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CASE REPORT
Year : 2020  |  Volume : 13  |  Issue : 3  |  Page : 279-281  

Chronic dacryocystitis and its ayurvedic management


Department of Shalakya, IPGT and RA, Jamnagar, Gujarat, India

Date of Submission17-Jun-2019
Date of Decision15-Oct-2019
Date of Acceptance15-Oct-2019
Date of Web Publication3-Jun-2020

Correspondence Address:
Sangita Odhabhai Kamaliya
Department of Shalakya, IPGT and RA, Jamnagar, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_176_19

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  Abstract 


Chronic dacryocystitis is a chronic infection of the lacrimal sac. In chronic dacryocystitis, there is obstruction of the nasolacrimal duct at the junction of lacrimal sac followed by stasis in the lacrimal sac, causing watering and discharge from the eye. In the present case report, a 24-year-old female patient suffered from this disease. She presented with the chief complaints of watering from both eyes for 6 months and mild swelling and pain over the lacrimal sac area in both eyes for 5 days. She was treated with Triphala Guggulu and Triphaladi Netra Parisheka, along with Mardana in lacrimal sac area for 1 month. After 1 month of treatment, the patient got relief from all the complaints. In lacrimal syringing, there was no any obstruction or regurgitation found. On analysis of all the data, it can be concluded that Ayurvedic management with Triphaladi Netra Parisheka and T. Guggulu along with Mardana in the lacrimal sac area offers effective result in the treatment of chronic dacryocystitis.

Keywords: Chronic dacryocystitis, Mardana, Netra Parisheka, Triphala Guggulu


How to cite this article:
Kamaliya SO, Khoja R, Vaghela D. Chronic dacryocystitis and its ayurvedic management. Med J DY Patil Vidyapeeth 2020;13:279-81

How to cite this URL:
Kamaliya SO, Khoja R, Vaghela D. Chronic dacryocystitis and its ayurvedic management. Med J DY Patil Vidyapeeth [serial online] 2020 [cited 2020 Jul 12];13:279-81. Available from: http://www.mjdrdypv.org/text.asp?2020/13/3/279/285757




  Introduction Top


Chronic dacryocystitis is a chronic infection of the lacrimal sac which is more common than acute dacryocystitis.[1] It is prevailing in the fourth and fifth decades, and females are prone to it. Usually, there is a block at the nasolacrimal duct where it opens into the inferior meatus.[2] This is caused by the obstruction of drainage of the mucous layer of the tear film with collection of debris and denuded epithelial cells from the surface of the eye. Chronic low-grade bacterial infection inside the lacrimal sac is caused by Staphylococcus aureus and Streptococcus pneumonia. Consequently, there is stasis in the lacrimal sac. Stasis later gives rise to infection leading to watery, mucopurulent, or purulent discharge from the eye. A small test like lacrimal passage irrigation is enough to make the diagnosis.

In Ayurveda, dacryocystitis can be correlated with Puyalasa[3] on the basis of its symptoms and signs. Puyalasa is a Sandhigata Netra Roga [4] which occurs specifically in Kaninika Sandhi.[3] It is said to be Sadhya Vyadhi[5] though it is Tridoshaja[6] in nature. The line of treatment based on the stage helps to combat the pathology easily.


  Case Report Top


A fully conscious, normal oriented female patient, aged 24 years, visited the outpatient department of Shalakya Tantra, IPGT and RA, Jamnagar, Gujarat, India, with the chief complaints of watering from both eyes for 6 months and mild swelling and pain over the lacrimal sac area in both the eyes for 5 days.

Past history: Patient having history of recurrent attacks of dacryocystitis once in a year for 3 years.

Personal history: Registered patient was vegetarian, appetite was moderate, bowel was regular, micturition and sleep were found normal.

Examination

Ocular examination (torch light and slit lamp) (both eyes)

  • Lid : Normal
  • Conjunctiva : Normal
  • Cornea : Normal
  • Anterior chamber : Normal
  • Iris : Normal
  • Pupils : NSNR
  • Lens : Normal.


Syringing

Lacrimal passage irrigation was done. Obstruction with regurgitation was found in both eyes.

