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critical analysis of netra roga nidana.pptx

This document discusses the nidanas (causes) of eye diseases according to Ayurvedic classics. It groups the nidanas into several categories - Aharaja (diet-related), Viharaja (lifestyle-related), Rutu Viparyaya (seasonal changes), Manasika (mental), and others. Specific nidanas mentioned include intake of spicy, sour, or fermented foods; excessive alcohol; trauma; excessive reading, driving, or sex; and fatigue. Understanding the nidanas is important for assessing dosha vitiation, prognosis, pathogenesis, and treatment planning for eye diseases.

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“CRITICAL ANALYSISOF NIDANA OF NETRAROGA” Dr. Shraddha Joshi Ph.D. 2nd year Shalakya Tantra dept.
Why understanding Nidana is important? • To assess Dosha vitiation. • Helps to decide Sadhya, Asadhyata of Vyadhi. • To analyse the Samprapti. • For proper planning of treatment.
Adi balapravrutta  Due to defect in Shukra and Shonita.  Kulaja Vikara (Hereditary disorder).  Eg. Naktandhya (Night blindness) Albinism, etc.
Janmabala pravrutta  These are congenital disorders caused because of Rasa and Dauhrida Apchara Kruta.  Eg.Jatyandha, Microcornea/ Megalocornea, Keratoconus, Congenital myopia, hypermetropia, congenital cataract, ptosis, dacryocystitis.
Ushna, Katu, Kshara Ahara Ati Sevana. DoshaBalaPravrittaja Atiyoga, Ayoga, Mithyayoga of Vihara Mithyayoga- Looking into very near/very distant objects. Aayoga- Completely avoiding the vision. Atiyoga- Looking into illuminating & bright objects. Vitiation of Dosha either in Amashya/Pakvshaya.
Sanghata bala pravrutta • These are traumatic disease due to trauma/ bite of animals/ birds. • Vyala Krut: (animated injuries) • Bite of insects, irritation with animal hairs. • Shastra Krut: (Instrumental injuries) • Stab injuries, abrasions. Probable disease:  Chakshushya Vibhrama  Astigmatism  Injury to Avarta & Apanga marma causes Andhyatva & Drishti Upghata.
Kalabala pravrutta • Seasonal eye diseases are produced due to change in the climatic conditions. • Vyapanna Ritu: (diseases arising due to Vaikrita Ritu) • Abhishyandana • Avyapanna Ritu: (diseases arising due to Prakrita Ritu) • Spring catarrah.
Daivabalapravrutta  Diseases arising due to observing bright light / Graha/ Devta.  These diseases are produced due to microbes.  Eg. Timira, Herpes keratitis.
Swabhava bala pravrutta • Age related degenerative changes. • Akalaja: (Earlier changes due to pathology) • Cataract in adult (diabetic cataract), Visual problem in children. • Kalaja: (Normal changes by age) • Presbyopia, senile cataract, arcus senilis, ARMD.
Nidana of Netra Roga उष्ण अभितप्तस्य जलः प्रवेशाद दुरेक्षणात् स्वप्न ववपरययययात् | प्रसक्त संरोदन कोपर शोक क्लेश अभिघातत् अतत मैथुनात् || शुक्तारनालाम्लक ु लत्थमाषतनषेवणाद्वेगववतनग्रहाच् | स्वेदादथो धूमतनषेवणाच् छदेववययघाताद्वमनाततयोगात् || बाष्परग्रहात् सूक्ष्मतनरीक्षणाच् नेत्रे ववकारान् जनयन्तत दोषाः|
Acharya Nidana आ ाययय िावप्रकाश रजोधूमतनषेवणात् , अततशीघ्र यानतः, ऋतु ववपरयययय, भशरो अभितापर आ ाययय योगरत्नाकर अततद्रव परानम् , अततमद्य परानम् आ ाययय ववदेह तीक्ष्ण अञ्जन , कीटदंश, स्परशाययदीभिः अभिहतेषु, सभलल क्रीडा, अतत लङ्घन,क्रमणरूपर प्रेक्षण आ ाययय डल्हण आवन्क्शर शयनम्, उन्च् तभशर शयनं, ज्वर् अभितापर आ ाययय वाग्िट पराद परीडन Other Nidanamentionedby different Acharyas
The Nidanas as explianedin the classicscan be further groupedas follows: 1. Aharaja 2. AharaVidhi 3. Viharaja 4. RutuViparyaya 5. Manasika 6. Agantuja 7. Bheshaja 8. Nidanarthakara 9. Sankramika
Aharaja Nidana PittaPrakopaka Ahara • ShuktaArnala • AmlaAhara • Kullatha • Madhya • Kshara,Tikshna,Ushna,KatuAhara KaphaPrakopaka Ahara • Masha • DravaAnna • ShitaAhara • GuruAhara
• Ahara containing Agneya Bhavas deranges eyes. • These Ahara possess: Rasa: Katu, Amla Guna: Tikshna, Vyavayi, Vishada, Sara Virya: Ushna Vipaka: Katu • Result: Daha, Raga, Paka i.e. Inflammatory changes. Kumbheeka (Multiple stye) Abhishyada (Conjunctivitis) Pilla Rogas (Inflammatory diseases)
शुक्तारनालाम्ल Fermented products They have properties opposite to Oja with toxicating action. Shukta-Arnala • Probable Dosha: Pitta & Rakta. • Diseases: Hypertensive retinopathy, Cytomegalo virus retintis, etc. They contain histamines and so acts as vasodilators leading to allergic manifestation. Amla rasa causes “Akshi Bhru Nikochana” causes ciliary muscle strain and sudden voluntary actions of lids
क ु लत्थ तनषेवण Excessive use of horse gram Kullatha • Laghu,Vidahi,KashayaRasa,KatuVipaka,UshnaVirya. • Leadsto DhatuKshaya • Tridosha • TridoshajaNetraRoga Pentosan present in kullatha can even lead to inflammatory changes.
