Drik Pariksha, or eye examination in Ayurveda, is a crucial component of Ashtavidha Pariksha (Eightfold Examination). It helps diagnose systemic diseases, metabolic disorders, and ocular pathology by evaluating the eyes’ structure, function, and appearance.
In modern ophthalmology, eye examination involves various diagnostic techniques, including slit-lamp examination, fundoscopy, visual field analysis, tonometry, and imaging techniques such as OCT and fluorescein angiography.
I. Ayurvedic Perspective of Drik Pariksha
1. Importance of Eyes in Ayurveda
According to Ayurveda, the eyes are considered the seat of Alochaka Pitta, a sub-type of Pitta Dosha responsible for vision. Proper function depends on the balance of Vata, Pitta, and Kapha Doshas, and imbalances can lead to various eye disorders.
| Dosha | Role in Vision | Disorders Due to Imbalance |
|---|---|---|
| Vata (Air & Space) | Controls movement of the eye, blinking, and nerve function | Dryness, blurred vision, eye twitching, optic nerve disorders |
| Pitta (Fire & Water) | Maintains visual perception and light processing | Redness, burning sensation, inflammation (uveitis, conjunctivitis) |
| Kapha (Water & Earth) | Provides lubrication, stability, and nourishment | Excessive tearing, heaviness, cataracts, cloudy vision |
2. Ayurvedic Methods of Eye Examination
| Examination Method | Observations | Possible Diagnosis |
|---|---|---|
| Varna (Color of Eyes & Conjunctiva) | Redness, pallor, bluish tint | Red: Inflammation (Conjunctivitis, Uveitis), Pale: Anemia, Blue tint: Iron deficiency |
| Akshi Sandhi (Eye Joints & Movements) | Smoothness, tremors, or restricted movement | Tremors: Vata imbalance, Restricted movement: Oculomotor nerve palsy |
| Drishti Shakti (Visual Acuity & Field of Vision) | Clarity of vision, peripheral vision | Myopia, Hypermetropia, Glaucoma |
| Tears & Lubrication (Ashru Pariksha) | Excessive or reduced tear production | Excessive: Kapha imbalance, Dry eye syndrome, Reduced: Sjögren’s syndrome |
| Netra Paka (Eye Infections & Inflammation) | Pus, swelling, redness | Conjunctivitis, Blepharitis, Corneal ulcer |
II. Modern Approach to Eye Examination
A comprehensive eye examination in modern medicine includes multiple steps and tools for accurate diagnosis.
1. Visual Acuity Testing
- Snellen Chart for distance vision
- Jaeger Chart for near vision
- Pin-hole test for refractive errors
2. External Eye Examination
- Inspection of eyelids, conjunctiva, sclera, cornea
- Pupillary reflex testing (Direct, Consensual, and Near Reflex)
- EOM (Extraocular Movement) Test for cranial nerve assessment
3. Slit Lamp Examination
- Used to assess corneal ulcers, cataracts, inflammation (uveitis), and infections
4. Tonometry (Intraocular Pressure Measurement)
- Applanation Tonometry (Goldmann method) – Gold standard for Glaucoma
- Non-contact Tonometry (Air-puff test)
5. Fundoscopy (Retinal Examination)
- Direct Ophthalmoscopy: Basic retinal evaluation
- Indirect Ophthalmoscopy: Detailed retinal assessment
6. Advanced Imaging & Functional Tests
- Optical Coherence Tomography (OCT): For detecting retinal diseases (Diabetic Retinopathy, Glaucoma)
- Fluorescein Angiography (FA): Vascular abnormalities
- Visual Field Testing (Perimetry): Glaucoma & Neurological disorders
III. Disease-Based Discussion with Ayurvedic & Modern Correlation
| Disease | Ayurvedic View | Modern Diagnosis & Tests | Treatment |
|---|---|---|---|
| Conjunctivitis (Netra Abhishyanda) | Pitta-Kapha imbalance, inflammation | Slit lamp exam, Conjunctival swab | Antibiotics, Anti-inflammatory drugs |
| Cataract (Timira) | Kapha accumulation, aging-related vision loss | Slit lamp exam, Ophthalmoscopy | Phacoemulsification surgery |
| Glaucoma (Adhimantha) | Vata-Pitta imbalance, increased eye pressure | Tonometry, OCT, Perimetry | Anti-glaucoma meds, Laser trabeculoplasty |
| Diabetic Retinopathy | Madhumeha affecting retinal blood vessels | Fundoscopy, OCT, FA | Anti-VEGF injections, Laser photocoagulation |
| Macular Degeneration | Diminished Pitta function (Alochaka Pitta depletion) | Fundus Photography, OCT | Anti-VEGF, Lifestyle changes |
| Dry Eye Syndrome (Shushkakshipaka) | Vata-Pitta imbalance, reduced tear production | Schirmer’s test, Tear Break-up Time (TBUT) | Artificial tears, Ayurvedic Netra Tarpana |
IV. Ayurvedic & Modern Management of Eye Disorders
1. Ayurvedic Treatments for Eye Health
- Tarpana (Eye Rejuvenation Therapy): Nourishes dry eyes, improves vision
- Netra Dhara (Eye Wash Therapy): Treats infections, reduces redness
- Anjana (Herbal Collyrium): Clears vision, prevents cataracts
- Nasya (Nasal Therapy): Treats chronic eye conditions, sinus-related eye issues
- Triphala Rasayana: Antioxidant-rich herbal formulation for vision enhancement
2. Modern Treatments
- Medications: Anti-inflammatory, Antiglaucoma, Anti-VEGF
- Surgical Interventions: LASIK, Cataract Surgery, Trabeculectomy
- Laser Therapy: Diabetic Retinopathy, Macular Degeneration
V. Flowchart for Comprehensive Eye Examination
plaintextCopyEdit Patient presents with eye complaints
|
┌───────────────────────────────────┐
| Step 1: Visual Acuity Testing |
| (Snellen, Jaeger, Pinhole) |
└───────────────────────────────────┘
|
┌───────────────────────────────────┐
| Step 2: External Eye Inspection |
| (Lids, Conjunctiva, Pupil) |
└───────────────────────────────────┘
|
┌──────────────────────────────┬──────────────────────────────┐
| Slit Lamp Exam | Fundoscopy (Retina Exam) |
└──────────────────────────────┴──────────────────────────────┘
|
┌──────────────────────────────┬──────────────────────────────┐
| Tonometry (IOP for Glaucoma) | OCT (Retinal Evaluation) |
└──────────────────────────────┴──────────────────────────────┘
|
┌───────────────────────────────────┐
| Final Diagnosis & Treatment Plan |
├───────────────────────────────────┤
| Ayurvedic (Tarpana, Anjana) |
| Modern (Surgery, Medications) |
└───────────────────────────────────┘
VI. Conclusion & Clinical Insights
- Integrating Ayurvedic & Modern Ophthalmology: Ayurveda emphasizes dosha balance, herbal therapies, and lifestyle modifications, whereas modern medicine provides precision diagnostics and surgical interventions.
- Early Diagnosis is Key: Diseases like glaucoma, diabetic retinopathy, and macular degeneration require early screening to prevent vision loss.
- Holistic Eye Care: Incorporating Triphala, eye exercises (Trataka), blue light protection, and hydration ensures long-term ocular health.