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K.S.DUTTA SHARMA.G, APPLICATION OF AYURVEDA SIDDHANTA IN THE MANAGEMENT OF COMPUTER VISION SYNDROME, DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA, GOVERNMENT AYURVEDA MEDICAL COLLEGE, …

K.S.DUTTA SHARMA.G, APPLICATION OF AYURVEDA SIDDHANTA IN THE MANAGEMENT OF COMPUTER VISION SYNDROME, DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA, GOVERNMENT AYURVEDA MEDICAL COLLEGE, MYSORE. 2008

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  • 1. “APPLICATION OF AYURVEDA SIDDHANTA INTHE MANAGEMENT OF COMPUTER VISIONSYNDROME”ByDr. K.S.DUTTA SHARMA.G, B.A.M.S.,Dissertation submitted to theRajiv Gandhi University of Health Sciences,Karnataka, Bangalore.In the partial fulfillment of the requirements for the degree ofDOCTOR OF MEDICINE (AYURVEDA)inAYURVEDA SIDDHANTAUnder The Guidance ofDr.K.NASEEMA AKHTAR M.D. (Ayu)Professor,Department of Post-Graduate Studies in Ayurveda Siddhanta,G.A.M.C., Mysore.Co-GuideDr.T.R.SHANTALA PRIYADARSHINI M.S. (Ayu)Asst. ProfessorDepartment of Post-Graduate Studies in Ayurveda Siddhanta,G.A.M.C., Mysore.DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGE,MYSORE.2008
  • 2. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGE, MYSORE.DECLARATIONI hereby declare that this Dissertation “Application of Ayurveda Siddhantain the Management of Computer Vision Syndrome” is a bonafide and genuineresearch work carried out by me under the guidance of Dr.K.Naseema Akthar,Professor, Department of Post Graduate Studies in Ayurveda Siddhanta,Government Ayurveda Medical College, Mysore.Date : Signature of the CandidatePlace: Mysore Name: Dr. K.S.Dutta Sharma.G
  • 3. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKADEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGE, MYSORE.CERTIFICATEThis is to certify that the dissertation entitled “Application of Ayurveda Siddhantain the Management of Computer Vision Syndrome” is a bonafide research workdone by Dr.K.S.Dutta Sharma.G in partial fulfilment of the requirement for thedegree of Doctor of Medicine (Ayurveda).Date: Signature of the GuidePlace: Mysore Dr.K.Naseema Akthar M.D. (Ayu).,ProfessorDepartment of Post Graduate Studies InAyurveda Siddhanta, Government AyurvedaMedical College,Mysore.
  • 4. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKADEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGE, MYSORE.CERTIFICATEThis is to certify that the dissertation entitled “Application of Ayurveda Siddhantain the Management of Computer Vision Syndrome” is a bonafide research workdone by Dr.K.S.Dutta Sharma.G in partial fulfilment of the requirement for thedegree of Doctor of Medicine (Ayurveda).Date: Signature of the Co-GuidePlace: Mysore Dr. T.R.Shantala Priyadarshini M.S. (Ayu).,Asst ProfessorDepartment of Post Graduate Studies InAyurveda Siddhanta, Government AyurvedaMedical College,Mysore.
  • 5. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKADEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTAGOVERNMENT AYURVEDA MEDICAL COLLEGE,MYSORE.ENDORSEMENT BY THE HOD, PRINCIPAL /HEAD OF THE INSTITUTIONThis is to certify that the dissertation entitled “APPLICATION OFAYURVEDA SIDDHANTA IN THE MANAGEMENT OF COMPUTERVISION SYNDROME” is a bonafide research work done by Dr.K.S.DuttaSharma.G under the guidance of Dr. K.Naseema Akthar Professor, Department ofPost Graduate Studies in Ayurveda siddhanta, Government Ayurveda MedicalCollege, Mysore.Seal & Signature of the HOD Seal & Signature of the PrincipalDr. N.Anjaneya Murthy Dr. Ashok D.SatputeDate: Date:Place: Mysore Place: Mysore
  • 6. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA.DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGE, MYSORE.COPY RIGHTDeclaration by the CandidateI hereby declare that the Rajiv Gandhi University of Health Sciences,Karnataka shall have the rights to preserve, use and disseminate this dissertation /thesis in print or electronic format for academic / research purpose.Date : Signature of the CandidatePlace : Mysore Dr. K.S.Dutta Sharma.G© Rajiv Gandhi University of Health Sciences, Karnataka
  • 7. Dedicated to…My Loving Parents  &  Dearest  Brothers  
  • 8. ACKNOWLEDGEMENTAt this moment of submitting this dissertation in this Post Graduate study, myhead bows down with great humility at the feet of almighty Mother Chamundeshwari andLord Dhanwantari, without whose blessing, I would not have been able to attain thesestages in my life.I express my heartfelt and profound sense of gratitude to my beloved, Professorand HOD, Department of PG Studies in Ayurveda Siddhanta, GAMC, Mysore,Dr.N.Anjaneya Murthy for his constant guidance, continuous supervision and help atevery stage of this study.Words cannot express the zeal of ecstasy while depicting my deep source ofgratitude to my proficient guide Dr Naseema Akhtar.Her fruitful suggestions, optimisticview & motherly affection showered on me during this whole period & inspired me toaccomplish this work in all aspects.Words cannot express the zeal of ecstasy while depicting my deep source ofgratitude to my proficient Co-guide Dr.T.R.Shantala Priyadarshini. Her fruitfulsuggestions, optimistic view & motherly affection showered on me during this wholeperiod of study & inspired me to accomplish this work in all aspects.I am also thankful to Dr. Ashok D. Satpute, Principal, GAMC, Mysore, for hissupport during the period of my study.I would like to place on record my heartfelt thanks and deepest sense of gratitudeto my respected teachers Dr.V.A.Chate, Dr Venkata Shivudu for their keen observationand valuable recommendations throughout the dissertation and without whom mydissertation would not have taken this shape.I would like to place on record my heartfelt thanks to Dr.Rajendra, Dr.AnandKatti, for their patient hearing during times of my frustration and for offering valuablesuggestions and inspiration from time to time during my P.G. studies.
  • 9. I express my enormous amount of thanks to my colleague’s & fabulousclassmates, Dr.Savitha, Dr.Soubhagya, Dr.Yogesh, Dr.Vijayalakshmi, Dr.Abdul,Dr Naveen, Dr L.N.Shenoy, and Dr Savita. H, and all P.G. colleagues, who made mystay in college very joyful and educative.I convey my thanks to my junior P.G. Colleagues Dr.Pankaj, Dr.Rajesh,Dr.Annapooorani, Dr.Aparna,Dr Ranjith,Dr Kalyani,Dr Ramesh & Dr Geetha fortheir help and overall support.I remain ever thankful to physician Dr.Ramachandra Naik, internees Dr.Aravind, Dr Vinutha and all other hospital staff for their valuable support during thecourse of the study.I extend my deepest regards to Mr. Subbanna, Smt. Varalakshmi, Mr.Basavaraju & Mr.Somashekhar Librarians, GAMC, Mysore, for their generous helpduring the course of my work.At the same time, it gives me immense pleasure to remember my respectedParents and brothers with a great dedication towards them with whose blessings,inspiration and moral support; I have been able to reach this height.I personally thank Dr. Lancy D’Souza for helping in statistical analysis andinterpretation.I acknowledge thanks to all persons who have helped me directly or indirectlywith apology for my inability to identify them individually.Small things make perfection but perfection is not a small thing. I seek pardon& apologize for any errors which might be remained in the work.Date:Place: Dr. K.S.Dutta Sharma.G
  • 10. LIST OF ABBREVIATIONA.H. Astanga HridayaA.S. Astanga SangrahaCH CharakaCD ChakradattaCS Charaka SamhitaCkp ChakrapaniMN Madhava NidanaSa.Sa Sarangdhara SamhitaSu.Sa Sushruta SamhitaVAG VagbhataAOA American Optometric AsssociationMW Monier Williams Sanskrit English DictionaryCVS Computer Vision SyndromeBP BhavaprakashaYR YogaratnakaraAK AmarakoshaVK Vaidyaka KoshaVSS Vaidyaka Shabda SindhuRN Raja NighantuMK Medini KoshaSKD Shabda Kalpa DrumaSS Statistically significantHS Highly SignificantNS Non Significant
  • 11. ABSTRACTBackground and ObjectiveComputer Vision Syndrome is a Vikara of Chakshurendriya, occurring due toAstmendriyartha samyoga and atiyoga of Chakshurendriya. Aggravated Tridosha, Vataand Pitta Dosha, in particular, are the prime factors involved in the pathogenesis. And itvery well co-relates with that of Netra roga poorvaroopa.CVS is a multifactorial condition commonly observed in the Computer users.According to the survey conducted by ‘India Today’, the prevalence of the disease in98% of software professionals. Considering the grave nature of the disease with its higherincidence, it has been selected for the present study to find out a better cure.Though Nidanaparivarjana is much highlighted and praised in the context ofchikitsa, it is not possible always to follow especially in a disease like CVS. In thepresent study Triphala Yashtimadhu Yoga a Chakshushya Rasayana is selected in theform of choorna owing to easy palatability, so that one can perform routine activitieswithout interruption.The objective of this present study was to understand the disease based onAyurvedic concepts and to evaluate the effect of Triphala Yashtimadhu Yoga in patientsof CVS.MethodsStudy Design - A conceptual study and a single blind clinical Study.Intervention – Total 30 patients were selected randomly and assigned into a single groupand administered with Triphala Yashtimadhu Choornam in the dosage of 12 grams BD(in divided dose)Data was collected before commencement of treatment, after completion of treatment andafter follow up. The data was analyzed using contingency coefficient and other statisticaltests.
  • 12. ResultsEffect of Triphala Yashtimadhu Choorna showed highly significant results in parameterssuch as Dry and irritated eyes, Redness of eyes, Tearing eyes, Headache, Burning in eyes,Blurred vision and Photophobia.Interpretation and ConclusionAyurvedic siddhantas are eternal and can be applied in understanding any disease.Triphala Yashtimadhu Yoga a Chakshushya Rasayana is effective in a disease caused dueto Asatmendriyartha Samyoga.Key Words Computer Vision Syndrome Netra Roga Asatmendriyartha Samyoga Triphala Yashtimadhu Yoga
  • 13. CONTENTSPage No #Introduction 1Objectives 3Review of LiteratureHetu 4Trividha Hetu 11Netra Shareera 18Netra Roga 28Netra Roga Chikitsa 41Drug Review 48Computer Vision Syndrome 56Previous works 65Materials 66Methods 67Observation 76ResultsDiscussion 117Conclusion 143Recommendation for Future Study 144Summary 145Bibliography 147Annexure i-xii
  • 14. LIST OF TABLESSl.No. Table Name Page No1. Showing the Synonyms of Hetu from various Sanskrit books 062. Showing the Synonyms of Hetu according to various classics 063. Showing the Asatmendriyartha samyoga of Gnanendriya 144. Showing the panchamahabhuta and its dominant parts in eye 185. Showing the chakshurendriya panchapanchaka 216. Showing the classification of Netra roga according to various acharyas 307. Showing the Netra roga nidana according to various Acharya 328. Showing the Netra roga nidana according to various commentators 339. Showing the lakshana of netra roga based on dosha predominance 3510. Showing the dosha predominace in lakshanas of CVS 3611. Netra Roga dosha predominant Lakshana in comparision to CVS 3612. Showing the comparision of CVS with various netra roga in Ayurveda 4013. Showing the pathya in netra roga 4414. Showing the apathya in netra roga 4515. Showing the rasa panchaka of drug 5316. Distribution of patients according to Age group 7617. Distribution of patients according to Sex 7618. Distribution of patients according to Occupation 7719. Distribution of patients according to Education 7720. Distribution of patients according to Marital status 7721. Distribution of patients according Socio Economic status 7722. Distribution of patients according to Religion 7823. Distribution of patients according to Locality 7824. Distribution of patients according to Diet 7825. Distribution of patients according to Diet pattern 7926. Distribution of patients according to Rasa Sevana 7927. Distribution of patients according to Sleep 7928. Distribution of patients according to Duty 8029. Distribution of patients according to Addiction 8030. Distribution of patients according to TV watching 8031. Distribution of patients according to duration of occupation 81
  • 15. 32. Distribution of patients according to duration of working hours 8233. Distribution of patients according to working hours in a week 8234. Distribution of patients according to prakruthi 8335. Distribution of patients according to sara 8336. Distribution of patients according to samhanana 8337. Distribution of patients according to pramana 8438. Distribution of patients according to satmya 8439. Distribution of patients according to satwa 8440. Distribution of patients according to agni 8441. Distribution of patients according to vyayama shakthi 8542. Distribution of patients according to desha 8543. Distribution of patients according to chief complaints 8544. Assessment of chief complaints before treatment 8645. Showing the result on Schirmers test-I 9746. Showing the result on Distant Vision 9747. Showing the result on Near Vision 9848. Showing the result on Dry & irritated eyes 9949. Showing the result on Rednes of eyes 9950. Showing the result on tearing eyes 10051. Showing the result on Headache 10152. Showing the result on Burning eyes 10153. Showing the result on Blurred Vision 10254. Showing the result on Photophobia 10355. Showing the result on Contact lens discomfort 10356. Showing the result on Slowness in focusing 10457. Showing the result on Changes is colour perception 10558. Showing the result on Pain in Shoulder 10559. Showing the result on Pain in Neck 10560. Showing the result on Pain in back 10661. The response of the therapy for individual symptoms after treatment 10762. The response of the therapy for individual symptoms after follow up 10863. Statistical analysis of Whole treatment results 109
  • 16. LIST OF CHARTSSl.No. Table Name Page No1. Showing the classification of Hetu 82. Showing the classification of kala 83. Showing the physiology of vision (netra roopa grahana) 224. Showing the samprapthi of Netra roga 385. Showing the Netra roga samanya chikitsa 43LIST OF PHOTOGRAPHSSl.No Particulars Page No1 Showing the Raw Drugs in Triphala Yashtimadu Yoga 542 Showing the Prepared Medicine 553 Showing the Schirmers Test Strips 714 Showing the Schirmers Test Procedure 71LIST OF GRAPHSSl.No. Particulars Page No1. Distribution of Patients According to Age 882. Distribution of Patients According to Sex 883. Distribution of Patients According to Occcupation 894. Distribution of Patients According to Educational Status 895. Distribution of Patients According to Marital Status 906. Distribution of Patients According to Socio Economic Status 907. Distribution of Patients According to Religion 918. Distribution of Patients According to Locality 919. Distribution of Patients According to Diet 9210. Distribution of Patients According to Diet Pattern 9211. Distribution of Patients According to Rasa sevana 9312. Distribution of Patients According to Nidra 9313. Distribution of Patients According to Duty 9414. Distribution of Patients According to Vyasana 9415. Distribution of Patients According to Work duration 95
  • 17. 16. Distribution of Patients According to Agni 9517. Distribution of Patients According to Symptoms 9618. Drug effect on Schirmers test - I 11019. Drug effect on Dry Eyes 11020. Drug effect on Red Eyes 11121. Drug effect on Tearing Eyes 11122. Drug effect on Headache 11223. Drug effect on Burning Eyes 11224. Drug effect on Blurred Vision 11325. Drug effect on Photophobia 11326. Drug effect on all symptoms before after & follow up of trial 11427. Clinical improvement in Dry Eyes 11528. Clinical improvement in Red Eyes 11529. Clinical improvement in Tearing Eyes 11530. Clinical improvement in Headache 11631. Clinical improvement in Burning Eyes 11632. Clinical improvement in Blurred Vision 116
  • 18. Introduction1Ayurveda Siddhanta & Computer Vision SyndromeINTRODUCTIONAyurveda the science of "Ayu" – deals with maintenance of health and relieffrom the disease. This can be successfully achieved only when we follow the normslaid in Ayurveda. Apart from its rich and renounced heritage, Ayurveda has a rarecharm and glory of its own. As a great healer of the suffering mankind its contributionis eminent and unique.Ayurveda has put forward Siddhantas that are eternal and can be applied tounderstand the disease in all its aspects, in its diagnosis and treatment.TrisutraSiddhanta and Panchalakshana Siddhanta are a few among those Sidddhantas that aretime tested and can be applied to understand any disease irrespective of time.With the advent of time inevitable changes in food habits, life styles,occupational challenges and environment has lead to the manifestation of newdisorders. Computer Vision Syndrome is one among such disorders occurring incomputer professionals characterized by complex eye and vision problems related tonear work which are experienced during working with computers involving bothocular and non ocular symptoms. The catastrophic effects of this disorder are lowwork performance, agony, extreme discomfort that hampers daily routine. Negligencetowards it could cost ones career resulting in Physiopsychological upset and severeeye problems.The problem is grave according to American Optometric Association with anincidence in 75% -90% of employees working with Computers and more people arelikely to suffer in the future due to rapid growth of jobs in IT sector in India. So it isthe need of the hour to find a holistic solution to this problem.In the present context I have taken Computer Vision Syndrome and madeeffort to explain it on the basis of Ayurveda Siddhanta like Hetu,trividha hetu,panchlakshana nidana and the general line of management mentioned in Ayurveda samhitasfor aganthuja netra roga. So this study is intended to study and understand “ComputerVision Syndrome” a disorder not mentioned in Ayurvedic classics based on various
  • 19. Introduction2Ayurveda Siddhanta & Computer Vision SyndromeAyurveda Siddhanta and to find out a suitable Chikitsa Siddhanta based on the aboveobservations, from these prospects the present study has been taken.It also comprises of a clinical study to evaluate the efficacy of TriphalaYashtimadhu Yoga and its efficacy on symptoms with a time span of sixty days fortreatment and also its focus being on reliving of symptoms and management of thedisease.The first part is mainly concerned with the review of literature regardingvarious aspects of the disease such as, nirukti, bheda, paribhasha, Hetu, Trividha hetuand Nidana panchaka etc, are reviewed and elaborately discussed. The second partconsists of details of clinical trials of the effect of Triphala Yashtimadhu Yoga onComputer Vision Syndrome.It comprises of the materials and the methods used for the study, the resultsand the observations of the study and the discussion on them. A summary of the studyis provided in the last part of the dissertation with some suggestions for the futurestudies.The study has shown that Ayurveda has a significant role to play in themanagement of Computer Vision Syndrome.  
  • 20. Objective3Ayurveda Siddhanta & Computer Vision SyndromeOBJECTIVES OF THE STUDYThe present study was undertaken with the following objectives1. To understand Trividha hetu involved in causation of Computer Vision Syndrome.2. To understand the disease based on Pancha Lakshana Nidana.3. To make an analytical study on the role of Prakruthi, and occupational influence incausation of the disorder.4. To evaluate suitable Chikitsa based on the above observations.5. To evaluate the efficacy of TriphalaYasthimadhu yoga in patients of ComputerVision Syndrome clinically.
  • 21. Review of Literature4Ayurveda Siddhanta & Computer Vision SyndromeHETUAccording to Ayurveda a vyadhi is generally studied under the five mainheadings to understand the entire process of a disease manifestation. They are Nidana,Purvaroopa, Roopa, Upashaya and Samprapti respectively, also called as NidanaPanchaka1. Among these nidana panchaka ‘Hetu’ stands first and forms the base orroot cause for the latter stages viz, purvaroopa, roopa etc. A vyadhi is never devoid ofits hetu. Even the Karyakarana sidhantha confirms that a karya / vyadhi are not devoidof its karana / hetu2. Further it can be said that a wise treatment begins with nidanaparivarjana as told by Acharya Sushruta i.e., “Nidanaparivarjanameva chikitsa”. Thushetu plays a chief role in roga nidana and its chikitsa also.DerivationThis is a “pumling” word3Hetu = hi gatou (dhatu) 4+ Tuna pratyayaHi- to send forth, to impel, to promoteHi- hinoti, hita1. Hinoti vyapnoti karyam iti 5Hinothi- To promote furtherVyapnothi- pervading, penetrating, to spread throughoutThe word meaning of hetu is that which promotes and spreads the karya and is akarana.2. Pum hi tanu kaarane anumithi sadhane vyape phale chaIt is the pumlinga shabda with synonyms like karana, anumiti, sadhana, vyape, phale.Definition1. Seti kartavyatako rogotpaadaka heturnidaanam6The factor which causes rogotpatti by vitiating the dosha is called nidaana2. Tatra nidaanam kaaranam7Etiological factor or causative factor3. Vyadhi utpattti hetuhu nidaanamThe factor which is responsible for the disease causation or manifestation.4. Tatra hetuhu utpattikaaranamHetu is a causative factor (karana) for vyadhi.
  • 22. Review of Literature5Ayurveda Siddhanta & Computer Vision Syndrome5. Hetus tad udbhave 8Hetu is that which gives rise to disease*In all the above context hetu = nidanam, hetu and nidanam are used as samanarthaHISTORICAL REVIEW OF HETUA) Veda kalaRogotpadaka karanas are shareeragata mala roopavisha, krimi, vata, pitta and kapha.9B) MahabharataSheeta, Ushna, and Vayu are the cause for shareerika vyadhis is found in Shantiparva16thadhyaya.C) Samhita kalaa. Brihat Trayee1. Charaka Samhita: Acharya Charaka has explained hetu in sutra sthana 1st, 11th,25th, and 28thchapter. In nidana sthana 1stchapter and in shareera sthana1st& 2ndchapter and in vimana sthana 6thchapter.2. Sushruta Samhita: Acharya Sushruta has explained hetu in sutrasthana 3rdhapter,explained it as an ‘upaya’ and karaka hetu.3. Asthang Hrudaya: Acharya Vagbhata has explained hetu in sutrasrhana 1stchapterand also under nidanapanchaka in nidanasthana 1stchapter.b. Laghu Trayee1 Madhava nidana explained in 1stchapter about hetu.2 Bhavaprakasha: Bhavamishra mentioned and described hetu in Rogaprateekaraprakarana the 7thchapter of poorvakhanda.c. Other classical texts1 Astanga Sangraha: Acharya Vagbhata described hetu in sutrasthana 1st, 22ndchapter and under nidana panchaka in nidana sthana 1stchapter.2 Yogaratnakara: Has explained that kupita malas are the nidana for all the diseases.Kupitamala here means vata, pitta and kapha.3 Gadanigraha: Gadanigrahakara explained hetu under rogagnana sadhana injwaradhikara.
  • 23. Review of Literature6Ayurveda Siddhanta & Computer Vision Syndromed.Recent Ayurvedic literature1. Nidanachikitsa hastamalaka: Vd Ranajit rai desai expalained hetu under nidanapanchaka.2. Doctrines of pathology in Ayurveda: Dr K.R.Srikantha Murthy described hetu in9thchapter3. Ayurveda Vikriti Vignaan: Vd Vidyadhar shukla explained hetu in 20thchapterunder nidana panchaka.Table No.1 Synonyms of Hetu as per Sanskrit textsTypes of hetu AK VK RN MK VSS1. Hetu  - - - -2. Karana  - -  3. Nidana  - - - -4. Aadikarana  - - - -5. Anumiti - - - - 6. Sadhana - - - - 7. Vyape - - - - 8. Phale - - - - 9. Roganirnaya -  - - -10. Beejam  - - - -11. Roga Hetu - -  - -Synonyms of HetuVarious synonyms as per different classics are as follows. All of them give commonmeaning as hetu karana10Table No.2 Synonyms of Hetu as per Ayurveda SamhitaSl.no CS11Ckp12AS AH13MN14BP151 Hetu      2 Nimitta      3 Aayatana      4 Karta    - - -5 Karana      6 Pratyaya      
  • 24. Review of Literature7Ayurveda Siddhanta & Computer Vision Syndrome7 Samutthana    - - -8 Utthana - -  - - -9 Nidana   - - - 10 Yoni -   - - -11 Mukha -  - - - -12 Mula -   - - 13 Karaka - -  - - -14 Prerana -  - - - -15 Prakruthi -  - - - -16 Nibandha - - - - - Types of HetuAccording to Madukosha tika 16the hetu’s are broadly classified according to theirrole in causation of a disease.A) Dvividha hetu:1) a) Bahya b) Abhyantara2) a) Utapadaka b) VyanjakaB) Trividha hetu: 1. a) Asatmendriyartha Samyoga b) Prajnaparadhac) Parinaama.2. a) Dosha hetu b) Vyadhi hetu c) Ubhaya hetu.C) Chathurvidha hetu: a) Sannikrishta b) Viprakrusta c) Vyabhicharid) Pradhanika
  • 25. Review of Literature8Ayurveda Siddhanta & Computer Vision SyndromeAti.Y Ayo Mit.yImportance of HetuThe Ttrisutra of Ayurveda explained in Charaka Samhita states that theknowledge of hetu, linga, aushadha is applicable to both swastha and atura. Hetu isconsidered the first among trisutra, also denoting its importance as karana for rogaand arogya. Kala, artha and karma are 3 types of hetu and its tri vikalpa i.e., atiyoga1. Sannikrishta, 2. Viprakrishta 3. Vyabhichari 4. PradhanikaHetu1.Astamendriyarthasamyoga2. Prajnaparadha3. ParinaamaDosha HetuVyadhi HetuUbhaya HetuDhiDhrtiSmrtiVibhramsha1. Bahya Hetu 2.Abhyantara Hetu 1. Vyanjaka 2. UtpadakaHetuSparsTwakhaSamavayiDushyaAsamavayiDosha dushya sammurchana(dhatu & mala)NimittaMithyahara viharaParinama (kala)Prajnaparadha (Karma)Asatmendiyartha Samyoga (Artha)GandhaGhranaRasaJihwaRupaChaksuSabdaSrotraAti.y Ayo Mith.ManasikaVachikaKayikaAti.y Ayo Mith.y Ati.y Ayo Mith.y Ati.y Ayo Mith.y
  • 26. Review of Literature9Ayurveda Siddhanta & Computer Vision Syndromeayoga and mithyayoga are the cause for diseases and their samyagyoga (of indriyarthaprajna, and parinama) is the cause for health. So it can be understood that Roga Hetuare Atiyoga, Ayoga and Mithyayoga of Kala,Artha,Karma and Arogya Hetu aresamyagyoga of Kala,Artha,Karma.Utility of HetuHetu is helpful in knowing1. Vyadhi karana:Hetu is karana for vyadhi. So by knowing the hetu involved the vyadhi Karanaand its severity is known.2. Vyadhi vinischaya:If there is any doubt regarding the diagnosis of a disease, observation of theetiological factors leads to the confirmation of vyadhi.3. Sadhya asadhyata:Hetu is very helpful to decide the sadhyasadhyata of a vyadhi. Alpa hetu causesalpa Lakshana in a vyadhi and its sukhasaadhya lakshana.4. Upashaya anupashaya:Upashaya is opposite to hetu and anupashaya is similar to hetu.5. Chikitsa:Nidana is a synonym for hetu and nidana parivarjana is a type of chikitsa.MODERN REVIEWEtiology or Cause18Hetu word is synonymous to etiology in modern medical literature.DerivationEti-ol-o-gy or Aeti-olo-gy,Aitia - a charge, accusation, causeLogos (logy) – word of speech, treatise, discourseAitia + logos = the doctrine of causes,So the word meaning of etiology can be derived asThe discourse about the cause of a disease
  • 27. Review of Literature10Ayurveda Siddhanta & Computer Vision SyndromeDefinitionThe study of causes specifically the cause of disease 19orThe science dealing with causes of disease 20.In modern terms there are two major classes of etiological factors1. Intrinsic or genetic2. Acquired (infectious, chemical, nutritional, physical)Knowledge or discovery of the primary cause remains the backbone on which thediagnosis can be made, a disease understood or a treatment adopted.The four aspects of a disease process that form the core of pathology are1. Etiology- cause2. Pathogenesis- the mechanism of its development.3. Morphology- the structural alterations/changes induced in cells and organs of thebody.4. Symptoms/Clinical manifestations - the functional consequences of morphologicchanges.In Ayurveda a disease is studied under 5 stages (Nidana panchaka) and inmodern it is studied in 4 stages. In both these medical systems etology/hetu is the firstand foremost factor which denotes the cause / causative factor of a disease.
