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A case study on Squint Eye / Amblyopia/ lazy eye


Abstract:

A case study to unravel the journey of Squint eye/ Amblyopia/ Lazy eye through Ayurveda line of treatment called Netra Dhara. Amblyopia is common neurodevelopmental visual disorder carries a significant risk of serious visual impairment and disability later in life. It is reversible if treated at the earlier stage itself and there are many ways of intervention in treating amblyopia. Ayurveda is one such way, where in the condition can be treated in an effective way by using various treatment modalities like Netra dhara, Netra tarpana etc.


A 5 year old kid approached us with a complaint of squint in the right eye since one year. After detailed analysis of the condition, we started with Netra Dhara line of treatment for 7 days followed by internal medication and eye exercises. After Netra dhara line of treatment for 7 days, there was a significant changes noticed with respect to her vision and advised to continue the same line of treatment.


Introduction:

Amblyopia is a type of poor vision that usually happens in just 1 eye caused by abnormal visual development early in life. It generally develops from birth upto7years. The prevalence of amblyopia is estimated to be 1-3 % of the population and the condition is leading cause of uncorrectable vision loss in children and adults under the age of 60. So it’s very much essential to identify and to treat the condition at the earliest in order to prevent the visual impairment.


In Ayurveda lazy eye is also called as Jihma (squint eye). The treatment advised for jihma are Tarpana and Netra dhara, eye exercises and dietary and life style changes which helps to restore the condition at the earliest.


As per Ayurveda literature:

In Ayurveda, the clinical features related to visual disturbances are seen in Drushtighata rogas. Amblyopia is one such drushtighata roga, which has a clinical feature of visual impairment with squint in the eye caused by Vata Pradhana Tridosha. Snehana (Tarpana and Netra dhara) are the line of treatment advised for treatment of jihma roga.


As per modern science:

Amblyopia is a disorder of the development of sight. It is due to the failure of cortical visual development in one or both eyes from ocular pathology early in life. Often, amblyopia is referred to as a "lazy eye" by the general public. Amblyopia results in permanent decreased vision in the pathological eye if not treated early enough, even if the ocular pathology is removed later on in life. It is the most common cause of decreased vision in a single eye among children and younger adults.


Amblyopia occurs early in life when the developing visual system fails to transmit a sharp image to the visual cortex. Amblyopia can be the result of media opacities, cataracts, strabismus, or anisometric refractive errors that place one eye at a developmental disadvantage to the other. Amblyopia usually occurs unilaterally but can occur bilaterally with cataracts of either eyes or high refractive errors.


Case detail:

A female patient aged about 5 years approached our OPD with gradual development of squint in the right eye from one year. After consulting an ophthalmologist at private hospital she was diagnosed with Amblyopia of right eye and was advised for spectacles. But she did not get much relief even after using the spectacles so her parents brought her to global Ayurveda for further management.


On examination there was visual impairment noted and was diagnosed as a case of lazy eye called as Jihma in Ayurveda and treated appropriately by adopting the classical line of treatment called Netradhara and Rasayanas and eye exercises with dietary and life style changes which has given a promising result in treating the case.


In specific with the case we decided to do Netra dhara line of treatment for 7 days with Jeeanatyadi grita. Liquefied medicated ghee was poured continuously over the eye at a specified distance from inner canthus to outer canthus for a period of 45 minutes. Like this the procedure was repeated for 7 days followed by Triphala wash and also advised to do eye exercises on regular basis and internal medication at bed time regularly.


After 7 days of Netra dhara line of treatment with the jeevantyadi grita, eye exercises and internal medications, there was gradual improvement in her condition, where the frequency of the squinting of right eye got reduced by 25% and there was improvement in her vision as well. Patient was advised to continue with the internal medication and eye exercises for 48 days and then repeat the Netra dhara line of treatment in every three month once.


After three months, 2nd sitting of netra dhara line of treatment was conducted for 7 days with the same medicated ghee and advised to get the vision test done.


After 2nd sitting of netra dhara , subjectively there was remarkable improvement was seen in the eye and objectively there was improvement noticed.

Visual changes observed are as follows,

Discussion:


Jihma and dosha involved and its treatment

Lazy eye/ amblyopia/ Jihma is one of the Vata pradhana eye disorder. Snehana line of treatment plays a significant role in any vata pradhana condition. Tarpana and Netra dhara are one such Snehana lines of treatment which is done locally in order to treat any eye disorders where deeper tissues are involved.


Netra dhara line treatment was adopted in this case particular as the child was 5 years old and doesn’t cooperate for Tarpana line of treatment so we decided to do Netra Dhara for 7days with Jeevantyadi grita.


Jeevantyadi grita is one of the best medicines in order to treat Vata related disorder specially when there are any degenerative changes involved. Hence in the above case jeevantyadi grita was selected as a drug of choice for Netra dhara procedure as there were degenerative changes which were noticed with respect to visual path in the early age itself due to vata.


Amblyopia and its pathology

Amblyopia (also called lazy eye) is a condition where there’s a breakdown in how the brain and the eye work together, and the brain can’t recognize the sight from 1 eye. Over time, the brain relies more and more on the other stronger eye while vision in the weaker eye gets worse. The brain may try to work around it and starts to “turn off” signals from the weaker eye and rely only on the stronger eye and results in lazy eye.


Netra dhara line of treatment and its significance

Tarpana and Netra dhara are line of treatment helps to nourish the eye, increases the blood circulation in the affected area, strengthens the muscle in the affected area, helps to get rid of dosha imbalances and helps to improve the eye sight by re-establishing the visual pathway and by restoring the degenerative changes occurring in the eye.


Restabilising the connection between brain and eye should be the main line of treatment in amblyopia condition. Netra dhara is one such line of treatment which helps to re-establish the path way between the visual cortex of the brain and visual system of eye and there by correct the visual impairment.


With respect to the above case, with the Dhara line of treatment for 7 days with jeevantyadi grita, there were considerable changes noticed both subjectively and objectively.


Conclusion:

Netra dhara line of treatment is the significant line of treatment in order to correct the visual impairment caused by Doshas.


Especially in Vata predominant condition of eye, Sneha Dhara line of treatment plays a pivotal role in order to correct the visual impairment or degeneration caused by Vata.


In lazy eye or Jihma by birth, Netra Dhara with jeevantyadi grita helps to restore the condition by establishing the connection between cortex and visual system and by rejuvenating the cells.

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