अततमद्य परानम्(योगरत्नाकर) Drinking excessive Alcohol Present era: many are addicted to alcohol. • Toxic in nature. • Lack of adequate proteins, vitamins. • Alcohol causes deficiency of Vitamin B1. • Methyl alcohol metabolizes very slowly & oxidizes into formic acid & formaldehydes in tissues. • Probable Dosha: Tridosha • Diseases: cataract, nystagmus, paralysis of eye muscles, macular degeneration, toxic amblyopia. • Causes degeneration to ganglion cells, a main factor to cause toxic amblyopia.
Excess intake of Kshara, Teekshna, Ushna, Katu Ahara Excessive intake of Kshara, teekshna and Ushna Ahara • Increases body & eyes pH • Breakdown into hydroxyl ion & cation • Saponifies the cell membrane. • Interacts with collagen, glycosaminoglycans. • Produces stromal damage. • Causes epithelial defect. • Causes ciliary body irritation. Excessive intake of Katu Ahara • Stimulates prostaglandins (powerful vasodialators) • Inhibits aggregation of platelets. • Leads to inflammatory changes. • Desensitizes the neurons causing pain.
• Acharya Charaka, stated that Netra will always have threat from Kapha, thus excess Kapha accumulation is to be avoided. • These Ahara possess: Rasa: Madhura Guna: Guru, Snigdha, Pichilla, Virya: Sheeta Vipaka: Madhura • It causes Jathragni and Dhatvagni Mandhya leading to Srotorodha and Mala Sanchaya. • Result: Discharge, opacity, haziness, Shopha etc. Kaphaja Timira (cataract) Krimigranthi (Blephritis) Upnaha (Dacryocystitis) Shopha (Peri orbital swellinng)
माषतनषेवण Excessive use of Black gram Masha • MadhuraRasa, Madhura Vipaka, Guru, SnigdhaGuna • CausesDhatuVriddhi. • Kapha • KaphajaNetraRoga It increases level of oxalates in body and decreases iron level and so increases oxidative stress and damages surrounding structures.
अततद्रव परानम् (योगरत्नाकर) Drinking excessive liquid Present era: diet conscious. • Fluid retention takes place beneath skin which causes localized swelling. • Increases abdominal pressure. • Increases extracellular fluid volume. • Exerts pressure in arterioles. • Micro circulation in eye causes occlusion & inflammatory changes.
Intake of cold items • Lowers metabolism & alters the digestion. • Nutrition absorption & excretion also gets affected. Lowers immunity • Hampers the normal circulation. • Abnormal nutrition leads to weakness. Probable Dosha: Kapha
Heavy Food intake • They are rich in carbohydrates, which increases glucose level. • Extra glucose level accumulates in lens. • To dilute this glucose lens absorbs more fluid which changes the shape of lens.
Aharaja Vidhi • VirrudhaAhara • AsatmayaAhara
ववरुद्ध् आहार Dosha Utklesha Dhatu Utklesha Increases Guru, Snigdha, Pichilla Guna • Deranges vasculature. • Deranges permeability of vessels. Abhishyandi Srotas, Srotorodha, Netra Malsanchaya.
असात्मय आहार Ama Uttpatti Jathragni Mandhya Kaphaotklesha & Srotorodha Also vitiates Pittta Ama Lakshana of Netra: Raga, Shopha, Srava, Shoola, Daha which indicates inflammatory changes.
Viharaja Nidana VataPrakopaka Vihara • Durekshnat • SukshmaNirikshanat • Vividha RupaPrekshana • SakampenaAtikramana • Shranta Klanta • AtiShighraYanatah • AtiMaithuna • Maloshna,Sankatana,Pada Pidana • SwapanaViparyay • VegaVinigraha • AvakShir Shayana • UcchrittaShayana • Atilanghana • Bahyu Bharnam • TailaAbhyanjan Varjanam Pitta Prakopaka Vihara • Ushnaabhitaptsya Jalah Praveshata • Rajo DhoomaNishevana KaphaPrakopaka Vihara • SwapnaViparyay • AbhyanjanaNithantena • ChardiVighatat
Accomodation problem, cataract, macular degeneration, toxic amblyopia, valsalva retinopathy). • Shushkakshipaka (Dry eye) • Arma (Pterygium). • Abhishyanda (Allergic conjunctivitis, uveitis). • Balasgrathita (Pingueculae) Ruksha & Khara Guna increases. Does Shoshana Impairs Prana vata & Vyana Vata Indriya grahana shakti altered
दुरेक्षणात ् Looking at very distant object for a longer time Present era:  Drivers, shooters, archery, working with telescopes • Accomodative capacity of the lens will be destroyed. • Probable Dosha: Vata • Diseases: Hypermetropia
Present era: Working with computers, laptops, mobiles, reading, tailoring, embroidery, etc. Causes strain to ciliary muscles and lens. • Probable Dosha: Vata • Diseases: Dry eye syndrome, Accomodative errors. सूक्ष्मतनरीक्षण Watching minute objects for long duration
क्रमणरूपर प्रेक्षण (ववदेह) Continuously seeing moving objects Present era: Playing computer games, video games, traffic police, from high speed moving vehicles Strain to eye muscles specially ciliary muscles • Probable Dosha: Vata • Diseases: Squint, nystagmus, weakness of ocular muscles Spasm of accomodation occurs also causes difficulty in sensory perception. On starring continuously the blinking rate also will reduce, which make tear film to evaporate rapidly. All these constitutes the Atiyoga & Mithyayoga
श्रातत क्लाततः Fatigue & tiresome eyes Over usage of eyes Leads to strain on ciliary muscles and accomodation Sustained accomodative efforts Asthenopic symptoms
अततशीघ्र यानतः Travelling very fast Present era: Driving in high speed, running Speed blow of air/ dust directly comes in contact with eyes. • Probable Dosha: Vata • Diseases: Dry eye, Netra Srava Leads to hyperplasia which encroaches cornea destroying bowmans layer and superficial tissues.