  • 28. Review of Literature11Ayurveda Siddhanta & Computer Vision SyndromeTRIVIDHA HETUINTRODUCTIONIn Ayurvedic classics it’s often stressed that trividha hetu namelyAsatmendriyartha samyoga, Prajnaparadha and Parinaama are the prime cause in thedisease origin especially of shareerika and manasika21. Though varieties of hetuclassification have been made like dvividha, trividha, chaturvidha etc but all thesehetus can be incorporated under single heading as trividha hetu. Among these trividhahetu again we can find the specific role of single hetu in different diseases, eg-Asatmendriyartha samyoga, plays an important role in indriyajanya vyadhis22.Thustrividha hetu occupy a broader place in the field of hetu.DefinitionThe hinayoga atiyoga and mithyayoga of artha, karma and kala is termed as treeniaayatanani or trividha hetu23.TypesAsatmendriyartha samyoga, prajnaparadha and parinaama are of three type’s each24HISTORICAL REVIEW OF TRIVIDHA HETUUpanishadIn Shwetashwaropnishad ‘Kaalo hi naama sarva bhutanaam aviparitanaama hetu’ ismentioned.BhagavadgeetaIn 2ndchapter indriya nigraha as the cause for sukha has been menSamhita kaalaa. Brihat TrayeeCharaka samhita1st, 11th, 20th, 25th, 28thchapters in sutrasthana. 1stchapter in nidanasthana. 1stand 2ndchapter in shareersthana explains about trividha hetu.Sushruta samhitaAcharya Sushruta has explained Asatmendriyartha samyoga, andPrajnaparadha as hetu in 61stchapter of uttaratantra, mithyayoga, ayoga and atiyogaof artha, karma as apasmara hetu and also explanation of kala is available insutrasthana 6thchapter.
  • 29. Review of Literature12Ayurveda Siddhanta & Computer Vision SyndromeAstanga SangrahaVagbhata sutrasthana explains trividha hetu in 1st, 22ndchapters and in 1stchapter of nidanasthana.Astanga Hrudaya1stand 12ndchapter of sutrasthana, and under nidanapanchaka in nidanasthana.LaghutrayeeMadhava Nidana-1stchapter explains about trividha hetud. Recent Ayurvedic literature1. Nidanachikitsa hastamalaka: Vd Ranajit rai desai expalained hetu under nidanapanchaka.2. Doctrines of pathology in Ayurveda: Dr K.R.Srikantha Murthy described hetu in9thchapter3. Ayurveda Vikriti Vignaan: Vd Vidyadhar shukla explained hetu in 20thchapterunder nidana panchaka.Trividha Hetu Importance1. For all sorts of vedana the trividha hetu in the form of dhi, dhriti and smritivibhramsha, karma, kaala samprapti and asatmendriyartha samyoga are maincauses.252. The mithyayoga, ayoga and atiyoga of Kaala (parinaama varshadi ritu), Buddhi(prajna), Indriyartha (shabda, sparshadi, bhogya dravya guna karma) are the maincause in all type of shareerika and manasika vikaras26.3. This is again strengthened by charaka in sutrasthana stating them as ‘treeniaayatanani’ & ‘nidanatrayi’ respectively27.4. It is further declared by charaka in shareera sthana, that it is trividha hetu only viz(Astmendriyartha adi….) as main cause in the disease origin28.ASATMENDRIAYRTHA SAMYOGAIntroductionThe literal meaning of Asatmendriyartha is a state unfavourable for the indriyawith their vishaya. The word indriyartha is applied for jnanendriya only which are
  • 30. Review of Literature13Ayurveda Siddhanta & Computer Vision Syndromefive in number viz (Shabda, Sparshadi, etc).The hina yoga, atiyoga and mithya yogaof indriyas with their respective vishyas create unfavourable situation specifically toindriyas and thereby to the body causing a disease. Among trividha hetu’s it is thenearest or immmediate cause in the disease manifestation.AsatmyaDerivation‘Asatmya’ word is formed by derived by adding two upasarga A+SA to Atma shabdathen the word Asatmya is formed. A+sa+atma = asatmyaDefinitionAsatmya – Those vishaya of indriya creating unfavorable state for body and mind29IndriyaDerivationIndriya- derived from ‘Ida’ dhatu and ‘gha’ pratyaya meaning it is the ruler of the body.DefinitionPrana is termed as Indra and its linga is indriya. So, that which gives sensoryknowledge is called indriya.ArthaVishaya or knowledge attained through a particular indriya is called artha. Indriyavishyas viz shabda, sparsha roopa rasa adi are the indriyarthas of shrotrendriya,Sparshendriya etcSamyogaDerivationIt is derived from adding Sama (upasarga) + yuj (dhatu) + gha (pratyaya)DefinitionSamyogam nama dwayorbahoonaam vaa dravyanam samhatee bhavaha. Combinationof two or more dravyas is called Samyoga.TypesDepending upon the indriya, its indriyartha and its hina, ati or mithya yoga theasatmendriyartha samyoga is classified as follows30
  • 31. Review of Literature14Ayurveda Siddhanta & Computer Vision SyndromeTable No.3 Asatmendriyartha Samyoga of GnanendriyaIndriya IndriyaArthamAtiyoga Ayoga MithyayogaKarna ShravanamAtiShravanamAshravanam Uccha,parusha,bhishanadishravanamTwak SparshanamAtiSparshanamAsparshanam Abhighata,visha,vaatadisparshanamChakshu DarshanamAtiDarshanamAdarshanam Sookshma,atidoora,bhaswadarshanamNasa Ghranam Ati Ghranam Aghranam Putya,medhyati,teekshna,ugra,ghranamJihwa Rasanam Ati Rasanam Arasanam Apathy,vishama,arasagrahanamPARINAAMAIntroductionParinaama in general means avastha or parivartana brought by the influence ofkala. Acharya charaka had used tha word ‘kaala’ for parinaama31.since ati, hina andmithya yoga of kaala brings dosha vitiation in the shareera and causes vyadhi. Inayurveda kaala is also given importance and its explaination is found in many placesin classics.DerivationIt is derived from ‘pari’ upasarga, ‘nama’ shabda and ‘ghama’ pratyaya.Meaning of which is transformation32KaalaKa + Aa+ La = KaalaThe lakaar and akaar of kaala shabda and lakaar of lee dhatu when unites thekaala shabda occurs.Similarly, the one which destroys the entire things of the worldand assemble them together and also brings all the karya dravya to their destruction.Definition‘Sa sookshmamapi kalaam na leeyate iti’That which does not stay even for the fraction of second and is gatisheela iscalled kaala33
  • 32. Review of Literature15Ayurveda Siddhanta & Computer Vision SyndromeTypesThough variety of classification of kaala is elaborately explained by ouracharyas 34but for the vyadhi utapatti and chikitsa purpose the entire kaala is dividedinto four in one samvtsara and again in the trividha kaala namely sheeta, ushna andvarsha are the main under which the remaining kaala is to be considered and treatmentcan be carried based on this kaala only35.Kaala ChartImportance of Parinaama1. The hina, ati or mithya yoga of any of the seasonal variation becomes a cause forvyadhi utapatti36.2. Parinaama is also understood as ‘kaala’ and since kaala is transforming the resultsof shubha ashubha karma, dharma and adharma etc.,37KaalaSamvatsara1. Visarga2. AdanaTrividha Shadvidha Dvadashavidha1. Sheeta2. Ushna3. Varsha1. Sishira2. Vasanta3. Grishma4. Varsha5. Sharat6. Hemanta1. Magha2. Phalguna3. Chaitra4. Vaishakha5. Jyesta6. Aashada7. Shravana8. Bhadrapada9. Ashwaija10. Kartika11. Margasirsha12. PushyaDvividha
  • 33. Review of Literature16Ayurveda Siddhanta & Computer Vision Syndrome3. The kaalaja rogas are powerful in their respective kaala and hence their treatmentshould be done in advance to subdue their effect38.4. For the kaalaja swabhavika rogas like jara, mrityu, there is no treatment i.e.akalajanya jaradi conditions are treatable39.PRAJNAPARADHAIntroductionThe very literal meaning of prajna is consciousness. It is one of theimportant hetu among trividha hetu. Some commentators limit the meaning of prajnato intellect, however the definition of prajnaparadha stating as the error of dhi, dhruti,and smriti resulting ashubha karma of kaya, vacha and mana surpasses this limitationof merely intellectual error40. The word ‘karma’ is used for prajnaparadha. The wordkarma has a very wide meaning indicating the karma of kaya, vacha and manasa aswell as purvajanmakrita and sadyojanmakrita too. The word ashubha karma in thedefinition states that disturbed state of dhi, dhriti, and smriti respectively. The hina, atiand mithya yoga of such karma causes vyadhi utapatti. Thus prajnaparadha occupiesan important place in trividha hetu.DerivationIt is derived from jna (mulashabda) – jnayate iti shabda, ‘pra’ upasrga, jnayate itiartha i.e, prajna and its aparadha forming prajnaparadha41.The word prajnaparadha is a karmadhari samasa composed of two words – Prajna –To know/ understand (especially a way or mode of buddhi)Aparadha – An offencePrajnaIt is a streelinga shabda representing buddhi tattva of saraswati devi.AparadhaIt is a pumlinga shabda derived from ‘apa’ and’ radha’ dhatu..DefinitionThe ashubha karma brought about by kaya, vacha and manas in the disturbedstate of dhi, dhriti and smriti is said or defined as prajnaparadha.TypesAs per the definition it is classified into 3 types viz kayika, vachika andmanasika with again its three subtypes as hina, ati and mithyayoga respectively.
  • 34. Review of Literature17Ayurveda Siddhanta & Computer Vision SyndromePrajnaparadha as major cause for diseasesIt is stated in the classics that the rogotapatti of jwaradi rogas (viz. jwara,raktapitta, gulmadi…etc) are started because of dharma hrasa or adharma in dwapaarayuga. Along with it there is decline in the quality of sasya also.42The factors like lobha, abhidroha and kopa are included under adharma injanapadodhwansa adhyaya. It is mentioned in classics that for vatadi dusti andadharma the prajnaparadha is the moola yoni or karana43. This clearly indicates that, itis the prajnaparadha only in the form of adharma as the root cause in the jwaradirogas.In the manifestation of almost all the disease the trividha hetu vizasatmendriyarthadi always exists. However, prajnaparadha is the prime root in all thedisease maniefestation accompanied with asatmendriyartha samyoga and kaala. Thiscan be understood by nidanokta samprapti of diseases, which will reveal the fact thatall the diseases are caused by the stimuli of prajnaparadha associated withasatmendriyartha samyoga and parinaama.
  • 35. Review of Literature18Ayurveda Siddhanta & Computer Vision SyndromeNETRA SHAREERAImportance of EyesOne need not emphasize the importance of the eyes as scriptures say‘Sarvendriyanaam Nayanam Pradhaanam’ “nothing in this world is as good andperfect as, unaided vision”. Eyes were greatly valued by ancient Indians and muchimportance was accorded to their protection and care.Historical reviewThe description of eye can be traced in Vedic litrature.The divine Vaidyas,Ashwini used to perform ophthalmic operations with the knowledge of anatomy. TheBrhadāranyaka Upanishad narrates about Akşhi. Chakshushopanishat is also devotedto eye care.The Uttara Tantra of sushruta samhita gives a vivid description of the eye, itsanatomical description, along with classification of its diseases and their managementis explained in detail44.Synonyms of eyeAkşi, Cakşu, Dŗşţi, Netra, Nayana and Lochana are the different synonymsused in Ayurveda Samhitas. The synonyms related to the organ of sight are Akshi,Netra, Nayana, and Lochana these words are used in anatomical sense and Netra is awidely used word for the organ of sight45-.Panchabhautika concept of NetraThe Netra, like all other organs of the body is made up of Panchamahabhutasand drushti is pancha maha bhuta prasasda bhaga.Sushruta has clearly mentioned thecontribution of Panchamahabhutas as follows46Table No 4. Panchamahabhoota dominant parts in netraMahabhoota PartPrithvi Mamsabhaga (muscular portion)Jala Shweta bhaga (white portion)Tejas (Agni) Rakta bhaga (red portion)Vayu Krishna bhaga (black portion)Akasha Ashru marga/ Srotas (tear channels)
  • 36. Review of Literature19Ayurveda Siddhanta & Computer Vision SyndromeNetra Rachana47Situation: Siras is the uttamanga of the body. All the senses are situated in it andsupported by the head. Netra are the two among the seven external openings of theShirasShape: Acharya Sushruta in Sushruta Samhita Uttartantra has described Netra as“Suvrittam, Gostanakaram Nayana Budbudam”, which denotes the shape andconsistency of the Netra.Size: The measurements of the eyeball was described by Sushruta as 2 AngulaBahulya (anterio posteriorly) or equal to central part of ones own thumb(swangushtodara sammitam) and 2½ Angula Sarvata sardham (circumference).Parts of NetraThe anatomical parts present in eye consists of 5 Mandala, 6 Sandhi and 6Patala.The same division was adopted by Vagbhatta, Madhavakara and Bhavamishraalso.MandalaThe word Mandala is made from root ‘Mad’ + ‘Klach’ pratyaya means,covering circular areas or concentric circles. The are 5 Mandala1) Pakshma Mandala2) Vartma Mandala3) Shweta Mandala4) Krishna Mandala5) Drishti MandalaSandhiSandhis are the junctional areas between two Mandalas. The Sandhis areimportant as far as the pathogenesis of the diseases is concerned, because the diseases,of one Mandala may spread to another through these junctional areas. They are1. Pakshma – Vartma gata Sandhi2. Vartma – Shukla gata Sandhi3. Shukla – Krishna gata Sandhi4. Krishna – Drishti gata Sandhi
  • 37. Review of Literature20Ayurveda Siddhanta & Computer Vision Syndrome5. Apanga Sandhi6. Kaneenika SandhiPatalaV.S. Apte, in his Sanskrit – English dictionary describes the meaning of Patalaas a film or coating over the eyes. According to Monier Williams, it can be consideredas a layer of the eyeball.The thickness of each Patala is 1/5th of the Drishti Mandala.There are 2Vartma Patalas and 4 Akshi Patalas. The Vartma Patalas can be considered as thelayers of the Vartma – the eyelids and palpebral conjunctivaThe four Akshi Patalas are related to the eyeball itself. 1st Patala Tejas + Jala,2nd Patala Mamsa (Pisita or Mamsashrita), 3rd Patala Medas Medoashrita, 4th PatalaAsthi –Asthyashrita.Akshi BandhanaSirā, Kandarā, Meda and Kālakāsthi aid in maintaining the position of netra.Sira & DhamaniThere are 38 Sirā which transport Vāta (8), Pitta (10), Kapha (10) and Rakta(10) in the Netra. Vāgbhata has mentioned 65 Sirā in the Netra the two Dhamani arein each eye for transmission of Roopa (visual impulses) to the mind and otherdhamani are for ashru vahana.Peshi and snayuMandala (circular) type of Peshi and Pruthu (broad) type of Snayu are found inthe eyes. They are respectively two and thirty in number.Asthi and sandhiNetra are situated in Akshi kosha surrounded by TarunasthiMarma‘Apānga’ a Sira Marma and ‘Avarta’ a Sandhi Marma are related with Netra.Any injury to these sites may result in loss or impairment of vision.
  • 38. Review of Literature21Ayurveda Siddhanta & Computer Vision SyndromeDescription of DrishtiEtymologyDrish + ‘Ktin Karane’ pratyaya meaning there by a “tool to see”Drishti is described by Sushruta as: Masura dala matra (size of a Masura dala) Prasada of Panchamahaboota Covered by the external Patala Khadyotavisphulingabha (Sparkling like a glow worm) Shape resembles a hole (Vivirakritim) Benefited with cold thingsDrishti means vision. All the anatomical structures through which light passes toreach the retina including the optical zone of cornea, aqueous humour, lens, vitreoushumour and retina can be included in the Drishti as per many scholars.CONCEPT OF DRISHTI IN AYURVEDAVisual perception, like all other sensory phenomena, is dependent upon thestate of mind and soul. Acharya Charaka has described this process as the conjunctureof soul, mind and the sense organ with their objects. Kashyapa classifies senses intoSannikrishta Indriyas and Viprakrishta Indriyas. Eyes and ears are ViprakrishtaIndriyas, where in object need not directly fall on the senses. Eyes are developed withsufficient skills to perceive the object from a sufficiently large distance.The theory of Panchapanchaka given by Acharya Charaka depicts thephenomenon of sensory perception by enumerating the five important factors that takepart in this process. They are Indriya, Indriya Dravya, Indriya Artha, IndriyaAdhisthana and Indriya Buddhi. In case of eye, these factors are as followsTable No.5. Indriya panchapanchaka of netraIndriya ChakshuIndriya Dravya TejasIndriya Artha RupaIndriya Adhishthana Eyes (2 Netra)Indriya Buddhi Chakshurbuddhi
  • 39. Review of Literature22Ayurveda Siddhanta & Computer Vision SyndromeImpulses from both these Akshis are collected at Chakshu47(Indriya), which isonly one in number. Further it will be analyzed at the level of Chakshurbuddhi(Indriya Buddhi) to give actual knowledge of the objects.The subtypes of Doshas likePrana Vayu and Vyana Vayu are specifically held responsible for Vata Karmas,Alochaka Pitta for Darshana and Tarpaka Kapha for Akshi Tarpana.Eyes are most important among the five Jnanendriyas. So its function can beconsidered as the function of Jnanendriya. The physiology of vision can besummarized as followsIndriyartha (Object)VataIndriyavayavaChakshurvaisheshikaAlochaka PittaIndriya Samvedaka (nerve impulse)Prana VayuBuddhi (occipital cortex)BuddhirvaisheshikaAlochaka PittaPratyakshajnana(Atma – seat of knowledge)Similar ideas are reflected in the description of two phases of Chakshurbuddhi48. Themomentary knowledge is obtained by Kshanika Chakshurbuddhi, which will befurther confirmed in the second stage by Nischayatmika Chakshurbuddhi, accordingto Chakrapanidatta.
  • 40. Review of Literature23Ayurveda Siddhanta & Computer Vision SyndromeANATOMY OF EYEIntroductionEven though the eye is small, it serves a very important function i.e. sense ofsight. Vision is arguably the most useful of the five senses and is one of the primarymeans to gather information from the surroundings. Eye is often compared to acamera. Two eye balls are situated in the two bony orbits of the norma-frontallis ofthe skull49and protected by eye lids and eye lashes. Each eye ball is a cystic structurekept distended by the pressure inside it. Each of them gathers light and thentransforms that light into a “picture”.Dimensions of an adult eye ballAntero-posterior diameter 24mmLateral diameter 23.5mmVertical diameter 23mmCircumference 75mmVolume 6.5mlWeight 7gmsCoats of the eye ballThe eye ball comprises of three coats1) The outer fibrous tunic = sclera and cornea2) The middle vascular tunic = iris, ciliary body and choroids3) The inner nervous tunic = retinaInterior of the eyeball has the following structures1) Aqueous humor2) Lens3) VitreousThe accessory structures are1) Eyebrows2) Eyelids and eyelashes3) Lacrimal apparatus
  • 41. Review of Literature24Ayurveda Siddhanta & Computer Vision SyndromeScleraThe sclera forms posterior 5/6 of the eye ball. It has received its name from itsextreme dense fibrous tissue which is hard and maintains the shape of eyeball. Itsexternal surface is white in colour.CorneaThe cornea is a transparent anterior one-sixth of the fibrous coat of the eyeball.It is almost circular in outline.It is convex anteriorly and projects like a dome in frontof the sclera. The cornea is dense and of uniform in thickness throughout; its posteriorsurface is perfectly circular in outline, and exceeds the anterior surface slightly indiameter. its separated from iris by the aqueous humour in the anterior chamber.IrisThe iris has received its name from its various colors in different individuals.It is a thin, circular, contractile disk, suspended in the aqueous humor between thecornea and lens, and perforated a little to the nasal side of its center by a circularaperture, the pupil. On its periphery it is continuous with the ciliary body, and is alsoconnected with the posterior elastic lamina of the cornea by means of the pectinateligament; its surfaces are flattened, and look forward and backward, the anteriortoward the cornea, the posterior toward the ciliary processes and lens. The iris dividesthe space between the lens and the cornea into an anterior and a posterior chamber.RetinaThe Retina is soft, semitransparent, having a purple tint in the fresh state,owing to the presence of a coloring material named rhodopsin or visual purple; but itsoon becomes clouded, opaque, and bleached when exposed to sunlight. Exactly inthe center of the posterior part of the retina, corresponding to the axis of the eye, is anoval yellowish area, the macula lutea; in the macula is a central depression in thefovea centralis. At the fovea centralis the retina is exceedingly thin, and the dark colorof the choroid is distinctly seen through it. About 3 mm to the nasal side of the maculalutea is the entrance of the optic nerve (optic disk), the circumference of which isslightly raised to form an eminence (colliculus nervi optici) the arteria centralis retinæpierces the center of the disk.
  • 42. Review of Literature25Ayurveda Siddhanta & Computer Vision SyndromeThis is the only part of the surface of the retina which is insensitive to light, and it istermed the blind spot.Aqueous humorThe aqueous humor fills the anterior and posterior chambers of the eyeball. Itis small in quantity, has an alkaline reaction, and consists mainly of water, less thanone fiftieth of its weight being solid matter, chiefly chloride of sodium.Crystalline lensThe lens is made up of soft cortical substance and a firm, central part, thenucleus.The crystalline lens, enclosed in its capsule, is situated immediately behindthe iris, in front of the vitreous body, and encircled by the ciliary processes, whichslightly overlap its margin. The lens is a transparent, biconvex body, the convexity ofits anterior being less than that of its posterior surface.EyebrowsEye brows are two arched eminences of integument, which surmount theupper circumference of the orbits, and support numerous short, thick hairs, directedobliquely on the surface.EyelidsEyelids are two thin, movable folds, placed in front of the eye, protecting itfrom injury by their closure. The upper eyelid is the larger, and the more movable ofthe two, and is furnished with an elevator muscle, the Levator palpebrae superioris.EyelashesEyelashes are attached to the free edges of the eyelids; they are short, thick,curved hairs, arranged in a double or triple row: those of the upper eyelid, morenumerous and longer than those of the lower, curve upward; those of the lower eyelidcurve downward, so that they do not interlace in closing the lids.Lacrimal apparatusLacrimal apparatus consists of the lacrimal glands, which secretes the tearsand convey the fluid to the surface of the eye, and its excretory ducts, the lacrimal
  • 43. Review of Literature26Ayurveda Siddhanta & Computer Vision Syndromeducts, the lacrimal sac, and the nasolacrimal duct by which the fluid is conveyed intothe cavity of the nose.Physiology of visionIn some ways the eye is like a camera. Its optical elements focus the image ofobjects on a light sensitive film- the Retina, while ensuring the correct amount of lightmakes the proper exposure. In order to achieve clear vision, light reflected fromobjects within the visual field is focused to the retina of both eyes. The processesinvolved in producing a clear image are –a) Refraction of the light rays by the lens and camerab) Accommodation of the eyes to lightThe retina is the photosensitive part of the eye. The light sensitive cells are therods and cones. When light falls upon the retina, it acts as a stimulus to the rods andcones, which serve as the sensory nerves endings. An image focused on the retinastimulates photo receptors, which transduce the light stimulus into receptor potentialand pass the information on to bipolar cells. Bipolar cells, in turn communicateganglion cells, which project their axons to the lateral geniculate body of thethalamus. From the thalamus, fibers carrying visual nerve impulses extend to theprimary visual center in the occipital lobe.In the outer segment of the photoreceptors,the transduction of light into electrical signals takes place. The first step in thisprocess is absorption of light by rhodopsin/iodopsin (photopigments). These photopigments have two parts -i) A glycoprotein - Opsinii) Derivative of Vitamin A - RetinalVitamin A derivates are formed from the carotenoids. Photopigments arecoloured proteins in outer segment membranes that undergo structural changes uponlight absorption. They initiate the events that lead to production of a receptorpotential. The single type of photopigment in rods is called rhodopsin. A conecontains one of the three different kinds of photopigments, thus there are three typesof cones. Retinal is the light absorbing portion of all visual photopigments. In thehuman retina, there are four different opsins, one for each cone photopigment and onefor rhodopsin. Small variations in the amino acid sequences of the different opsinspermit the rods and cones to absorb different colours of incoming light. Rhodopsin
  • 44. Review of Literature27Ayurveda Siddhanta & Computer Vision Syndromeabsorbs blue to green light most effectively whereas the three cone photo pigmentsmost effectively absorb blue, green or yellow to red light. Retinal exists in two forms.a) Cis b) Trans.In darkness, it has a bent shape called cis – retinal. When it absorbs light itstraightens out to a shape called Trans-retinal forming Cis Trans Isomerisation cis toTran’s conversion is called isomerisation and it is the first step in transduction.Forming of a visual image begins with isomerisation of particular photopigments incertain rods and cones.After this process, several unstable substances form and disappear. In about a minute,transretinal completely separates from the opsin. In darkness, an enyme called retinalisomerase can reconvert Trans to cis – retinal, which then binds to opsin and reformsa functional photopigment. This is called regeneration.This process is contributed bylarge storage of vitamin A by pigment epithelium.
  • 45. Review of Literature28Ayurveda Siddhanta & Computer Vision SyndromeNETRA ROGAThe diseases occurring in various parts of the Netra are termed as Netra rogaHistorical review of netra roga1. Veda kaalaa) In Yajurveda Taittareeya sakha explanation of drushti prapti is mentioned50.b) In Atharvana veda explanation is available about Andhatwa nivarana andimportance of drushti.2. Upanishad & Purana kalaa) In Garuda purana explanation of netra roga is availableb) In Koushika sutra netra roga lakshana and chikitsa are explained.c) In Ramayana darkness in forest is denoted by thr word “timira” which is also anetra roga51.3. Darshana kaalaa) In vedantha darshana anitya type of netra drushti and timira are explained.b) In bouddha darshana symptoms of timira and other eye diseases are mentioned52.4. Samhita kaalaBruhatrayeea) Acharya charaka mentioned netra rogas in trimarmeeya chikitsa adhyaya ofchikitsa sthana.b) Acharya sushruta explained netra roga and their chikitsa in detail in uttaratantra.c) Acharya vagbhata explained netra roga and their chikitsa in detail in uttarasthana.Laghutrayeea) Madhavakara in Madhavanidana explained nidana and lakshana of netra rogas inNetraroganidana adhyaya.b) Bhavamishra in Bhavaprakasha explained netra roga and their chikitsa in detailunder Netrarogaadhikara.c) Sarangadhara explained netra roga and their chikitsa in detail in uttarakhanda.
  • 46. Review of Literature29Ayurveda Siddhanta & Computer Vision SyndromeOther classical textsa) Harita Samhita explained Netra roga and their chikitsa in netra roga chikitsaadhyaya.b) Yogaratnaka explained Netra roga and their Chikitsac) Chakradatta also explained Netra roga and their Chikitsa under chikitsaprakarana.Recent booksa) Dr Vishwanath Dwivedi in ‘Nimi tanthra’ book explained Netra roga and theirChikitsab) Dr Ravindra Chandra Choudary in ‘Shalakya Vignana’ text book explained Netraroga and their Chikitsac) Dr D.Lakshman Acharya in ‘Shalakya Tantra’ text book explained Netra roga andtheir Chikitsad) Dr P.K.Shantakumari in text book ‘Opthalmology in Ayurveda’ explained Netraroga and their ChikitsaClassification of Netra RogaAyurveda Samhitas have classified the diseases according to nature ofoccurrence and the site of occurrence. The netra roga also can be classified asfollowsNature of Occurrence531. Aadi Bala Pravrutta- Includes hereditary disorders acquired from mother andfather.2. Janma Bala Pravrutta- Includes Congenital abnormalities3. Dosha Bala Pravrutta- Eye Problems caused by Dosha vitiation.4. Sanghatha Bala Pravrutta. – Abhighata janya netra roga due to factors likebhoutikaabhighata,yantrika,abhighata,rasayanika,abhighata,keetanu,suryavalokana,agni,aatapa,atiyoga,ayoga and mithyayoga of drushti, seeing very bright light etc,.5. Kala Bala Pravrutta- Netra roga caused due to seasonal changes.6. Daiva Bala Pravrutta Netra roga caused due to natural calamities, accidents etc.7. Swabhava bala pravrutta – Netra roga due to Senile or age related changes.
