Abstract
The human eye is a complex organ that enables vision by capturing light and converting it into signals that the brain interprets as images. Light first enters the eye through the cornea, which focuses it. The amount of light is then regulated by the pupil, a black circular opening in the center of the iris, which adjusts its size. Behind the pupil is the lens, which further focuses light and helps the eye adjust focus for objects at different distances. The retina captures light and turns it into electrical signals. These signals are sent to the brain via the optic nerve. The optic disk is where the optic nerve exits the eye and has no light-sensitive cells, creating a “blind spot”. The macula densa in the center of the retina is responsible for sharp, detailed central vision. Together, these parts help us see clearly. Glaucoma is a complex neurodegenerative eye disease that leads to irreversible damage to the optic nerve, frequently resulting in vision loss and, in some cases, permanent blindness. It is one of the leading causes of blindness worldwide, affecting millions of people across various age groups, although it is most commonly diagnosed in older adults. It contributes to about 12% of blindness world-wide. The primary risk factor for glaucoma is increased intraocular pressure (IOP), but other factors such as genetics, systemic diseases, and environmental influences play important roles in its manifestation. Despite the lack of a definitive cure, early detection and treatment can significantly slow down its progression and preserve vision.
Introduction
Glaucoma refers to a group of eye conditions that lead to damage of the optic nerve which is often associated with elevated intraocular pressure (IOP). This can eventually cause blindness if left untreated. The optic nerve is responsible for passing on visual information from the eyes to the brain, and any damage to it will result in permanent vision loss. A healthy eye maintains a balance in the production and drainage of aqueous humor, which helps in regulation of the intraocular pressure. However, when this balance is disrupted, excess fluid accumulates within the eye, increasing pressure and potentially damaging the optic nerve. While the condition is most commonly linked to high IOP, it is essential to remember that glaucoma can also occur in individuals with normal pressure levels, a condition known as “normal-tension glaucoma”.
Glaucoma is often referred to as the “silent thief of sight” because it progresses without any obvious symptoms until significant vision loss has already occurred. By the time patients start noticing changes in their vision, irreversible nerve damage may have already occurred. This signifies the importance of early diagnosis and routine eye exams, especially for those at higher risk of developing the disease.
Causes/Triggers
The exact cause of glaucoma is not completely understood, but the primary mechanism involves an imbalance in the production and drainage of aqueous humor—the fluid inside the eye. Sometimes, normal-tension glaucoma occurs despite normal IOP levels, suggesting that other factors, such as poor blood flow to the optic nerve, genetic predisposition, or other underlying conditions, may contribute to nerve damage.
The exact cause is unknown but there are some risk factors which can trigger glaucoma. They are:
- Elevated Intraocular Pressure (IOP): This is the most common factor for glaucoma and can occur when the eye’s drainage system is impaired, preventing the proper outflow of aqueous humor. Increased IOP puts pressure on the optic nerve, causing nerve damage.
- Poor Blood Supply to the Optic Nerve: Conditions such as low blood pressure or restricted blood flow to the eyes can contribute to optic nerve damage. This can be particularly relevant in normal-tension glaucoma.
- Eye Injury or Trauma: Any direct trauma to the eye, such as a blow to the face, can cause a sudden increase in IOP. Also, long-term trauma can disrupt the eye’s drainage system, causing chronically increased IOP.
- Medications: Prolonged use of steroids can be particularly concerning in individuals already predisposed to the disease.
- Age: The risk of developing glaucoma increases with age. People over the age of 60 are particularly vulnerable, and the incidence rises further in those over 70.
- Family History: Genetics plays a significant role; therefore, if anyone in your blood relations has glaucoma, it can be a triggering factor.
- Ethnicity: African-Americans have a higher risk of developing primary open-angle glaucoma (POAG) at a younger age and will more likely experience severe vision loss. Asians and Eskimos are more prone to angle-closure glaucoma, while individuals of Hispanic descent are at increased risk for POAG.
- Medical Conditions: Conditions like diabetes, hypertension, and heart disease can increase the risk of developing glaucoma due to their effects on blood flow and the health of the optic nerve.
- Other Eye Conditions: People with underlying conditions like myopia (nearsightedness), hyperopia (farsightedness), or a history of eye trauma are at a higher risk of developing glaucoma.
Types
1. Primary Open-Angle Glaucoma (POAG)
This is the most common form of glaucoma. It is assumed to develop from the gradual decrease in the drainage of aqueous humor, leading to increased IOP and optic nerve damage. This typically develops slowly and without any noticeable symptoms.
2. Angle-Closure Glaucoma
This form of glaucoma occurs when the angle between the iris and the cornea is too narrow causing the blockage of the drainage of aqueous humor and causing a sudden increase in IOP. Angle-closure glaucoma can develop acute symptoms such as severe eye pain, nausea, and vomiting.