अतत मैथुनात् Excessive indulgence in sex Leads to Dhatu Kshaya Also Shukra Dhatu Kshaya leading to purva Dhatu Kshaya Deprived nourishment to eyes • Probable Dosha: Tridosha • The presence of receptors in epithelial cells of lacrimal gland, meibomian gland dysfunction, tear film instability & disturbs the regulation of immune system & alters the secretory functions of lacrimal glands.
पराद परीडन (वा.) Strain on foot/ sole Present era: Not wearing slippers, wearing uncomfortable foot wears, tailoring, excessive cycling. Damage to Nadis of foot which are directly connected to head. • Probable Dosha: Vata • Diseases: Drishti Mandhya, Timir • Feet have mechanical receptors of the nervous system. These receptors are sensitive to touch, so whenever there is any sort of blow, injury to feet/soles it can affect
स्वप्न ववपरययययात् Abnormal sleeping habits (Diwaswapana/ Ratrijagrana) Present era:  Night shifts  Sleeping late night • Probable Dosha: Tridosha • Divaswap: Kapha prakopa • Ratrijagrana: Vata & Pitta Parkopa. • Decreased oxygen supply to brain • Causes loss of cognitive abilities and involuntary , spontaneous, localized quivering of ocular muscle occurs. • Leads to excessive stress to ciliary muscles cause defect inn acomodation.
वेगववतनग्रह Suppression of Natural Urges Suppression of Vata, Vit, Jrimbha, Ashru, Kshavthu, Hikka, Kshudha all leads to Netra Rogas. Present era: During classes, in office. • Probable Dosha: Tridosha • The pressure exerted by controlling these urges increases pressure within the globe, causes pain. • In advance stages causes vasodialation leading to haemorrhages in Shukla Mandala or Drishti Mandala.
अतत लङ्घन (ववदेह) Excessive fasting Present era: Excessive diet conscious Leads to Hypoglycemia • Probable Dosha: Vata • Diseases: Netra Shosha Decreased supply of glucose & so reduces energy production. Retinal cells will not be able to meet metabolic demands Defiecient in retinal function.
आवन्क्शर शयनम ् (डल्हण) Sleeping in head down position Present era: Sleeping on working table, bus, etc. • Due to gravitational pressure there occurs compression to blood vessels. • Also increase the pressure over optic nerve. • Probable Dosha: Vata • Diseases: Occipital neuralgia, CRVO, etc.
उन्च् तभशर शयनं (डल्हण) Sleeping with head elevated Present era: Use of high pillows, sleeping on sofa, etc. Decreased blood circulation to head & so hampers metabolism to eyes. • Probable Dosha: Vata • Diseases: Vataja Netra Roga, Optic atrophy
बाहु िारनम ् Carrying heavy loads over head Increases Intrathoracic pressure (against closed glottis) Rupture of Retinal capillaries
तैल वजययन Not using oil properly Increases Ruksha, Khara, Sukshma Guna.
बाष्परग्रहात् Suppressing tears during grief Suppressing the tears. Vitiated Vayu obstructs the Doshas • Probable Dosha: Kapha & Vata Diseases of Ashruvaha Srotas Further causes instability of tear film, dryness of ocular surface.
• Abhishyanda (Conjunctivitis) • Adhimantha (Glaucoma) • Pitta Vidagdha Drishti (Day blindness) • Dhumadarshi (Haziness of vision) Serves Achakshushya Rakta Dushti Syanda Srotas Increases Tikshna & sara guna of Pitta Rakta Dushti Syanda Srotas Disturbs tejo guna Indriya grahan daurbalya
“उष्ण अभितप्तस्य जलः प्रवेशाद” Immersing in cold water immediately after getting exposed to heat/sun Present era:  Bathing/drinking cold water  Entering into AC compartment soon after exposure to heat/sun. • Tissue integrity will be spoiled • Probable Dosha: Pitta. • Circulatory disturbances occurs
रजोधूमतनषेवणात् Exposure to dust & smoke Present era: While walking, driving, addicted to smoking Causes oxidative stress • Probable Dosha: Vata • Oxidative damage evokes. • Ocular injury may occur. Potent irritant Causes infection to conjunctiva & sclera • Immediate hypersensitivity reaction mediated by IgE & mast cell activation.
Dosha Utklesha Interacts with Rakta & Pitta Syanda srotas • Abhishyanda (Conjunctivitis) • Sleshma Vidagdha Drishti ( Night blindness) • Pothaki (Trachoma).
स्वप्न ववपरययययात् Abnormal sleeping habits (Diwaswapana/ Ratrijagrana) Present era:  Night shifts  Sleeping late night • Divaswap: Kapha prakopa • Ratrijagrana: Vata & Pitta Parkopa. • Probable Dosha: Tridosha Fluid in eye fails to drain properly, making it susceptible for nerve damage.
अभ्यञ्जन तनत्हतते Excessive oil massage • Increases Snigdha, Pichilla, Guru Guna & Dosha Utklesha.
छदेववययघात Suppressing urge of vomiting Suppressing the urge of vomit. Causes strain to eye & Akshi Kandu • Probable Dosha: Vata • Diseases: Eye lesions, Arjuna (Sub- conjunctival hammeorrhages.
Consuming Ushna Drvyas in Ushna Ritu causes Pitta Prakopa. Consuming Shita Drvyas in Shita Ritu- Kapha Prakopa. i.e. not following Ritucharya • Seasonal eye changes are produced due to change in the climatic conditions. • The conjunctiva of eye is more sensitive than skin. Ritu Viparyay (Seasonal variation) • In warm climate, there will be hyperplasia of epithelium & sub epithelium of conjunctiva. • Cold climate can constrict the blood vessels and can even restrict the normal metabolism of cornea. • Cann be painful & may affect visual clarity & may also lead to dryness of eyes.
