Abstract

ROLE OF PRATIMARSHA NASYA IN THE MANAGEMENT OF DRY EYE SYNDROME: A CLINICAL CASE REPORT

Dr. Anubhav Jain*, Dr. Babita Dash MD (Ayu), PhD

Abstract

Dry Eye Syndrome is a multifactorial ocular surface disorder characterized by tear film instability and symptoms such as dryness, irritation, and itching. In Ayurveda, it can be correlated with Shushkakshipaka, a condition arising due to vitiation of Vata and Pitta Dosha leading to Rukshata (dryness) and impaired ocular lubrication. Conventional management primarily includes artificial tear substitutes and antiinflammatory agents, which provide only symptomatic relief and require long-term dependency without addressing the underlying pathophysiology. Among various Ayurvedic therapies like Netra Tarpana and Aschyotana, the efficacy of Pratimarsha Nasya is evaluated in this study. Nasya Karma is considered the prime therapeutic modality for Urdhva Jatrugata Rogas, as emphasized in classical texts—―Nasa hi Shiraso Dwaram.‖ It facilitates targeted drug delivery to the cranial region, influencing ocular tissues through Srotoshodhana, Snehana, and Indriya Prasadana. From a modern perspective, intranasal administration enables rapid absorption through the nasal mucosa, stimulating the trigeminal and olfactory pathways, thereby modulating lacrimal gland function and improving tear secretion. Pratimarsha Nasya, due to its mild and daily applicability, ensures sustained nourishment and lubrication of ocular structures. A 67-year-old female patient presenting with bilateral dryness, irritation, and itching of the eyes, along with sleeplessness, was subjected for clinical evaluation. The patient was administered Pratimarsha Nasya with Anu Taila in a dose of 8 drops to each nostril daily in morning time after brushing for 2 months, along with Soft Gel Capsule Ksheerbala 101 Avarti 300 mg 2 Cap twice daily with lukewarm water as internal medication. Assessment was carried out using subjective parameters and objective evaluation through the Schirmer’s tear test before and after intervention. The intervention resulted in marked relief in ocular symptoms and improvement in sleeplessness. Objective findings demonstrated increased tear secretion and enhanced tear film stability, as evidenced by improved Schirmer’s test values. Pratimarsha Nasya proved to be an effective, safe, and non-invasive therapeutic modality in the management of Dry Eye Syndrome. Its dual action—through Ayurvedic principles of Snehana and modern neuro-ophthalmic pathways—highlights its significant role in restoring ocular homeostasis. This study underscores the clinical importance of Nasya and advocates further large-scale studies for validation.

Keywords: Pratimarsha Nasya, Nasya Karma, Dry Eye Syndrome, Shushkakshipaka, Anu Taila, Schirmer’s Test, Neuro-ophthalmic pathway.