  • 47. Review of Literature30Ayurveda Siddhanta & Computer Vision SyndromeTable No. 6 Netra Rogā according to different Āchārya 54-59Su.Sa AS AH MN YR BP SA KTSandhigata Rogās 09 09 09 09 09 09 09 09Varthmagata Rogās 21 24 24 21 21 21 24 27Śhuklagata Rogās 11 13 13 11 11 11 13 13Kŗişhņagata Rogās 04 05 05 04 04 04 05 06Sarvagata Rogās 17 16 16 17 17 17 16 16Pakşhmagata Rogās - - - 02 02 02 - -Dŗşhtigata rogās 12 27 27 12 12 12 27 25Bahyaja 02 - - 02 - 02 - -Total 76 94 94 78 78 78 94 96NIDANA OF NETRA ROGA60 -63After discussing the definition derivations and classification of the netra rogait is very essential to concentrate on etiological factors that are responsible for thecausation of the disease.Nidana is one of the five factors of diagnosis of any disease called as nidanapanchaka. It is the factor which is the cause of any diseases. It is also that factor whichdirects us towards a diagnosis of disease.Nidana is classified into different groups in Ayurvedic classics on differentbasis. Some of them are in relation to the time taken in causing a disease and some areon the basis of their diagnostic significance.In this chapter the causative factor ofnetra roga will be dealt for the study of netra roga process.Nidana is categorized broadly into two main divisions:1) General causative factor (samanya nidana)2) Specific causative factor (vishesha nidana)General etiological factors are responsible for the manifestation of all varietiesof where as the specific etiological factors are responsible for the specific variety ofnetra roga.The Nidana Panchaka consists of Nidana, Purvaroopa, Lakshana, Upashaya
  • 48. Review of Literature31Ayurveda Siddhanta & Computer Vision Syndromeand Samprapti which help to understand the disease in detail.The Nidana Panchaka ofNetra Roga is explained below.Acharya Charaka in sutrasthana 18 chapter Trishotheeya adhyaya says that it’snot necessary to name all the diseases and it’s not possible also to name them.anintelligent physician should diagonise the disease, basing on dosha because the sametridosha getting prakopa due to various factors gets lodged in various parts of shareeraand causes various diseases. Thus this Siddhanta of Acharya Charaka is valid inunderstanding new diseases like CVS which though not mentioned in AyurvedaSamhitas can be understood by applying panchlakshana nidana as follows.
  • 49. Review of Literature32Ayurveda Siddhanta & Computer Vision SyndromeTable No. 7 Netraroga NidanaNo Etiological factors of NetraRogaSu.Sa MN BP YR1. Ushna Abhitaptasya JalaPravesha   2. Doorekshana    3. Swapna Viparyaya    4. Prasakta Samrodana    5. Kopa    6. Shoka -   7. Klesha    8. Shiro Abhighata    9. Atimaithuna    10. Shukta Aranala    11. Amla    12. Kulattha    13. Masha Atinishevana    14. Vega vinigraha    15. Ati Swedana    16. Ati Dhooma Nishewana    17. Rajo nishevana    18. Chardi vighata    19. Vamanaatiyoga    20. Bhashpanigrahat    21. Sookshma nireekshanat    22. Ati vega yaanaat - -  -23. Rutu viparyaya -   24. Atidravapana -   25. Atimadyapana -   26. Upasarga   - 
  • 50. Review of Literature33Ayurveda Siddhanta & Computer Vision SyndromeAcharya Dalhana while commenting on uttaratanthra 19thchapter ‘Nayanabhighatapratishedha adhyaya’ has mentioned about Abhighata nidana causing netra roga byamoortha dravyas like vata,atapa,dhooma,raja,keeta, makshika, mashaka,“Ahita ashanaat, Bhrusha bhasva chala sookshma veekshanaatcha”.According to Acharya Nimi Nidana for netra roga are ahita aahara and visual contactwith excessively sparkling, fast moving and minute objects.Pujyapada Muni in Netra Prakashika gives the following nidanas wrong wayof oil bath -either in excess or less, witch craft, drug addiction, weight lifting ,staringat luminous objects like sun,jwala-nireekshana etc cause netra roga.Table No. 8 Netra roga Nidana according to CommentatorsCkp DalAvakshira shayya - +Shiro ucchitha - +Kshara sevana - +Darshana ayoga + +Darshana atiyoga + +Darshana mithya yoga + +Bhasavarna + +Upasarga - +Acharya Chakrapani73while commenting on Matrashitiya adhyaya of CharakaSamhita sutrasthana in the context of guru and laghu aahara and its relation to agnisays that “the eye is the seat of tejas. Perception of vision occurs due to the union ofthe eye with tejas. The same tejas if excess causes loss of vision or impairs thevision”.
  • 51. Review of Literature34Ayurveda Siddhanta & Computer Vision SyndromePOORVAROOPAThe feebly manifested symptoms which are produced during the processes ofsthana samshaya avastha of kriya kala in the manifestation of disease process areknown as poorva rupas65.Poorvaroopa are that group of signs and symptoms appearing in milder formand indicative of forth coming disease.The description of prodromal symptoms of netra roga was not given separatelyin all Ayurvedic texts but only Acharya Sushruta had mentioned them in uttaratanthra.Poorvaroopa of Netra roga are explained in general for all eye diseases and are asfollows. All these lakshana are alpa vyaktha in the poorva roopavastha of netra roga.So the general poorva rupas explained in the context of netra roga are considered here.1. Avila2. Samrambha3. Ashru4. Kandu5. Upadeha6. Guru7. Oosha8. Toda9. Ragayuktam10. Sashoolam vartma-kosheshu11. ShukapurnabhamAcharya Dalhana commenting on this state’s another version i.e.,kandupoornopadehavat (excess Itching) is present instead of ashrupoornopadehavat(excess lacrimation) and sa shoolam as ishat shoolam i.e., mild pain are present in thisstage. Purva roopa has not been specifically mentioned by Acharya Charaka andVagbhata and it is implied that the lakshnas in lesser intensity are to be considered aspoorva roopa of netra rogas.
  • 52. Review of Literature35Ayurveda Siddhanta & Computer Vision SyndromeROOPAThe stage of disease manifestation where the signs and symptoms areexhibited clearly is the vyakthavasta and such a group of clinical features is called asroopaor lakshana of the disease.This roopa can be very specific to a disease and indicative of the underlyingpathology. This can be subjective or objective however, it becomes the main aid indiagnosis due to clear cut manifestation of disease at this stage.Generally rupa are classified into samanya and vishista rupas. Under samanyaRoopa/Lakshanas the following Lakshanas can be considered based on doshapredominance according to Acharya Charaka66.Table No.9 Dosha predominant lakshana in netra rogaVata Pitta KaphaAlparaga Daha ShuklopadehaUpadeha Atiruja Bahu picchila ashruToda Raga GurutaBheda Peetopadeha KanduROOPA wsr TO CVSSigns and symptoms of Computer Vision Syndrome and the probable dosha vitiationinvolved in it is being considered based on the signs and symptoms as follows. Thesigns & symptoms of CVS can vary but mostly include Eye Irritation (Dry Eyes, Itchy Eyes, Irritated Eyes) Red Eyes Blurred Vision (Distance Or Near), Headaches Light Sensitivity, Double Vision Backache Neck Ache Muscle Fatigue
  • 53. Review of Literature36Ayurveda Siddhanta & Computer Vision Syndrome Eye Strain Difficulty Refocusing the Eyes.Table No.10 CVS symptoms and their dosha involvementThe lakshana of netra roga based on dosha predominance wsr to CVS is comparedhere.Table No.11 Netra Roga Lakshana in comparision to CVSVata Lakshana CVSAlparaga Redness Upadeha Excessive secretions of eye / stickiness Toda Mild pain (pricking) Bheda Tearing pain Pitta LakshanaSymptoms Ayurvedic terms Dosha vitiationDry and irritated eyes Visushka Netra /Rooksha NetraVataEye Strain Netra Klama VataBlurred vision Avila Darshanam PittaRed Eyes Netra Raaga PittaBurning Eyes Netra Daha PittaExcessive lacrimation Ashru Bahulata VataDouble vision Dwidha pashyati (Mithyadarshana)VataDifficulty in focusing Roopa darshana asahyata(heena tarpita lakshana)VataChange in colour perception Vikruta varna patavam Vata / PittaPhotophobia Prakasha Asahyatva Vata / PittaHeadache Sirashoola Vata/PittaPain in shoulder, neck and back. Greeva, Bahu ,Kati ShoolaVataContact lens discomfort --------------- -Slowness in changing focus Alpa kriya laghava ofnetraVata
  • 54. Review of Literature37Ayurveda Siddhanta & Computer Vision SyndromeDaha Burning sensation Atiruja Excessive pain Raga Redness Peetopadeha Yellow discoloration -Kapha LakshanaShuklopadeha White discoloration -Bahu picchila ashru Excess sticky secretions in eyes -Guruta Heaviness Kandu Itching UPASHAYAUpashaya-Anupashaya67The Ahara-Vihara-Aushadha, which helps to relieve disease symptoms, iscalled as Upashaya and that which cause aggravation of the symptoms is calledAnupashaya.In the context of netra roga direct reference is available about Upashaya& Anupashaya. Hence, all those factors mentioned under anupashaya along withapathyas and nidana can be considered as Anupashaya and in Upashaya those factorswhich relieve symptoms of Netra roga, can be included. Upashaya and Anupashayafor netra roga will be discussed in detail under netra roga pathyapathya and samanyachikitsa.SAMPARPTHIAfter discussing nidana it is very essential to consider samprapti of the diseaseproper. Samprapti is that, which explains disease process starting from dosha dusti,their spread and the manifestation of the disease. Thus complete knowledge ofsamprapti is very essential in planning the successful treatment.The samanyasamprapthi of netra roga according to various Acharyas is as follows.
  • 55. Review of Literature38Ayurveda Siddhanta & Computer Vision SyndromeCharaka68Charaka considers netraroga under trimarmeeya rogas and its samprapthi isexplained as the dusta vayu reaches the indriyas and manifests loss of function of thatsense organ (loss of vision if it’s the eye,etc) .In the same sloka he says that if dushtavayu gets inside the sira it manifests as mild pain, (mandaruk) oedema, (shofa) driesup, (Shusyathi) excessive pulsation, (Spandathe) loss of sensation, (supathata)constriction or decrease in size (tanvyo means thinning),dilatation or increase in size(mahatyo means to become bigger ) of the sira.Sushruta69The doshas are vitiated due to achakshushya nidana and enter the urdhwagatasiras, lodge in the various parts of the eye and manifest as netrarogas.Commenting onthe above Dalhana says "the siras referred here are the netragata siras, the termNetrabhaga means the different structures of the eye, and according to some it meansnetraraaji i.e., the capillaries supplying the eye.Vagbhata70The doshas getting vitiated by achakshushya nidana as mentioned in sarvaroganidana with predominance of pitta dosha enter the urdwagata siras, and lodging indifferent parts of the eye manifest the netrarogasIllustration Showing the Scheme of Samprapti in Netra RogaAchakshushya Nidana SevanaDosha Vruddhi and Dosha Dushti(Nidana sevana continued)Dosha prakopa with predominance of Vata and Pitta DoshaSpreading of dosha in the body through all sira and srotasEntry of doshas into Urdhwagata Sira
  • 56. Review of Literature39Ayurveda Siddhanta & Computer Vision SyndromeUrdhwagati of Prakupita Dosha through the Urdhwagata SiraSthana Samshraya of Prakupita Dosha in various parts of the NetraPoorvaroopa lakshanaManifestation of Netra RogaSamprapti Ghataka Dosha- Vata Pitta Pradhana Tri Dosha Dooshya- Rasa,Rakta,Mamsa,Medas Srotas- Netragata Sira Srotodusti- Sanga,Atipravrutti Udbhava sthana- Chakshu (Netra) Vyaktha sthana-Netra Sanchara sthana- Urdhwagata Sira Rogamarga- Madhyama Adhisthana- Chakshurendriya Swabhava- ChirakariVYAVACCHEDAKA NIDANABefore confirming the diagnosis of CVS, it has to be differentiated from otherdiseases which mimic netra roga with some specific symptoms. For this one shouldtake proper examinations as well as investigations in order to differentiate it fromother diseases which have similar specific symptoms mentioned in Ayurveda Samhita.For this the following disorders can be considered.
  • 57. Review of Literature40Ayurveda Siddhanta & Computer Vision SyndromeTable 13.Comparision of CVS with Netra Roga mentioned by various AcharyasThe lakshanas of CVS resemble the lakshana of the diseases mentioned inAyurveda, as above but a detailed examination and interrogation is necessary to ruleout the above said diseases.CVS is not a very severe disease, compared to the diseasestaken for Vyavacchedaka nidana and CVS is also always associated with patientsworking with computers.these diseases may occur along with CVS and make thecondition severe and worse but CVS cannot be compared as such with any of theses.SADHYASADHYATABefore going to start the chikitsa of a particular disease one should know aboutthe sadhyasadhyata of a disease, i.e. According to prabhava, the diseases are classifiedas Sadhya and Asadhya. Sadhya is subdivided as sukha sadhya and krichra sadhya,asadhya is subdivided as yapya and pratyakheya.CVS is an easily curable condition i.e., sukhasadhya if chikitsa is started earlyand if nidanaparivarjana and pathya are followed properly. But if nidana parivarjanaand pathy are not followed by computer user’s then CVS becomes a kricchra sadhyaor yapya vyadhi.UPADRAVAIn Ayurveda, Acharyas has not described the Upadrava separately forindividual netra roga but mentioned that if netraroga are left untreated they becomechronic and lead to complications like timiraName of disease Charaka Sushruta As Ah MnVatabhishyanda -    Sushkaakshipaka -    Asopha -    Sasopha -    Sirotpata -    
  • 58. Review of Literature41Ayurveda Siddhanta & Computer Vision SyndromeNETRA ROGA CHIKITSA“Yaabhihi kriyaabhihi jaayanthe shareere dhatava samaahSa chikitsa vikaaranaam karma tat bhishaja smrutham” (Ch .su.16/34)Chikitsa is that procedure/entity which brings the bodily components to a state ofnormalcy. In general, Chikitsa for any roga is told asSamshodhanam Samshamanam nidaanasya cha varjanametavatbhishajaa karyam roge roge yatha vidhihi (Ch-vi 7/30)The management principles of Netra Roga in general consist of avoidance ofetiological factors as the first line of management. The second principle is to counteract increased Vata and other Doshas in the poorvaroopa stage itself, because ifneglected these diseases progress rapidly and become incurable in later stages.Management of netra roga can be broadly classified into71a) Nidana parivarjana (Prophylactic measures)It is the first line of treatment of any disease and it is most important line oftreatment for Netra roga also.It indicates that the root of Samprapti process is nidanaand it must be avoided for best management of the disease. In netra roga the factorswhich are mentioned as Nidana of the disease should be avoided.Nidana parivarjanamincludes avoiding by all means the etiological factors leading to aggravation of dosha,vyadhi and apathya.b) Vaatadi dosha shamanam (Curative measures)Vaatadi dosha shamanam includes treating the aggravated doshas involved incausing Netra roga by shamana and shodhana.AushadhaIn Nayanabhighata pratishedha adhyaya Acharya Dalhana says thatpittaabhishyanda, raktaabhishyanda and vataabhishyanda chikitsa is to be followed inabhighataja netra rogas with drugs having drushti prasaadana properties, like Nasya,Aalepa, snigdha dravya which are drushtiprasaadajanana should be used.
  • 59. Review of Literature42Ayurveda Siddhanta & Computer Vision SyndromeTriphala is said to be drug of choice in case of Netra Roga with various Anupana.Based on the involvement of Doşās. This drug is Cakşuşya, Rasāyana along withDeepana, Pācana properties. A number of herbal and animal drugs like madhu, ghrita,yashtimadhu etc are mentioned as Chakshushya in the Samhitas and Nighantus whereas many mineral drugs are described in the text books of Rasashastra, which can beused in treating various netra roga.Kriyakalpa72Sushruta has recommended ‘Kriyakalpa’ for the management of netra roga, alongwith other types of treatment. They can be advocated in almost all eye diseases and itcomprises of Tarpana, Putapaka, Anjana, Aschyotana and Seka.Later scholars likebhavaprakasha have advocated the use of Swarasa and Arka for local use in Netraroga.Shastra karmaThe shalya treatment of Netra roga begins with shastra karma including chedanaetc procedures to relieve Rakta and mamsa dushti.PanchakarmaPanchakarma is indicated for sarva deha gata dosha shodhana, A number ofnasya, vamana and vasti yoga are also described for Netra Roga based on the dosha.Pathyaapathya73Pathysevana plays a major role both in prevention and cure of netra roga.According to Sushruta, the person who is having the habit of regularly taking oldGhrita prepared from Shatavari or Amalaki, Yava cooked with sufficient quantity ofGhrita and the decoction of Triphala etc, by taking these ane has no reason to fearfrom even the severest form of Netra Roga.The cooked vegetables of Jivanti, Sunishannaka, Tanduliya, good quantity ofVastuka, Moolakapotika and jangala mamsa are beneficial for eyesight. Patola,Karkotaka, Karavellaka, Vartaka, Tarkari, Karira fruits, Shigru and Aartagala etc,. allthese vegetables cooked with Ghrita also promote eyesight. Acharya Vangasenasupports the same views.
  • 60. Review of Literature43Ayurveda Siddhanta & Computer Vision SyndromeAcharya Bhavaprakasha has mentioned that use of certain procedures like Lepa,Abhyanjana, Sechana, Dhavana, etc. in the sole of foot are beneficial for theimprovement of eyesightAştāňga Hŗdaya advocates Raktamokşaņa, Virecana, purity of mind, relaxation,Anjana, Nasya, meat of birds, oil. (A. S. Ut. 13/99-100). Pādābhyanga andPādarakşādhāraņa, Śitodaka Parişeka, Śitodaka Snāna, Śitodaka Gandūşadhāraņa,Dakşiņamāruta,keeping palmar region of the hands to the eyes are stated for therejuvenation of the eye sight74.The Chakshushya regimen mentioned in the classics is be useful in controllingthe progress of the disease. A combination of the above said drugs, in the form of oralsupplement, and kriyakalpas will play a definite role in the management of netra roga.NETRA ROGA SAMANYA CHIKITSĀNidana Parivarjana Dosha Shamana (Shodhana/Shamana)Sthanika SarvadehikaAushadha Shastra PanchakarmaAushadha Kriya KalpaTriphala Seka Chedana Snehana PathyapathyaYashtimadhu Āścyotana Bhedana Swedana VishramaSaptamritaloha Pindi Lekhana VamanaEtc.drugs Bidālaka Vyadhana VirecanaTarpana Raktamoksana BastiPutapāka Kshara karma NasyaAnjana AgnikarmaNetra vyayama Jalukavacharana
  • 61. Review of Literature44Ayurveda Siddhanta & Computer Vision SyndromeThe samanya chikitsa of netra roga are mentioned above but to plan a chikitsaSiddhanta for a disease not mentioned in samhita the following points are to beconsidered. CVS is a netra roga caused due to Nija and Aganthu karana janya doshaprakopa. Nidana parivarjana is the first line of treatment in all aganthuja rogas. Vataadi dosha shamana is the second line of treatment for the prakupita doshacausing specific lakshana in this particular vyadhi. In Nayanaabhighata Pratishedha adhyaya Acharya Sushruta mentioned netraprasadana janana, drushtiprasadajanana drugs should be used along withvaatabhishyanda chikitsa.i.e. procedures like aschotana ,tarpana putapaka andRasayana.PATHYA APATHYAPracticing appropriate Pathya-Apathya along with the treatment of disease isone of the unique characteristics of Ayurvedic science. Classical texts emphasize thatsuccess or failure of the treatment depends to a large extent on the practice of Pathyaand Apathya. The food articles, drugs and regimens which do not affect the body andmind adversely are regarded as Pathya and in the same way which adversely affectsthe body are considered to be Apathya75.By following the Pathya and avoiding apathya mentioned in the Ayurvedicclassics one can maintain his healthy vision and prevent it from many diseases.Table 14.Pathya in Netra RogaAahara Su.Sa AH YR CDYava    Godhuma -   Sali -   Shastika -   Mudga -   Kodrava -   Saindhava -   Sharkara -   
  • 62. Review of Literature45Ayurveda Siddhanta & Computer Vision SyndromeVarsha jala - -  -AushadhaTriphala    Amalaki    Punarnava -   Dadima -   Yashtimadhu    Shatavari -   Karavellaka -   Kustumburu -   Patola -   Draksha -   Lodhra -   Godugdha    Goghruta    Jangala mamsa    KarmaShirobhyanga    Padabhyanga    Netra aschotana    Chatra dharana    Padatra dharana    ManasikaManasika santulana    Sattwa pradhana    Table 15.Apathya in Netra RogaAahara Su.Sa AH YR CDPathrashaka    Pinyaka -   Dadhi -   Matsya -   
  • 63. Review of Literature46Ayurveda Siddhanta & Computer Vision SyndromeAmla sura    Atiyoga of Lavana    Teekshna -   Katu -   Ushna -   Guru    Atyamla -   Vidahi -   ViharaKshudha & other vegadharana   Abhighata    Suryavalokana    Diwaswapna    Ratrijagarana    Rukshata atisevana    Utkatasana    Bhashpa sevana    Dhooma sevana    ManasikaChinta    Shoka    Bhaya    Krodha    KriyaAtivamana    Ati virechana    Ati nasya    Mithya yoga of netrakriyakalpa   “Ahita ashanaat sada nivrutti,Bhrusha bhasva chala sookshma veekshanaatcha”
  • 64. Review of Literature47Ayurveda Siddhanta & Computer Vision SyndromeAccording to Acharya Nimi76apathya for netra roga are ahita aahara and visualcontact with excessively sparkling, fast moving and minute objects.By judiciouslyapplying the above said principles netra roga can be prevented and treated.
  • 65. Review of Literature48Ayurveda Siddhanta & Computer Vision SyndromeDRUG REVIEWDRUG REVIEW OF TRIPHALA YASHTIMADHU YOGAAcharya Vagbhata recomends Triphala mixed with honey and ghee to be takenin the night to improve visual acuity77.Amalaki and yasthimadhu pacifies pitta and alleviates defects of visionaccording to Vangasena78.Nimi opines that taking Triphala and Yasthimadhu churna with ghee and honeyat night, consuming wholesome diet and amalaki water helps one attain excellentvision79.HARITAKI80Name HaritakiBotanical name Terminalia chebula retzFamily CombretaceaeSynonyms Abhaya,Amrutha,Pathya,Putana,Jaya,Avyatha,Haimavathi,Kayastha,Vayastha,Siva,Chetaki,Pranadaa,Jivanthi,Rohini,Vijaya,ShreyasiRasa Pancharasa (Lavana Varjita)Guna Laghu RukshaVirya UshnaVipaka MadhuraPrabhava Tridoshaghna,Deeepana,Prajasthapana,Medhya,Chakshushya,Hrudya,Anulomana,RasayanaParts used Phala, PhalamajjaGana Charaka-Jwaraghna,Arśoghna,Kāsaghna,Kustaghna,PrajāsthāpanaSuśhruta-Āmalakyādi, Parushakādi, Triphalā
  • 66. Review of Literature49Ayurveda Siddhanta & Computer Vision SyndromeVāgbhata-ParushakādiChemical composition Fruit:Anthraquinone,Glycosides, ChebulicAcid, TannicAcid, Terchebin, Vit-CFruitkernel:Arachidic acid,Oleic acid, Palmitic acid, Behenic acid& Stearic acidFlower: Chebulin.Pharmacological activityAntimicrobial, Antifungal, Antibacterial, Antistress,Antispasmodic,Hypotensive,Antihepatitis B virus activity, Inhibitory activity againstHIV-1Protease.VIBHITAKI81Name VibhitakiBotanical Name Terminalia bellerica roxbFamily CombretaceaeSynonyms Akshaphala,Karshaphala,Kalidruma,Bhootavasa,Kaliyugalaya,TrilingaRasa KashayaGuna Laghu RukshaVirya UshnaVipaka MadhuraPrabhava TridoshaharaKarma Keshya,Krimihara,Vatahara,ChakshushyaParts Used Phala, PhalamajjaGana Charaka-Jwarahara, Kāsahara, VirechanopagaSuśhruta-Mustādi, TriphalāVāgbhata-MustādiChemical Composition Fruit:Fructose,Galactose,Mannitol,Glucose,Rhamnose,B-SitosterolPharmacological activityAntihistaminic, purgative, antifungal, blood pressure dipressent, activity against viralhepatitis and vitiligo, bronchodialator, antispasmodic, CNS stimulant.