Mansika Nidana • Prasakta Sanrodanam • Bhaya • Shoka • Klesha • Kopa
प्रसक्त संरोदन Continuous weeping for longer duration Causes excessive stimulation to lacrimal gland by which the gland secrets more fluid that washes away nutrients and bacterio static effect of conjunctival sac. • Probable Dosha: vata • Diseases: Xerosis and diseases of lacrimal apparatus. Conjunctival sac & lacimal apparatus looses the stamina against diseases.
कोपर शोक Excessive anger and grief (They are Mansika Dharniya Vega) • Probable Dosha: Pitta & vata • Diseases: Subconjunctival hameorrhage, Vataja Vikara. During anxiety attacks Body gets a rush of Adrenaline Pupil gets dialated Blurred vision occurs as a reaction to unnecessary extra light
क्लेश Excessive Stress • Probable Dosha: Vata • Diseases: Vataja Netra Rogas Stress, suffering pain, trouble Frequent changes in endocrine, immune autonomic nervous and cardiovascular system Fundamentally influenced by brain func. & neurotransmitters Impact on eyes
िय Fear is reinforcement of a safety signal, which is autonomic neuro endocrine action. Causes muscle twitching, increases heart rate, leads to sudden dilation of pupil
Agantuja Nidana • Abhighata • Salila Kreeda • Keetamakshika Sparshadibhi • Chandragrahana, Nakshtra kramana • Divakara Agni Tejasa, Ratnanam Vilokana
अभिघातत् Trauma to eyes Minute irritating injuries or contusion injuries or perforating injuries cause a great loss to the eye. No proper care Blindness Present era:  Chemical injuries, occupational hazards, accidents. • Probable Dosha: Tridosha • Diseases: Corneal abrasion, Corneal erosion, Periorbital abcess, etc.
कीटदंश (ववदेह) Insect bite Causes Injury May release toxins Acts as foreign body • Probable Dosha: Tridosha • Diseases: Pain, Burning, Swelling
स्परशाययदीभिः अभिहतेषु (ववदेह) Contact with toxic materials Present era: Accidental contact with paint, perfumes, deos, detergents, soaps, lab materials, etc. Causes local tissue damage • Probable Dosha: Tridosha • Diseases: can worsen from irritation to blindness.
सभलल क्रीडा (ववदेह) Water sports Present era: Not wearing swimming goggles during swimming or water games. Entry of contaminated water into eyes. • Probable Dosha: Tridosha • Diseases: burning sensation to eyes, corneal abrasions, conjunctivitis, ulcerative keratitis, etc.
तद्रग्रह, नक्षत्र क्रमण Visualizing Lunar eclipse It will lead to ciliary muscles strain in eyes. The penetrating & high illuminating rays can lead to retinal damage.
ददवाकर अन्ग्न तेजस, रत्नानां ववलोकन By the glare of sun & by visualizing the precious stone • Retinal damage occurs due to photo-chemicals rather than thermal injury. • By sun gazing, ( though there is 4 degree celcius increase in temp insufficient to photo coagulate) the light promotes oxidation, chemical reactions occur in exposed tissues with unbonded molecules. • The duration of exposure is necessary to cause injury & it varies with intensity of light.
Bheshaja • Atiswedana • Vamana Atiyogata • Anjana
स्वेद Excessive sudation to eye Only Mridu Swedana is advised in Netra Rogas. In diseases like Timira, Swedana is contraindicated. Present era: Working in coal mines, cooking, bakers. • Probable Dosha: Pitta & Rakta • Diseases: Pittaja Abhishyanda, Dry eye. The vasculature will be altered leading to dilatations of vessels leads to Pitta Prakopa Netra rogas.
वमन अततयोगात् Excessive Vamana therapy Causes “Akshir vyavruthi” (Protusion of eyeball) • Probable Dosha: Vata Vriddhi, Kapha & Pitta Kshaya • Diseases: Retinal detachment, Viterous prolapse, Arjuna (Sub- conjunctival hammeorrhages. • Ati Vamana causes Vata Prakopa. • Upward pressure exerted during Vamana causes the fragile vessels of eyes to rupture & bleed.
तीक्ष्ण अञ्जन (ववदेह) Applying teekshnanjana to patients who are already tired due to wind, sun,etc. Local irritation, excessive lacrimation, conjunctiva damage, cornea, etc. • Probable Dosha: Tridosha • Diseases: Sirajala, Siraharsha, etc.
Nidanarthkara • Jwarotpata • Granthi • Meha
भशरो अभितापर Exposure of head to excessive heat Present era: Engineers, Constructors, Coolies, Traffic police. • Probable Dosha: Vata & Pitta Prakopa. • Diseases: Photokeratitis “Deha Indriya Manastapa” “Indriya Tapina Timiradaya” (Ch. Chi. 3) Santapa is a cardinal feature of Jwara so it affects eye also.
ज्वर् अभितापर (डल्हण) High fever Due to high fever Along with head temp. of eye lso increases • Probable Dosha: Pitta • Diseases: Peri-orbital swelling, conjunctivitis in hay fever, etc.
ग्रन्तथ Glandular disorders have impact on eyes like swelling around the eyes in hypothyroidism.
मेह • As a complication of diabetes, eyes can also be affected. • Diabetes mellitus leading to diabetic retinopathy.
Aupsargika Roga The Nidanas stated are: प्रसंगात् (get together) गात्र संस्पर्ााद् (Touching the skin) न िःश्वसाद् (Contact with exhaled air) सह भोज ाद् (Eating together) सह्र्य्या अस ात् (Sleeping and Sitting together) वस्त्रमाल्य अ ुलेप ात् (Sharing clothes, garlands & cosmetics)
critical analysis of netra roga nidana.pptx

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critical analysis of netra roga nidana.pptx

  • 1.
    “CRITICAL ANALYSISOF NIDANAOF NETRAROGA” Dr. Shraddha Joshi Ph.D. 2nd year Shalakya Tantra dept.
  • 2.
    Why understanding Nidana isimportant? • To assess Dosha vitiation. • Helps to decide Sadhya, Asadhyata of Vyadhi. • To analyse the Samprapti. • For proper planning of treatment.
