Effect of Seka in the management of VernalKeratoconjunctivitis

Introduction

Allergic conjunctival disease is one of the most common eye disorders, commonly occur in school going children aged between 8-20 years male. It more affect in spring and hot season. This will shows the dry eyes symptoms like itching, irritation, and watering of eyes. VKC is a chronic, bilateral, at times asymmetrical, seasonally exacerbated, allergic inflammation ocular surface, involving tarsal and bulbar conjunctiva. Spring catarrh, phylectenular pallida, circum corneal hypertrophy, recurrent vegetative conjunctiva, vericosa conjunctiva and estivale conjunctiva.

Although allergic nature of this entity has been accelerated for a long time, its exact etiology and pathogenesis is still unclear. Vkc is not having direct reference in ayurvedic classics. However in similar clinical manifestation can be observed in a disease called as Vata pradhana sannipataja Abhishyanda. It is a vata, pitta and kaphaja vyadhi having symptoms like nistoda, bhashpa samuchhraya, sangharsha, guruta, upadeha, kandu, daha and prapaka^2,3. In ayurvedic classics specific treatment has been mentioned for vata pradhana sannipataja abhishyanda such has Triphala + Yastimadhu + Haridra kashaya Seka 2 for 7 days. After 7 days of treatment patient found relief from the complaints.

Material and Methods

Case history: A 14yrs male patient came with the complaints of itching, pricking pain, redness of both eyes, foreign body sensation, watering of eyes and photophobia since 4 months , he was diagnosed as a case of VKC on the present clinical features. .

Clinical findings: PR -78b/m, RR -18c/m BP120/80mmhg, Systemic examination was within normal.

Ocular examination: On slit lamp examination, cornea was clear in both eyes, anterior chamber was normal in both the eyes, pupil were the normal size and normal in reaction, on slit lamp examination finding cicatrices scars, inner lid surface congestion.

Dashavidha pareeksha: He was the vata pradhana pitta prakruti,vikruti is found to be vata pita kapha ,he was in balyavasta,his sara, satwa, samhanana, aharashakti, vyayama shakti,pramana, satmya were madhyama.

Sroto pareeksha: Rasa, rakta and mamsavaha srotas are involved.

Diagnostic assessment:

• Papillary reactions

• Conjunctival redness and edema

• Limbal gelatinous infiltrate

• Mucous discharge

• Cupids bar.

Therapeutic intervention

: • Lukewarm water vadana and mukha prakshalana twice dially

• Warm water bath

• Triphala kwatha churna-1 1/2tsp

• Haridra-2-3pinch

• yastimadhu-1/2tsp

All three should be add to 2glass of water and boil it properly then it should be reduce up to 1/4th then filter it properly then make it lukewarm and pore over the closed eyes in clockwise and anticlockwise direction up to 3-5minutes, then kept cotton over closed eyes which is soaked in cold water.

Result

There was drastically improvement in both signs and symptoms, seka showed marked improvement, no adverse or unanticipated events were reported during the study.

Discussion

Both the cases were vatapradhana pitta prakruti, where in liking more dry and spicy food leads to vata and pit sanchay. The rising atmospheric temperature in the spring season leads to vata pitta prakopata. This vitiated vata along with kapha through blood reaches to supraclavicular region, where the already vitiated vata and kapha dominating the parts like eyes I,e vartma mandala, shweta mandala, krishnamandala and drishti mandala also leads to features like Nistoda, Sangharsha, Shotha, Bhashpasamucchraya, Kandu, Upadeha, Daha and Prapaka.Vitiated vata, pitta and kapha being carried through the blood vessels vitiates the Rasa, Rakta, Mamsa dhatu.The pitta is also vitiated when provoked in the sun and or heat, where in the eyes get reddened and photophobia as well as lacrimation and discharge appear. If the rakta/pitta vitiation is more than the chances of corneal ulcers increase therefore treatment aspect should be vata, pitta and kaphahara, this is reason sannipataja abhishyanda chatagorised. The surprising fact came to be noticed when the drug reviewed was critically analysed and it was found that the present trial drug Triphala churna+Yastimadhu+Haridra.

Mode of action: Due to haritaki having tannin, chebulagic, and chebulanic acid, Bibitaki having tannin, glucose, Amalaki having vit-c, gallic acid, Yastimadhu having isoliquiritin , glycirryzine, And Haridra having vit –A, and curcumin. These are act as anti-inflammatory, anti-biotic, analgesics, and anti-histamine.

Conclusion

Incidence of VKC has become more due to allergy and this disease is commonly affected in the spring season and hot climate. It is more commonly seen in school going children aged between 8-20yrs male, hence I took this disease condition and treated with Triphala churna+Yastimadhu+Haridra seka7, these are easily available. After taking this treatment patient got relief. There were no complication and adverse reaction of the drugs was found during and after the treatment. Hence this treatment can be adopted for treating VKC