HTML Full Text

Introduction

Humans are increasingly exposed to pollution in the modern period, which introduces toxins into the environment, causing instability, chaos, and destruction to the ecosystem. This entire filthy conclusion resulted in a single word- Allergy. The primary cause of an allergic response in the body is compromised immunity or hypersensitivity. Because of its continual contact to the external environment, ocular allergy is one of the most prevalent allergic reactions. It has been demonstrated that the conjunctiva mucous membrane is roughly 10 times more exposed than other regions of the body. Allergic conjunctivitis is the most frequent kind of eye allergy, and it affects a large proportion of the world's population. It is distributed quite evenly around the planet. The term Abhishyanda appears often in Ayurvedic literature in various settings. According to Sushruta Samhita, Abhishyanda is the fundamental cause of all eye ailments. 1 Abhishyanda's clinical picture closely resembles the word "Conjunctivitis"2 described in current nomenclature. Allergic conjunctivitis is the most frequent kind of eye allergy and affects a large proportion of the world's population. Having a prevalence rate of 5-22% in general population and a recurrence rate of 41-62 %. It arises as a result of a dirty environment and allergen exposure. The key etiological element is hypersensitivity of the body's immune system to certain allergens, which is also frequent in persons who have other symptoms of allergic illnesses. Asthma, eczema, and rhinitis are a few examples. It is the commonest abnormality affecting the eyes leading to functional difficulties and can potentially contribute to impairment of vision if cornea is implicated. Abhishyanda is a Sarvagata Netra Roga that affects all portions of the eye and has a decent prognosis. Signs and symptoms of allergic conjunctivitis, such as redness, itching, watering, burning, feeling, photophobia, and ropy discharge, are similar to those described in our classics. It is classified into four categories based on the prevailing Dosha: Vataja, Pittaja, Kaphaja, and Raktaja Abhishyanda. The form of discomfort, discharge, congestion, edema, and so on differs depending on the kind of Abhishyanda. The prevalent Dosha can be determined by evaluating the indications and symptoms. If these Abhishyanda are not treated promptly, they might progress to a painful disease known as Adhimantha6. After describing Sarvagata Roga, four different chapters in Sushruta Samhita are devoted to the treatment of Abhishyanda. It should be addressed as soon as possible since consequences from Abhishyanda are severe and difficult to treat.1-3

Material and Method

References regarding Abishyanda were collected from various classical and Ayurveda published works, published research papers and previous thesis work and compilation was done on the concept Abishyanda and allergic conjunctivitis in detail.

Detailed view

The term abhishyanda is a combination of two words: "Abhi" and "Syandana." "Abhi" means "abundant" or "more" and "Syandana" means "discharge or secretions," therefore the combined meaning is "abundant discharge from all parts of the eye5". Bacteria and viruses are the most prevalent causes of conjunctivitis. Abhishyanda is the underlying cause of nearly all eye diseases and should be addressed as soon as feasible. In all sorts of abhishyanda discomfort, discharge, congestion, edema, and so forth. Ocular allergies are estimated to impact 5- 22% of the population The majority of patients have simultaneous allergic rhinitis, whereas just 6% have isolated ocular symptoms. Up to 44% of children and 20% of adults with asthma develop allergic conjunctivitis symptoms (AC). Modern ophthalmology's treatment of simple allergic conjunctivitis is quite expensive and must be continued for a longer period of time to battle the allergy, but Ayurveda can give greater relief in such manifestations. Abhishyanda is the fundamental cause of practically all eye problems and must be addressed as soon as possible; else, its ramifications can be serious and difficult to treat. If Abhishyanda is not treated properly, it can cause problems such as Vataja Adhimantha (Glaucoma), Hatadimantha (Atrophy of the eyeball), Akshipakatyaya (Hypopyon or Keratomalacia), Avranashukla (Opacity of Cornea), and others. Shalakya Tantra, one of the eight primary disciplines of Ayurvedic medicine, deals with disorders of the eye, ear, nose, throat, and head.4-6 Among them, ophthalmology was the most popular branch for Shalakya Tantra practitioners at the time, and they were known as Netra Visharada or the Shalaki. Even the Vedas mention eye problems, probably most notably the recovery of Rishi Ravrija's lost eye sight by Ashwini Kumaras in the Rigveda. The Atharvavedic Kenasutra describes sensory organs and the location of the eye in the skull. There is also a mention to the local use of A jana in eye problems. Abhishyanda is formed from the root "Syanda," which is preceded by "Abhi" Upasarga and suffixed by "Ghan" Pratyaya. Abhishyanda causes Kledana (moistening) in the Dosha, Dhatu, and Mala, resulting in copious discharge from all areas of the eye. Thus, Abhishyanda refers to profuse discharge from the eyes or conjunctivitis, whereas Vatajaabhishyanda refers to Allergic conjunctivitis.7,8 Netra Abhishyanda is one of the Sarvagata Roga (disease) as described by Acharya Sushruta1. All the Netra Rogas are mainly caused by Abhishyanda. According to Ayurvedic text, it is an “Aupsargic” Vyadhi (communicable disease) caused by Contamination of discharge. Netrabhishyanda is classified into four types according to Doshic predominance viz. Vataj, Pittaj, Kaphaj and Raktaj Abhishyanda. In Kaphaja Abhishyanda, Kapha is a predominant Dosha and Rasa and Rakta (blood) are the Dushyas. In this condition the Netra Srotas (channel) are vitiated by Kapha, Snigdha (smooth), Sheeta (cold), Guru, Pichchila (slimy), gunas (quality) are increased and the fluid system of the eye becomes denser and heavier. This affects intraocular circulation and the drainage slows down.9

