Management of primary open-angle glaucoma through Ayurveda – An observation

Primary Open-Angle Glaucoma (POAG) is characterized by the normal appearance of the anterior-chamber angle and raised intraocular pressure (IOP) with no underlying disease or cause. Majority of cases are asymptomatic. Blurred vision and constricted visual fields appear in later stages of the condition. Due to the irreversible nature of visual loss, early detection and diagnosis are paramount. Ayurvedic management of a case of already-diagnosed POAG is presented in this report. A 55-year-old male presented with complaints of bilateral diminished distant vision associated with headache since January 2015. Examination of the anterior chamber in both eyes was normal, IOP was increased, visual fields were markedly constricted, and optic discs showed increased cup-to-disc ratio and bayonetting of blood vessels. The patient underwent two courses of inpatient management comprising Virechana (~therapeutic purgation), Marsha nasya (~high-dose medication through nasal route), Pratimarsha nasya (~low-dose medication through nasal route), and Shamana aushadhi (~palliative medicines including Vainateya ghrita, Dhanadarasnadi kwatha, Akshabijadi kwatha, and Bharngyadi kwatha). Sthanika chikitsa (~local treatments) including Netra kriyakalpa (~ocular therapeutic procedures) such as Seka (~ocular therapy by streaming), Aschyotana (~eye drops), Anjana (~collyrium), Netra tarpana (~therapeutic retention of medicated liquids over the eyes), and Bandhana karma (~bandaging) and therapies for the head such as Tala (~paste over the bregma), Talapoticchil (~paste on a plantain leaf over the head), and Shirodhara (~pouring medicated oil over the scalp) were also done. IOP was lowered and some expansion of the visual field was noted posttreatment. Ayurvedic management of POAG was observed to be useful in limiting the further progression of neuronal damage and maintaining the condition.