  • 3.
    Adi balapravrutta  Dueto defect in Shukra and Shonita.  Kulaja Vikara (Hereditary disorder).  Eg. Naktandhya (Night blindness) Albinism, etc.
  • 4.
    Janmabala pravrutta  Theseare congenital disorders caused because of Rasa and Dauhrida Apchara Kruta.  Eg.Jatyandha, Microcornea/ Megalocornea, Keratoconus, Congenital myopia, hypermetropia, congenital cataract, ptosis, dacryocystitis.
  • 5.
    Ushna, Katu, Kshara Ahara AtiSevana. DoshaBalaPravrittaja Atiyoga, Ayoga, Mithyayoga of Vihara Mithyayoga- Looking into very near/very distant objects. Aayoga- Completely avoiding the vision. Atiyoga- Looking into illuminating & bright objects. Vitiation of Dosha either in Amashya/Pakvshaya.
  • 6.
    Sanghata bala pravrutta • Theseare traumatic disease due to trauma/ bite of animals/ birds. • Vyala Krut: (animated injuries) • Bite of insects, irritation with animal hairs. • Shastra Krut: (Instrumental injuries) • Stab injuries, abrasions. Probable disease:  Chakshushya Vibhrama  Astigmatism  Injury to Avarta & Apanga marma causes Andhyatva & Drishti Upghata.
  • 7.
    Kalabala pravrutta • Seasonal eyediseases are produced due to change in the climatic conditions. • Vyapanna Ritu: (diseases arising due to Vaikrita Ritu) • Abhishyandana • Avyapanna Ritu: (diseases arising due to Prakrita Ritu) • Spring catarrah.
  • 8.
    Daivabalapravrutta  Diseases arisingdue to observing bright light / Graha/ Devta.  These diseases are produced due to microbes.  Eg. Timira, Herpes keratitis.
  • 9.
    Swabhava bala pravrutta • Agerelated degenerative changes. • Akalaja: (Earlier changes due to pathology) • Cataract in adult (diabetic cataract), Visual problem in children. • Kalaja: (Normal changes by age) • Presbyopia, senile cataract, arcus senilis, ARMD.
  • 10.
    Nidana of NetraRoga उष्ण अभितप्तस्य जलः प्रवेशाद दुरेक्षणात् स्वप्न ववपरययययात् | प्रसक्त संरोदन कोपर शोक क्लेश अभिघातत् अतत मैथुनात् || शुक्तारनालाम्लक ु लत्थमाषतनषेवणाद्वेगववतनग्रहाच् | स्वेदादथो धूमतनषेवणाच् छदेववययघाताद्वमनाततयोगात् || बाष्परग्रहात् सूक्ष्मतनरीक्षणाच् नेत्रे ववकारान् जनयन्तत दोषाः|
  • 11.
    Acharya Nidana आ ायययिावप्रकाश रजोधूमतनषेवणात् , अततशीघ्र यानतः, ऋतु ववपरयययय, भशरो अभितापर आ ाययय योगरत्नाकर अततद्रव परानम् , अततमद्य परानम् आ ाययय ववदेह तीक्ष्ण अञ्जन , कीटदंश, स्परशाययदीभिः अभिहतेषु, सभलल क्रीडा, अतत लङ्घन,क्रमणरूपर प्रेक्षण आ ाययय डल्हण आवन्क्शर शयनम्, उन्च् तभशर शयनं, ज्वर् अभितापर आ ाययय वाग्िट पराद परीडन Other Nidanamentionedby different Acharyas
  • 12.
    The Nidanas asexplianedin the classicscan be further groupedas follows: 1. Aharaja 2. AharaVidhi 3. Viharaja 4. RutuViparyaya 5. Manasika 6. Agantuja 7. Bheshaja 8. Nidanarthakara 9. Sankramika
  • 13.
    Aharaja Nidana PittaPrakopaka Ahara • ShuktaArnala •AmlaAhara • Kullatha • Madhya • Kshara,Tikshna,Ushna,KatuAhara KaphaPrakopaka Ahara • Masha • DravaAnna • ShitaAhara • GuruAhara
  • 14.
    • Ahara containingAgneya Bhavas deranges eyes. • These Ahara possess: Rasa: Katu, Amla Guna: Tikshna, Vyavayi, Vishada, Sara Virya: Ushna Vipaka: Katu • Result: Daha, Raga, Paka i.e. Inflammatory changes. Kumbheeka (Multiple stye) Abhishyada (Conjunctivitis) Pilla Rogas (Inflammatory diseases)
  • 15.
    शुक्तारनालाम्ल Fermented products They haveproperties opposite to Oja with toxicating action. Shukta-Arnala • Probable Dosha: Pitta & Rakta. • Diseases: Hypertensive retinopathy, Cytomegalo virus retintis, etc. They contain histamines and so acts as vasodilators leading to allergic manifestation. Amla rasa causes “Akshi Bhru Nikochana” causes ciliary muscle strain and sudden voluntary actions of lids
  • 16.
    क ु लत्थ तनषेवण Excessiveuse of horse gram Kullatha • Laghu,Vidahi,KashayaRasa,KatuVipaka,UshnaVirya. • Leadsto DhatuKshaya • Tridosha • TridoshajaNetraRoga Pentosan present in kullatha can even lead to inflammatory changes.
  • 17.
    अततमद्य परानम्(योगरत्नाकर) Drinking excessiveAlcohol Present era: many are addicted to alcohol. • Toxic in nature. • Lack of adequate proteins, vitamins. • Alcohol causes deficiency of Vitamin B1. • Methyl alcohol metabolizes very slowly & oxidizes into formic acid & formaldehydes in tissues. • Probable Dosha: Tridosha • Diseases: cataract, nystagmus, paralysis of eye muscles, macular degeneration, toxic amblyopia. • Causes degeneration to ganglion cells, a main factor to cause toxic amblyopia.
