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1. CASE PRESENTATION ON
KRIMIGRANTHI
PRESENTED BY: AMUL SAI
GUIDED BY :DR. DIVYA MA’AM

2. CASE PRESENTATION
 Name : Sagar
 Age : 32 yrs
 Sex : Male
 Religion : Hindu
 Profession : Farmer
 Marital status : Unmarried
 Adress : Yelahanka
 Date of admission : 24/O8/2021
 Date of discharge : 26/08/2021

3. • PRADHANA VEDHANA AND AVADHI [CHIEF
COMPLAINTS AND DURATION]
Patient complaints of Itching, Burning sensation and
Swelling.
• ANUBANDHA VEDHANA [ ASSOCIATED
COMPLAINTS]
a. Lacrimation
b. Falling of eye lashes
c. Whitish scales on the root of eye lashes
• ADYATANA VYADHI VRUTANTA [ HISTORY OF
PRESENT ILLNESS]
a. Patient Sagr, 32 yr old, developed itching and burning
sensation with mild lacrimation since 15 days.
b. Swelling since 15 days.
c. Falling of lashes and whitish scales on root since a week.

4. • POORVA VYADHI VRITTANTA [ PAST
HISTORY]
Notghing significant.
• KULA VRITTANTA [FAMILY HISTORY]
Nothing significant
• VAIYAKTIKA VRITTANTA [PERSONAL
HISTORY]
Appetite – good
Bowel – regular
Sleep – disturbed
Micturition – normal

5.  SAMANYA PARIKSHA [ GENERAL
EXAMINATION]
a)Heart rate – 78/min
b) BP – 130/80 mm of Hg
c)Respiratory rate – 22/min
d) Pulse - 80/min
e)Temperature – 98 degree F
 STHANIKA PARIKSHA [ LOCAL
EXAMINATION]
1.Pakshma mandala pariksha
eyelashes are falling.
2.Vartma mandala pariksha
reddish colored eyelid.

6. 3.Shukla Mandala Pareeksha
Conjunctival congestion.
4.Krishna Mandala Pareeksha
Corneal examination is normal.
5.Drushti Mandala
pupil – greyish black in color.
6.Netra Sandhi Pareeksha
Pakshma vartma sandhi - redness and slight
swelling.
7.Netra Patala Pareeksha
scaly appearance under the slit-lamp
examination

7. VISUAL ACQUITY TEST
Acutness of vision Rt eye Lt eye
1. Distant vision
Snellen’s chart 6/6 6/6
2. Near vision
Jaegers chart N6 N6
3. Colour vision N N
INTRAOCCULAR PRESSURE
Normal 10P – 12-22 mm Hg

8. INVESTIGATIONS
• Digital Tonomectry
Ask the patient to close their eyes and look down.
Place both the tips of index fingers on the closed
upper eyelid and the rest of the figers on the cheeks.
Apply slight pressure with the right index, then left
and right.
Repeat on the other eye.
It is important to compare the two eyes.
A normal eye will feel neither too solid nor very soft.
Very high 10P will feel abnormally hard and solid.

9. NIDANA
Sudden exposure to cold water of the heat.
Looking at very distant object for long time.
Continuous crying.
Soka and Klesha.
Injury
Anger
Not maintaining hygiene

10. PURVARUPA
 Netra mala vridhi
 Burning sensation
SAMPRAPTHI
Disease originates in vartma shukla sandhi by different
shaped krimi
↓
Further moves to vartma pakhma sandhi
↓
Produce kandu and krimi will invade the inner structure
of eye

11. DIFFERENTIAL DIAGNOSIS
DISEASE INCLUSION EXCLUSION
Pakhmasata Itching, Falling of
eyelashes
Absence of whitish
scales on root of
eyelid
Kukunaka Itching, tamraakshi Occurs in children
Prakilnna vartma Swelling, itching Painless
Krimigranthi Itching, falling of
lashes, whitish
scales are present
-
VYADHI VINISCHAYA
 Krimigranthi
SADHYA/ASADHYATA
 Bhedana sadhya

12. CHIKITSA
1. Prakshalna/Seka
2. Swedana to lid margin
3. Pratisarana/Anjana with krimighna dravya
Varti anjana with Mashiladi varti
SAMANYA CHIKITSA
7 Days
Jatimukuladi varti 1-0-1
Collyrium application
NIREEKSHANA[OBSERVATION]
Symptoms are gradually reduced

13. CHIKITSA PARINAMA
Patient is relised of the treatment
RESULT
LAKSHANA BEFORE AFTER
Lid itching
Kandu kurya
Severe Absent
Eye lid swelling and
forign body
sensation
Moderate Mild
Plugging of
meibomian gland
orifice
Plugging>2/3 of
orifice
Clear orifice in
middle of lower lid
Erythema
(nanarupa)
Moderate Mild
Redness of eyelid
and eye
Moderate Mild

14. BLEPHARITIS
 It is a chronic inflammation of eyelid margin.
 TYPE
1. Anterior blepharitis
2. Posterior blepharitis
3. Parasitic blepharitis
 Anterior Blepharitis –
- Caused by staphylocci
- Feature - Itching, mild lacrimation
- Signs – yellow crusts – seen at root of cilia which glue
together
a. Bacterial
b. Seburrheic
c. Mixed Staphylococcus with squamous

15.  Posterior Blepharitis –
- It is the inflammation of meibomian gland.
a. Chronic
b. Acute – due to staphylocal infection
 Parasitic Blepharitis –
- Occurs due to infestation of lashes by lice
a. Crab loase – STI
b. Pediculosis/ head louse
TREATMENT
Treatment depends on the type of blepharitis.
Antibiotic ointment
Yellow mercuric oxide 1% to lid margin