The different therapeutic procedures that are practiced to treat the disorder of the eye as well as to enhance the excellence of its functioning are referred by the name netra-prasadana karma. Which include seka, ashchotana, pindi, vidalaka, tarpana, putapaka and anjana. Among these, the akshitarpana is already discussed under the title bahya snehana.
The procedure of pouring thin streams of medicines in liquid form over the closed eye from a height of 4 angula is known as Seka.
TYPES OF SEKA
Depending upon the therapeutic utility there are three types of seka. Unctuous medicated liquid is used in clients suffering from any disease of the eye due to morbid vata dosha and is known as snehana seka. Medicated liquids having the therapeutic effect of healing the ulcerations is preferred in diseases of the eye caused due to vitiation of pitta dosha as well as rakta dhatu. Such a seka is called as ropana seka. The therapeutic effect of scarifying is achieved by the seka therapy, eye due to morbid kapha dosha.
This therapy may be carried out at any time during the day. In the case of an emergency, even this may be done during the night. No specific preparation of the client is needed to undergo this treatment. The client is made to lie down on the treatment table in supine position. He is then asked to close his eyes. The prescribed medicine is poured into the eyes at the medial end of the eye. For pouring either the metal dropper may be used or else the stiff leaf (leaf of jack fruit) that is rolled in to conical shape. The leaf when rolled in a conical shape there should be small opening at the apex. This cone simulates a funnel in shape. The cone of the leaf is held upside down, with its apex approximately four inches above the eye. The prescribed medicated liquid is now poured all around the closed eyes through this funnel. The medicine flowing out of the eye is collected by holding a bowl against the temporal region just below the outer canthus.
The total duration of the therapy varies in different clinical conditions. Snehana seka is done for 192 seconds (600 vak shata). 128 seconds (400 vak shata) is the duration of ropana seka. Lekhana seka should be restricted to 96 seconds (300 vak shata).
There is no any specific regimen or restrictions following the akshiseka. After the completion of the procedure the client may be allowed to wash his face as well as eyes.
The unique therapy of dropping medicines in liquid form on the eyes with the eyes kept open is known as ashcotana.
TYPES OF ASHCHOTANA
Quite similar to the akshiseka the ashchotana therapy is also classified into three as snehana, ropana and lekhana ashchotana. Unctuous medicine that are bitter in taste are used in the snehana ashchotana. Cold medicines that are sweet in taste are used for the ropana ashchotana. Likewise warm medicines having ruksha (dry) property and are bitter in taste are used in lekhana ashchotana in general.
Ashcotana therapy is done during the day time, employing this procedure at night is contraindicated. There is no any specific preparation of the client to carry out this therapy. The client is made to lie down on the treatment table in supine position. The body is draped up to the neck. Both the eyes are treated one after the other. The lower lid is retracted with one hand.
The liquid medicine is poured drop by drop on the cornea of the eye from a height of 2 angula. While dropping the medicine the client is asked to keep his eye open. In the cold weather warm medicine is dropped into the eyes, but in hot weather there is no need to make the medicines warm.
DOSE OF MEDICINE
Dose varies according to the type of ashchotana therapy. 8 drops is the dose of lekhana ashchotana. In case of ropana ashchotana 10 drops of the medicine is dropped into the eyes. Further in the snehana type of ashchotana 12 drops of the medicine is dropped into each eyes.
DURATION OF ASHCHOTANA Netra-Prasadana Karma
Following dropping of the medicines it is left undisturbed for 32 second (100matra).
The procedure of bandaging the paste of herbs on the eyes is referred by the name Pindi. This therapy is also called by the name kavalika. All types of conjunctivitis and the ulceration of the eyes are best treated with the pindika. The clients suffering from vatabhishyanda (conjunctivitis due to morbid Vata dosha) is treated with pindika which is warm and unctuous. Contrary to this cold pindika is useful in morbidity of pitta dosha as well as rakta dhatu.
No specific preparation of the client is needed to carry out this procedure. The client is made to lie down on the treatment table in supine position. The head is elevated a little by placing a pillow. The body below the neck is draped. The herbal paste is spread on a near round cotton size of the eye and is covered with another cotton gauze of similar size thus making a pad of herbal paste. This pad is then placed over the eyes while the client keeps his eyes closed.The eye is then bandaged.
The simple smearing of the herbal paste on the skin surface of the eye lids is called by the name vidalaka. The application is made all over the eye lids avoiding the area or eye lashes. The prescription, indication and the beneficial effects of this treatment are similar to the pindika.