  • 18.
    Excess intake ofKshara, Teekshna, Ushna, Katu Ahara Excessive intake of Kshara, teekshna and Ushna Ahara • Increases body & eyes pH • Breakdown into hydroxyl ion & cation • Saponifies the cell membrane. • Interacts with collagen, glycosaminoglycans. • Produces stromal damage. • Causes epithelial defect. • Causes ciliary body irritation. Excessive intake of Katu Ahara • Stimulates prostaglandins (powerful vasodialators) • Inhibits aggregation of platelets. • Leads to inflammatory changes. • Desensitizes the neurons causing pain.
  • 19.
    • Acharya Charaka,stated that Netra will always have threat from Kapha, thus excess Kapha accumulation is to be avoided. • These Ahara possess: Rasa: Madhura Guna: Guru, Snigdha, Pichilla, Virya: Sheeta Vipaka: Madhura • It causes Jathragni and Dhatvagni Mandhya leading to Srotorodha and Mala Sanchaya. • Result: Discharge, opacity, haziness, Shopha etc. Kaphaja Timira (cataract) Krimigranthi (Blephritis) Upnaha (Dacryocystitis) Shopha (Peri orbital swellinng)
  • 20.
    माषतनषेवण Excessive use ofBlack gram Masha • MadhuraRasa, Madhura Vipaka, Guru, SnigdhaGuna • CausesDhatuVriddhi. • Kapha • KaphajaNetraRoga It increases level of oxalates in body and decreases iron level and so increases oxidative stress and damages surrounding structures.
  • 21.
    अततद्रव परानम् (योगरत्नाकर) Drinkingexcessive liquid Present era: diet conscious. • Fluid retention takes place beneath skin which causes localized swelling. • Increases abdominal pressure. • Increases extracellular fluid volume. • Exerts pressure in arterioles. • Micro circulation in eye causes occlusion & inflammatory changes.
  • 22.
    Intake of colditems • Lowers metabolism & alters the digestion. • Nutrition absorption & excretion also gets affected. Lowers immunity • Hampers the normal circulation. • Abnormal nutrition leads to weakness. Probable Dosha: Kapha
  • 23.
    Heavy Food intake •They are rich in carbohydrates, which increases glucose level. • Extra glucose level accumulates in lens. • To dilute this glucose lens absorbs more fluid which changes the shape of lens.
  • 24.
  • 25.
    ववरुद्ध् आहार Dosha UtkleshaDhatu Utklesha Increases Guru, Snigdha, Pichilla Guna • Deranges vasculature. • Deranges permeability of vessels. Abhishyandi Srotas, Srotorodha, Netra Malsanchaya.
  • 26.
    असात्मय आहार Ama Uttpatti JathragniMandhya Kaphaotklesha & Srotorodha Also vitiates Pittta Ama Lakshana of Netra: Raga, Shopha, Srava, Shoola, Daha which indicates inflammatory changes.
  • 27.
    Viharaja Nidana VataPrakopaka Vihara• Durekshnat • SukshmaNirikshanat • Vividha RupaPrekshana • SakampenaAtikramana • Shranta Klanta • AtiShighraYanatah • AtiMaithuna • Maloshna,Sankatana,Pada Pidana • SwapanaViparyay • VegaVinigraha • AvakShir Shayana • UcchrittaShayana • Atilanghana • Bahyu Bharnam • TailaAbhyanjan Varjanam Pitta Prakopaka Vihara • Ushnaabhitaptsya Jalah Praveshata • Rajo DhoomaNishevana KaphaPrakopaka Vihara • SwapnaViparyay • AbhyanjanaNithantena • ChardiVighatat
  • 28.
    Accomodation problem, cataract, macular degeneration, toxic amblyopia,valsalva retinopathy). • Shushkakshipaka (Dry eye) • Arma (Pterygium). • Abhishyanda (Allergic conjunctivitis, uveitis). • Balasgrathita (Pingueculae) Ruksha & Khara Guna increases. Does Shoshana Impairs Prana vata & Vyana Vata Indriya grahana shakti altered
  • 29.
    दुरेक्षणात ् Looking atvery distant object for a longer time Present era:  Drivers, shooters, archery, working with telescopes • Accomodative capacity of the lens will be destroyed. • Probable Dosha: Vata • Diseases: Hypermetropia
  • 30.
    Present era: Working with computers, laptops,mobiles, reading, tailoring, embroidery, etc. Causes strain to ciliary muscles and lens. • Probable Dosha: Vata • Diseases: Dry eye syndrome, Accomodative errors. सूक्ष्मतनरीक्षण Watching minute objects for long duration
  • 31.
    क्रमणरूपर प्रेक्षण (ववदेह) Continuouslyseeing moving objects Present era: Playing computer games, video games, traffic police, from high speed moving vehicles Strain to eye muscles specially ciliary muscles • Probable Dosha: Vata • Diseases: Squint, nystagmus, weakness of ocular muscles Spasm of accomodation occurs also causes difficulty in sensory perception. On starring continuously the blinking rate also will reduce, which make tear film to evaporate rapidly. All these constitutes the Atiyoga & Mithyayoga
  • 32.
    श्रातत क्लाततः Fatigue &tiresome eyes Over usage of eyes Leads to strain on ciliary muscles and accomodation Sustained accomodative efforts Asthenopic symptoms
  • 33.
    अततशीघ्र यानतः Travelling veryfast Present era: Driving in high speed, running Speed blow of air/ dust directly comes in contact with eyes. • Probable Dosha: Vata • Diseases: Dry eye, Netra Srava Leads to hyperplasia which encroaches cornea destroying bowmans layer and superficial tissues.
  • 34.
    अतत मैथुनात् Excessive indulgencein sex Leads to Dhatu Kshaya Also Shukra Dhatu Kshaya leading to purva Dhatu Kshaya Deprived nourishment to eyes • Probable Dosha: Tridosha • The presence of receptors in epithelial cells of lacrimal gland, meibomian gland dysfunction, tear film instability & disturbs the regulation of immune system & alters the secretory functions of lacrimal glands.