  • 67. Review of Literature50Ayurveda Siddhanta & Computer Vision SyndromeAMALAKI82Name AmalakiBotanical Name Emblica officinalisFamily EuphorbiaceaeSynonyms Abhaya,Amruthaphala,Dhatri,Vayastha,Sitaphala,Tishyaphala,Sriphala,Vrishya,Vayasya.Rasa Amlapradhana PancharasaGuna Snigdha,Sitavirya SitaVipaka MadhuraDoshaghnata TridoshaharaKarma Vayasthapana,Rasayana,Vrishya,Chakshushya,pramehahara,raktapittaharaParts used PhalamajjaGana Charaka-Jwaragna,Kāsagna,Virechanopaga,Kustagna, VayasthāpanaSuśhruta - Amalakyadi, Parushakādi, TriphalāVāgbhata – ParushakadiChemical Composition Vit-C, Phyllembin, Linolic acid, Indole Aceticacid,Axyubrin,Corialgin,Trigaloyl Glucose.Elagic acid, and saltsPharmacological activityAntimicrobial, anti fungal, anti inflammatory, anti bacterial, anti ulcer, spasmolytic,mild CNS depressant, hypolipidemic, antiatherosclerotic, antimutagenic, antioxidant,and immunomodulator.YASHTIMADHU83Name YashtimadhuBotanical Name Glycyrrhiza Glabra
  • 68. Review of Literature51Ayurveda Siddhanta & Computer Vision SyndromeFamily FabaceaeSynonyms Klitaka,Madhuka,Madhuyashti,MadhulikaRasa MadhuraGuna Guru,SnigdhaVirya SitaVipaka MadhuraDoshaghnata Kaphavata Shamaka, TridoshaharaKarma Netrya,Swarya,Rasayana,Vrishya,ChakshushyaParts used RootChemical composition Glycyrrhizine, Glycyrrhizic acid,Iso Neo Liquirtin, Liquirtinogen, Glabrin,Licoridin,GHRITA84Name GhritaZoological Name Bos taurusFamily HerbivoraSynonyms jeevaneeya, pavithra, navaneetha,Sarpi, adhara, aajya, havi, amrutahvaRasa MadhuraGuna Guru, Snigdha, mrudu, yogavahiVirya SitaVipaka MadhuraDoshaghnata Pitta vata Shamaka, Tridoshashamaka,rasayanaKarma Rasayanaparam,chakshushya,jeevaneeya,Buddhi, smruthivardhakaChemical composition 5gms of ghee contains vit-A 165 I.U,vit -D 25 I.U.Copper- 0.075%MADHU85Name MadhuZoological Name APISFamily Orthropoda
  • 69. Review of Literature52Ayurveda Siddhanta & Computer Vision SyndromeSynonyms Makshika,Kshaudra,Madhvika,Sharadam,Varati,Bhringavantham,Pushparasodbhavam,Kusumasavam,Pushparasam.Rasa Madhura, kashaya anurasaGuna Sheeta,Laghu,RukshaVirya Sita (Ch) Ushna (Su,Bp)Vipaka Katu (A.S)Doshaghnata Tridoshashmaka,mainly Kapha shamaka.Karma Chakshushya, chhedi,vishaharavatalaUses Indicated in netra roga,krimi,medovikara,shwasa,hikka,atisara and is yogavahi.Chemical composition Glucose- 84.9% Sucrose-2.69%Alkaloids-0.12% water-10.03%Sp.gravity-1.36 nitrogen-1.29% The above table shows that the compound drug possesses predominance ofMadhura, Kashaya rasa, Guru Snigdha guna, Sheeta virya, Madhura vipaka. Madhura rasa is told as Shadindriya prasadaka by Acharya Charaka. All the drugs are having Chakshushya,Rasayana,Netrya,karma.Hence acts as Vatapitta Shamaka by virtue of its Rasa, Guna Vipaka Virya and DoshaKarmata,and by combination they act as Chakshushya,Rasyana and Tridosha shamaka
  • 70. Review of Literature53Ayurveda Siddhanta & Computer Vision SyndromeTable No.16 Rasa panchaka of Drugs in Triphala Yashtimadhu YogaRasa Guna Virya Vipaka DoshaKarmaDrugNameM A L K T KSLAGURUSUU S M A K V P KHaritaki + + - + + + + - + - + - + - - + + +Vibhitaki - - - - - + + - + - + - + - - + + +Amalaki + + - + + + - + - + - + + - - + + -Yashtimadhu+ - - - - - - + - + - + + - - + + -Madhu + - - - - + - + + - + + - - + - - +Ghrita + - - - - - - + - + - + + - - + + -
  • 71. Review of Literature54Ayurveda Siddhanta & Computer Vision SyndromeFIGURES SHOWING THE DRUGS IN TRIPHALA YASHTIMADHU YOGAHaritaki AamalakiVibhitaki Yashtimadhu
  • 72. Review of Literature55Ayurveda Siddhanta & Computer Vision SyndromeTriphala Yashtimadhu YogaTriphala Choorna Yashtimadhu ChoornaGhrita Madhu
  • 73. Review of Literature56Ayurveda Siddhanta & Computer Vision SyndromeCOMPUTER VISION SYNDROME (CVS)As we entered the 21st century, the growing use of computers be at home oroffice, brings with it an increase in health risks, especially sense organs, more so theeyes.A WHO press release (1998) mentions that glare and reflections from VDTdisplays are a source of eyestrain and headache. Surveys of computer workers revealthat vision related problems are most frequently reported health problems, occurringin over 70 percent of computer workers. The pain and discomfort associated with theproblem can affect workplace performance and domestic activities also. With a fewpreventative measures, however, the symptoms associated with CVS can be easilyavoided86.Definition of CVSThe American Optometric Association (AOA) defines Computer VisionSyndrome as “The complex of eye and vision problems related to near work whichare experienced during or related to computer use” CVS is a temporary conditionresulting from focusing the eyes on a computer display for protracted, uninterruptedperiod of time87.IncidenceMost studies indicate that computer operators, who view their Video DisplayTerminals (VDTs), report more eye-related problems than non-VDT office workers.A number of investigators have reported that visual symptoms occur in 75-90% ofVDT workers. In contrast to the popular conception regarding carpal tunnelsyndrome, a study released by NIOSH (National Institute of Social Health USA)showed that only 22% of VDT workers have musculoskeletal disorders89.A survey of optometrists in USA indicated that 10 million eye examinationsare annually done primarily because of visual problems at VDTs. This studydelineated the series of symptoms which eventually called as CVS. The causes forthese visual symptoms are a combination of individual visual problems, poorworkplace conditions and improper work habits. The above mentioned survey alsoconcluded that two-thirds of the complaints were related to vision problems whileone-third was due to environmental factors. Many people have marginal vision
  • 74. Review of Literature57Ayurveda Siddhanta & Computer Vision Syndromedisorders which do not cause symptoms when performing less demanding visualtasks. However, it has also been shown that VDT users also have a higher incidenceof complaints than non-VDT users in the same environment.Etiology of CVSThe main causes of CVS include an unsuitable environment and the improperuse of eyeglasses or contact lenses along with that working at a computer is morevisually demanding than doing other standard office work such as reading printeddocuments etc., aspects of the design of the computer video display such as screenresolution and contrast, image refresh rates and flicker, and screen glare, as well asworking distances and angles all may contribute to worker symptoms.In order to accomplish specific computer related tasks, frequent eyemovements from work document to the computer screen, or from the screen to thekeyboard and back again, are performed. In addition, as the object being viewedchanges, so does the need for a change in eye focusing to maintain a clear image.These changes occur repeatedly during computer use. The flexibility of the lenswithin the eye and weakening of the ciliary muscle gradually decreases with age(onset of presbyopia) which affects most people after age 40. The normal blink rate inhuman eyes is 16-20 per minute. Studies have shown the blink rate decreases to aslow as 6-8 blinks/minute for persons working on the computer screen. This leads todry eyes.Additionally, the near focusing effort required for such long hours puts strainon ciliary muscles of the eye. This induces symptoms of asthenopia and leads to afeeling of tiredness in the eyes after long hours of work. Some patients present withinability to properly focus on near objects after a short duration. This can be seen inpeople aged around 30-40 yrs of age, leading to a decrease in the accommodative andfocusing mechanisms of the eye. This can be a setting in due to early presbyopia.Signs & symptoms of CVSThe signs & symptoms of CVS can vary but mostly include Eye Irritation (Dry Eyes, Itchy Eyes, Irritated Eyes) Red Eyes Blurred Vision (Distance Or Near), Headaches
  • 75. Review of Literature58Ayurveda Siddhanta & Computer Vision Syndrome Light Sensitivity, Double Vision Backache Neck Ache Muscle Fatigue Eye Strain, Difficulty Refocusing the Eyes.Symptoms and their manifestationDry and irritated eyesDry and irritated eye is one among the most common problem of Computerand VDT users. It is also termed as VDTS Video Display Terminal Syndrome.Thefrontal surface of the eye is covered with a tissue consisting of lacrimal glands whichsecrete the tears. These tears cover the eye surface and maintain moisture for thenormal functioning of the eye. They also help to maintain the proper oxygen balanceof the external eye structures and maintain optical properties of the visual system.The normal tear layer is cleaned off and refreshed by the blinking action of theeyelids.The blink reflex is one of the fastest reflexes in the body. However, these blinkrate varies with different activities faster when we are very active, slower when we aresteady or concentrating. Research has shown that the blink rate of VDT workersdropped very significantly during work at a Computer/VDT compared to before andafter work. Possible explanations for the decreased blink rate include concentration onthe task or a relatively limited range of eye movements. The size of the eye opening isrelated to the direction of gaze- as we gaze higher, the eyes open wider. The amountof evaporation roughly relates to eye opening, the higher gaze angle when viewing aVDT screen results in faster tear loss and reduced percentage of blinks which result indry eyes leading to irritation.Red eyesEyes appear red because of the excess flow of blood to the capillaries in theeye.Sometimes it may be also due to soreness in the eye. This may be due to pooroffice ergonomics and unclean environment.
  • 76. Review of Literature59Ayurveda Siddhanta & Computer Vision SyndromeHeadacheHeadache is one of the ‘discomfort’ symptoms of CVS and is the primaryreason, for which most people seek an eye examination. Visual headaches occur morefrequently, often occur toward the front of the head, occur most often toward themiddle or end of the day, and can occur on one side of the head more than theother.VDT workers most likely get tension-type headaches. These can be precipitatedby many forms of stress, including anxiety and depression; numerous eye conditions,including astigmatism and hyperopia; improper workplace conditions, including glare,poor lighting, and improper workstation setup are the predisposing factors.Burning eyesBlinking is very essential to maintain the moisture of the eye surface. Whenthe blinking rate slows down due to continuous viewing the eyes become dry andcause burning sensation.Blurred visionThe ability of the eye to change its focal power is called accommodation andvaries due to many factors. An image that is not focused accurately will appearblurred.Blurred vision symptoms can result from refractive error (e.g., hyperopia,myopia, and astigmatism), improper prescription lenses, presbyopia (age-relatedfocusing problem) or other focusing disorders. Considering the working environment,blurred images can also arise from a dirty screen, poor viewing angle, reflected glareor a poor quality or defective monitor. All of these factors should be considered whenthis symptom occurs.Double visionDouble vision is a very uncomfortable and unacceptable condition for the visualsystem. Double vision is a serious symptom and can be caused by several factors. Acomplete eye examination is indicated if this symptom persists.Photophobia / glare sensitivityThe eyes are designed to be stimulated by the light and to control the amountof light entering the eyeball. Lighting conditions in office environment are foreign tothe natural lighting and can cause an adverse reaction to light. The largest single
  • 77. Review of Literature60Ayurveda Siddhanta & Computer Vision Syndromefactor in the workplace is glare which is mostly caused by large disparities inbrightness in the field of view. It is much desirable to eliminate bright sources of lightfrom the field of view and strive to obtain a relatively even distribution of luminance.A person is at greater risk to experience discomfort glare when the source is brighterand when it is closer to the point of attention.Neck, shoulder and back acheIt is often heard in medical circles that ‘the eyes lead the body’. Nature hasdesigned our visual system to be so dominant that we will alter our body posture toaccommodate any deficiency in the way we see. In many office situations the visionof a worker is compromised and they must adapt their posture to ease the strain on thevisual system. Uncomfortable seating arrangements and continuous, working withcomputers for longer duration in the same posture causes pain in shoulder, neck andback.Contact lens discomfortThis is commonly found in regular Contact lens users. Computer viewingresults in decreasing blinking rates to one third of normal, while the straight-aheadgaze needed to look at a screen exposes to more air. Combined, this causes the eye todry out and become itchy much faster than usual.If frequent blinking is not enough toeliminate the dryness and itching, an ophthalmologist prescribed eye drops madeespecially for contact lenses can be used.Changes in colour perceptionChanges in colour perception results from long working hours,long standingeye pathologies and flickering colours resolution of VDT screen.FatigueIt is a general symptom of tiredness because of improper work stationconditions.It can also occur due to mental tension, work overload or long workinghours.EyestrainEyestrain is one of those vague terms that have different meanings. The termeye care professionals use for eyestrain is asthenopia (AS-then-OH-pee-ah),.
  • 78. Review of Literature61Ayurveda Siddhanta & Computer Vision Syndromeasthenopia is defined as the subjective complaint of uncomfortable, painful andirritable vision caused from problems such as focusing spasm, difference of vision ineach eye, astigmatism, Hyperopia (far-sighted), Myopia (near-sighted), excess light,voluntary focusing, eye coordination difficulties, etc., In the VDT environment,eyestrain in all of its manifestations may be caused by a number of differentenvironmental and visual conditions97.Aggravating factorsThe symptoms of CVS can be further aggravated by Long working hours Improper lighting conditions (ie. bright overhead lighting or glare) Air moving past the eyes (e.g. overhead vents, direct air from a fan). Altered sleeping habits Refraction errors AgeAlthough CVS has not been found to cause any permanent damage to the eyes, itspainful symptoms can affect performance at work and home90.Treatment modalities for CVSIn the opinion of AOA four hours of continuous work on a computer was consideredsafe. The treatment modalities followed for the management used in CVS include91a. Medicalb. Non medicalMedical Analgesics Topical NSAIDs Topical Steroids Topical Cycloplegics Topical Anesthetics Sedatives/ Anxiolytics
  • 79. Review of Literature62Ayurveda Siddhanta & Computer Vision SyndromeNon Medical Looking away from the computer screen and blinking periodically Use of convergence and divergence exercises Use of bifocals, trifocals or any spectacles for protection of eyes. Viewing angle /Ergonomics Anti glare screensMedicalThe treatment adopted in modern medicine is for symptomatic relief comprisingregular usage of above said drugs based on the predominance of symptoms and nodefinite cure is promised.Non MedicalLooking away from the computer screen and blinking periodically92Proper rest to the eye and its muscles is recommended to relieve the associatedeye strain. Giving the eyes and body frequent breaks from computer work to reduceeye and muscle fatigue is recommended.Since prolonged computer use requires aperson to sit in the same position for an extended period, taking time out to stand,stretch and look around will not only help muscles, but will also give the eyes achance to relax. If the opportunity to get up for full breaks is not frequently available,then “mini” breaks will suffice by looking up from the computer into the distanceabout every 15 minutes. Frequent blinking or the use of eye drops too, will keep eyesfrom drying out and feeling itchy. A routinely recommended approach is toconsciously blink the eyes every now and then (this helps replenish the tear film), andlook out of the window into a distance object or the sky - (this provides rest to theciliary muscles). One of the catchy phrases is the "20-20-20 rule": every 20 minutes,focus the eyes on an object 20 feet (6 meters) away for 20 seconds. This basicallygives a convenient distance and time frame for a person to follow the advice from theophthalmologist. Otherwise, the patient is advised to close his/her eyes (which have asimilar effect) for 20 seconds, at least every half hour or even more frequently.EyeglassesA visit to an ophthalmologist for update of prescription is the first step inimproving the effectiveness of optical aids in eliminating the symptoms of CVS.
  • 80. Review of Literature63Ayurveda Siddhanta & Computer Vision SyndromePatients should be sure to include information on special lifestyle concerns, such ascomputer use, to help the doctor find the right prescription for their needs. With this inmind, the doctor may find that a person who does not normally need glasses shouldwear them when using a computer. Additionally, the ophthalmologist can diagnosewhether another unsuspected disease is the cause of certain symptoms andrecommend treatment optionsViewing angle /Ergonomics101Various studies have shown that viewing angle can be a contributing factor inthe occurrence of asthenopia.Taptagaporn et al as well as Quaranta et al.recommended a downward gaze so as to work comfortably on VDT. When thecomputer operator keeps the terminal at about eye level rather than below eye level.Jaschinski et al. in their study found that high screens at or above the eye levelreported result in greater eyestrain and asthenopia than low screens.Anti glare screensUse of antiglare filters over VDT screens has been associated with shorter, lessfrequent and less intense eye complaints.some Studies had proved that significantlylower prevalence of asthenopia in the subjects who used antiglare screen. Similar wasthe observation in those who adjusted the contrast and brightness of the monitorscreen as per their need.
  • 81. Review of Literature64Ayurveda Siddhanta & Computer Vision SyndromeLIST OF PREVIOUS WORKS1. ‘The Study of Trividha Hetu wsr to present day life style and AsatmendriyarthaSamyoga of Chakshurindriya’.Pawar Vishali Dinakar, Dept of AyurvedaSiddhanta B.V.College of Ayurveda, B.V.University, Pune, 2002.2. ‘A Study on Computer Vision Syndrome and its management with Indigenousmedicine –A clinical study’.- Siddhapur Chandrasekhar.M, Dept of Shalakya,G.A.M.C.Bangalore, RGUHS 2002.3. Effect of selected yoga techniques in “Computer Vision Syndrome” incomparison with selected Ayurvedic modalities.- Venkata Krishna.K.V, Dept ofSvasthavritta, Govt Ayurveda College, Trivandrum University, 2003. 4. A Study on Asatmendriyartha Samyoga wsr to Chakshurendriya’-ArchanaD.Jugale, Dept of Ayurveda Siddhanta BNMET Ayurveda College, Bijapur,RGUHS, 2007.
  • 82. Materials and Methods66Ayurveda Siddhanta & Computer Vision SyndromeMATERIALS AND METHODSMATERIALS1. Literary study2. Drugs3. InstrumentsCollection of Materials1) Literary StudyThe Literary source for the present study was obtained from, vedic scriptures,classical texts of Ayurveda, Sanskrit dictionaries, Modern texts, published articles inreputed journals and also from various media like internet etc.,followed by aretrospective study of related research works.2) DrugsThe ingredients comprises of Triphala (Harithaki, Vibhitaki, Amalaki) andYashtimadhu. Triphala and Yashthimadhu were taken in equal quantity. All these rawdrugs were properly identified and purchased from NKCA pharmacy Mysore.PREPARATION OF MEDICINETriphala Yashtimadhu YogaHaritaki 4 kgVibhitaki 4 kgAmalaki 4 kgYashtimadhu 12 kgThe obtained raw drugs were cleaned, finely powdered and sieved throughstrainer to get a sookshma choorna.A total of 22 kg of raw drug was obtained withwastage of 2 kg.For Anupana patients were advised to mix Madhu and Ghrita duringthe administration of medicine.All the patients were advised to take Dabur Honey,and Cow Ghee manufactured from Nandini Dairy as both are easily available over thecounter.
  • 83. Materials and Methods67Ayurveda Siddhanta & Computer Vision SyndromeINSTRUMENTS1. Snellen’s distant vision chart2. Jaeger’s near vision chart3. Schirmer’s test strips – Conta care opthalmics and diagnoistics ltd vadodra4. Torch light - Everyday electronics ltdMETHODSAIMThe present study was undertaken to study the disease Computer VisionSyndrome based on Ayurveda Siddhantas like Trividha Hetu, Panchalakshana Nidanaand to find out a suitable chikitsa siddhanta and the efficacy of TriphalaYashtimadhuyoga in this disease clinically.OBJECTIVES1. To understand Trividha hetu involved in causation of Computer VisionSyndrome.2. To understand the disease based on Pancha Lakshana Nidana.3. To make an analytical study on the role of Prakruthi, and occupational influencein causation of the disorder.4. To evaluate a suitable Chikitsa based on the above observations.5. To evaluate the efficacy of TriphalaYasthimadhu yoga in patients of ComputerVision Syndrome clinically.RESEARCH DESIGNOBSERVATIONAL STUDYPatients were diagnosed as having Computer Vision Syndrome based on adetailed questionnaire including signs and symptoms (Annexure-II). The general andspecific examination was carried out as per the Ayurvedic and modern parameters.The data was collected after enquiring different nidanas.Those nidanas were collectedand analyzed under the heading of nidana including Prajnaparadha in the form ofaharaja, viharaja etc., and the role of sleep pattern, nature of work and its duration andits role on the disease were studied.
  • 84. Materials and Methods68Ayurveda Siddhanta & Computer Vision SyndromeCLINICAL STUDYAll the patients of CVS were administered Triphala Yashtimadhu yoga toevaluate the efficacy of the drug clinically.SOURCE OF PATIENTSPatients from OPD, IPD, other referrals and special camps conducted inGAMC and hospital Mysore were selected for the study, appropriately satisfying theselection criteria.METHOD OF COLLECTION OF DATA1. Patients suffering from CVS belonging to either sex were selected randomlyand made into a single group.2. Informed consent was obtained before study.3. Those patients were registered and studied with a case-sheet proforma preparedfor the study based on history of signs and symptoms, no of working hours,habits, TV watching, duration of work,aahara sevana,agni,prakruthi, etc.SELECTION CRITERIA1. Patient diagnosed as having CVS2. Patients were selected with respect to age irrespective of sex, caste, occupationand socio economical status.3. Patients fulfilling inclusion criteria.4. Patient willing to participate in the study were selected by explaining theintervention in detail.INCLUSION CRITERIA1. Patients indulging in occupation of working with computers for more than 4hours a day having signs and symptoms of Computer Vision Syndrome2. Patients of either sex.3. Patients between the age group of 20-50 Years.EXCLUSION CRITERIA1. Patients suffering from chronic systemic diseases.2. Degenerative eye diseases and severe ocular problems including high myopia.
  • 85. Materials and Methods69Ayurveda Siddhanta & Computer Vision Syndrome3. Patients suffering from congenital ocular Anomalies.DIAGNOSTIC CRITERIAThe diagnosis of CVS was made based on a questionnaire containing signs andsymptoms index stated by AOA (American optometric Association).SAMPLING METHODTotal 30 patients of Computer Vision Syndrome were randomly selected andmade in to a single group.STUDY DESIGNPresent study was observational and a single blind clinical study with pre andpost test design,INVESTIGATIONSTESTS FOR DISTANT VISION BY SNELLEN’S CHARTDistant central vision is estimated with snellens chart. The snellen’s chart isplaced at 6 meters or 20 feet distance from the patient. The patient is asked to sit on astool facing the chart at 6 meters distance and asked to read the prints of thechart.(Each eye may be closed alternately for the reading of individual eyes).The chartcontains different sized prints in 8 lines, from bigger size to smaller from top tobottom. Each line is marked with a specific number. They are (from top to bottom)60, 36, 24, 18, 12, 9, 6, 5.If the patient is able to read up to 6 number row; his vision is6/6- normal. If the patient is able to read only first line his vision is 6/60. 2ndline 6/36:3rdline 6/24,: 4thline 6/18,: 5thline 6/12,: 6thline 6/9,: 7thline 6/6,: and 8thline 6/5.TESTS FOR NEAR VISION BY JAEGER’S TEST TYPESVisual acuity at the ordinary reading distance is assessed by using reading testtypes of varying sizes. The notation being based on the printer’s point system. Thesmallest point is N14 and largest is N1. The near vision is recorded as the smallesttype which the patient can read comfortably.
  • 86. Materials and Methods70Ayurveda Siddhanta & Computer Vision SyndromeSCHIRMER’S TEST- IThis test measures the rate of tear formation or basic tear function. Itdetermines whether the eye produces enough tears to keep it moist. This test is usedwhen a person experiences very dry eyes or excessive watering of the eyes. It posesno risk to the subject. Schirmers test uses paper strips inserted into the eye for severalminutes to measure the production of tears.In this test both eyes are tested at the sametime.A negative (more than 10 mm of moisture on the filter paper in 5 minutes) testresult is normal. Both eyes normally secrete the same amount of moisture. A youngperson normally moistens 20 mm of each paper strip.Physiologically Hypolacrimationoccurs with ageing.ProcedureThis test consists of placing a small strip of filter paper inside the lower eyelid.Take a 5 x 30 mm strip of no 41 Whatman filter paper. A 5mm tab is folded andgently inserted into the lower lid (conjunctival sac). The eyes are closed for 5 minutes.The paper is then removed and the amount of moisture is measured. If the wetting isless than 10 mm after 5 minutes. It is diagnostic of dry eye. The normal range is 10-25mm in 5 minutes.TORCH LIGHTEye examination was done by the torch.
  • 87. Materials and Methods71Ayurveda Siddhanta & Computer Vision SyndromeSCHIRMERS TEST STRIPSSCHIRMERS TEST -1
  • 88. Materials and Methods72Ayurveda Siddhanta & Computer Vision SyndromeINTERVENTION1. All the 30 patients were administered with Triphala Yashtimadhu choorna.2. The drug is administered with anupana of of ghrita and madhu inasamapramana (unequal quantity) i.e., more quantity of Ghrita was advisedthan Madhu in the ratio of 2:1.3. The dose of drug administered is 12 grams per day (1 karsha) in divided dosesof 6 grams twice a day.4. The time of administration of drug is once in early morning, and once in nightbefore sleep.5. The duration of treatment is for 60 days.6. Data was collected before treatment, after completion of treatment and at theend of follow up.7. All the patients were advised to avoid aahara like madyapana, dadhi, teekshna,katu, amla, vidahi and abhishyandi aahara, upavasa and vishamashana.8. All the patients were advised to avoid vihara like dhoomapaana, doorekshana,swapna viparyaya, ratri jagarana, ushna jala sira snana,vegadharana, bhaya,shoka, kopa, atimaithuna, dhooma ,raja sevana, excessive exposure to sun lightetc.,9. All the patients were advised to do abhyanga to siras and pada, wash their eyeswith cold water frequently and take aahara which is madhura, snigdha, andalso advised to take ghrita in their aahara.10. All the patients were advised to reduce the duration of TV watching from theirregular watching duration.11. All the patients were advised to follow the 20-20-20 rule mentioned by AOA.12. All the patients were advised to take short breaks frequently, and adjust theseating position and to use spectacles if they are having previously.ASSESSMENT FOR CLINICAL IMPROVEMENTClinical improvement in the signs and symptoms of CVS after the trial wereassessed based on the reduction of the individual signs and symptoms and overallseverity as below. The values are compared with before treatment after treatment and
  • 89. Materials and Methods73Ayurveda Siddhanta & Computer Vision Syndromefollow up by utilising the normal values for objective parameters and grading forsubjective parameters.GRADING FOR SUBJECTIVE VARIABLESIRRITATION IN THE EYEI0- No Irritation in the EyeI1- Irritation occurs after 1 hour of working and disappears after workI2-Irritation occurs after 1 hour of working and continues for 2 hrs after withdrawalfrom work.I3- Irritation continues for the whole day and relieved after sleepREDNESS OF EYESR0- No Redness of EyesR1- Redness occurs after 1 hour of working and disappears after workR2- Redness occurs after 1 hour of working and continues for 2 hrs afterwithdrawal from work.R3- Redness continues for the whole day and relieved after sleepTEARING OF EYEST0- No tearsT1- Tearing occurs after 1 hour of working and disappears after workT2- Tearing occurs after 1 hour of working and continues for 2 hrs after withdrawalfrom work.T3- Tearing continues for the whole day and relieved after sleepHEADACHEH0- No HeadacheH1- Headache occurs after 1 hour of working and disappears after workH2- Headache occurs after 1 hour of working and continues for 2 hrs afterwithdrawal from work.H3- Headache continues for the whole day and relieved after sleep
  • 90. Materials and Methods74Ayurveda Siddhanta & Computer Vision SyndromeBURNING IN EYESBu0- No Burning in EyesBu1- Burning in Eyes occurs after 1 hour of working and disappears after workBu2- Burning in Eyes occurs after 1 hour of working and continues for 2 hrs afterwithdrawal from work.Bu3- Burning in Eyes continues for the whole day and relieved after sleepBLURRED VISIONBl0- No Blurred visionBl1- Blurred vision occurs after 1 hour of working and disappears after work.Bl2- Blurred vision occurs after 1 hour of working and continues for 2 hrs afterwithdrawal from work.Bl3- Blurred vision continues for the whole day and relieved after sleepDIPLOPIAD0- No DiplopiaD1- Diplopia occurs after 1 hour of working and disappears after workD2- Diplopia occurs after 1 hour of working and continues for 2 hrs after withdrawlfrom work.D3- Diplopia continues for the whole day and relieved after sleepOBSERVATIONAL PARAMETERS1. Photophobia Present/ absent2. Contact lens discomfort Present/ absent3. Slowness in changing focus of eyes Present/ absent4. Changes in colour perception Present/ absent5. Pain in shoulder Present/ absent6. Pain in Neck Present/ absent7. Pain in Back Present/ absent
  • 91. Materials and Methods75Ayurveda Siddhanta & Computer Vision SyndromeGRADING FOR CLINICAL IMPROVEMENT OF INDIVIDUAL SYMPTOMSAND OVERALL SEVERITY IS GRADED AS BELOWCD Clinically detiorated i.e., increase in severity score against the initial score.CS Clinically stable i.e., severity score remains same against the initial score.CI-1 Encouraging i.e., one degree reduction in severity score against the initialscoreCI-2 Good i.e., two degree reduction in severity score against the initial scoreCI- 3 Excellent i.e., three degree reduction in severity score against the initialscoreDATA COLLECTIONData was collected before treatment, after treatment and at the end of follow up.ASSESSMENTAssessment of the patients was made before the treatment after treatment andat the end of follow up. The data was collected and analysed for the total score beforetreatment, after treatment and after follow up was assessed by using.• Chi-square test• Frequencies / Descriptives• Contingency Co efficient• Paired-Samples T Test• Repeated measure ANOVAAnalysis was done through SPSS for Window (Statistical Presentation System Software),version 14.0, evaluation version (SPSS, 2005, SPSS Inc. New York).
  • 92. Observations  76Ayurveda Siddhanta & Computer Vision SyndromeOBSERVATIONSTotal 30 patients coming under the inclusion criteria were randomly taken forthe clinical study and made into a single group. Observations in the present studywere done in three stages.i) General Observations for all the patientsii) Observations on Nidanas in Computer Vision Syndromeiii) Result related observations pre, post treatment and follow up.GENERAL OBSERVATIONSIn the present study total 42 patients were registered, out of which 12 patientsdiscontinued the treatment during various stages of the clinical study and with 30patients the clinical study was completed.Table No.17 Age wise distribution of 30 patients with CVSAge in years No. of patients Percentage (%)21-30 yrs 21 70.0%31-40 yrs 3 10.0%41-50 yrs 6 20.0%AGEIn present study there was limitation for age. The patients of the age between 20-50yrs were selected. It was found that the patients of age group between 21-30 yrs are 21(70.0%) 31-40 yrs are 3 (10.0%) 41-50 yrs are 6 (20.0%).Table No.18 Sex wise distribution of 30 patients with CVSSex group No. of patients Percentage (%)Male 16 53.33%Female 14 46.66%SEXIn the present study it was observed that more number of patients were males i.e., 16(53.33%) and female patients were 14 (46.66%).
