Category:

The problem:

Signs & Symptoms of Conjunctivitis due to swimming with contact lenses and extensive computer work with contact lenses.

The approach:

Netra Tarpana Treatment in Ayurveda

The result:

Conjunctivitis cleared up quickly.

Detailed Ayurvedic Case Study:

Bacterial conjunctivitis (Netra Abhishanda)

Date:
Saturday, 25.10.10

Client Details:
Name: xxx
Sex: Female
DoB: xxx
Age: 40 years
Prakruti: P/V
Occupation: Office manager/computer
Family Status: Single/no children
Address: xxx, London, UK.

Presenting Symptoms:
Redness of the eye, itching, yellow mucous fluid oozing out of the eye and feeling as if there was a small scratching/scraping object in the eye, eye is trying to close and looks a bit swollen and deformed. Other symptoms including pain, blurring of vision and photophobia are not prominent.

Onset:
Thursday 23.10.2010, three days back.

Etiology (causative factors):
Conjunctivitis is most commonly caused by viral infection, but bacterial infections, allergies, other irritants and dryness (contact lenses) are also common etiologies for its occurrence.

History of Complaint:
No previous eye problems other than short sightedness. No history of complaint. Continuos day time contact lens wearing (3 months disposables) for several years approx. 5 years. Over extending the life of contact lenses. A little photosensitivity is always present with patient, but not increased due to disease.

Family History:
none, all short sighted

Provisional Diagnosis:
Bacterial Infection of the eye = Bacterial conjunctivitis

Differential Diagnosis:
Allergic conjunctivitis – however, likely that two eyes are affected at the same time and the discharge would be watery and in greater quantity, not in form of yellow oily oozing.
Viral conjunctivitis – Viral conjunctivitis is often associated with an infection of the upper respiratory tract, a common cold, and/or a sore throat, which is not present.
Other symptoms including pain, blurring of vision and photophobia should not be prominent in conjunctivitis. Fluctuating blurring is common, due to tearing and mucoid discharge. Mild photophobia is common. However, if any of these symptoms are prominent, it is important to exclude other diseases such as glaucoma (optic nerve damage), uveitis (inflammation of inner eye where urgent treatment required can lead to blindness), keratitis (inflammation of cornea) and even meningitis (viral or bacterial inflammation of protective membrane of spinal cord) or caroticocavernous fistula (abnormal channel growth).

Previous Treatment:
No previous treatment, but diagnosis confirmed at A&E Hospital in Harrow on 24.10.2010, patient has come for alternative ayurvedic treatment.

Allopathic Treatment:
The hospital suggested Chloramphenicol eye drops 0.5 %, 4 x a day until symptoms recede. Chloramphenicol is effective against a wide variety of Gram-positive and Gram-negative bacteria, including most anaerobic organisms. Due to resistance and safety concerns, it is no longer a first-line agent for any indication in developed nations, although it is sometimes used topically for eye infections. The most serious adverse effect associated with chloramphenicol treatment is bone marrow toxicity, which may occur in two distinct forms: bone marrow suppression, which is a direct toxic effect of the drug and is usually reversible, and aplastic anemia, which is idiosyncratic (rare, unpredictable, and unrelated to dose) and generally fatal.

=> Ayurvedic Treatment
Roga Lakshanas (presenting complaints):
netra daha present (burning sensation in the eye)
netra sodha (inflammation of the eye)
netra kandy, titalu, nasimirulu, nanalu, navalu present (itching in the eyes)
netra malinamu, poralu, pusulu (discharge from conjunctiva)
scratching sensation in the eye
antlu (sticking together of the eye lids due to conjunctival discharge)
but no netra ruja present (pain in the eyes) and no manda drusti (defective vision) and no cikatulu (day/night blindless).

Provisional Diagnosis:
Nayana Roga (eye disease): Netra vikara (disorder of the eye), Abhisyanda (conjuctivitis).

Nidana/Causes:
Nidana for this patient is swimming with contact lenses, rubbing of the eye, overextending the life of contact lenses, continuos day time use of contact lenses for a number of years.

Types of Abhisyanda:
Vata (red eyes, shooting pain, oozing of water)
Pitta (red eyes, burning sensation, scraping in the eyes)
Kapha (pus formation and scraping sensation).
The present symptoms match most closely to Pitta Abhisyanda.

Rogi Cikitsa / Patient Treatment Plan:
Eye Patch with Milk over night
Eye Bath with Triphala cold infusion or decoction
Tarpana with Triphala Ghee

Ayurvedic Rationale of Cikitsa (= Treatment):
Eye Patch: Milk antibacterial, ayurveda advises in particular human breast milk for eye diseases, but cows milk is second best.
Eye Wash Option 1: Decoction option is dry powder (1 part) in water (8 parts) boil until 1/4 remains for a strong decoction, or 1/2 for a moderate decoction or 3/4 for a weak decoction. Working with fresh herbs is herbs (1 part) and water )16 (parts). Strain through a muslin cloth and use the cooled liquid for an eye bath.

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