  • 35.
    पराद परीडन (वा.) Strainon foot/ sole Present era: Not wearing slippers, wearing uncomfortable foot wears, tailoring, excessive cycling. Damage to Nadis of foot which are directly connected to head. • Probable Dosha: Vata • Diseases: Drishti Mandhya, Timir • Feet have mechanical receptors of the nervous system. These receptors are sensitive to touch, so whenever there is any sort of blow, injury to feet/soles it can affect
  • 36.
    स्वप्न ववपरययययात् Abnormal sleepinghabits (Diwaswapana/ Ratrijagrana) Present era:  Night shifts  Sleeping late night • Probable Dosha: Tridosha • Divaswap: Kapha prakopa • Ratrijagrana: Vata & Pitta Parkopa. • Decreased oxygen supply to brain • Causes loss of cognitive abilities and involuntary , spontaneous, localized quivering of ocular muscle occurs. • Leads to excessive stress to ciliary muscles cause defect inn acomodation.
  • 37.
    वेगववतनग्रह Suppression of NaturalUrges Suppression of Vata, Vit, Jrimbha, Ashru, Kshavthu, Hikka, Kshudha all leads to Netra Rogas. Present era: During classes, in office. • Probable Dosha: Tridosha • The pressure exerted by controlling these urges increases pressure within the globe, causes pain. • In advance stages causes vasodialation leading to haemorrhages in Shukla Mandala or Drishti Mandala.
  • 38.
    अतत लङ्घन (ववदेह) Excessivefasting Present era: Excessive diet conscious Leads to Hypoglycemia • Probable Dosha: Vata • Diseases: Netra Shosha Decreased supply of glucose & so reduces energy production. Retinal cells will not be able to meet metabolic demands Defiecient in retinal function.
  • 39.
    आवन्क्शर शयनम ्(डल्हण) Sleeping in head down position Present era: Sleeping on working table, bus, etc. • Due to gravitational pressure there occurs compression to blood vessels. • Also increase the pressure over optic nerve. • Probable Dosha: Vata • Diseases: Occipital neuralgia, CRVO, etc.
  • 40.
    उन्च् तभशर शयनं(डल्हण) Sleeping with head elevated Present era: Use of high pillows, sleeping on sofa, etc. Decreased blood circulation to head & so hampers metabolism to eyes. • Probable Dosha: Vata • Diseases: Vataja Netra Roga, Optic atrophy
  • 41.
    बाहु िारनम ् Carryingheavy loads over head Increases Intrathoracic pressure (against closed glottis) Rupture of Retinal capillaries
  • 42.
    तैल वजययन Not usingoil properly Increases Ruksha, Khara, Sukshma Guna.
  • 43.
    बाष्परग्रहात् Suppressing tears duringgrief Suppressing the tears. Vitiated Vayu obstructs the Doshas • Probable Dosha: Kapha & Vata Diseases of Ashruvaha Srotas Further causes instability of tear film, dryness of ocular surface.
  • 44.
    • Abhishyanda (Conjunctivitis) • Adhimantha (Glaucoma) •Pitta Vidagdha Drishti (Day blindness) • Dhumadarshi (Haziness of vision) Serves Achakshushya Rakta Dushti Syanda Srotas Increases Tikshna & sara guna of Pitta Rakta Dushti Syanda Srotas Disturbs tejo guna Indriya grahan daurbalya
  • 45.
    “उष्ण अभितप्तस्य जलःप्रवेशाद” Immersing in cold water immediately after getting exposed to heat/sun Present era:  Bathing/drinking cold water  Entering into AC compartment soon after exposure to heat/sun. • Tissue integrity will be spoiled • Probable Dosha: Pitta. • Circulatory disturbances occurs
  • 46.
    रजोधूमतनषेवणात् Exposure to dust& smoke Present era: While walking, driving, addicted to smoking Causes oxidative stress • Probable Dosha: Vata • Oxidative damage evokes. • Ocular injury may occur. Potent irritant Causes infection to conjunctiva & sclera • Immediate hypersensitivity reaction mediated by IgE & mast cell activation.
  • 47.
    Dosha Utklesha Interacts with Rakta& Pitta Syanda srotas • Abhishyanda (Conjunctivitis) • Sleshma Vidagdha Drishti ( Night blindness) • Pothaki (Trachoma).
  • 48.
    स्वप्न ववपरययययात् Abnormal sleepinghabits (Diwaswapana/ Ratrijagrana) Present era:  Night shifts  Sleeping late night • Divaswap: Kapha prakopa • Ratrijagrana: Vata & Pitta Parkopa. • Probable Dosha: Tridosha Fluid in eye fails to drain properly, making it susceptible for nerve damage.
  • 49.
    अभ्यञ्जन तनत्हतते Excessive oilmassage • Increases Snigdha, Pichilla, Guru Guna & Dosha Utklesha.
  • 50.
    छदेववययघात Suppressing urge ofvomiting Suppressing the urge of vomit. Causes strain to eye & Akshi Kandu • Probable Dosha: Vata • Diseases: Eye lesions, Arjuna (Sub- conjunctival hammeorrhages.
  • 51.
    Consuming Ushna Drvyasin Ushna Ritu causes Pitta Prakopa. Consuming Shita Drvyas in Shita Ritu- Kapha Prakopa. i.e. not following Ritucharya • Seasonal eye changes are produced due to change in the climatic conditions. • The conjunctiva of eye is more sensitive than skin. Ritu Viparyay (Seasonal variation) • In warm climate, there will be hyperplasia of epithelium & sub epithelium of conjunctiva. • Cold climate can constrict the blood vessels and can even restrict the normal metabolism of cornea. • Cann be painful & may affect visual clarity & may also lead to dryness of eyes.
  • 52.
    Mansika Nidana • PrasaktaSanrodanam • Bhaya • Shoka • Klesha • Kopa
  • 53.