  • 93. Observations  77Ayurveda Siddhanta & Computer Vision SyndromeTable No.19 Occupation wise distribution of 30 patients with CVSOccupation No. of patients Percentage (%)Students 1 3.33%Software professionals 11 36.66%Office Clerk 8 26.66%Accountants 4 13.33%Medical transcription 2 6.66%Call centre employee 4 13.33%OCCUPATIONIn this study it was observed that majority of the patients were software professionalsare 11 (36.66%) office clerk category were 8 (26.66%), accountants 4 (13.33%), callcentre employees 4 (13.33%), medical transcriptionists 2 (6.66%) and students were 1(3.33%).Table No.20 Education wise distribution of 30 patients with CVSEducation No. of patients Percentage (%)Graduation 24 80.0%Post- Graduation 6 20.0%EDUCATIONIn the present study it was found that the majority of patients are graduatesi.e., 24 (80.0%) and Post graduates were 6 (20.0%).Table No.21 Marital status wise distribution of 30 patients with CVSMarital Status No. of patients Percentage (%)Unmarried 18 60.0%Married 12 40.0%MARITAL STATUSIn the present study it was observed that majority of patients were unmarried.i.e.18 (60.0%) and married were i.e., 12 (40%).Table No.22 Socio economic status wise distribution of 30 patients with CVSSocio economic status No. of patients Percentage (%)Middle class 23 76.66%
  • 94. Observations  78Ayurveda Siddhanta & Computer Vision SyndromeUpper middle class 6 20.0%Rich 1 3.33%SOCIO ECONOMIC STATUSIn the present study it was found that majority of the patients belong to middleclass i.e., 23 (76.66%) upper middle class were 6 (20 %) and rich are 1 (3.33%).Table No.23 Religion wise distribution of 30 patients with CVSReligion No of patients PercentageHindu 24 80.0%Muslim 2 6.66%Christian 1 3.33%Others 3 10.00%RELIGIONIn the present study it was observed that majority of patients were from Hinducommunity i.e., 24 (80.0%) from Muslim community are 2 (6.66%) from christiancommunity are 1 (3.33%) and others (Jain) are 3 (10.0%) respectively.Table No.24 Locality wise distribution of 30 patients with CVSHabitat No. of patients Percentage (%)Urban 28 93.33Rural 2 6.66LOCALITYIn the present study it was found that the patients from urban residency are more i.e.,28 (93.33%) and patients belonging to Rural were 2 (6.66%).Table No.25 Diet wise distribution of 30 patients with CVSDiet Pattern No. of patients PercentageVegetarian 15 50%Mixed 15 50%
  • 95. Observations  79Ayurveda Siddhanta & Computer Vision SyndromeDIETIn the present study it was found that the patients with vegetarian diet are 15 (50%)and mixed diet are 15 (50%) both are equally present.Table No.26 Diet pattern wise distribution of 30 patients with CVSDiet Pattern No. of patients PercentageVishamashana 26 86.77%Samashana 4 13.33%DIET PATTERNIn the present study it was found that the patients following vishamashana are morei.e., 26 (86.77%) and patients following samashana were 4 (13.33%).Table No.27 Rasa Sevana wise distribution of 30 patients with CVSRasa Sevana No. of patients PercentageMAL 5 16.66%MALK 21 70.0%MALKT 2 6.66%Sarvarasa 2 6.66%RASA SEVANAIn the present study it was found that the patients taking 4 rasa MALK are 21 (70.0%)taking 3 rasa MAL are 5 (16.66%) and taking 5 rasa MALKT are 2 (6.66%) andtaking all the 6 rasa are also 2 (6.66%).Table No.28 Sleep wise distribution of 30 patients with CVSSleep Pattern No. of patients PercentageSound Sleep 15 50%Disturbed 15 50%SLEEPIn the present study it was found that the patients with sound sleep are 15 (50%) anddisturbed sleep are 15 (50%) both are equally present.
  • 96. Observations  80Ayurveda Siddhanta & Computer Vision SyndromeTable No.29 Duty wise distribution of 30 patients with CVSDuty Shift Pattern No. of patients PercentageDay Shift (Ratri Swapna) 15 50%Night Shift (Diwaswapna) 15 50%DUTYIn the present study it was found that the patients working in day shifts (doing ratriswapna) are 15 (50%) and those working in night shift (doing diwa swapna) are 15(50%) both are equally present.Table No.30 Addiction wise distribution of 30 patients with CVSAddiction No. of Patients PercentageMilk 1 3.33%Tea 24 80.0%Coffee 5 16.66%Smoking 7 23.33%Alcohol 7 23.33%Tobacco chewing 2 6.66%ADDICTIONIn the present study it was found that the patients having the habit of drinking teawere 24 (80%) habit of smoking were 7 (23.33%) drinking alcohol were 7 (23.33%)drinking coffee were 5 (16.66%) and tobacco chewing were 2 (6.66%) and takingmilk were only 1 (3.33%) respectivelyTable No.31 TV watching duration wise distribution of 30 patients with CVSDuration in hours No of Patients Percentage1 9 30%2 12 40%3 4 13.33%4 4 13.33%5 1 3.33%
  • 97. Observations  81Ayurveda Siddhanta & Computer Vision SyndromeWORK DURATIONIn the present study it was found that the patients having the habit of watching TV for5 hours were 1 (3.33%) for 4 hours are 4 (13.33%),, for 3 hours are 4 (13.33%), for 2hours are 12(40%), for 1 hour are 9 (30%), respectively.Table No.32 Duration of Occupation wise distribution of 30 patients with CVSDuration No of Patients Percentage3 months 1 3.33%4 months 2 6.66%6 months 1 3.33%7 months 1 3.33%10 months 1 3.33%1 year 5 16.66%2 year 3 10%3 year 5 16.66%4 year 1 3.33%5 year 4 13.33%6 year 2 6.66%7 year 2 6.66%8 year 2 6.66%OCCUPATIONIn the present study it was found that the patients working with computers from 8years were 2 (6.66%) 7 years were 2 (6.66%) 6 years were 2 (6.66%) 5 years were 4(13.33%) 4 years were 1 (3.33%) 3 years were 5 (16.66%) 2 years were 3 (10%) 1year were 5 (16.66%). And patients working from 3,6,7 and 10 months were 1 eachi.e.total 4 (13.33%) and 4 months were 2 respectively (6.66%)
  • 98. Observations  82Ayurveda Siddhanta & Computer Vision SyndromeTable No.33 Duration of working with computers wise distribution of CVS patientsDuration No of Patients Percentage3 hr 1 3.33%4 hr 2 6.66%5 hr 3 10%6 hr 3 10%7 hr 1 3.33%8 hr 8 26.66%9 hr 2 6.66%10 hr 3 10%12 hr 4 13.33%15 hr 2 6.66%16 hr 1 3.33%In the present study it was found that the patients working with computers for 16 hrswere 1 (3.33%) 15 hrs were 2 (6.66%) 12 hrs were 4 (13.33%) 10 hrs were 3 (10%) 9hrs were 2 (6.66%) 8 hrs were 8 (26.66%) 7 hrs were 1 (3.33%) 6 hrs were 3 (10%) 5hrs were 3 (10%) 4 hrs were 2 (6.66%) 3 hrs were 1 (3.33%)Table No.34 Duration of computers work in a week wise distribution of CVS patientsDuration No of Patients Percentage4 days 1 3.33%5 days 4 13.33%6 days 15 50%7 days 10 33.33%DURATION OF WORKIn the present study it was found that the patients working with computers for 7 days aweek were 10 (33.33%) for 6 days a week are 15 (50%), for 5 days a week are 4(13.33%), for 4 days a week are 1 (3.33%), respectively.
  • 99. Observations  83Ayurveda Siddhanta & Computer Vision SyndromeTable No.35 Prakruthi wise distribution of 30 patients with CVSPrakruthi No. of patients Percentage (%)Vata pitta 15 50.0%Vata kapha 5 16.7%Kapha pitta 10 33.33%PRAKRUTHIIn the present study among 30 patents 15 patients (50%) had Vata pitta prakruthi, 5patients (16.66%) had Vata kapha prakruthi and 10 patients (33.33%) belong to kaphapitta prakruthi.Table No.36 Sara wise distribution of 30 patients with CVSSara No. of patients Percentage (%)Avara 0 0%Madhyama 30 100%Pravara 0 0%In the present study all the 30 patients (100%) were having madhyama sara.Table No.37 Samhanana wise distribution of 30 patients with CVSSamhanana No. of patients Percentage (%)Avara 1 3.33%Madhyama 29 96.66%Pravara 0 0%SAMHANANAAmong 30 patents 29 patients (96.66%) had madhyama samhanana, 1 patient (3.33%)has avara samhanana.Table No.38 Pramana wise distribution of 30 patients with CVSPramana No. of patients Percentage (%)Avara 0 0%Madhyama 30 100%Pravara 0 0%
  • 100. Observations  84Ayurveda Siddhanta & Computer Vision SyndromePRAMANAOIn the present study all the 30 patients (100%) were having madhyama pramana.Table No.39 Satmya wise distribution of 30 patients with CVSSatmya No. of patients Percentage (%)Avara 1 3.33%Madhyama 29 96.66%Pravara 0 0%SATMYAAmong 30 patients 29 patients (96.66%) had madhyama satmya and 1 patient (3.33%)had avara satmya.Table No.40 Satwa wise distribution of 30 patients with CVSSatwa No. of patients Percentage (%)Avara 4 13.33%Madhyama 26 86.66%Pravara 0 0%SATWAAmong 30 patents 26 patients (86.66%) had madhyama satwa and 4 patients (13.33%)had avara satwa.Table No.41 Agni wise distribution of 30 patients with CVSAgni No. of patients Percentage (%)Manda 8 26.66%Vishama 18 60.0%Teekshna 4 13.33%Sama 0 0%AGNIAmong 30 patents 18 patients (60%) had Vishamagni, 8 patients (26.66%) hadmandagni and 4 patients (13.33%) were having teekshna agni.
  • 101. Observations  85Ayurveda Siddhanta & Computer Vision SyndromeTable No.42 Vyayama Shakthi wise distribution of 30 patients with CVSVyayama Shakthi No. of patients Percentage (%)Avara 2 6.66%Madhyama 28 93.33%Pravara 0 0%VYAYAMA SHAKTIAmong 30 patents 28 patients (93.33%) had madhyama vyayama shakti, and 2patients (6.66%) were having avara vyayama shakti.Table No.43 Desha wise distribution of 30 patients with CVSDesha No. of patients Percentage (%)Anupa 24 80.0%Jangala 6 20.0%Sadharana 0 0%DESHAAmong 30 patents 24 patients (80%) belong to Anupa Desha, and 6 patients (20%)belong to Jangala Desha respectively.Table No.44 Chief complaints wise distribution of the patients with CVSSymptoms No of patients PercentageDry & Irritated eyes 24 80%Redness of eyes 25 83.33%Tearing in eyes 18 60%Headache 28 93.33%Burning in eyes 30 100%Blurred vision 17 56.66%Diplopia 0 0%Photophobia 20 66.66%Contact lens discomfort 5 16.66%Slowness in changingfocus of eyes12 40%Changes in colourperception1 3.33%Pain in shoulder 25 83.33%Pain in Neck 27 90%Pain in Back 21 70%
  • 102. Observations  86Ayurveda Siddhanta & Computer Vision SyndromeCHIEF COMPLAINTSIn the present study it was observed that patients having Dry & Irritated eyes were 24(80%),Redness of eyes were 25 (83.33%),Tearing of eyes are 18 (60%),Headachewere 28 (93.33%),Burning in eyes were 30 (100%),Blurred vision were 17 (56.66%)Diplopia were 0 (0%),Photophobia are 20 (66.66%),Contact lens discomfort are 5(16.66%),Slowness in changing focus of eyes are 12 (40%),Changes in colourperception of eyes are 1 (3.33%),Pain in shoulder are 25 (83.33%),Pain in Neck are27 (90%) and having Pain in Back are 21 (70%)Table No.45 Assessment of subjective symptoms before treatmentDry & Irritated EyesMajority of patients are from Grade-2,in 17 patients, (56.66%) Grade-3 were 6patients, (20%) Grade-1 were 1 pt, (3.33%) and Grade-0 i.e., normal were 6 patients(20%)Redness Of EyesMajority of patients are from Grade-2 20 patients, (66.66%) Grade-3 were 4 patients,(13.33%) Grade-1 were 1 pt, (3.33%) and Grade-0 i.e., normal were 5 patients(16.66%)Symptoms Grade 0 Grade 1 Grade 2 Grade3Dry & IrritatedEyes6 20% 1 3.33% 17 56.66% 6 20%Redness Of Eyes 5 16.66% 1 3.33% 20 66.66% 4 13.33%Tearing In Eyes 12 40% 5 16.66% 13 43.33% 0 0%Headache 2 6.66% 1 3.33% 20 66.66% 7 23.66%Burning In Eyes 0 0% 2 6.66% 19 63.33% 9 30%Blurred Vision 13 43.33% 4 13.33% 10 33.33% 3 10%Diplopia 30 100% 0 0% 0 0% 0 0%
  • 103. Observations  87Ayurveda Siddhanta & Computer Vision SyndromeTearing In EyesMajority of patients are from Grade-2 13 patients, (43.33%) Grade-3 were 0 patients,(0%) Grade-1 were 5 patients, (16.66%) and Grade-0 i.e., normal were 12 patients(40%).HeadacheMajority of patients are from Grade-2 20 patients, (66.66%) Grade-3 were 7patients,(23.33%) Grade-1 were 1 patients, (3.33%) and Grade-0 i.e., normal were 2 patients(6.66%).Burning in EyesMajority of patients are from Grade-2 19 patients, (63.33%) Grade-3 were 9patients,(30.0%) Grade-1 were 2 patients, (6.66%) and Grade-0 i.e., normal were 0 patients(0%).Blurred VisionMajority of patients are from Grade-2 10 patients, (33.33%) Grade-1 were 4patients,(13.33%) Grade-3 were 3 patients, (10%) and Grade-0 i.e., normal were 13 patients(43.33%).DiplopiaNone of the patients were having Diplopia. All the 30 patients (100%) were normal.INTERVENTION BASED OBSERVATIONS1. All the patients selected for the study are having on or the other signs andsymptoms of CVS.2. All the patients followed pathyapathya without interruption and discontinuity.3. All the patients took the drug treatment without interruption and discontinuity.4. The drug dose was adjusted to 12 grams divided in 2 equal doses of 6 gramseach.5. Patients were comfortable at the end of treatment.6. There were no complications observed in patients during the study.7. Patients received the drug treatment for 60 days.
  • 104. Observations  88Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION TO SHOW DISTRIBUTION OF AGE AMONG THE 30PATIENTS TAKEN FOR STUDYILLUSTRATION TO SHOW DISTRIBUTION OF SEX AMONG THE 30PATIENTS TAKEN FOR STUDY
  • 105. Observations  89Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION TO SHOW DISTRIBUTION OF OCCUPATION AMONGTHE 30 PATIENTS TAKEN FOR STUDYILLUSTRATION TO SHOW DISTRIBUTION OF EDUCATION AMONGTHE 30 PATIENTS TAKEN FOR STUDY
  • 106. Observations  90Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION TO SHOW DISTRIBUTION OF MARITAL STATUSAMONG THE 30 PATIENTS TAKEN FOR STUDYILLUSTRATION TO SHOW DISTRIBUTION OF SOCIO ECONOMICSTATUS AMONG THE 30 PATIENTS TAKEN FOR STUDY
  • 107. Observations  91Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION TO SHOW DISTRIBUTION OF RELIGION AMONG THE30 PATIENTS TAKEN FOR STUDYILLUSTRATION TO SHOW DISTRIBUTION OF LOCALITY AMONG THE30 PATIENTS TAKEN FOR STUDY
  • 108. Observations  92Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION TO SHOW DISTRIBUTION OF DIET AMONG HE 30PATIENTS TAKEN FOR STUDYILLUSTRATION TO SHOW DISTRIBUTION OF DIET PATTERN AMONGTHE 30 PATIENTS TAKEN FOR STUDY
  • 109. Observations  93Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION TO SHOW DISTRIBUTION OF RASA SEVANA AMONGTHE 30 PATIENTS TAKEN FOR STUDYILLUSTRATION TO SHOW DISTRIBUTION OF NIDRA AMONG THE 30PATIENTS TAKEN FOR STUDY
  • 110. Observations  94Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION TO SHOW DISTRIBUTION OF DUTY AMONG THE30 PATIENTS TAKEN FOR STUDYILLUSTRATION TO SHOW DISTRIBUTION OF VYASANA AMONGTHE 30 PATIENTS TAKEN FOR STUDY
  • 111. Observations  95Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION TO SHOW DISTRIBUTION OF WORK DURATIONAMONG THE 30 PATIENTS TAKEN FOR STUDYILLUSTRATION TO SHOW DISTRIBUTION OF AGNI AMONG THE30 PATIENTS TAKEN FOR STUDY
  • 112. Observations96Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION TO SHOW DISTRIBUTION OF SYMPTOMS AMONG THE30 PATIENTS TAKEN FOR STUDY
  • 113. Results97Ayurveda Siddhanta & Computer Vision SyndromeRESULTS RELATED OBSERVATIONSOBJECTIVE PARAMETERSTable No.46 Showing the result on Schirmers Test-IAssessment MeanLengthSD NBefore 21.8667 2.87358 30After 22.5000 3.17045 30SchirmersTest -IFollow up 22.5000 3.17045 30Source Sum ofSquaresdf MeanSquareF SignificanceChange 8.022 2 4.011 26.913 .000Errorchange8.64458 .149P = .000 HSSCHIRMERS TEST-IBefore treatment the Mean Length was 21.8667 with SD of 2.87358, after treatmentMean Length was 22.5000 with SD of 3.17045 after follow up the Mean Length was22.5000 with SD of 3.17045,P values for overall changes from before treatment to after treatment and aftertreatment to follow up is found to be statistically significant at .000.This shows that the wetting in eyes increased from before treatment to after treatmentand remained stable during the follow up period.Table No.47 showing the result on Distant Vision (Snellen’s Chart)Assessment 6/6D 6/9D 6/12D 6/18D 6/24D 6/60D NBefore 16 3 2 3 5 1 30After 17 2 2 3 5 1 30Follow up 17 2 2 3 5 1 30
  • 114. Results98Ayurveda Siddhanta & Computer Vision SyndromeP = 1.000 NSDISTANT VISION BY SNELLEN’S CHARTP values for overall changes from before treatment to after treatment and aftertreatment to follow up is found to be statistically non significant at 1.000.This shows that the Acuity for Distant Vision in both eyes remained same from beforetreatment to after treatment and follow up in 29 paitients and in 1 patient the visualacuity improved from 6/9 to 6/6 and remained stable during follow up period.Table No.48 showing the result on Near Vision (Jaeger’s Chart)Assessment N5 N6 N7 N8 N12 N13 N14 NBefore 1 4 1 1 2 18 3 30After 1 4 1 1 2 17 4 30Follow up 1 4 1 1 2 17 4 30Symmetric Measures Value Approx. Sig.Nominal by Nominal ContingencyCoefficient.049 1.000N of Valid Cases 90P = 1.000 NSNEAR VISION BY JAEGER’S CHARTP values for overall changes from before treatment to after treatment and aftertreatment to follow up is found to be statistically non significant at 1.000.This shows that the Acuity for Near Vision in both eyes remained same from beforetreatment to after treatment and follow up in 29 paitients and in 1 patient the visualacuity improved from N13 to N14 and remained stable during follow up period.Symmetric Measures Value Approx. Sig.Nominal byNominalContingency Coefficient.060 1.000N of Valid Cases 90
  • 115. Results99Ayurveda Siddhanta & Computer Vision SyndromeSUBJECTIVE PARAMETERSTable No.49 Showing the result on Dry and Irritated EyesAssessment Mean SD NBefore 1.7667 1.00630 30After .7000 .74971 30Dry andIrritated EyesFollow up .7333 .73968 30Source Sum ofSquaresdf MeanSquareF SignificanceChange 22.067 2 11.033 43.831 .000Errorchange14.600 58 .252P = .000 HSDRY AND IRRITATED EYESBefore treatment the Mean grading was 1.7667 with SD of 1.00630, after treatmentMean grading was 0.7000 with SD of 0.74971 after follow up the Mean grading was0.7333 with SD of 0.73968,P values for overall changes from before treatment to after treatment and aftertreatment to follow up is found to be statistically highly significant at .000 HS.This shows that the symptom Dry and Irritated Eyes reduced from before treatment toafter treatment but slightly increased during the follow up period.Table No.50 Showing the result on Redness of eyesAssessment Mean SD NBefore 1.7667 .89763 30After .6667 .75810 30Redness of eyesFollow up .7333 .73968 30Source Sum ofSquaresdf Mean Square F SignificanceChange 22.822 2 11.411 59.211 .000Error change 11.178 58 .193P = .000HS
  • 116. Results100Ayurveda Siddhanta & Computer Vision SyndromeREDNESS OF EYESBefore treatment the Mean grading was 1.7667 with SD of 0.89763, after treatmentMean grading was 0.6667 with SD of 0.75810 after follow up the Mean grading was0.7333 with SD of 0.73968.P values for overall changes from before treatment to after treatment and aftertreatment to follow up is found to be statistically highly significant at .000 HS.This shows that the symptom Redness of Eyes reduced from before treatment to aftertreatment but slightly increased during the follow up period.Table No.51 Showing the result on Tearing in eyesAssessment Mean SD NBefore 1.0333 .92786 30After .4000 .56324 30Tearing in eyesFollow up .3667 .55605 30Source Sum ofSquaresdf MeanSquareF SignificanceChange 8.467 2 4.233 29.943 .000Error change 8.200 58 .141P = .000 HSTEARING IN EYESBefore treatment the Mean grading was 1.0333 with SD of 0.92786, after treatmentMean grading was 0.4000 with SD of 0.56324 after follow up the Mean grading was0.3667 with SD of 0.55605.P values for overall changes from before treatment to after treatment and aftertreatment to follow up is found to be statistically highly significant at .000 HS.This shows that the symptom Tearing in Eyes reduced from before treatment to aftertreatment and further decreased during the follow up period
  • 117. Results101Ayurveda Siddhanta & Computer Vision SyndromeTable No.52 Showing the result on HeadacheAssessment Mean SD NBefore 2.0667 .73968 30After .7667 .77385 30HeadacheFollow up .7333 .78492 30Source Sum ofSquaresdf MeanSquareF SignificanceChange 34.689 2 17.344 88.937 .000Error change 11.311 58 .195P = .000 HSHEADACHEBefore treatment the Mean grading was 2.0667 with SD of .73968, after treatmentMean grading was 0.7667 with SD of 0.77385 after follow up the Mean grading was0.7333 with SD of 0.78492.P values for overall changes from before treatment to after treatment and aftertreatment to follow up is is found to be statistically highly significant at .000 HSThis shows that the symptom Headache reduced from before treatment to aftertreatment and further decreased during the follow up period.Table No.53 Showing the result on Burning in eyesAssessment Mean SD NBefore 2.2333 .56832 30After .8000 .80516 30Burning in eyesFollow up .8000 .80516 30Source Sum ofSquaresdf MeanSquareF SignificanceChange 41.089 2 20.544 124.411 .000Error change 9.578 58 .165P = .000 HS
  • 118. Results102Ayurveda Siddhanta & Computer Vision SyndromeBURNING IN EYESBefore treatment the Mean grading was 2.2333 with SD of 0.56832, after treatmentMean grading was 0.8000 with SD of 0.80516 after follow up the Mean grading was0.8000 with SD of 0.80516,P values for overall changes from before treatment to after treatment and aftertreatment to follow up is is found to be statistically highly significant at .000 HSThis shows that the symptom Burning in Eyes reduced from before treatment to aftertreatment and remained stable during the follow up period.Table No.54 Showing the result on Blurred visionAssessment Mean SD NBefore 1.1000 1.09387 30After .3333 .75810 30Blurred visionFollow up .3333 .75810 30Source Sum ofSquaresdf Mean Square F SignificanceChange 11.756 2 5.878 20.159 .000Errorchange16.911 58 .292P = .000 HSBLURRED VISIONBefore treatment the Mean grading was 1.1000 with SD of 1.09387, after treatmentMean grading was 0.3333 with SD of 0.75180 after follow up the Mean grading was0.3333 with SD of 0.75810.P values for overall changes from before treatment to after treatment and aftertreatment to follow up is found to be statistically highly significant at .000 HSThis shows that the symptom Blurred Vision reduced from before treatment to aftertreatment and remained stable during the follow up period.
  • 119. Results103Ayurveda Siddhanta & Computer Vision SyndromeOBSERVATIONAL PARAMETERSTable No.55 Showing the result on PhotophobiaAssessment Absent Present TotalBefore 10 20 30After 26 4 30PhotophobiaFollow up 25 5 30Value Approx. Sig.Nominal byNominalContingencyCoefficient.463 .000N of Valid Cases 90P = .000 HSPHOTOPHOBIAP values for overall changes from before treatment to after treatment and aftertreatment to follow up is is found to be statistically highly significant at .000Out of total 30 patients, 20 patients (66.66%) had photophobia before treatment. Aftertreatment 16 (53.33%) patients got relieved, but 4 patients (13.33%) persisted withPhotophobia. After the completion of follow up 5 patients (16.66%), persisted withphotophobia with increase in 1 patient (3.33%).Table No.56 Showing the result on Contact Lens DiscomfortAssessment Absent Present TotalBefore 25 5 30After 26 4 30Contact LensDiscomfortFollow up 26 4 30Value Approx. Sig.Nominal byNominalContingencyCoefficient.045 .914N of Valid Cases 90P = .914 NSCONTACT LENS DISCOMFORTP values for overall changes from before treatment to after treatment and aftertreatment to follow up is is found to be statistically non significant at .914
  • 120. Results104Ayurveda Siddhanta & Computer Vision SyndromeOut of total 30 patients, 5 patients (16.66%) had Contact Lens Discomfort. Aftertreatment only 1 (3.33%) patient got relieved,but 4 patients (13.33%) persisted withContact Lens Discomfort. After the completion of follow up 4 patients (13.33%),persisted with Contact Lens Discomfort. This shows that during follow up period thecondition is stable.Table No.57 Showing the result on Slowness in FocusingAssessment Absent Present TotalBefore 18 12 30After 24 6 30Slowness inFocusingFollow up 24 6 30P = .129 NSSLOWNESS IN FOCUSINGP values for overall changes from before treatment to after treatment and aftertreatment to follow up is is found to be statistically non significant at .129Out of 30 patients, 12 patients (40%) had Slowness in Focusing. After treatment 6(20%) patients got relieved,but 6 patients (20%) persisted with Slowness inFocusing.After the completion of follow up 6 patients (20%), persisted with Slownessin focusing with no further decrease. This shows that during follow up the condition isstable.Table No.58 Showing the result on Change in Colour PerceptionAssessment Absent Present TotalBefore 29 1 30After 29 1 30Change in ColourPerceptionFollow up 29 1 30Value Approx. Sig.Nominal by Nominal ContingencyCoefficient.000 1.000N of Valid Cases 90P = 1.000 NSValue Approx. Sig.Nominal byNominalContingencyCoefficient.209 .129N of Valid Cases 90
  • 121. Results105Ayurveda Siddhanta & Computer Vision SyndromeCHANGE IN COLOUR PERCEPTIONP values for overall changes from before treatment to after treatment and aftertreatment to follow up is is found to be statistically non significant at 1.000Out of 30 patients, only 1 patient (3.33%) had Change in Colour Perception.Aftertreatment no relief was found in Change in Colour Perception.After the completion offollowup patient, persisted with Change in Colour Perception without anyimprovement. This shows that during follow up the condition is stable without anyrelief.Table No.59 Showing the result on Shoulder painAssessment Absent Present TotalBefore 5 25 30After 10 20 30Shoulder PainFollow up 12 18 30Value Approx. Sig.Nominal byNominalContingencyCoefficient.209 .127N of Valid Cases 90P = .127 NSSHOULDER PAINP values for overall changes from before treatment to after treatment and aftertreatment to follow up is is found to be statistically non significant at .127Out of 30 patients, 25 patients (83.33%) had shoulder pain.After treatment 5 (16.66%)patients got relieved,but 20 patients (66.66%) persisted with Shoulder pain. After thecompletion of follow up 18 patients (60%), persisted with shoulder pain and 2 patients(6.66%) got relieved in follow up period.Table No.60 Showing the result on Neck painAssessment Absent Present TotalBefore 3 27 30After 6 24 30Neck PainFollow up 7 23 30
  • 122. Results106Ayurveda Siddhanta & Computer Vision SyndromeValue Approx. Sig.Nominal byNominalContingencyCoefficient.147 .372N of Valid Cases 90P = .372 NSNECK PAINP values for overall changes from before treatment to after treatment and aftertreatment to follow up is is found to be statistically non significant at .372Out of 30 patients, 27 patients (90%) had neck pain .After treatment 3 (10%) patientsgot relieved, but 24 patients (80%) persisted with neck pain. After the completion offollow up 23 patients (76.66%), persisted with shoulder pain and 1 patients (3.33%)got relieved in follow up period. The result obtained regarding the parameter shoulderpain is showing statistically non significant result with relief only in 4 patients.Table No.61 Showing the result on Back PainAssessment Absent Present TotalBefore 9 21 30After 11 19 30Back PainFollow up 11 19 30Value Approx. Sig.Nominal byNominalContingencyCoefficient.066 .821N of Valid Cases 90P = .821 NSBACK PAINP values for overall changes from before treatment to after treatment and aftertreatment to follow up is is found to be statistically non significant at .821Out of 30 patients, 21 patients (70%) had Back pain .After treatment 2 (6.66%)patients got relieved, but 19 patients (63.33%) persisted with Back pain. After thecompletion of follow up 19 patients (63.33%), persisted with Back pain and nopatients (0%) got relieved in follow up period. The result obtained regarding theparameter back pain is showing statistically non significant result.