Synonyms

Abhisyanda, Abhisyanna, Syanda, Akshikopa.

Samprapti10-15

Samprapti' is defined as the pathological alterations caused by etiological causes, which result in the emergence of illness signs and symptoms. The Samprapti of the Abhishyanda is the general Samprapti of Netra Roga. According to Sushruta Samhita, the Doshas become vitiated and migrate to the upper portion of the body via different Sira and Srotas as a result of Achakshushya Ahara and Vihara. These Doshas get concentrated in the eyes, resulting in Netra Rogas. Acharya Vagbhata does not explain particular Nidanas for Netra Roga, but does state that the Achakshushya Nidana causes an aggravation of Pitta Dosha, which spreads to Urdhva JatruBhaga through Sira and exhibits Akshi Roga.  Abhishyanda, like any other sickness, may be classified into stages based on Kriya Kala ideas such as Sanchaya, Prakopa, Prasara, Sthanasamshraya, Vyakti, and Bheda. Doshas Sanchaya creates Netra Roga by Tridasha Prakopa, which causes Agnimandya, which causes Ama creation and Srotorodha, and then Vatadi Doshas Dushti and Vridhi in Koshtha. Provocation of the Doshas occurs in Prakopavastha as a result of persistent Nidana Sevana. Doshas diffuse throughout the body in Prasaravastha via Siras and Srotas, ascending to Urdhvajatrugata Srotasa. Doshas are localized in all areas of the eyes during Sthanasamshryavastha. Dosha Dushya Samurchana occurs at that time. Poorvaroopa manifestations such as redness, itching, discomfort, and other symptoms begin at this stage.

Samprapti Ghatakas

• Dosha: Tridosha, Rakta
• Dushya: Rasa and Rakta
• Agni: Mandagni
• Srotasa: Rasavaha and Raktavaha
• Sroto Dushti: Sanga, Vimargagamana and Atipravriti
• Rogamarga: Madhyama
• Adhishthana: Sarvaakshi

Poorva Roopa16

1. Avila (dirty / muddiness of the eye)
2. Samrambha (slight congestion, pain and oedema)
3. Ashru (watering)
4. Kandu (itching)
5. Upadeha (stickiness)
6. Guruta (heaviness)
7. Ushna (burning sensation)
8. Toda (pricking pain)
9. Shooka Poorna Netra (foreign body sensation)
10. Vihanyamana Roopa (visual disturbance)

Roopa

Full manifestation of the disease is known as Roopavastha. These Roopas are varying according to the predominance of different Doshas. On the basis of Dosha predominance Abhishyanda is of four type viz. Vataja, Pitaja,Kaphaja and Raktaja Abhishyanda.17

Chikitsa (Treatment) 17-20

Snigdh or ushna medications are prescribed for Vataj abhishyanda, Mrudu and shitala treatment for Pittaja abhishyanda, and Tikshna, Ruksha, and Vishada drugs for Kaphaja abhishyanda. Kaphaj Abhishyanda benefits from Snehan, Swedana, Anjana, Seka, Ruksha Aschyotan, and Ruksha Putpaka, among others. External application of medicine pastes to eyelids; pharmaceuticals such as Rasanjan, Shunthi, Vacha, Haridra, and Murungi, among others, might be utilized for this purpose in the case of Abhishyanda. When signs of Abhishyanda appear, Tikshna gandusha and Nasya are also recommended. Snehana with Ghee, Sneha virechana, Snehana nasya and Sirobasti, etc. are also recommended