    प्रसक्त संरोदन Continuous weepingfor longer duration Causes excessive stimulation to lacrimal gland by which the gland secrets more fluid that washes away nutrients and bacterio static effect of conjunctival sac. • Probable Dosha: vata • Diseases: Xerosis and diseases of lacrimal apparatus. Conjunctival sac & lacimal apparatus looses the stamina against diseases.
  • 54.
    कोपर शोक Excessive angerand grief (They are Mansika Dharniya Vega) • Probable Dosha: Pitta & vata • Diseases: Subconjunctival hameorrhage, Vataja Vikara. During anxiety attacks Body gets a rush of Adrenaline Pupil gets dialated Blurred vision occurs as a reaction to unnecessary extra light
  • 55.
    क्लेश Excessive Stress • ProbableDosha: Vata • Diseases: Vataja Netra Rogas Stress, suffering pain, trouble Frequent changes in endocrine, immune autonomic nervous and cardiovascular system Fundamentally influenced by brain func. & neurotransmitters Impact on eyes
  • 56.
    िय Fear is reinforcementof a safety signal, which is autonomic neuro endocrine action. Causes muscle twitching, increases heart rate, leads to sudden dilation of pupil
  • 57.
    Agantuja Nidana • Abhighata •Salila Kreeda • Keetamakshika Sparshadibhi • Chandragrahana, Nakshtra kramana • Divakara Agni Tejasa, Ratnanam Vilokana
  • 58.
    अभिघातत् Trauma to eyes Minuteirritating injuries or contusion injuries or perforating injuries cause a great loss to the eye. No proper care Blindness Present era:  Chemical injuries, occupational hazards, accidents. • Probable Dosha: Tridosha • Diseases: Corneal abrasion, Corneal erosion, Periorbital abcess, etc.
  • 59.
    कीटदंश (ववदेह) Insect bite CausesInjury May release toxins Acts as foreign body • Probable Dosha: Tridosha • Diseases: Pain, Burning, Swelling
  • 60.
    स्परशाययदीभिः अभिहतेषु (ववदेह) Contactwith toxic materials Present era: Accidental contact with paint, perfumes, deos, detergents, soaps, lab materials, etc. Causes local tissue damage • Probable Dosha: Tridosha • Diseases: can worsen from irritation to blindness.
  • 61.
    सभलल क्रीडा (ववदेह) Watersports Present era: Not wearing swimming goggles during swimming or water games. Entry of contaminated water into eyes. • Probable Dosha: Tridosha • Diseases: burning sensation to eyes, corneal abrasions, conjunctivitis, ulcerative keratitis, etc.
  • 62.
    तद्रग्रह, नक्षत्र क्रमण VisualizingLunar eclipse It will lead to ciliary muscles strain in eyes. The penetrating & high illuminating rays can lead to retinal damage.
  • 63.
    ददवाकर अन्ग्न तेजस,रत्नानां ववलोकन By the glare of sun & by visualizing the precious stone • Retinal damage occurs due to photo-chemicals rather than thermal injury. • By sun gazing, ( though there is 4 degree celcius increase in temp insufficient to photo coagulate) the light promotes oxidation, chemical reactions occur in exposed tissues with unbonded molecules. • The duration of exposure is necessary to cause injury & it varies with intensity of light.
  • 64.
  • 65.
    स्वेद Excessive sudation toeye Only Mridu Swedana is advised in Netra Rogas. In diseases like Timira, Swedana is contraindicated. Present era: Working in coal mines, cooking, bakers. • Probable Dosha: Pitta & Rakta • Diseases: Pittaja Abhishyanda, Dry eye. The vasculature will be altered leading to dilatations of vessels leads to Pitta Prakopa Netra rogas.
  • 66.
    वमन अततयोगात् Excessive Vamanatherapy Causes “Akshir vyavruthi” (Protusion of eyeball) • Probable Dosha: Vata Vriddhi, Kapha & Pitta Kshaya • Diseases: Retinal detachment, Viterous prolapse, Arjuna (Sub- conjunctival hammeorrhages. • Ati Vamana causes Vata Prakopa. • Upward pressure exerted during Vamana causes the fragile vessels of eyes to rupture & bleed.
  • 67.
    तीक्ष्ण अञ्जन (ववदेह) Applying teekshnanjanato patients who are already tired due to wind, sun,etc. Local irritation, excessive lacrimation, conjunctiva damage, cornea, etc. • Probable Dosha: Tridosha • Diseases: Sirajala, Siraharsha, etc.
  • 68.
  • 69.
    भशरो अभितापर Exposure ofhead to excessive heat Present era: Engineers, Constructors, Coolies, Traffic police. • Probable Dosha: Vata & Pitta Prakopa. • Diseases: Photokeratitis “Deha Indriya Manastapa” “Indriya Tapina Timiradaya” (Ch. Chi. 3) Santapa is a cardinal feature of Jwara so it affects eye also.
  • 70.
    ज्वर् अभितापर (डल्हण) Highfever Due to high fever Along with head temp. of eye lso increases • Probable Dosha: Pitta • Diseases: Peri-orbital swelling, conjunctivitis in hay fever, etc.
  • 71.
    ग्रन्तथ Glandular disorders haveimpact on eyes like swelling around the eyes in hypothyroidism.
  • 72.
    मेह • As acomplication of diabetes, eyes can also be affected. • Diabetes mellitus leading to diabetic retinopathy.
  • 73.
    Aupsargika Roga The Nidanasstated are: प्रसंगात् (get together) गात्र संस्पर्ााद् (Touching the skin) न िःश्वसाद् (Contact with exhaled air) सह भोज ाद् (Eating together) सह्र्य्या अस ात् (Sleeping and Sitting together) वस्त्रमाल्य अ ुलेप ात् (Sharing clothes, garlands & cosmetics)

Editor's Notes

  • #70 These Nidanas holds good to understand not only the existing disorders, but also the trending new diseases and changing pattern of old diseases.