  • 123. Results107Ayurveda Siddhanta & Computer Vision SyndromeRESULT RELATED OBSERVATIONS FOR SYMPTOMS AFTERTREATMENTTable 62 The response of the therapy for individual symptoms after treatmentSymptoms CD CS CI-1 CI-2 CI-3Dry & Irritated eyes 0 2 14 6 2Redness of eyes 0 2 13 10 0Tearing in eyes 0 1 15 2 0Headache 0 2 13 13 0Burning in eyes 0 2 14 13 1Blurred vision 0 3 6 7 1Diplopia - - - - -EXCELLENT2 patients (6.67%) with Dry & Irritated eyes, 1 patient (3.34%) with Burningin eyes and 1 patient (3.34%) with Blurred vision showed excellent response.GOOD6 patients (20%) with Dry & Irritated eyes, 10 patients (33.34%) with Redness ofeyes,2 patients (6.67%) with Tearing in eyes, 13 patients (43.34%) with Headache,13 patients (43.34%) with Burning in eyes, and 7 patients (23.34%) with Blurredvision showed good response at the end of the treatment.ENCOURAGING14 patients (46.67%) with Dry & Irritated eyes, 13 patients (43.34%) with Rednessof eyes,15 patients (50%) with Tearing in eyes, 13 patients (43.34%) with Headache,14 patients (46.67%) with Burning in eyes,and 6 patients (23.34%) with Blurredvision showed encouraging response at the end of the treatment.STABLE2 patients (6.67%) with Dry & Irritated eyes, 2 patients (6.67%) with Redness of
  • 124. Results108Ayurveda Siddhanta & Computer Vision Syndromeeyes,1 patient (3.34%) with Tearing in eyes, 2 patients (6.67%) with Headache ,2patients (6.67%) with Burning in eyes,and 3 patients (10%) with Blurred vision werestable and showed no response at the end of the treatment.DETIORATEDNone of the patients showed increase in severity of symptoms.RESULT RELATED OBSERVATIONS FOR SYMPTOMS AFTER FOLLOWUPTable 63 The response of the therapy for individual symptoms after follow upSymptoms CD CS CI-1 CI-2 CI-3Dry & Irritated eyes 0 2 15 5 2Redness of eyes 0 2 15 8 0Tearing in eyes 0 1 14 3 0Headache 0 2 13 12 1Burning in eyes 0 2 14 13 1Blurred vision 0 3 6 7 1Diplopia - - - - -EXCELLENT2 patients (6.67%) with Dry & Irritated eyes, 1 patient (3.34%) with headache,1patient (3.34%) with Burning in eyes and 1 patient (3.34%) with Blurred visionshowed excellent response at the end of follow up.GOOD5 patients (16.67%) with Dry & Irritated eyes, 8 patients (26.67%) with Redness ofeyes,3 patients (10%) with Tearing in eyes, 12 patients (40%) with Headache ,13patients (43.34%) with Burning in eyes, and 7 patients (23.34%) with Blurred visionshowed good response at the end of follow up.
  • 125. Results109Ayurveda Siddhanta & Computer Vision SyndromeENCOURAGING15patients (50%) with Dry & Irritated eyes, 15 patients (50%) with Redness ofeyes,14 patients (46.67%) with Tearing in eyes, 13 patients (43.34%) with Headache14 patients (46.67%) with Burning in eyes,and 6 patients (23.34%) with Blurredvision showed encouraging response at the end of follow up.STABLE2 patients (6.67%) with Dry & Irritated eyes, 2 patients (6.67%) with Redness ofeyes,1 patient (3.34%) with Tearing in eyes, 2 patients (6.67%) with Headache ,2patients (6.67%) with Burning in eyes,and 3 patients (10%) with Blurred vision werestable and showed no response at the end of follow up.DETIORATEDNone of the patients showed increase in severity of symptoms.Table.64 STATISTICAL ANALYSIS OF RESULTSVariable GradingonMean SD SE T P-valueSignificanceBT 1.76 1.0 0.18AT 0.70 0.74 0.13 6.72 .000 HSDRY &IRRITATEDEYES FU 0.73 0.73 0.13 6.65 .000 HSBT 1.76 0.89 0.16AT 0.66 0.75 0.13 7.94 .000 HSREDNESSOF EYESFU 0.73 0.73 0.13 7.87 .000 HSBT 1.03 0.92 0.17AT 0.40 0.56 0.10 5.64 .000 HSTEARINGIN EYESFU 0.36 0.55 0.10 5.52 .000 HSBT 2.06 0.73 0.13AT 0.76 0.77 0.14 10.14 .000 HSHEADACHEFU 0.73 0.78 0.14 9.63 .000 HSBT 2.23 0.56 0.10AT 0.80 0.80 0.14 11.56 .000 HSBURNINGIN EYESFU 0.80 0.80 0.10 11.56 .000 HSBT 1.10 1.09 0.14AT 0.33 0.75 0.13 4.49 .000 HSBLURREDVISIONFU 0.33 0.75 0.13 4.49 .000 HS
  • 126. Results110Ayurveda Siddhanta & Computer Vision SyndromeRESULTSILLUSTRATION SHOWING THE DRUG EFFECT ON SCIRMERS TESTBEFORE TREATMENT, AFTER TREATMENT AND AFTER FOLLOW UPILLUSTRATION SHOWING THE DRUG EFFECT ON DRY EYESBEFORE TREATMENT, AFTER TREATMENT AND AFTER FOLLOW UP
  • 127. Results111Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION SHOWING THE DRUG EFFECT ON RED EYESBEFORE TREATMENT, AFTER TREATMENT AND AFTER FOLLOW UPILLUSTRATION SHOWING THE DRUG EFFECT ON TEARING EYESBEFORE TREATMENT, AFTER TREATMENT AND AFTER FOLLOW UP
  • 128. Results112Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION SHOWING THE DRUG EFFECT ON HEADACHEBEFORE TREATMENT, AFTER TREATMENT AND AFTER FOLLOW UPILLUSTRATION SHOWING THE DRUG EFFECT ON BURNING EYESBEFORE TREATMENT, AFTER TREATMENT AND AFTER FOLLOW UP
  • 129. Results113Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION SHOWING THE DRUG EFFECT ON BLURRED VISIONBEFORE TREATMENT, AFTER TREATMENT AND AFTER FOLLOW UPILLUSTRATION SHOWING THE DRUG EFFECT ON PHOTOPHOBIABEFORE TREATMENT, AFTER TREATMENT AND AFTER FOLLOW UP
  • 130. Results114Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION SHOWING THE DRUG EFFECT ON TOTAL SYMPYOMSBEFORE TREATMENT, AFTER TREATMENT AND AFTER FOLLOW UP
  • 131. Results115Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION SHOWING THE CLNICAL IMPROVEMENT IN DRY ANDIRRITATED EYES GRADINGS AFTER TREATMENT AND AFTERFOLLOW UPILLUSTRATION SHOWING THE CLNICAL IMPROVEMENT IN REDNESSOF EYES GRADINGS AFTER TREATMENT AND AFTER FOLLOW UPILLUSTRATION SHOWING THE CLNICAL IMPROVEMENT IN TEARINGOF EYES GRADINGS AFTER TREATMENT AND AFTER FOLLOW UP
  • 132. Results116Ayurveda Siddhanta & Computer Vision SyndromeILLUSTRATION SHOWING THE CLNICAL IMPROVEMENT INHEADACHE GRADINGS AFTER TREATMENT AND AFTER FOLLOW UPILLUSTRATION SHOWING THE CLNICAL IMPROVEMENT IN BURNINGEYES AFTER TREATMENT AND AFTER FOLLOW UPILLUSTRATION SHOWING THE CLNICAL IMPROVEMENT INBLURRED VISION AFTER TREATMENT AND AFTER FOLLOW UP
  • 133. Discussion117Ayurveda Siddhanta & Computer Vision SyndromeDISCUSSION ON REVIEWTITLE OF THE STUDY“Application of Ayurveda Siddhanta in the Management of Computer VisionSyndrome.”This study is intended to understand Ayurveda Siddhantas that can be appliedto understand a new disease, Computer Vision Syndrome in all its aspects, i.e., itsdiagnosis prevention and treatment.In this present work an attempt was made tounderstand Computer Vision Syndrome based on the Ayurveda Siddhantas like Hetu,Trividha hetu, Nidanapanchaka, and to find out a sitable Chikitsa and to find the roleof Rasayana in its treatment..Computer is an Electronic deviceVision is physiological function of cognitionSyndrome A group of symptoms, signs, laboratory findings or physiologicaldisturbances that are linked by a common anatomical, biochemical or pathologicalhistory.So CVS means a a group of eye or vision related signs or symptoms occurring inexcessive computer users.DISCUSSION ON REVIEW OF LITERATUREHetuDefinitionThe factor which causes rogotpatti by vitiating the dosha is called nidana.All the definitions of hetu in general mean that hetu is an etiological, causative factorfor a disease manifestation, gives rise to a disease or karana for a vyadhi. Hetu word isalso used as synonymous to nidana in many contexts in the classiscs.The disease CVS is caused due to working or seeing computer screens continuosly forlonger duration.Here watching computers is the etiological/causative factor for adisease manifestation; it gives rise to the disease and is a karana for a vyadhi. So inthis disease Computer watching is the hetu or nidana for manifestation of CVS.
  • 134. Discussion118Ayurveda Siddhanta & Computer Vision SyndromeClassification of HetuThe various hetu explained in samhita can be applied here stating theircausative efficacy in disease Computer Vision Syndrome and their nature ofinfluencing a disease.Bahya hetuThe external factors causing dosha prakopa are bahya hetu.Working with computers and watching television for longer duration, looking at fastmoving images and bhasvara vasthu darshana and multiple colours very frequently,improper lighting arrangement, improper seating position, etc acts as a bahya hetu incausing Computer Vision Syndrome.Abhyantara hetuThe hetu present internally is responsible in the disease origin. Ex – Doshas,vata, pitta kapha, Vatadi dosha prakopa due to various nidana which cause the diseaseand its lakshans are to be considered as abhyantara hetu. In Computer VisionSyndrome already prakupita tridosha due to various nidanas along with existing eyediseases like Presbyopia, Myopia, Asthenopia, Dry Eye, Glaucoma further aggravatethe severity.These factors act as abhyantara hetu.Utapadaka hetuThe hetu bringing dosha vitation by its nature as it is the important chief orpotent cause. Ex - Madhura rasa sevana causes increase of kaphaSitting in uncomfortable positions and following mithya ahara, mithya vihara,vyasana,etc act as hetu for vatadi dosha prakopa and cause manifestation of diseaseand they are to be considered as utpadaka hetu.Vyanjaka hetuThe hetu stimulating for a disease origin, the hetu excites the already sanchitadosha to produce disease. Ex– Surya santapa in vasantha rutu acting as a cause forkaphaja rogas.Following the acts which cause the prakopa of already increased doshalike ratrijagarana, and alpashana and vishamashana acts as vyanjaka hetu in ComputerVision Syndrome.
  • 135. Discussion119Ayurveda Siddhanta & Computer Vision SyndromeUbhaya hetuThe hetu responsible for disease considering both dosha and vyadhi.Watchingand working with computers for longer duration causes both vaatadi dosha prakopaand netra vyadhi thus can be considered under ubhaya hetu.Sannikrushta hetuThe nearest or immediate cause responsible in the disease origin.Ex –Vatadidosha prakopa in disease origin.In Computer Vision Syndrome the sannikrushta hetuis Asatmendriyartha Samyoga (Atiyoga) of Chakshurendriya.Pradhanika hetuA powerful or potent cause capable of producing a disease by itself.In Computer Vision Syndrome the pradhanika hetu is watching ati bhrusha, bhasvarachala and sookshma vastu darshana.DISCUSSION ON TRIVIDHA HETUAsatmendriyartha samyogaAmong the trividha hetu, the asatmendriartha samyoga is related mainly toPancha gnanendriya based on hinayoga, mithyayoga and atiyoga with their vishayas.The asatmendriyartha samyoga of chakshurendriya are as follows.Ati YogaAti Darshanam i.e., seeing very bright light or objects for long periods of time.In the present study the following factors were found which can be considered asAtiyoga of chakshurendriya like working with computers for more than 8 hrs a daywere 20 patients i.e., (66.67%)In the present study it was found that all the 30 patients were having the habitof watching TV which can also be considered under Chakshurendriya Atiyoga.AyogaAdarshanam remaining in dim light or darkness, seeing objects and reading indim light or not utilizing the Chakshurendriya properly.In the present study no patientwas found following ayoga of Chakshurendriya.
  • 136. Discussion120Ayurveda Siddhanta & Computer Vision SyndromeMithya yogaSeeing for a long time those objects which are very near or very far, which are veryminute, which are very bright and sparkling. In the present study it was found thatpatients were having the habit of following various Netra indriya mithyayoga like• Watching computer from very near (10 ‐33.33%)• Working with computer and watching TV in darkness or dim light orimproper lighting. (6 ‐20.0%)• Reading small font and watching flickering images (15‐50%)• Sitting in an improper position while working with computers (15‐50%)PrajnaparadhaIn the present study it was observed that maximum no of patients ie 15 wereworking for 6 days a week and 10 patients working 7 days a week with computerswith average of 8.5 hrs a day. In this study it was observed that maximum no ofpatients were working with computers from 1 year 5 patients, 3 year 5 patients and 5years 4 patients with an average working period of 3.5 years with computers. Basedon these observations it can be considered as kayika prajnaparadha atiyoga.Manasika prajnaparadha is also found in the patients of Computer VisionSyndrome as most of them are stressed from the nature of the job especially thoseworking in software companies and call centre.Vachika prajnaparadha is not found in all the patients except call centreemployees whose nature of job is voice based so have to answer and talk continuouslywhile attending the calls.ParinamaThe hina, mithya and atiyoga of kaala lead to vatadi dosha prakopa by theinfluence of the kaala leading to the diseases manifestation.In the present study it was observed that more exposure to cold in airconditioned atmosphere also aggravates vatadi dosha and increases the dryness ineyes as its not a natural atmosphere.It becomes a factor of kala mithya yoga i.edifferent from external natural enviroment and atiyoga i.e,sheeta guna atiyoga causingdosha prakopa. The duration of work can also be considered under kala i.e., more the
  • 137. Discussion121Ayurveda Siddhanta & Computer Vision Syndromeduration the patient is exposed to computer work he is more prone to developComputer Vision Syndrome.DISCUSSION ON CHAKSHURENDRIYAChakshu is the organ of vision and first and the most important among thePancha Gnanendriya.In Ayurveda samhita a lot of importance has been givenregarding this and a detailed discussion regarding its utpatti,its adhishthana,mahabhoota and its importance. Acharya Nimi in astanga hrudaya says for a blindperson day and night are same even though he is having a lot of wealth stating theimportance of netra.In Sushruta samhita acharya sushruta has explained measures toprotect one’s eyes and the treatment of netra roga in detail in uttaratantra. InAyurvedic literature it is also mentioned that “sarvendriyanam nayanampradhanam“stating the importance of chakshurendriya.ScleraThe sclera forms posterior 5/6 of the eye ball. It has received its name from itsextreme dense fibrous tissue which is hard and maintains the shape of eyeball. Itsexternal surface is white in colour. In Computer Vision Syndrome the sclera turns redwhich is called as the red eye due to excessive flow of blood to eye or inflammationor due to continuous work.Lacrimal apparatusThese lacrimal apparatus keeps the eye moistened and supplies essentialnutrition and lubrication.In Computer Vision Syndrome due to uninterrupted watchingand reduced blink rate of eyes, the tear secretion decreases or tears quickly getevapourated and the eye is not properly moistened.This causes the sensation of dryeye and burning in the eyes.Muscles of the eyeEye ball is kept in position by the Ocular muscles.All the muscles help in themovement of the eye ball in multi directions.Persons working with computer need tomove their eyes frequently as to focus on the screen and on the near by documentsalternatively while entering various data which causes muscle strain resulting in eyestrain, tiredness and pain in the eyes.
  • 138. Discussion122Ayurveda Siddhanta & Computer Vision SyndromeDISCUSSION ON NETRA ROGADetail description of netra roga is available in in Sushruta uttaratantra alongwith their etiology, pathogenesis, symptoms, complications, medical and surgicaltreatments and sadhyasadhyata. In the same sthana there is description about thepanchalakshana nidana and samanya chikitsa of aganthuja/abhighataja diseases indetail. Apart from nija rogas Aganthuja netra roga have also been mentioned causeddue to Abhighata,and other external factors.CVS can be included under bahya orAbhighata janya netra roga.DISCUSSION ON NIDANA PANCHAKAThe samanya Nidana of netra roga mentioned in Sushruta SamhitaUttaratanthra should be considered while eliciting the Nidana of Computer VisionSyndrome which is also a netra vyadhi.NidanaThe Nidana of netra roga can be classified as Aaharaja, Viharaja Manasika based ontheir cause and their role in aggravating doshas.1. Aharaja- The aharaja Nidana again can be catogorised as vata prakopaka,pittaprakopaka and kapha prakopaka nidana.Vata prakopa nidana: In this present study it was observed that most of the patients26 (86.77%) were following vishamashan which causes vata prakopa.Pitta prakopa nidana: In the present study it was found that the patients having thehabit of drinking tea were 24 (80%) drinking alcohol were 7 (23.33%) drinking coffeewere 5 (16.66%) respectively which causes pitta prakopa.Kapha prakopa nidana:In the present study it was found that 6 (20%) patients takecurd in the night which causes kapha prakopa.2. ViharajaVata prakopa nidana: In this present study it was observed that most of the patientswere following Ratrijagarana (Vata Pitta prakopaka) 15 (50%) patients and
  • 139. Discussion123Ayurveda Siddhanta & Computer Vision Syndromediwaswapna (Vata Kapha prakopaka) were 15 (50%) patients, vegadharana and ,disturbed sleep 15 (50%) which causes vata prakopa.Pitta prakopa nidana:In the present study dhooma pana was found in 7 (23.33%)patients and ratrijagarana in 15 (50%) and madyapana in 7 (23.33%) of patients whichalso causes pitta prakopa.Kapha prakopa nidana: In the present study it was found that 15 (50%) patientswere divaswapna which may cause kapha prakopa.Manasika- The manasika Nidana mentioned in netra roga Nidana arekopa,shoka,klesha, Prasaktha smrodana, shrantha, klantha etc mansika bhava.In thepresent study most of the patients are stressed and complained of various manasikabhavas like shrantha,klantha,kopa,Klesha,chinta,udwega.According to Acharya Nimi Nidana for netra roga are ahita aahara and visualcontact with excessively sparkling, fast moving and minute objects.In the presentstudy all the 30 patients were found to follow this Nidana of watching excessivelysparkling, fast moving and minute objects while working with computers andwatching TV.Thus watching and working with computers is the cause for the netra vyadhiComputer Vision Syndrome and various ahitakara ahara vihara and manasa bhavashelp in promoting the disease further and they in turn also act as sahakari karana.PoorvaroopaNo specific prodromal symptoms were mentioned for the disease ComputerVision Syndrome.In the present study the roopa of CVS i.e., burning in eyes, wateringin eyes, dry and irritated eyes, headache, redness of eyes and blurred vision difficultyin focusing and photophobia with less severity are considered as prodromalsymptoms,as these symptoms are found in patients with less severity.Roopa/LakshanaThe Visishta lakshanas of Computer Vision Syndrome are
  • 140. Discussion124Ayurveda Siddhanta & Computer Vision Syndrome Eye Irritation (Dry Eyes, Itchy Eyes, Irritated Eyes) Red Eyes Blurred Vision (Distance Or Near), Headache Light Sensitivity, Double Vision Backache Neck Ache Muscle Fatigue Eye Strain, Difficulty Refocusing the Eyes.In the present study a comparision was made regarding the lakshanas told inAyurveda samhitas and their probable dosha involvement which is as follows.Symptoms Ayurvedic terms DoshavitiationDry and irritated eyes Visushka Netra /Rooksha NetraVataEye Strain Netra Klama VataBlurred vision Avila Darshanam PittaRed Eyes Netra Raaga PittaBurning Eyes Netra Daha PittaExcessive lacrimation Ashru Bahulata VataDouble vision Dwidha pashyati(Mithya darshana)VataDifficulty in focusing Roopa darshanaasahyata (heenatarpita lakshana)VataChange in colour perception Vikruta varnapatavamVata / pittaPhotophobia Prakasha Asahyatva Vata / pittaHeadache Sirashoola Vata/pittaPain in shoulder, neck andback.Greeva, Bahu ,Kati ShoolaVataContact lens discomfort --------------- -Slowness in changing focus Alpa kriya laghava ofnetraVata
  • 141. Discussion125Ayurveda Siddhanta & Computer Vision SyndromeWhen the lakshanas of Computer Vision Syndrome are compared with doshapredominance and lakshanas told in Ayurveda it is assumed that Computer VisionSyndrome is a disease with Vata Pitta dosha predominance. In the present study it wasobserved that the Samanya Poorvaroopa Lakshana of Netra Roga are similar with thelakshana of Computer Vision Syndrome.So it can be assumed that the samanyaPoorvaroopa lakshana of netra roga are similar to the Poorvaroopa and also to theRoopa of Computer Vision Syndrome.Though an exact comparision of ComputerVision Syndrome with the existing netra roga cant be made in this study, it can beinferred that Computer Vision Syndrome is the poorva roopa condition of netra rogawith predominance of vata pitta dosha and CVS is also an independent netra vyadhi.Upashaya and AnupashayaIn the present study it was observed that taking break from work intermittently every1 hour (intermittent rest), maintaining eye hygine,good night sleep,good seatingposition, less glare from computer screens and sitting in a properly illuminated roomwithout shadows on screen and healthy nutritious food are to be considered upashayain CVS.The factors exactly opposite to upashaya like ratrijagarana, alpashana, anashana,improper lighting, and improper seating are to be considered as anupashaya in CVS.SamprapthiThe samprapthi of Computer Vision Syndrome can be explained as follows.Samprapti Ghataka Dosha- Vata Pitta Pradhana Tri Dosha Dooshya- Rasa,Rakta,Mamsa,Majja Srotas- Netragata Sira Srotodusti- Sanga,Atipravrutti Udbhava sthana- Chakshu (Netra). Vyaktha sthana-Netra Sanchara sthana- Urdhwagata Sira Rogamarga- Madhyama Adhisthana- Chakshurendriya.
  • 142. Discussion126Ayurveda Siddhanta & Computer Vision Syndrome Swabhava- ChirakariIllustration No Showing the Scheme of Samprapti of CVSAchakshushya Nidana Sevana(Working with computer for longer duration & following other dosha aggravatingfactors )Dosha Vruddhi and Dosha Dushti(Nidana sevana continued further)Dosha prakopa with predominance of Vata and Pitta DoshaSpreading of dosha in the body through all sira and srotasEntry of doshas into Urdhwagata SiraUrdhwagati of Prakupita Dosha through the Urdhwagata SiraSthana Samshraya of Prakupita Dosha in various parts of the NetraPoorvaroopa lakshanaManifestation of Netra Roga (Computer Vision Syndrome)SadhyasadhyataComputer Vision Syndrome is an easily curable condition i.e.,sukhasadhya if chikitsa is started early and if nidanaparivarjana and pathya arefollowed properly. But if nidana parivarjana and pathya are not followed by computerusers then Computer Vision Syndrome becomes a kricchra sadhya or yapya vyadhi.