The medicine in liquid form is prepared by a social procedure of heating, and is then poured and retained for certain duration over the eyes, where in the procedure of administration is identical to the akshitarpana is known by the name putapaka. Depending upon the therapeutic effect quite similar to the other netra-prasadana karma this is also of three types and are named as snehana putapaka, ropana putapaka and lekhana putapaka. Putapaka is said to be beneficial in pacifying the morbidity of pitta dosha, rakta dhatu as well as vata dosha. This also improves the eye sidht. The indication and contraindications of this therapy are similar to the akshitarpana therapy. If clients suffering from morbidity of kapha dosha, putapaka is advised only one day. Treating the eyes with putapaka for consecutive two days is ideal in disorders of the pitta dosha. Further employment of putapaka regularly for three days is indicated in eye diseases due to morbid vata dosha.
PROCEDURE OF PUTAPAKA THERAPY
The procedure of pouring the medicine is identical to the procedure of akshitarpana. Snehana putapaka is retained for 64 seconds (200 matra). Lekhana putapaka is retained for 32 seconds (100 matra). Ropana putapaka should be retained for 96 seconds (300 matra).
After removing the putapaka, the eyes are subjected to mild fomentation. For this, a pad of cotton cloth is soaked in warm water, and the water is squeezed off. This moist warm pad of cloth is placed on the closed eyes. Following treatment with putapaka the client is advised to avoid seeing of bright objects. Exposing oneself to breeze is also not ideal.
The application of the medicine to the outer or inner aspect of the eye lid is called as anjana. Medicines in different forms like pill, liquid, and powder are used in the form of anjana. The therapeutic efficacy of the anjana in the pill form is said to be maximum, where as the efficacy of the anjana in powder form is said to be minimum. Anjana may be applied either with a shalaka (rod) or finger.
TYPES OF ANJANA
Depending upon the therapeutic efficacy it is of three types and are named as snehana anjana, ropana anjana and lekhana anjana. Unctuous medicines having sweet taste form the ingredient of the snehana anjana. Snehana anjana is also known by the name prasadana anjana and is said to rectify the morbidity of dosha present in the eye. The unctuous medicines having bitter and astringent taste is used in the preparation of ropana anjana. This anjana also improves the complexion of eyes as well as eyesight. Further medicines having kshara (alkaline), tikshna (irritant) property probably with sour taste is used in the administration of lekhana anjana. This lekhana anjana is capable of eliminating the morbid dosha accumulated in and around the eyes.
TIME OF APPLYING THE ANJANA
Always the application of anjana is preferred in the formed (pakva) state of the dosha. Further anjana is applied at different time of the day in different seasons. During the cold seasons like hemanta (early winter) and shishira (winter), the anjana is applied during the afternoon. Application of anjana during the morning is preferred in the grishma ritu (summer). During the sharat ritu (autumn) anjana is preferably applied during the evening hours. Anjana should be applied when the atmospheric temperature is moderate during the varsha ritu (monsoon). And during this vasanta ritu (spring) anjana may be applied at any time of the day. More to say, anjana to the eyes may be applied either in the morning or evening but not always. But this therapy should be avoided during the extremes of atmospheric temperature either cold or hot. Even when the sky is covered with clouds, the application of the Anjana is not advisable.
Anjana is indicated when the morbidity of the dosha is restricted to the eyes. Therefore the client is initially subjected to other procedure like putapaka and ashchotana that creates an ideal state for the application of anjana. Following employment of this therapeutic procedure the anjana is applied according to the prescription. For this, the client is made to lie down on the table in supine position. The head may be supported by a thin pillow. The body below the neck is draped with a cloth. The lower lid of the eye is retracted with the left thumb. The medicine is taken in a rod by just dipping its tip in the medicine. Then the anjana is applied to the portions of the inner surface of the lower lid below the cornea. Application is made by moving the rod either from inner canthus to outer one or from out canthus to the inner one. This is the method of applying the anjana to the inner surface of the lid. When prescribed, the application of the anjana is restricted to the border of the eye lid, and is the external form of the anjana.
Different dosage is prescribed for the different forms of anjana. If varti is used in the anjana then its dosage should be 1 ½ harenu (size equal to 1 ½ pea) if the medicine is moderately potent. Less potent drugs when used in the preparation of varti then it should be administered in a dose of 2 harenu (size equal to 2 pea). Like wise If the medicine is more powerful than its dose should be one harenu (size equal to 1 pea). When the anjana is used in the form of a liquid medicine then its dose should be 2 vidanga in an average. 3 vidanga is the maximum dose of rasakriya and 1 vidanga is the minimum dose. The snaihika anjana in the churna form is applied four times with a rod. Application of the lekhana anjana in the churna form is applied twice with a rod. Further the ropana anjana when applied in the churna form, it should be applied thrice with the rod and is the dose of the churna anjana.