Visual acuity

Visual acuity of both the eyes is described in [Table 1].
Table 1: Visual acuity

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Treatment protocol

Treatment was given to the patient as described in [Table 2].
Table 2: Treatment protocol

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  Results Top


Significant improvement was observed in swelling and pain over the lacrimal sac area and there was mild relief in watering after 7 days of treatment. After 1 month of treatment, complete relief was found in pain and swelling over the lacrimal sac area and watering from the eyes. Lacrimal syringing was done after treatment. There was no obstruction or regurgitation found. With this treatment, the patient was completely cured. No recurrence was found in any symptoms and signs after follow-up of 1 month. No adverse reaction was found during the study and follow-up periods.


  Discussion Top


The classical line of treatment of Puyalasa includes Raktamokshana, Upanaha Swedana, Vimardana, and Vimlapana.[7] wherein some of them were adopted in this case study. Mardana (digital massage) over the lacrimal sac area increases the hydrostatic pressure in the sac and helps to open up the occlusions. Triphaladi Netra Parisheka with lukewarm decoction was performed for better purification of the eye after massage. It also increases blood circulation inside the lids which reduces the pain and it has anti-inflammatory and antimicrobial properties that reduce swelling of the lacrimal sac area. Triphaladi Netra Parisheka has Chakshushya[8] property which is beneficial for the maintenance of eye health. Triphala Guggulu[9] has Tridoshahra, Rasayana, Sukshma, Krimighna, and Vranaropana properties. Thus, aggravated Tridosha were pacified. It also helps in eradicating infection and preventing further infection of the lacrimal sac.


  Conclusion Top


After analysis of all the data, it can be concluded that Ayurvedic management with Triphaladi Netra Parisheka and T. Guggulu along with Mardana on lacrimal sac area offers effective result in the treatment of chronic dacryocystitis. Thus, it can be concluded that Ayurvedic approaches are helpful in managing chronic dacryocystitis. The current study was a single-case study. The study should be carried out on large sample size for more convincing results.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Khurana AK. Comprehensive Ophthalmology. 6th ed., Ch. 16. Jaypee brothers medical publishers, New Delhi; 2015. p. 395.  Back to cited text no. 1
    
2.
Kanski JJ, Bowling B. Clinical Ophthalmology: A Systematic Approach. 3rd ed. Elsevier Health Sciences Edinburgh; 2011. p. 66.  Back to cited text no. 2
    
3.
Vaidya Yadavji Trikamji Acharya. Uttar tantra. Sushruta Samhita with Dalhan Tika. Ch. 2/4. Varanasi: Chaukhambha Sanskrit Sansthan; 2015. p. 598.  Back to cited text no. 3
    
4.
Vaidya Yadavji Trikamji Acharya. Uttar tantra. Sushruta Samhita with Dalhan Tika. Ch. 2/3. Varanasi: Chaukhambha Sanskrit Sansthan; 2015. p. 598.  Back to cited text no. 4
    
5.
Vaidya Yadavji Trikamji Acharya. Uttar tantra. Sushruta Samhita with Dalhan Tika. Ch. 1/42. Varanasi: Chaukhambha Sanskrit Sansthan; 2015. p. 598.  Back to cited text no. 5
    
6.
Vaidya Yadavji Trikamji Acharya. Uttar tantra. Sushruta Samhita with Dalhan Tika. Ch. 1/41. Varanasi: Chaukhambha Sanskrit Sansthan; 2015. p. 598.  Back to cited text no. 6
    
7.
Vaidya Yadavji Trikamji Acharya. Uttar tantra. Sushruta Samhita with Dalhan Tika. Ch. 12/45. Varanasi: Chaukhambha Sanskrit Sansthan; 2015. p. 618.  Back to cited text no. 7
    
8.
Chunekar KC. Haritakyadi varg. Bhavprakash Nighantu. Reprint 2010. Ch. 42-43, Chaukhambha Bharati Akadami, Varanasi; p. 45.  Back to cited text no. 8
    
9.
Vidyasagar PS, Khanda M, Samhita S. Reprint 2013. Ch. 7/82 Vataka Kalpana Adhyaya, Chaukhambha Varanasi; 2013. p. 162.  Back to cited text no. 9
    



 
 
    Tables

  [Table 1], [Table 2]



 

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   Abstract
  Introduction
  Case Report
  Results
  Discussion
  Conclusion
   References
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