  • 143. Discussion127Ayurveda Siddhanta & Computer Vision SyndromeUpadrava and Arishta LakshanaIn the present study during the period of intervention no upadravas or arishtalakshana were seen.Discussion on Netra Roga Chikitsa SidddhantaThe management principles of Netra Roga in general consist of avoidance ofetiological factors as the first line of management. The second principle is to counteract increased Vata and other Doshas in the poorvaroopa stage itself, because ifneglected these diseases progress rapidly and become incurable in later stages.i.e.,a) Nidana parivarjana (Prophylactic measures)In patients of Computer Vision Syndrome Nidanaparivarjana in total as such isnot possible and is far from practical as all of the computer workers are dependent onthe job for their livelihood.In the present study 5 patients applied leave due to various reasons and took a breakfrom office work for 1 month, in them the severity of symptoms was found lessduring the period of vacation.Based on this observation it can be infered that nidanaparivarjana is the best chikitsa.b) Vaatadi dosha shamanam (Curative measures)Vaatadi doshashama includes sthanika and sarvadehika traeatment procedureslike shamana and shodhana which include Rasayana, Aushadha, Kriyakalpa, thoughthe disease Computer Vision Syndrome is not mentioned in Ayurveda Samhitas basedon the principles the following Chikitsa Siddhanta can be formulated.In an aganthu karana vyadhi like Computer Vision Syndrome netra prasadanajanana, drushtiprasadajanana drugs should be used which cause dosha shamana andsamprapthi vighatana along with vaatabhishyanda chikitsa.i.e, procedures likeAschotana, Tarpana, Putapaka etc with netrya and snigdha vtahara drugs arebeneficial.In Netra vyadhi Chakshushya rasayana drugs are to be administrated likeTriphala as vatatapika rasayana sevana vidhi. All rasayana are beneficial inindriyajanya vyadhi especially which are chakshushya.vatatapika chakshushyarasayana thus administered gives strength to that particular indriya and prevent
  • 144. Discussion128Ayurveda Siddhanta & Computer Vision Syndromediseasease due to asatmendriyartha samyoga and help in performing the dailyactivities.In the present study the patients are unable to follow nidana parivarjana astheir livelihood is dependent on the job and also lengthy and time consumingtreatment procedures like tarpana and putapaka could not be administered due to lackof time and nature of job. So a Chakshushya rasayana yoga was selected which is veryeasy to consume and also having the properties of vatadi dosha shamana, Rasayanaand Netrya.In the present study it was also observed that Computer Vision Syndromeis associated with non ocular symptoms like pain in shoulder, neck and back due toimproper seating arrangement and poor office ergonomics. So giving onlychakshushya rasayana may not cure the disease completely but a multicentricapproach like pathya sevana,vata hara/shoola hara aushadhies,use of spectacles,mildexercise to prevent pain in shoulder back etc and proper office ergonomics arebeneficial which can be considered under yukthivyapashraya chikitsa. If all thementioned principles are followed rationally Computer Vision Syndrome can beeasily cured.DISCUSSION ON MATERIALS AND METHODSInstrumentsNear vision Jacquers ChartNear vision eye examination was done to find out the Acuity of near vision in patientsof CVS.Distant vision Snellen’s ChartDistant vision eye examination was done to find out the Acuity of distant vision inpatients of CVSSchirmers test -1Schimmers test -1 examination was done to find out the amount of dryness in eyes ofpatients suffering from CVS.As dry eyes is a common symptom complained by allcomputer users this test was done to find out the amount of dryness.Discussion on Drug-Triphala Yashtimadhu Yoga
  • 145. Discussion129Ayurveda Siddhanta & Computer Vision SyndromeThe ingredients of Triphala Yashtimadhu Yoga are Haritaki, Vibhitaki,Amalaki and Yashtimadhu. All the above drugs were selected on the basis of theirindication in Netra roga as they are mentioned as Netrya, Swarya, Chakshushya,Rasayana, Antistress and also as Anti inflammatory. They are useful in the preventingand curing various types of Netra roga and they also improve vision. They are Madurarasa pradhana, snigdha guna, sheeta virya and madhura vipaka, jeevaneeya andtridosha shamaka in nature.Thus this drug was taken for the study based on the aboveproperties and also as it is directly indicated in netra roga.Discussion on AnupanaMadhu and Ghrita are used as Anupana in the present study as per theirindication in the classics. Madhu and Ghrita are having Madhura rasa, guru snigdhamrudu yogavahi guna,also having Rasayana karma,and Chakshushya prabhava thusthey are specially indicated in Netra roga.All the above drugs are easily available, economical and the preparation of Choorna isalso easy.Therefore with the above intention Triphala Yashtimadhu Yoga withanupana of Madhu and Ghrita is selected to evaluate its efficacy in netra roga likeComputer Vision Syndrome.Selection CriteriaPatients were selected by screening with the help of a detailed questionnaire,and those fulfilling the inclusion criteria, and willing to take the treatment.As patientsof both sex work with computers the study was conducted irrespective of sex.Patients of age group between 20-50 years were selected as subjects of age group inthe range of 20-50 years are commonly found in computer related jobs.In this studypatients having high myopia, colour-blindness, cataract, glaucoma, and with otherocular problems were excluded as these diseases are chronic and need different andvarious modalities of treatment.Inclusion CriteriaPatients indulging in occupation of working with computers for more than 4hours a day were taken for the study because 4 hours of computer work is consideredsafe as per different studies available.Patients of either sex are taken as both male and
  • 146. Discussion130Ayurveda Siddhanta & Computer Vision Syndromefemale are equally working with computers. Age group of 20-50 years was includedas people of this age group are found more in computer jobs and work for more than 4hrs in a day.Exclusion CriteriaPatients suffering from chronic systemic diseases, degenerative eye diseasesand severe ocular problems including high myopia and from congenital ocularanomalies as they may interfere with the course of the study.Diagnostic CriteriaThe diagnosis of patients suffering with CVS was made based on aquestionnaire containing signs and symptoms index stated by AOA (Americanoptometric Association) though the individual symptoms found in CVS may mimicother disesases,but are collectively found in CVS only.Sampling MethodThe patients were randomly selected and made in to a single group to avoidbias.Study DesignPresent study was an observational and a single blind clinical study with preand post test design.This study design was taken to assess the changes in severity ofsymptoms before and after drug trial to find out the clinical efficacy of drug on CVS.Grading for subjective variablesThe gradings for subjective parameters were done based on the previousresearch works done in various institutes on the same subject Computer VisionSyndrome.Data collectionData collection was done before treatment, after and follows up to assess theeffect of drug and pathya from before treatment to after treatment and after treatmentto follow up.Discussion on Intervention
  • 147. Discussion131Ayurveda Siddhanta & Computer Vision SyndromeThe dose of drug administered in the present study was 12 grams per day (1karsha).In classics the Chakshushya drugs were to be taken during night.The dosageof the drug was made 6 grams twice a day for easy administration with anupana ofGhrita and Madhu.Discussion on ObservationsThe observations were made in the patients of Computer Vision Syndromeexcluding dropouts were based on the clinical trial on 30 patients registered for thestudy. The data was collected in a case sheet and were analyzed after the completionof the study.DropoutsTotal 40 patients got registered for the study, out of which 10 patientsdiscontinued the treatment after various stages. Among the dropouts 5 patientsdiscontinued due to personal reasons and 5 patients discontinued due to lack of timefor follow-up visits.AvailabilityAll the cases were reported to OPD of GAMC & H directly during the 6months camp period.AgeIn the present clinical study it was observed that maximum numbers ofpatients were in the age group between 21-30 years. The collected data indicates thatthe incidence of Computer Vision Syndrome is higher in youngsters as more jobopportunities are available in computer related field for freshers.SexAmong 30 patients in the present study 16 patients were male and 14 patientswere female. The ratio of male and female is almost similar stating that jobopportunities are equal for both sexes in computer related jobs thus both are equallyprone to this disease.
  • 148. Discussion132Ayurveda Siddhanta & Computer Vision SyndromeOccupationIn this study it was observed that majority of the patients were softwareprofessionals are 11 (36.66%), office clerk 8 (26.66%), accountants 4 (13.33%), callcentre employees 4 (13.33%), medical transcriptionists 2 (6.66%) and students were 1(3.33%).The collected data indicates that the incidence of Computer Vision Syndromeis usually more in software professionals as they have relatively more work load andlong working hours as per the demands of the employer.EducationIn the present study it was observed that maximum i.e., 24 patients (80%)were graduates, and 6 patients (20%) are post-graduates. Due to easy employment andattractive salaries more people are opting for computer jobs than for higher education.It was also observed that 9 (30%) people are studying through correspondence forhigher degrees because, though these jobs pay good for freshers,career growth,promotions and pay scale are qualification dependent.Marital StatusAmong 30 patients maximum numbers of patients were unmarried i.e. 18(60%) and 12 (40%) patients were married.Though marital age in india is 21 as goodjob and higher salary are requsite for marriage in the present society the urban Indianmarital age is nearing 30 due to good career.Though the exact relation of the diseasewith marital status though could not be established in this study,the reason may beneed for good career,thats why majority of patients are unmarried.ReligionIn the present study it was observed that majority of patients were from Hinducommunity i.e., 24 (80.0%) from Muslim community are 2 (6.66%) from Christiancommunity are 1 (3.33%) and others (Jain) are 3 (10.0%) respectively. As Indiansociety is hindu dominant with more literacy rate is found in hindus suffering withComputer Vision Syndrome.Socio Economic statusAmong 30 patients maximum numbers of patients were from middle class i.e.23 (76.7%) and 6 (20%) patients were from upper middle class and only 1 (3.33%)
  • 149. Discussion133Ayurveda Siddhanta & Computer Vision Syndromepatient was from rich class. As more Indians are from middle class.It can beconcluded that people with middle socio-economic status are the majority working incomputer jobs due to higher salary, and they also can’t do Nidanaparivarjana as theirlivelihood is job related, thus they are more prone to Computer Vision Syndrome.LocalityIt was observed that out of 30 patients, majority of the patients i.e. 28 (93.3%)patients were from urban area followed by 2 (6.66) patients from rural area.Thisshows that software companies and computer firms are more in urban areas, thuspeople residing and working in urban are more prone to Computer Vision Syndrome.Tv watchingIn the present study it was found that all the patients were having the habit ofwatching TV. Watching TV for 5 hours were 1 (3.33%) for 4 hours are 4 (13.33%),,for 3 hours are 4 (13.33%), for 2 hours are 12(40%), for 1 hour are 9 (30%),respectively.Computer job doers also watch TV for relaxation,but for less durationcompared to professionals of other jobs but watching TV more frequently along withcomputer work further aggravates the condition of Computer Vision Syndrome.Working hoursIn the present study on observing the no of working hours the minimum were3 hrs and maximum was 16 hrs with more no of patients working for 8hrs. As perAOA the safe number of working hours to work with a computer are 4 but in thestudy the mean no of working duration is 8.5 hrs which is twice the time mentionedby AOA. So it can be inferred that more computer working duration furtheraggravates the condition of Computer Vision Syndrome.Working durationIn the present study on observing the working duration the minimum were 3months and maximum was 8 years with more no of patients working for 5 years.So itcan be inferred that exposure to computers for longer duration of time aggravates thecondition of Computer Vision Syndrome.
  • 150. Discussion134Ayurveda Siddhanta & Computer Vision SyndromeWorking in a weekIn the present study on observing the no of working days the minimum were 4days and maximum was 7 days with more no of patients working for 6 days aweek.So it can be inferred that more computer working duration further aggravatesthe condition of Computer Vision Syndrome.PrakrutiAmong 30 patients it was observed that majority of patients 15 (50%) hadVata Pitta Prakruti followed by Pitta Kapha Prakruti in 10 patients (33.33%) andVatakapha Prakruti is present in 5 (16.7%) patients. It shows that Vata Pitta Prakrutipersons are more prone to this disease because working for longer hours withcomputers and sitting in same posture causes Vata Pitta Prakopa and Vata PittaPrakruthi persons because of their parakruthi which may be an aggravating factor inthis condition.DietIn the present study it was found that the patients with vegetarian diet are 15(50%) and mixed diet are 15 (50%) both are equally present. Diet Pattern and itscorrelation with the incidence of the disease couldn’t be established in the presentstudy.Diet patternIn the present study it was found that the patients following vishamashana aremore i.e., 26 (86.77%) and patients following samashana were 4 (13.33%).this showsthat persons following vishamasana are more in number due to busy work scheduleand unable to take timely food.vishamashana causes vata dosha prakopa and furthercauses the already sanchita dosha to prakopa avstha and may help in causing thevyadhi.Rasa sevanaIn the present study it was found that the patients taking 4 rasa MALK are 21(70.0%) taking 3 rasa MAL are 5 (16.66%) and taking 5 rasa MALKT are 2 (6.66%)and taking all the 6 rasa are also 2 (6.66%).It was observed that patients takingMALK rasa are having more symptoms. But with the available sample size no
  • 151. Discussion135Ayurveda Siddhanta & Computer Vision Syndromeconclusions can be drawn on the role of rasa sevana in causing Computer VisionSyndrome.VyasanaIn the present study it was found that the patients having the habit of drinkingtea were 24 (80%) habit of smoking were 7 (23.33%) drinking alcohol were 7(23.33%) drinking coffee were 5 (16.66%) and tobacco chewing were 2 (6.66%) andtaking milk were 1 (3.33%) respectively.vyasana like smoking,tobacco chewing anddrinking alcohol further increase doshaprakopa and may aggravate the condition.DutyIn the present study on interrogation it was found that people working in nightshifts are are complaining of discomfort with the shift, and sleep deprivation.It can be inferred that people working in night shift were having morediscomfort compared to day shift and its an aggravating factor for Computer VisionSyndrome as ratrijagarana causes Vata Pitta dosha prakopa.SleepIn the present study it was found that the patients with sound sleep are 15(50%) and disturbed sleep are 15 (50%) both are equally present. On interrogation itwas found that people having disturbed sleep are complaining of discomfort with theeyes.It was observed that persons with disturbed sleep are suffering more fromComputer Vision Syndrome.TreatmentMaximum number of patient i.e. 27 patients freshly reported for the study.This clearly indicates the ignorance of the patients regarding this disease. So that untilall the symptoms of the disease get manifested they do not approach the medicalauthority.Mode of OnsetAmong 30 patients all patients had gradual onset and no patient hadcomplained of sudden onset. Based on above observation in the present study it was
  • 152. Discussion136Ayurveda Siddhanta & Computer Vision Syndromeinferred that all the patients had gradual onset of symptoms and Computer VisionSyndrome is said to be gradual in onset.SaraIn the present study it was found that all the 30 (100%) patients were ofmadhyama sara. With the available sample size no conclusions can be drawn on therole of sara in causation of Computer Vision Syndrome.SamhananaIn the present study it was found maximum number of the patients 29(96.66%) were of madhyama samhanana. With the available sample size noconclusions can be drawn on the role of Samhanana in causation of Computer VisionSyndrome.PramanaIn the present study it was found that all the 30 (100%) patients were ofmadhyama Pramana. With the available sample size no conclusions can be drawn onthe role of Pramana in causation of Computer Vision Syndrome.SatmyaIn the present study it was found maximum number of the patients 29(96.66%) were of madhyama satmya. With the available sample size no conclusionscan be drawn on the role of Satmya in causation of Computer Vision Syndrome.SatwaIn the present study it was found maximum number of the patients 26(96.66%) were of madhyama satva and 4 were with avara satwa. Satwa bala has adefinite role to play in causation of Computer Vision Syndrome as chinta shoka bhayaanxiety like emotions may further aggravate due to work load associated manasikakarana and cause dosha prakopa,which may further aggravate the condition.AgniAmong 30 patients it was observed that majority of patients 18 (60%) hadVishamagni and 8 (26.7%) had mandagni and 4 patients (13.33%) had teekshnagni.
  • 153. Discussion137Ayurveda Siddhanta & Computer Vision Syndromethis shows that as the vyadhi is vata pitta pradhana and vishamagni may beaggravating the comndition by vata dosha prakopa.VyayamaIn the present study it was found maximum number of the patients 20(66.66%) were doing madhyama vyayama and 10 (33.34%) were doing avaravyayama. vyayama bala has a definite role to play in prevention of Computer VisionSyndrome as a person can withstand from stress for longer duration with vyayama.DeshaIn the present study it was found maximum number of the patients 24 (80%)were belonging to anupa desha.and 6 patients belong to jangala desha (20%). With theavailable sample size no conclusions can be drawn on the role of Desha in thecausation of Computer Vision Syndrome.DISCUSSION ON RESULTS30 patients who completed the clinical trial were considered for assessing theresults. The cardinal symptoms were considered for statistical analysis and wereassessed totally 3 times, before the treatment and after 2 month of drugs trial and afterfollow up. Along with the symptomatology vision tests and Schirmer test-I valueswere statistically assessed by comparing pre, post tests and follow up values.In the present study it is observed that Triphala yashtimadhu yoga withanupana of madhu and ghrita along with pathya sevana and correction in work stationand usage of glasses has reduced some of the signs and symptoms of ComputerVision Syndrome significantly.OBJECTIVE PARAMETERSSchirmer’s Test-IThe levels of Schirmers test-I showing raised values initially, but remained innormal levels after the study period of 60 days and after follow up. The resultindicated statistically significant P < 0.001 was observed.This signifies that the drugincreases the moisture content of the eyes and normalizes the lacrimal secretion
  • 154. Discussion138Ayurveda Siddhanta & Computer Vision Syndromemaintaining the snigdhata of the netra, and is effective in dry and irritated eyes.Thisproves the chakshushya,rasayana,netrya properties of the triphala yashtimadhu yoga.Visual acuity Distant and Near VisionIn patients having defects in visual acuity only 1 patient has improvement ofreading in distant vision from 6/9 to 6/6 all other patients readings were stable. Inreadings of near vision only 1 patient has improvement of acuity of near vision fromN13 to N14. Remaining other’s readings was stable. None of the values obtained areshowing statistical significance.As the duration of the present study was short no conclusions can be drawnbased on the results. But improvement of 1 patient each for distant and near visionproves the Chakshushya effect of the drugs used in the yoga and it can be inferred thatthat the drug may be improving the visual acuity of the eyes and if continued forlonger duration may have a significant role to play in the management of acuity ofvision associated with Computer Vision Syndrome.SUBJECTIVE PARAMETERSDry and irritated eyesThe drug effect was statistically highly significant in patients with Dry andirritated eyes after the completion of treatment but increased slightly during the followup period.Out of total 24 patients complaining dry eyes only 2 patients had noresult.Grade 3 improvement was found in 2 patients. Grade 2 improvement was foundin 5 patients and Grade 1 improvement was found in 15 patients.This proves the effectof Chakshushya, Netrya, Tridoshashmaka, Rasayana, and Antistress, Antiinflammatory properties of the drugs in the yoga and also having guru snigdha gunawhich reduces the dryness and irritation in the eye. It suggests that the theraphy ifcontinued for longer duration gives better results.Redness of EyesThe drug effect was statistically highly significant in patients with Redness ofeyes after the completion of treatment but increased slightly during the follow upperiod. Out of total 25 patients complaining red eyes only 2 patients had no
  • 155. Discussion139Ayurveda Siddhanta & Computer Vision Syndromeresult.Grade 3 improvement was found in none. Grade 2 improvement was found in 8patients and Grade 1 improvement was found in 15 patients.This proves the effect ofChakshushya,Tridoshashmaka,Rasayana,Antistress,and Anti inflammatory propertiesof the drugs in the yoga and also having guru snigdha guna and sheeta veerya they,may be acting as vata pitta shamaka thus reducing the redness of the eyes. It suggeststhat the theraphy if continued for longer duration gives better results.Tearing of EyesThe drug effect was statistically highly significant in patients with Tearing ofeyes after the completion of treatment and follow up. Out of total 18 patientscomplaining tearing eyes only 1 patient had no result.Grade 3 improvement was foundin none. Grade 2 improvement was found in 3 patients and Grade 1 improvement wasfound in 14 patients.This proves the action of tear regularization of the drug alongwith Chakshushya Tridoshashmaka, Rasayana, Anti inflammatory and Antistressproperties of the drugs in the yoga.HeadacheThe drug effect was statistically highly significant in patients with Headacheafter the completion of treatment and follow up. Out of total 28 patients complainingheadache only 2 patients had no result.Grade 3 improvement was found in 1 patient.Grade 2 improvement was found in 12 patients and Grade 1 improvement was foundin 13 patients. This proves the effect of Chakshushya Tridoshashmaka,Rasayana,saumanasa janana and medhya,Antistress and Antiinflammatory propertiesof the drugs in the yoga, and this yoga is also effective in reducing the headacheassociated with Computer Vision Syndrome.Burning in EyesThe drug effect was statistically highly significant in patients with Burning inEyes after the completion of treatment and follow up. Out of 30 patients complainingBurning eyes only 2 people had no result.Grade 3 improvement was found in 1patient. Grade 2 improvement was found in 13 patients and Grade 1 improvement wasfound in 14 patients.This proves the effect of Chakshushya Tridoshashmaka,
  • 156. Discussion140Ayurveda Siddhanta & Computer Vision SyndromeRasayana, and Antistress, Anti inflammatory properties of the drugs in the yoga andalso having guru snigdha, sheeta guna.Blurred VisionThe drug effect was statistically highly significant in patients with BlurredVision after the completion of treatment and follow up. Out of total 17 patientscomplaining dry eyes only 3 people had no result.Grade 3 improvement was found in1 patient. Grade 2 improvements were found in 7 patients and Grade 1 improvementwas found in 6 patients. This proves the effect of Chakshushya Tridoshashmaka,Rasayana , and Antistress Anti inflammatory properties of the drugs in the yogabecause of which it is reducing the blurred vision arising due to excess computerviewing.OBSERVATIONAL PARAMETERSPhotophobiaThe drug effect is statistically highly significant in patients with photophobiaafter completion but increased slightly during the follow up period. Out of total 20patients complaining Photophobia 5 people had no result after treatment meaning that15 patients got complete relief from photophobia.This proves the effect ofChakshushya Tridoshashmaka, Rasayana, and Antistress, Anti inflammatoryproperties of the drugs in the yoga. It suggests that the theraphy if continued forlonger duration gives better results.Contact lens discomfortThe drugs effect was non-significant in patients with contact lens discomfortin the present study. Out of total 5 patients complaining Contact lens discomfort 4people had no result.as contact lens discomfort is an individual specific symptomfound only in contact lens users and as lens are foreign body to the eyes the symptommay not be relieved so all the patients are advised to shift to spectacles instead ofcontact lenses.
  • 157. Discussion141Ayurveda Siddhanta & Computer Vision SyndromeSlowness in changing focus of eyesThe drugs effect was non-significant in patients with slowness in changingfocus of eyes. Out of total 12 patients complaining Slowness in changing focus ofeyes 6 people had no result after treatment. The above intervention if continued forlonger duration may have some significant effect on Slowness in changing focus ofeyes associated with Computer Vision Syndrome.Changes in Colour perceptionThe drugs effect was non-significant in patients with changes in colourperception of eyes. Only 1 patient complaining Changes in Colour perception had noresult after treatment.The above intervention if continued for longer duration mayhave some significant effect in the management of Changes in Colour perception ofeyes associated with Computer Vision Syndrome.Pain in shoulderOut of total 25 patients complaining Pain in shoulder 20 people had no resultafter treatment.The drugs effect was non-significant in patients with pain in shoulder.As the symptom is due to improper seating and frequent movement in position ofhand, the trial drug having only chakshushya rasayana properties may not givecomplete relief. Exercise, vatahara drugs and changing to comfortable seating positionshould be tried which may give better results.Pain in NeckOut of total 27 patients complaining Pain in neck 24 people had no result aftertreatment.The drugs effect was non-significant in patients with pain in neck.As thesymptom is due to improper seating and frequent movement in position of neck whilewatching monitors,the trial drug having only chakshushya rasayana properties maynot give complete relief. Exercise, vatahara drugs and changing to comfortable seatingposition should be tried which may give better results.Pain in BackOut of total 21 patients complaining Pain in back 19 people had no result aftertreatment.The drugs effect was non-significant in patients with pain in back.As thesymptom is due to improper seating position and lack of support to spine while
  • 158. Discussion142Ayurveda Siddhanta & Computer Vision Syndromewatching monitors, the trial drug having only chakshushya rasayana properties maynot give complete relief. Exercise, vatahara drugs and changing to comfortable seatingposition should be tried which may give better results.GENERAL OBSERVATIONS1. In the present study during the drug trial it was observed that patients haveslight difficulty in swallowing the drug because of its taste.2. In the present study during the drug trial it was observed that 3 patients gotrelieved of constipation.this may be due to anulomana property of the drug.3. In the present study during the drug trial it was observed that 2 patients gotrelieved of amlapitta.this may be due to sheetha guna, madhra rasa andrasayana property of the drug.4. In the present study during the drug trial it was observed that 6 patients gotsound sleep after taking the drug.this may be due to rasayana and anti stressproperty of the drugs.
  • 159. Conclusion144Ayurveda Siddhanta & Computer Vision SyndromeCONCLUSIONOn the basis of conceptual analysis and obseravations made in this clinicalstudy the following conclusions can be drawn.The Ayurveda siddanthas are formulated, time tested and applied sincecenturies to understand diseases, and to plan their management. This present studyhave the following points as a befitting conclusion proving that Ayurveda siddhantasare eternal and can be applied in understanding newer diseases like Computer VisionSyndrome.Asatmendriyartha samyoga Atiyoga of chakshurendriya like watching highlyluminous, fast moving flashing colours for a prolonged time have been mentioned inclassics and has been validated in understanding the aetiological factors of CVS.All aspects of pragnaparadha play an important role in exacerbation of thesymptoms. Improper ergonomics add up to cause further vitiation.Duration of computer work is directly proportional to the severity ofsymptoms in CVS.The Siddhanta Nidana parivarjanameva chikitsa is validated in the presentstudy.If the diseases are treated in poorvaroopavastha itself they don’t becomesevere.This Siddhanta is validated in CVS also.Chakshshya yoga selected in this study has proved that they are beneficial indiseases where nidana parivarjana is not completely possible.
  • 160. 145Ayurveda Siddhanta & Computer Vision SyndromeRECOMMENDATIONS FOR FUTURE STUDY• The same study can be conducted on larger sample with longer duration alongwith yogasanas and relaxation techniques.• The study can be done by comparing the drug along with Kriyakalpa• The same study can be conducted with other Chaksushya and vataharaRasayanas.• The study can be restricted to IPD only, as complete abstinence of nidana ispossible.• Similar studies can be conducted to understand newer diseases and theirtreatment.
  • 161. Summary145Ayurveda Siddhanta & Computer Vision SyndromeSUMMARYThe study titled “Application of Ayurveda Siddhanta in the Management ofComputer Vision Syndrome” was selected for the study to provide an understandingfor a new disease not mentioned in Ayurvedic classics based on Ayurveda siddhantasand to find out the role of prakruthi, and a suitable chikitsa siddhanta and the efficacyof Triphala Yashtimadhu yoga in Computer Vision Syndrome (CVS). The work ispresented in two parts. The first part deals with the Review of Literature consisting ofHetu,Trividha hetu,Nirukti, Paryaya, Bheda of Netra roga, Nidana Panchaka,Sadhyasadhyata, Chikitsa, Pathyapathya and Drug Review and literature on ComputerVision Syndrome.the second part consists of the observations,results of the clinicaltrial with Triphala Yashtimadhu Yoga,discussion and conclusion.Total 30 cases were randomly selected and were sampled into a single group,followed by a clinical study consisting of 30 patients with a pre-post test design.Statistical analysis was done using contingency coefficient table analysis, andsingle‘t’ test.The diagnosis was based on clinical features mentioned by AOA, AmericanOptometric Association.Among 30 patients taken for the study, Dry & Irritated eyes is found in 24patients, Redness of eyes is found in 25 patients, Tearing eyes is found in 18 patients,Headache is found in 18 patients,Burning sensation in eyes is found in 30 patients,Blurred Vision is found in 17 patients, Photophobia is found in 20 patients, Contactlens discomfort is found in 5 patients, Slowness in changing focus of eyes is found in12 patients, Changes in Colour perception is found in 1 patient, Pain in shoulder isfound in 25 patients, Pain in Neck is found in 27 patients and Pain in Back is found in21patients respectively.In the present study Asatmendriyartha samyoga especially chakshurendriyaatiyoga i.e., excessive watching and working with computers for longer duration
  • 162. Summary146Ayurveda Siddhanta & Computer Vision Syndromealong with mithyahara and vihara were the most common nidanas encountered in thepatients of CVS.All the patients were administered Triphala Yashtimadhu Yoga 12 grams aday in divided doses with anupana of ghrita and madhu for 60 days, once in themorning and once during bed time.Data regarding age, sex, occupation, education, economic status, diet,addiction etc were analysed after the study.The observations of the study alsoincluded the etiological factors of the disease. It was observed and recorded that CVSwas prevalent in both sexes equally. Its incidence was high in the age group of 21-30yrs; people belonging to middle socioeconomic status were more susceptible for thedisease.The assessment of improvement was based on the above parametersmentioned by AOA. The results revealed that a favorable response was obtained in all30 patients (100%). The percentage of reduction in the relief of symptoms wasstatistically highly significant in ocular problems like the increase in schirmers test–Ivalues, the reduction in the dryness of eye, redness of eye, tearing, headache, burningeyes, blurred vision, and photophobia.No significant result was observed in Slownessin changing focus of eyes, Changes in Colour perception, Contact lens discomfort andin non-ocular symptoms like Neck, Back and Shoulder pain.The conclusions derived on the basis of detailed observations are presentedunder the chapter of conclusion.Future prospects of this study are highlighted as anaid for the future research workers.
