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Ayurveda Multi Speciality Medical College Hospital
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Ayurveda Multi Speciality Medical College Hospital
Diabetic retinopathy is a diabetes complication that affects the eyes. It’s caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina).
At first, diabetic retinopathy might cause no symptoms or only mild vision problems. But it can lead to blindness.
The condition can develop in anyone who has type 1 or type 2 diabetes. The longer you have diabetes and the less controlled your blood sugar is, the more likely you are to develop this eye complication.
SYMPTOMS
CAUSES
Over time, too much sugar in your blood can lead to the blockage of the tiny blood vessels that nourish the retina, cutting off its blood supply. As a result, the eye attempts to grow new blood vessels. But these new blood vessels don’t develop properly and can leak easily.
TYPES
There are two main types of diabetic retinopathy:
When you have nonproliferative diabetic retinopathy (NPDR), the walls of the blood vessels in your retina weaken. Tiny bulges protrude from the walls of the smaller vessels, sometimes leaking fluid and blood into the retina. Larger retinal vessels can begin to dilate and become irregular in diameter as well. NPDR can progress from mild to severe as more blood vessels become blocked.
Sometimes retinal blood vessel damage leads to a buildup of fluid (edema) in the center portion (macula) of the retina. If macular edema decreases vision, treatment is required to prevent permanent vision loss.
Diabetic retinopathy
In the early stages of diabetic retinopathy, the walls of the blood vessels in your retina weaken. Tiny bulges protrude from the vessel walls, sometimes leaking or oozing fluid and blood into the retina. Tissues in the retina may swell, producing white spots. As diabetic retinopathy progresses, new blood vessels may grow and threaten your vision.
TREATMENT
Virechan and Basti with chakshyushya drugs should be advocated to control Vata. Sothahar (anti-inflammatory) treatment can be instituted with Basti treatment to reduce retinal/macular edema in general.
Nasya, Shirodhara, Shirolepa, and Shiropichu treatments can be given in different stages of diabetic retinopathy based on the principles of Vata shaman treatment for the head and body, and Pitta shaman treatment for the eyes.
Tarpana
The Tarpana procedure is of great importance in posterior segment diseases of the eye, like diabetic retinopathy, as most of the drug permeation to intraocular tissues occurs through the cornea to the aqueous humor and ciliary vessels. As the retinal pigment epithelium continues as the non-pigmented epithelium of the ciliary body, the drugs absorbed through the cornea may reach the inner three-fourths of the retinal layers, and the outer one-fourth of the retina gets its supply from choroidal vessels via the systemic route.
Ghritas used are:
Putapaka
Putapaka is similar to Tarpana in its administration procedure, but the methods of drug preparation differ. Ropana-type putapaka is indicated in Pitta, Rakta, and Vrana conditions of the eye, and therefore Ropana Putapaka can be used in different stages of diabetic retinopathy. Breast milk, meat of animals of Jangala origin, honey, ghee, and Tikta rasa herbal drugs are used for Ropana Putapaka. Putapaka prepared from Tikta dravya like Vasa can be used after Tarpana karma for optimum therapeutic effect in different stages of diabetic retinopathy.
Pariseka/Seka
Seka is done as a Poorvakarma before Tarpana. This helps in vasodilation of superficial vessels, and some medicine is absorbed through the medial canthus, which is highly vascularized. Ropana-type Seka is indicated in Rakta and Pitta diseases of the eye. Thus, Ropana-type Seka advised in diabetic retinopathy helps in improving the texture of blood vessels, endothelial repair, and thereby prevents the loss of pericytes, which is an initial factor in diabetic retinopathy development. Pariseka with drugs having Tikta Kashaya Rasa and Chakshyusya properties helps in healing intraretinal blood vessels and arrests bleeding due to Sthambhana properties.
Aschyotana
Aschyotana is the technique of repeatedly introducing a small volume of drug into the open eye. The medicines introduced in the form of medicated decoction are absorbed through the blood vessels of the fornices of the conjunctiva, sclera, and the highly vascularized part of the inner canthus. The therapeutic actions of Aschyotana are similar to the Seka procedure.
Anjana
Anjana is a medicinal preparation that is applied to the lower palpebral conjunctiva. Anjana is of three types: Gutika, Rasakriya, and Churna. Gutika and Churna types of Anjana can be correlated with ophthalmic suspensions, and the Rasakriya type with aqueous solutions/eye drops. Gutika and Churna Anjana have microparticles that may be deposited in the cul-de-sac and increase the precorneal retention time, thereby increasing the drug bioavailability to intraocular tissues. Due to their large molecular size, both trans-scleral and trans-corneal drug absorption may occur in the Anjana procedure. Ropana and Dristiprasadana types of Anjana might be helpful in treating and preventing diabetic retinopathy pathogenesis in Pakwavastha.
CONCLUSION
Diabetic retinopathy is a disease of the Dristipatala (retina) and a complication of long-standing uncontrolled diabetes due to defective metabolism and endocrine dysfunction. All three doshas are affected, with Rakta (as both dosha and dushya), mainly Vata, Pitta, Rakta, and Kapha Anubandha. All the dhatus are affected, with Rakta, Meda, and Mamsa predominant. The Sira srotas of the Raktavaha srotas and Ojavaha dhamani are affected in successive stages.
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Ashtamgam Ayurveda Chikitsalayam,
4/495A, Vavanoor, Koottanad
Palakkad, Dt. – 679 533
Kerala, India.
Tel: +91 466 237 2000
Mob: +91 828 137 2000
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To reach Ashtamgam Ayurveda Chikitsalayam, proceed along Pattambi Road from Koottanad Take a deviation at Vavannoor junction, from where Ashtamgam is just 1 km away.
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