To eliminate vitiated Doshas, take Sahacharadi ghruta or Taila Sneha Virechana of Tilwak ghruta with Tilwak kashay Sneha basti or Anuvasana basti orally. Nasya with Shatavari, Dashmula, Balamula, and Siddha Tail, among other things. Tarpana and Shriparni, Erand and Nagarmotha, with so on. Snehik putpaka also recommended. Ascyotana made from goat's milk and cooked with Tagara, Manjishta, and Hribera bark, among other things. Anjana was created by combining Haridra, Jeshtamadha, and Haritaki with goat's milk. Aanupves varena shiro vadana lepa is said to be beneficial. For Vataj Abhishyanda, Saktu pindika is employed. External use of Prajmoda juice aids in the treatment of conjunctivitis. Chandi milk has a calming effect. Rose-paste combined with butter reduces conjunctivitis symptoms. Tulsi leaves aid in the reduction of inflammation. Triphala Churna is thought to help with allergic irritation and burning sensations. Chandroyati Vati increases allergic resistance and can thus be used to treat conjunctivitis.

Discussion

It is a sickness seen in Urdva Jatru Srotas where there is Syandana. Kledana occurs in Dosha, Dhatu, and Mala, resulting in copious discharge from all surrounding or all portions of the eye. The kind and amount of Srava are used to classify and diagnose Abhishyanda. It changes according on the Dosha engaged. Pricking pain, stiffness, horripilation, irritation, roughness, headache, dryness, foreign body sensation, cold tears, and redness will be present in Vataja Abhishyanda, which is also a defining sign of Allergic Conjunctivitis. Achakshushya is caused by an excess of Amla, Kshara, Teekshna, and Ushna Dravya. Shukta, Aranala, Vidahi, Asatmya Ahara, Atimatra, Virrudha, Atisheeta, Guru Dravya, Kulatha Masha, Pinyaka, and Virudaka are examples of Apathya Annapana causing Agnimandya and Amadosha. Incorrect Agni will result in the development of Guna Heena Dhatu. These Guna Heena Dhatu are visible to the naked eye. Because they are Achakshushya, they cause poor eye nutrition. As a result, the eye becomes more susceptible to illness.All Acharya explain in the Ayurvedic literature references to dietary measures, medicaments for Shodhana and Shamana, and numerous treatment methods of Vataja Abhishyanda. Apatarpana, Ghrita Sevana, Sira Vyadhana, Svedana, Avapeedana, Anjana, Dhooma, Seka, Pralepa, Kavalagraha, Aschyotana, Rooksha Putapaka, and Tikta Annapana are all important in Vataja Abhishyanda, according to Acharya Sushruta in Abhishyanda. According to Acharya Charaka, Krimi Chikitsa should be performed with Apatarpana. Snehana should be combined with Purana Sarpi, Snigdha Svedana, Siramokshana, Snaihika Virechana, followed by Basti, Tarpana, Putapaka, Aschyotana, Nasya, Sneha Pariseka, and Sirobasti. Raktamokshana is conducted to eliminate Dushya, and then Dosa treatment procedures are implemented.

Swedana should be used sparingly near the eyes and should not be fomented directly.  Allergic conjunctivitis, the most severe eye ailment, causes us to shield our eyes to prevent the disease from spreading. People strive to find an urgent and quick way to address the problem while covering and avoiding touch. As a result, many procedures are being used all across the world, but no pharmaceutical has provided rapid relief. The Ayurvedic school of medicine, India's oldest traditional medicine, includes a comprehensive explanation of the disease Abhishyanda in all of its forms.

Conclusion

Abhishyanda is a Sarvagata Netra Roga characterized by foreign body sensation, itchy sensation, eye watering, and redness. One of the Aupasargika rogas. In modern science, it is linked to allergic conjunctivitis. It is one of the most frequent eye ailments that requires immediate care. It is widespread throughout the world and is prevalent in both developed and developing countries.

It affects people of all ages and both sexes. It is the leading cause of ocular disease and avoidable blindness worldwide. Aushadha Chikitsa is given special consideration in Ayurveda. As a result, a rapid and thorough search was conducted to identify an acceptable drug that is less inflammatory to the eyes and relieves discomfort and suffering in the eyes.