Ayurvedic management of Vartma sthambha (ptosis) with Panchakarma (bio purificatory measures) and Netrakriyakalpa (ocular therapies): A case report

This is to report a case of ophthalmoplegia developed after transsphenoidal surgery for pituitary adenoma, which was treated effectively with Ayurvedic Panchakarma (~bio purificatory measures) and Netrakriyakalpa (~ocular therapeutic procedures). Ophthalmoplegia refers to paralysis of both extrinsic and intrinsic muscles of the eyes. It is an uncommon complication after transsphenoidal surgery for pituitary adenoma and recovers spontaneously in most of the cases. If not resolved even after 6-12 months, surgery is done to correct the squint and ptosis. In this case, as the patient was apprehensive about surgery, Ayurvedic Panchakarma and Netrakriyakalpa procedures were prescribed. An Indian female aged 69 years reported with drooping of the left upper eyelid, deviation, and restricted eye movements in the left eye, and double vision for one year. It was a diagnosed case of postsurgical ophthalmoplegia due to third (oculomotor) and sixth (abducens) cranial nerve palsy. She was administered Panchakarma and Netrakriyakalpa. Oral medicines, Dhanadanayanadi kashaya and Ekangavira rasa, were prescribed for one month. After treatment, there was a remarkable improvement in ptosis. However, squint, restricted eye movements, and diplopia persisted. Ayurveda treatment, including Panchakarma and Netrakriyakalpa, is safe and effective in managing postsurgical ptosis, especially in patients who are apprehensive about surgery. This treatment plan could be further tried in ptosis of other etiologies as well. In Ayurveda, treating squint, restricted eye movements, and diplopia is challenging, and further research needs to be done.