“Sarvendriyanam Nayanam Pradhanam”
It means the eye is much more important than all other sense organs, because of good vision and it is responsible for Social and intellectual development. In Authentic classics like Sushrutha Samhita and Astanga Hridayam described Adhimantha is a sarvagata netra rogas.
Ancient classics described Glaucoma as Adhimanth which means Adhi (Excessive) and Mantha (Churning) conditions where excessive pain in the eye feels like a churning type of pain occurring in this disease. Glaucoma is a major cause for blindness globally it affects millions of people in the world.
It is an advanced condition or complication of Abhishyanda (The word Abhishyanda is derived from two words viz. “ Abhi” and “Syandana.” “Abhi” means profuse or more and “Syandana” means discharge or secretion, combined meaning is profuse discharge from all parts of the eye. The disease Abhishyanda is a Sarvagata Netra Roga, which means it affects all parts of the eye).
Ayurveda which dealt extraneously with all the aspects of life and disease. It was the science which was divided into eight specialties that itself indicates how much advance was the science of life at that time. Of the eight disciplines, Shalakya Tantra is claimed to be the second one in order by Sushruta.
Adhimantha is a disease which has been mentioned by Sushruta as an intense sensation in the eye, with the feeling of Scooping it from orbit along with the involvement of the one side of the head in association with specific features of the particular Dosha involved.
Glaucoma is called “The Sneak Thief of Sight” since there are no symptoms and once vision is lost, it’s permanent. The term Glaucoma does not define a disease entity but embraces a composite feature of pathological conditions which have the common features of their clinical manifestation that are more or less dominated by the raised intraocular pressure and its consequences. Glaucoma is a disease which is characterized by raised intraocular pressure, optic disc cupping and visual field defect.
As much as 40% vision can be lost without a person noticing. Glaucoma is not a single disease process, but a group of disorders characterized by a progressive optic neuropathy It gradually steals sight without warning. Vision loss is caused by damage to the optic nerve.
Glaucoma is a neurodegenerative disorder of optic nerve that occurs mostly elder age group especially those over 80 year of age. Any injury to the eye, Viruddh Ahar (improper diet) and Vihar (lifestyle) are cause of glaucoma.
Type Of Adhimantha
- Vataja Adhimantha
Vataja Adhimantha is generated if vataja abhishyanda is neglected.
- Severe pain of various nature like extraction, churning
- Foreign body sensation
- Pricking, tearing, splitting, bursting sensation
- Kampana (tremors) and half headache
- Churning type of pain in the head, eye and root of the nose and with giddiness.
- Pittaja Adhimantha
Pittaja Adhimantha is generated if Pittaja abhishyanda is neglected.
- Pain or sensations as if caustic alkali or burning coal is applied to eye
- Eyelids suppurated and its margins excessively swollen
- Red streaks are seen i.e. severe congestion
- Perspiration, fainting
- Burning sensation in eye and head
- Kaphaja Adhimantha
Kaphaja Adhimantha is generated if Kaphaja abhishyanda is neglected. In kaphaja Adhimantha the symptoms like:
- Grittiness i.e. foreign body sensation
- Headache, mild edema, feeling of cold
- Lacrimation and slimy discharge
- Itching, heaviness
- Difficulty in visualising object i.e. Corneal haziness
- Praseka i.e. excessive salivation
- Raktaja Adhimantha
Raktaja Adhimantha is generated if Raktaja abhishyanda is neglected.
- Severe pain of various nature like plucked out or pricking type
- Tenderness due to increased IOP (intraocular pressure)
- Coppery discolouration of the eye
- Eye is inflamed
- Burning sensation
- Blood colour discharge.
- Darkness before eyes
Nidana: Etiological factors
- Entering reservoirs of water immediately after getting heated up by exposure to sunlight, fire etc.
- Focusing on the objects that are very far.
- Avoiding sleep.
- Indulging in excessive weeping, anger, sorrow, and exertion.
- Injury in eye.
- Suppressing the urges (like passing urine/stools), excess sweating.
- Excess of vomiting
- Observing minute objects
By these causes Dosha get aggravated and produce diseases
Following the above mentioned Nidana aggravates Doshas and these Doshas start moving upward, through the Siras i.e. blood vessels and get lodged in the eye and give rise to various diseases, in different parts of eyes.
Ancient Acharyas described all 4 types of Adhimantha its manageable i.e. if attended in time are manageable. If ignored or patient does not follow diet and seasonal regime.Visual loss occurs as follow:
- Anjana karma– Eyes mainly have Teja property, they can easily get affected by Kapha dosha imbalance. Rasanjana should be done once a week.
- Anjana scrapes and expels dosha from Eyes
- Padabhyanga (foot massage) is Chakshushya (Enhances eyesight)
MANAGEMENT IN AYURVEDA:
For Glaucoma regular check up of Intraocular tension is important. Clinical features of Adhimanth can be correlated to Glaucoma. So, management is:
- In early stage-
- Tikshna shiro Virechana (Nasyam)
- Tikshna kawaldharan/gandush (Gargle/Mouth wash)
- Dhumpan ( Medicated smoke inhalation)
- Lepam (Application of herbal paste)
- Cleansing Treatment: The ancient Acharyas had mentioned to adopt 6 different events for Cleansing: –
- Langhana (fasting)
- Seka (Hot fomentation)
- Bashpa Sweda (Steaming)
- Intake of Madhura and Tikta food item (sweet and Bitter food items)
- General management-
After clinically assessing the strength, Indications, Contraindications in patients; (PANCHKARMA) Snehana, Swedana, Vaman, Virechana, should be followed.
- Raktamokshana (Bloodletting) is advised in all the 4 type of Adhimantha
- Medicines Advised – Triphala, Shigru, Shatavari, Triphala ghrita.
- Beneficial food: Ghee, Honey, Green Gram, Raisins, Pomegranate.
- Eye exercises- Palming, Distant and near focusing, Rotational movements of the eye will help to improve blood circulation to eyes. So oxygen supply, nutritional supply to the eyes is increased. These exercises will strengthen the muscles of eyes and maintain vision level.
Kriyakalpas are specific procedures for eyes. They lubricate and rejuvenate the eyes. Impurities are expelled out. It helps to bring back brightness and clarity to the eyes.
- Tarpana- Tarpana is a very effective kriyakalpa. It is used to treat early formation of glaucoma
- Nasya karma – Vaisheshika nasya is useful to improve eyesight. It is indicated in visual disturbances.
- Vamana- It is contraindicated in Drishtigata rogas. If done, it will increase Timira.
Adhimantha has drawn the attention of ancient physicians which is evident from the fact that its description, classification, symptomatology, complication and management are available in literature. Even though the disease Adhimantha has been considered as a curable disease if the treatment is given well in time otherwise the disease results in further deterioration and ultimately blindness ensues.