage | Add Basti (Ksheerabasti), Rasayana, and Tarpana |
Severe/Optic Atrophy | Yogendra Rasa, Vasantakusumākara, Majjā-nourishing Rasayana |
With Diabetes | Use Pathyadi Kwatha, Chandraprabha Vati, Vasantakusumākara |
📌 Summary:
Glaucoma in Ayurveda is best understood as a Vāta-dominant Netra Roga, treated by:
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Dosha shodhana (Virechana, Basti, Nasya)
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Optic nerve nourishment (Tarpana, Rasayana)
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Daily eye care & Pathya management
With early detection and systematic Ayurvedic chikitsā, progression can be slowed, and vision preserved.
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