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  • 170. AnnexureAyurveda Siddhanta & Computer Vision SyndromeANNEXURECLASSICAL REFERENCEWåûiÉÑ:-xÉåÌiÉMüiÉïurÉiÉÉMüÉå UÉåaÉÉåimÉÉSlÉæ WåûiÉÑ | (qÉÉ. ÌlÉ.)iÉ§É ÌlÉSÉlÉÇ MüÉUhÉÍqÉirÉÑaÉëå | (cÉ. ÌlÉ. 1/7)WåûiÉÑ mÉrÉÉïrÉ:-CWûÇ ZÉsÉÑ WåûiÉÑÌlÉïÍqɨÉqÉÉrÉiÉlÉÇ MüiÉÉï MüÉUhÉÇ mÉëirÉrÉ: xÉqÉÑijÉÉlÉÇ ÌlÉSlÉÍqÉirÉlÉjÉÉïliÉUqÉ |iÉÎi§ÉìÌuÉkÉqÉ-AxÉÉiqrÉåÎlSìrÉÉjÉï xÉÇrÉÉåaÉ: mÉë¥ÉÉmÉUÉkÉ: mÉËUhÉÉqɶÉåÌiÉ || (cÉ. ÌlÉ. 1/3)̧ÉÌuÉkÉ WåûiÉÑ:-MüÉsÉoÉÑÎkSÎlSìrÉÉjÉÉïlÉÉÇ rÉÉåaÉÉå ÍqÉjrÉÉ lÉ cÉÉÌiÉ cÉ |²rÉÉ´ÉrÉÉlÉÉÇ urÉÉÍkÉlÉÉÇ Ì§ÉÌuÉkÉÉå WåûiÉÑ xÉÇaÉëWû || (cÉ. xÉÑ. 1/54)AxÉÉiqrÉÍqÉÌiÉ iÉ̲±É±³É rÉÉÌiÉ xÉWûÉiqÉiÉÉqÉ | (cÉ, vÉÉ. 1/127)kÉÏkÉ×ÌiÉxqÉ×ÌiÉ ÌuÉpÉë¹: MüqÉï rÉiÉ MÑüÂiÉå AvÉÑpÉqÉ |mÉë¥ÉÉmÉUÉkÉÇ iÉÇ ÌuɱÉiÉ xÉuÉïSÉwÉmÉëMüÉåmÉhÉqÉ || (cÉ. vÉÉ, 1/102)ÍvÉiÉÉåwhÉuÉwÉïsɤÉhÉÉ: mÉÑlÉWåïûqÉliÉaÉëÏwqÉuÉwÉÉï xÉÇuÉixÉU: xÉ MüÉsÉÈ |MüÉsÉ mÉÑlÉÈ mÉËUhÉÉqÉ EcrÉiÉå || (cÉ xÉÑ. 11/12)qÉlÉ vÉUÏU xÉÇoÉÇkÉ:-vÉUÏUÇ xÉiuÉxÉÇ¥ÉÇ cÉ urÉÉkÉÏlÉÉqÉÉ´ÉrÉÉå qÉiÉÈ |iÉjÉÉ xÉÑZÉÉlÉÉÇ rÉÉåaÉxiÉÑ xÉÑZÉÉlÉÉÇ MüÉUhÉÇ xÉqÉ: || (cÉ. xÉÑ. 1/55)iÉå cÉ ÌuÉMüÉUÉ: mÉUxmÉUqÉlÉÑuÉiÉïqÉÉlÉÉ: MüSÉÍcÉSlÉÑoÉklÉÎliÉMüÉqÉÉSrÉÉå euÉUÉSrÉ¶É | (cÉ. ÌuÉ. 6/8)mÉë¥ÉÉmÉUÉkÉ qÉWûiuÉ:-mÉë¥ÉÉmÉUÉkÉɬrÉÌWûiÉÉlÉjÉÉïlÉ mÉgcÉ ÌlÉwÉåuÉåiÉ |xÉlkÉÉUrÉÌiÉ uÉåaÉÉÇ¶É xÉåuÉåiÉ xÉÉWûxÉÉÌlÉ cÉ || (cÉ. xÉÑ. 28/39)lÉ ÌWû MüqÉï qÉWûiÉ ÌMügcÉÏiÉ ÄTüsÉÇ rÉxrÉ lÉ pÉÑerÉiÉå |Ì¢ürÉÉblÉÉ: MüqÉïeÉÉ UÉåaÉÉ: mÉëvÉqÉÇ rÉÉÎliÉ iÉi¤ÉrÉÉiÉ || (cÉ. vÉÉ. 1/117)UÉåaÉÉåimɨÉÏ ¢üqÉ:-iÉiÉx§ÉåiÉÉrÉÉÇ sÉÉåpÉÉSÍpÉSìÉåWûÈ AÍpÉSìÉåWûÉSlÉ×iÉuÉcÉlÉqÉ AlÉ×iÉuÉcÉlÉÉiÉ |MüÉqÉ¢üÉåkÉqÉÉlɲåvÉmÉÉÂwrÉÉÍpÉbÉÉiÉpÉrÉiÉÉmÉvÉÉåMüÍcÉliÉÉå²åaÉÉSrÉ: mÉëM×üiÉ: || (cÉ. ÌuÉ. 3/24)iÉ§É mÉëjÉqÉiÉ LuÉ iÉÉuÉSɱÉssÉÉåpÉÉÍpÉSìÉåWûMüÉåmÉmÉëpÉuÉÉlɹÉåÇ urÉÉkÉÏlÉ |
  • 171. AnnexureAyurveda Siddhanta & Computer Vision SyndromeÌlÉSÉlÉmÉÑuÉåïlÉ ¢üqÉåhÉ urÉÉZrÉÉxrÉÉqÉ iÉjÉÉ xÉÑ§É xÉÇQû.aÉëWûqÉɧÉÇ ÍcÉÌMüixÉÉrÉÉ: |(cÉ.ÌuÉ.1/15)mÉëÌiÉMüÉU:-irÉÉaÉ: mÉë¥ÉÉmÉUÉkÉÉlÉÉÍqÉÎlSìrÉÉåmÉvÉqÉ: xqÉ×ÌiÉ: |SåvÉMüÉsÉÉiqÉÌuÉ¥ÉÉlÉÇ xÉSuÉרÉxrÉÉlÉÑuÉiÉïlÉqÉ || (A. WØû. xÉÑ. 4/32)lÉå§É UÉåaÉ xÉÇZrÉÉlÉuÉxÉlkrÉÉ´ÉrÉÉxiÉåzÉÑ uÉiqÉïeÉÉxcÉåMüÌuÉÇzÉÌiÉ: zÉÑYsÉpÉaÉå SzÉæMüxcÉ cÉiuÉU:û¢ÑüwÉçhÉpÉÉaÉeÉÉ:xÉuÉï´ÉrÉÉ xÉmiSzÉ: SìÓÎzOûeÉÉ ²SzÉæuÉiÉÑ oÉɽeÉÉæ ²Éæ xÉqÉZrÉiÉÉæ UÉåaÉÉ: mÉUqÉ SÂhÉÉæpÉÔrÉ rÉåiÉÉlÉç mÉëuɤrÉÉÍqÉ xÉlZrÉÉÃmÉÍcÉÌMüÎixÉiÉæ: || (xÉÑ E 1/44)lÉå§É UÉåaÉ ÌlÉSÉlÉÇEwhÉÉÍpÉiÉmiÉxrÉ eÉsÉå mÉëuÉåzÉɬÕUåYzÉhÉÉiÉç xuÉmlÉÌuÉmÉrÉïrÉÉŠ |mÉëxÉYixÉÇUÉåSlÉzÉÉåMüMüÉåmÉYsÉåzÉÉÍpÉbÉÉiÉÉSÌiÉqÉæjÉÑlÉÉŠ ||zÉÑ£üÉUhÉÉsÉÉqsÉMÑüsÉijÉqÉÉwÉÌlÉwÉåuÉhÉɲåaÉÌuÉÌlÉaÉëWûÉŠ |xuÉåSÉSrÉÉå kÉÔqÉÌlÉwÉåuÉhÉÉŠ NûSåïÌuÉïbÉÉiÉɲqÉlÉÉÌiÉrÉÉåaÉÉiÉçpÉÉwmÉaÉëWûÉiÉç xÉÔ¤qÉÌlÉUϤÉhÉÉŠ lÉå§Éå ÌuÉMüÉUÉlÉç eÉlÉrÉÎliÉ SÉåwÉÉ: || (xÉÑ E 1/26-27)lÉå§É UÉåaÉ xÉÉqÉÉlrÉ mÉÔuÉïÃmÉiɧÉÉÌuÉsÉÇ xÉxÉÇUqpÉÇA´ÉÑMülQÕûmÉSåWûuÉiÉç aÉÑÃwÉiÉÉåSUaÉɱæeÉÑï¹Ç cÉurÉY¨ÉsɤÉhÉæ: |xÉ zÉÔÔsÉÇ uÉiqÉï MüÉåwÉåwÉÑ zÉÔMümÉÔhÉÉïpÉqÉåuÉ cÉ|| ÌuÉWûlrÉqÉÉlÉÇ ÂmÉåuÉÉÌ¢ürÉÉxuÉÍ¤É rÉjÉÉ mÉÑUÉ ||SìÓ¹æuÉ kÉÏqÉÉlÉç oÉÑSèkrÉåiÉ SÉåwÉåhÉÉÍkÉÎzPûiÉÇ iÉÑ iÉiÉç || (zÉÑ F 1/22)lÉå§É UÉåaÉ xÉÉqÉÉlrÉ sɤhÉAsmÉxiÉÑ UaÉÉå AlÉÑmÉSåWûrÉÉÇxcÉ xÉiÉÉåSpÉåSÉÌlÉsÉeÉÉͤÉUÉåaÉåÌmɨÉÉiÉç xÉSWûÉåAÌiÉÂeÉ: xÉUÉaÉ: mÉÏiÉÉåmÉSåWû: xÉÑpÉëÑzÉÉåwhÉuÉÉWûÏzÉÑYsÉÉåmÉSåWÇû oÉWÒûÌmÉΊsÉÉ´ÉÑ lÉå§ÉÇ MüTüÉiÉç xrɪÒÂiÉÉ xÉMühQÒû:xÉuÉÉïÍhÉ ÃmÉÉÍhÉ iÉÑ xÉͳÉmÉÉiÉÉ....|| (cÉ ÍcÉ 26/129-130)lÉå§É UÉåaÉ xÉÉqÉÉlrÉ xÉqmÉëÉÎmiÉÍxÉUlÉÑxÉÉËUÍpÉSÉåïwÉæ:ÌuÉaÉÑhÉæÃkuÉïqÉÉaÉiÉæ: eÉrÉljÉå lÉå§ÉpÉÉaÉåwÉÑ UÉåaÉÉ: mÉUqÉSÂhÉ: || (zÉÑ F 1/21)lÉå§É UÉåaÉ xÉÉqÉlrÉ ÍcÉÌMüixÉÉxÉǤÉåmÉiÉ: Ì¢ürÉrÉÉåaÉÉå ÌlÉSÉlÉmÉËUuÉeÉïlÉÇ |
  • 172. AnnexureAyurveda Siddhanta & Computer Vision SyndromeuÉÉiÉÉSÏlÉÉÇ mÉëiÉÏbÉÉiÉ: mÉëÉå£üÉå ÌuÉxiÉUiÉ: mÉÑlÉ: (xÉÑ E 1/25)lÉå§É zÉÉUÏUÌuɱɲrÉlaÉÑsÉ oÉÉWÒûsrÉÇ xuÉÉlaÉÑwOûÉåSU xÉÎqqÉiÉqÉç ²rÉlaÉÑsÉqÉ xÉuÉïiÉ: xÉÉkÉï ÍpÉwÉaÉlÉrÉlÉ oÉѯÒSqÉç ||xÉÑuÉëѨÉÇ aÉÉåxiÉlÉÉMüÉUÇ xÉuÉïpÉÔiÉaÉÑhÉÉå°uÉÇ | mÉsÉÇ pÉÑuÉÉåAÎalÉiÉÉåU£Çü uÉÉiÉÉiÉç ¢ÑüwhÉÇ ÍxÉiÉÇ eÉsÉÉiÉçAMüÉÉzÉÉS´ÉÑqÉÉaÉÉïxcÉ eÉÉrÉliÉå lÉå§É oÉѯÒSå || (xÉÑ E 1/11)
  • 173. AnnexureAyurveda Siddhanta & Computer Vision SyndromeAnnexure –IICOMPUTER VISION SYNDROME -QuestionnaireAccording to American optometric association, (AOA) Computer Vision Syndrome isa complex of eye and vision problems related to near work that are experiencedduring or related to computer work. In other words, you work on a computer for awhile and your eyes bother you. This survey is an effort to identify and find outwhether you are suffering from CVS. We invite you to answer the following questionsand to check out yourselves. If you find suffering from 3-4 of the symptoms and yourprofession involves prolonged usage of computers, you could be suffering fromComputer Vision Syndrome.Name:Age: Sex:Occupation:Phone No: Place of work:Email: Designation:Postal Address:1. Primary use of computerData entry/ DTPCommunication internet / emailClericalFinancial accountingWeb designingOthers2. No of hours spent on computer per day______ since ______months/years.3. No of days spent in a week with computer _______4. Do you use vision corrective / protective lenses? Yes / noIf yes since____ months/years. What is their refraction and the purpose of usage?1. Is any of your family members suffering from eye related problems?
  • 174. AnnexureAyurveda Siddhanta & Computer Vision SyndromeYes/no. If yes, please specify?6. Have you ever noticed any of the following symptoms during or after prolongedusage of computer?Dry and irritated eyes Blurred vision Redness of eyes Burning in Eyes Tearing of eyes Diplopia Headache Photophobia Contact lens discomfort Slowness in changing focus of eyes Changes in colour perception Fatigue Pain in shoulder, neck and back 7. Any other symptoms8. You are experiencing the above symptoms since ____ weeks/months/years.9. The above symptoms if present do they disappear after discontinuing the workwithin ________ min/hrs/days.10. Are you undergoing any treatment or techniques (yoga/exercise, etc) to prevent ormanage the above symptoms? If yes, please specify.Place:Date: Signature:DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDASIDDHANTAGOVERNMENT AYURVEDA MEDICAL COLLEGE, MYSORE.PROFORMA OF CASE SHEET FOR THE STUDY OF“APPLICATION OF AYURVEDA SIDDHANTA IN THE MANAGEMENT OFCOMPUTER VISION SYNDROME”H.O.D : Dr.N.Anjaneya Murthy, M.D. (Ayu)Guide : Dr.Naseema Akthar, M.D. (Ayu)
  • 175. AnnexureAyurveda Siddhanta & Computer Vision SyndromeCo-Guide : Dr.T.R.Shantala Priyadarshini M.S.(Ayu)Researcher : K.S.Dutta Sharma.GHistory taking ExaminationSL No.: O.P.NoName DateAge: Sex:Occupation:Marital status: UM M W DReligion: Hindu Muslim Christian OthersSocio-economic status: P LM M UM REducation: 10 10+2 G PGLocality: Urban / RuralPhone No:Email:Postal Address:Diagnosis:Pradhana vedana with AvadhiDry and irritated eyesBlurred visionRedness of eyesBurning in EyesTearing of eyesDiplopiaHeadachePhotophobiaContact lens discomfortSlowness in changing focus of eyesChanges in colour perceptionFatiguePain in shoulder, neck and back.
  • 176. AnnexureAyurveda Siddhanta & Computer Vision SyndromeAnubandha Vedana: (Associated complaints) AvadhiPoorvavyadhivrittanta: (History of past illness)Chikitsa vrittanta: (Treatment history)Medical: Surgical:Paarivaarika vrittanta: (Family history)Maternal: Paternal: Siblings:Personal history: (Vayaktika Vrittanta)Ahara : Veg / Non-Veg regular/occasionalRasa : Madhura / Amla / Lavana / Katu / Tikta / KashayaType : Samashana / Adhayashana / Vishamashana / AnashanaNidra : Day - regular / irregular disturbed/ soundNight - regular / irregular disturbed/ soundDuration :VyasanaHabits Continuing Regular Occasional Quantity StoppedCoffee/TeaSmokingAlcoholTobaccoothersVyavasaya vrittanta:(Occupational History):1. Nature of work:Primary use of computer:Data entry/ DTPCommunication internet / emailClericalFinancial accountingWeb designingOthers2. Working hours:No of hours spent on computer per day______ since ______months/years.
  • 177. AnnexureAyurveda Siddhanta & Computer Vision Syndrome3. No of days spent in a week with computer _______4. Working conditions:Day bright light/ dim lightNight bright light/ dim light5. Duration of the present occupation:Previous occupation:6. Do you use vision corrective / protective lenses? Yes / noIf yes since____ months/years. What is their refraction and the purpose of usage?7. Any other detailsROGI PAREEKSHADashavidha Pareeksha:Prakriti :Vata/Pita/Kapha/Vatapitta/Vatakapha/Kapha pitta/ SannipataVikruthi : Dosha: DushyaSara : Pravara / Madhyama / AvaraSamhanana : Pravara / Madhyama / AvaraPramana : Pravara / Madhyama / AvarasSatmya :Pravara / Madhyama / AvaraSatwa :Pravara / Madhyama / AvaraAhara shakti :Pravara / Madhyama / AvaraVyayama shakti :Pravara / Madhyama / AvaraVaya :Baalya /Madhyama / VriddaDesha :Anupa / Janghala / SaadharanaAshtasthana pareekshaNadi ShabdaMutra SparshaMala DrukJihwa AakruthiSrotopariksha:Ashruvaha Srotas (lachrymal gland)
  • 178. AnnexureAyurveda Siddhanta & Computer Vision SyndromeLocal examination1. Head and face2. Lids and eyelashes3. Conjunctiva and Sclera4. Cornea Iris and anterior chamber5. Lens and pupilNetra PareekshaMandala1. Pakshma2. Varthma3. Shukla4. Krishna5. DrishtiSandhi1. Pakshma Varthmagata2. Varthma Shuklagata3. Shukla Krishnagata4. Krishna Drishtigata5. Kaneena6. ApangaInterpretationVikrutitah Pareeksha:Nidana:Aahara:Vihara:Manasika:Poorvaroopa:Roopa:Upashaya:Rest SleepDark room taking a break
  • 179. AnnexureAyurveda Siddhanta & Computer Vision SyndromeAnupashayaBright light TensionSeating position NoiseStrenuous work SleeplessnessSampraptighatakaDosha :Dushya:Agni :Koshta :Ama :Srotas :Srotodusti prakara:Udbhava sthana :Sanchara sthana :Vyakta sthana :Adhisthana :Rogamarga :Samprapti :Vyadhivinischaya :ChikitsaShamanoushadhi:Dose: Kala:Anupana: Date of commencement:Pathya: Date of completion:Apathya:Observation & AssessmentObjective parametersDryness of the eye - Present/ absentSchirmers test IRight eye BT AT FULeft eye
  • 180. AnnexureAyurveda Siddhanta & Computer Vision SyndromeAcuity of Vision Distant and NearWithoutGlassesBT AT FUNV DV NV DV NV DVBoth eyesRight eyeLeft eyeSubjective parametersSymptoms BT AT FU1. Irritation in eyes2. Redness of eyes3. Tearing in eyes4. Headache5. Burning in eyes6. Blurred vision7. DiplopiaObservational parametersSymptoms BT AT FUPresent/ Absent P A P A P A1. Photophobia2. Contact lensdiscomfort3. Slowness inchanging focus ofeyes4. Changes in colourperception5. Pain in shoulder6. Pain in Neck7. Pain in BackResult: Signature of HOD:Signature of Researcher:Signature of Co Guide:Signature of Guide:
  • 181. MASTER CHARTCASENOAGE SEX OCC REL E.S M.S SES LOCAAHARAPRAKRUTISARA SAMHANANAPRAMANASATMYASATWA AGNIVYAYAMADESHA1. 23 F CC MU PG UM UMC UR MI PK M M M M M Ma M A2. 26 F ST HI PG UM UMC UR MI VP M M M M M Vi M J3. 22 M SW HI G UM UMC UR VE VP M M M M M Te M A4. 29 F A HI G M MC UR MI VP M M M M M Ma M A5. 31 F A HI G M MC UR MI VK M M M M M Vi M A6. 40 F CL HI G M MC UR MI PK M M M M M Ma M A7. 50 M A HI G M MC UR MI PK M M M M M Vi M A8. 27 M A MU G M MC UR MI VP M M M M M Vi M A9. 24 F CC CI G UM MC UR MI VK M M M M M Vi M A10. 39 F CL HI G M MC UR VE PK M M M M M Ma M A11. 24 M CC HI G UM MC UR VE VP M M M M M Vi M A12. 23 M CL HI G UM MC RU MI VK M M M M M Vi M A13. 30 M SW HI PG M RIC UR VE VP M M M M M Te M J14. 49 M MT HI G M UMC UR MI PK M M M M M Ma M J15. 50 M CL JA G M MC UR VE PK M M M M M Te M A16. 28 F CL JA G UM MC UR VE VP M M M M M Vi M A17. 26 F SW JA G UM MC UR VE PK M M M M M Vi M A18. 49 M CC HI G M MC UR MI PK M M M M M Vi M A19. 21 F SW HI G UM UMC UR MI VP M M M M M Vi M J20. 21 M SW HI G UM MC UR VE VP M M M M M Vi M J21. 28 F SW HI PG UM MC UR VE PK M M M A A Vi M A22. 25 F SW HI G UM MC UR MI VP M M M M M Ma M A23. 25 F CL HI G UM MC UR MI VK M M M M M Vi M A24. 21 M CL HI G UM MC RU MI VP M M M M M Ma M A25. 23 F SW HI G UM MC UR VE PK M M M M M Vi M A26. 26 M SW HI G UM MC UR VE VP M M M M M Te M J27. 49 M CL HI G M MC UR VE VP M M M M A Vi A A28. 26 M SW HI G UM MC UR VE VP M A M M M Vi A A29. 49 M MT HI PG M UMC UR VE VK M M M M A Ma M A30. 26 M SW HI PG UM MC UR VE VP M M M M A Vi MA
  • 182. BEFORE TREATMENT AFTER TREATMENT FOLLOW UPST DE RE TE HE BU BL DI ST DE RE TE HE BU BL DI ST DE RE TE HE BU BL DI1. 20 I2 R2 T1 H2 BU3 BL1 DI 0 20 I1 R0 T0 H0 BU1 BL0 DI 0 20 I1 R0 T0 H0 BU1 BL0 DI 02. 22 I2 R3 T2 H2 BU3 BL0 DI 0 23 I1 R1 T0 H0 BU2 BL0 DI 0 23 I1 R1 T0 H0 BU2 BL0 DI 03. 20 I0 R2 T0 H2 BU2 BL1 DI 0 21 I0 R1 T0 H1 BU1 BL0 DI 0 21 I0 R1 T0 H1 BU1 BL0 DI 04. 22 I2 R2 T2 H2 BU2 BL0 DI 0 23 I0 R0 T1 H2 BU1 BL0 DI 0 23 I0 R1 T1 H2 BU1 BL0 DI 05. 21 I2 R2 T2 H2 BU2 BL0 DI 0 21 I1 R1 T1 H2 BU0 BL0 DI 0 21 I1 R1 T1 H2 BU0 BL0 DI 06. 18 I2 R3 T2 H2 BU2 BL2 DI 0 19 I1 R1 T1 H0 BU0 BL0 DI 0 19 I1 R1 T1 H0 BU0 BL0 DI 07. 19 I2 R0 T0 H2 BU2 BL2 DI 0 20 I1 R0 T0 H1 BU0 BL1 DI 0 20 I1 R0 T0 H1 BU0 BL1 DI 08. 23 I0 R1 T1 H2 BU2 BL0 DI 0 23 I0 R0 T0 H0 BU1 BL0 DI 0 23 I0 R0 T0 H0 BU1 BL0 DI 09. 21 I2 R0 T0 H2 BU2 BL2 DI 0 21 I0 R0 T0 H0 BU0 BL1 DI 0 21 I0 R0 T0 H0 BU0 BL1 DI 010. 26 I3 R3 T0 H3 BU3 BL2 DI 0 28 I2 R2 T0 H2 BU2 BL2 DI 0 28 I2 R2 T0 H2 BU2 BL2 DI 011. 18 I2 R2 T2 H2 BU2 BL2 DI 0 18 I1 R1 T1 H1 BU0 BL0 DI 0 18 I1 R1 T1 H1 BU0 BL0 DI 012. 21 I2 R2 T2 H3 BU3 BL0 DI 0 21 I1 R1 T1 H2 BU2 BL0 DI 0 21 I1 R1 T1 H2 BU2 BL0 DI 013. 25 I2 R2 T0 H2 BU2 BL0 DI 0 26 I0 R0 T0 H0 BU0 BL0 DI 0 26 I1 R1 T0 H1 BU1 BL0 DI 014. 23 I0 R2 T2 H0 BU3 BL3 DI 0 25 I0 R1 T1 H0 BU1 BL1 DI 0 25 I0 R1 T1 H0 BU1 BL1 DI 015. 28 I2 R2 T0 H3 BU2 BL2 DI 0 29 I1 R0 T0 H1 BU1 BL0 DI 0 29 I1 R0 T0 H1 BU1 BL0 DI 016. 20 I3 R2 T2 H2 BU2 BL1 DI 0 20 I1 R1 T1 H1 BU1 BL0 DI 0 20 I1 R1 T0 H0 BU1 BL0 DI 017. 28 I0 R2 T2 H3 BU3 BL0 DI 0 29 I0 R1 T1 H1 BU1 BL0 DI 0 29 I0 R1 T1 H1 BU1 BL0 DI 018. 18 I2 R2 T0 H3 BU2 BL2 DI 0 19 I2 R2 T0 H2 BU2 BL2 DI 0 19 I2 R2 T0 H2 BU2 BL2 DI 019. 25 I3 R2 T1 H2 BU1 BL1 DI 0 25 I0 R0 T0 H0 BU0 BL0 DI 0 25 I0 R0 T0 H0 BU0 BL0 DI 020. 25 I2 R2 T1 H3 BU2 BL0 DI 0 26 I1 R1 T0 H1 BU0 BL0 DI 0 26 I1 R1 T0 H0 BU0 BL0 DI 021. 24 I3 R2 T0 H3 BU3 BL3 DI 0 26 I0 R0 T0 H2 BU1 BL0 DI 0 26 I0 R0 T0 H2 BU1 BL0 DI 022. 25 I2 R2 T2 H2 BU3 BL2 DI 0 26 I0 R0 T1 H0 BU0 BL0 DI 0 26 I0 R0 T1 H0 BU0 BL0 DI 023. 24 I2 R2 T0 H2 BU2 BL0 DI 0 24 I1 R1 T0 H1 BU1 BL0 DI 0 24 I1 R1 T0 H1 BU1 BL0 DI 024. 20 I3 R3 T2 H2 BU3 BL3 DI 0 20 I3 R3 T2 H1 BU3 BL3 DI 0 20 I3 R3 T2 H1 BU3 BL3 DI 025. 20 I0 R0 T0 H1 BU1 BL2 DI 0 20 I0 R0 T0 H0 BU0 BL0 DI 0 20 I0 R0 T0 H0 BU0 BL0 DI 026. 19 I0 R2 T2 H0 BU2 BL0 DI 0 20 I0 R1 T1 H0 BU1 BL0 DI 0 20 I0 R1 T1 H0 BU0 BL0 DI 027. 19 I3 R0 T0 H2 BU2 BL2 DI 0 19 I1 R0 T0 H1 BU1 BL0 DI 0 19 I1 R0 T0 H1 BU1 BL0 DI 028. 20 I1 R2 T1 H2 BU2 BL0 DI 0 20 I0 R0 T0 H0 BU0 BL0 DI 0 20 I0 R0 T0 H0 BU0 BL0 DI 029. 20 I2 R2 T0 H2 BU2 BL0 DI 0 21 I1 R1 T0 H1 BU0 BL0 DI 021 I1 R1 T0 H1 BU0 BL0 DI 030. 22 I2 R0 T2 H2 BU2 BL0 DI 0 22 I1 R0 T0 H0 BU1 BL0 DI 0 22 I1 R0 T0 H0 BU1 BL0 DI 0
  • 183.                            Sex Male – M Female –F Age – AgReligion – RHindu – HI Muslim – MU Christian – CI Other (Jain)– JA Marital Status – M.S.Unmarried – UM Married – M  Socio EconomicalStatus – SES Middle Class ‐MC Upper Middle Class UMC  Rich – RI Locality – LUrban – UR Rural – RU Diet – DVegetarian – VE Mixed – MI  Occupation – OCCStudent –ST Cll Centre‐CC Software‐SW Accountant‐A Clerk –CL Medical Transcription –MT Education – E.D.Graduated – G Post Graduated – PG Ashana – AS.  Samashana – SA Anashana – AN Adhyashana – AD Vishamashana – VI Vihara – VI  Shramaja – 1  Ashramaja – 2 Appetite – APAvara – 1 Madhyama – 2  Pravara – 3  ResultsBT-Before TreatmentAT- After TreatmentFU-Follow Up Prakruthi‐ PRAK   VataPitta – VP   VataKapha – VK   PittaKapha – PK Sara‐SARA   Madhyama‐M   Avara‐A   Samhanana‐ SAM   Madhyama‐M   Avara‐A   Pramana‐PRAMA   Madhyama‐M    Avara‐A   Satmya‐ SATM   Madhyama‐M   Avara‐A   Sattva‐ SAT   Madhyama‐M   Avara‐A   Agni‐ AG   Manda –Ma   Vishama Vi   Teekshna –Te   Vyayama‐VYAYA   Madhyama‐M   Avara‐A  Key to master chart 
  • 184.                           
  • 185.