3. Normal-Tension Glaucoma
In this the optic nerve damage occurs even though the IOP remains normal. It is sometimes related to poor blood flow to the optic nerve or other structural abnormalities in the nerve.
4. Secondary Glaucoma
This develops due to external factors, such as eye trauma, eye surgery, certain medications (e.g., corticosteroids), or other diseases like diabetes or high blood pressure.
5. Congenital Glaucoma
In rare cases, glaucoma can be present at the time of birth due to a developmental abnormality in the eye’s drainage system. This form of glaucoma requires immediate medical attention to prevent vision loss.
Symptoms
Glaucoma is often asymptomatic in its early stages. However, as the disease progresses, a variety of symptoms can develop.
Common symptoms include:
- Loss of Peripheral Vision: This often goes unnoticed, as it develops gradually. It is also referred to as “tunnel vision.”
- Blurry Vision: Patients can experience difficulty focusing, mostly in low-light conditions. Vision may become cloudy or hazy, making it challenging to see clearly.
- Intense Headache
- Insensitivity to Bright Light
- Jerky Eye Movements: Called “nystagmus,” these involuntary eye movements can develop.
- Eye Pain: Patients may experience sudden, intense eye pain, often followed by nausea and vomiting.
- Halos Around Lights: Rainbow-colored circles around lights, particularly in low-light conditions or at night, may be experienced.
- Nausea and Vomiting: This is seen particularly in angle-closure glaucoma. Nausea and vomiting develop due to the severe pain and increased IOP.
Diagnosis
1. Tonometry
This test measures the intraocular pressure of the eye. Normal IOP is 16-21 mm of Hg. Values higher than this indicate increased IOP.
2. Ophthalmoscopy
In this, pupils are dilated with the help of eye drops and the optic nerve is examined for any signs of damage such as cupping or pallor. A damaged optic nerve is a hallmark sign of glaucoma.
3. Visual Field Testing
This test detects any loss of peripheral vision. It is helpful in tracking progress of disease over time.
4. Gonioscopy
This test measures the drainage angle of the eye between cornea and iris. It is helpful in diagnosing angle-closure glaucoma.
5. Optical Coherence Tomography (OCT)
It is a non-invasive imaging test that provides high-resolution images of the retina, macula densa & optic nerve. It helps assess the thickness of the retinal nerve fiber layer.
Treatment / Lifestyle Adjustments
While there is no cure for glaucoma, treatment focuses on reducing IOP to prevent further damage to the optic nerve. The following treatment options are commonly used:
1. Medications
Eye drops are the most common treatment for glaucoma. These medications either decrease the production of aqueous humor or increase its outflow, effectively lowering IOP.
2. Laser Treatment
Laser procedures to improve fluid drainage from the eye, lowering IOP. Laser trabeculoplasty is often done in open-angle glaucoma, while laser iridotomy is used in angle-closure glaucoma to improve fluid drainage.
3. Surgical Intervention
The most common surgical procedure for glaucoma is trabeculectomy, which creates a new drainage channel to reduce IOP.
4. Healthy Diet
A balanced diet rich in antioxidants, vitamins, and minerals supports eye health. Nutrients like vitamin C, E, omega-3 fatty acids, and zinc may help protect the optic nerve from further damage.
Ayurvedic Overview
सर्वेन्द्रियानाम नयनं प्रधानं
In Ayurveda, Acharya’s have explained about five “indriyas” (sense organs). Among them eyes are considered the most supreme sense organs. In Ayurveda, Glaucoma can be clinically correlated to Adhimantha as the presentation of symptoms is quite similar. It is explained by Acharya Sushrut [Father of Ayurvedic Surgery]. He has mentioned about five types of “Adhimantha”. Before this, a condition called “Abhishyandha” (Excessive discharge & pain in eyes) develops, but if it is not treated timely it complicates and develops into “Adhimantha”.
The types of Adhimantha are Vataj, Pittaj, Kaphaj, Raktaj and Hata Adhimantha.
Vataj, Pittaj and Raktaj Adhimantha are co-related with “Primary Angle Closure Glaucoma”; while Kaphaj Adhimantha can be correlated with “Primary Open Angle Glaucoma” and Hata Adhimantha can be co-related to “Absolute Glaucoma”.
In Vataj Adhimantha, there is a severe churning type of pain, headache of one side, ringing in ears. In the Pittaj Adhimantha there is redness and burning sensation in eyes causing extreme pain and sometimes inflammation. In the Kaphaj Adhimantha, there is swelling, watering of eyes, difficulty in focusing or seeing objects, headache and severe pain.
Even in Ayurveda, there is no specific cure for the disease but the disease can be managed with various ayurvedic herbs and procedures, so that the progression of the vision loss can be ceased.
Many therapies such as Aschyotana (instillation of herbal eye drops), Bidalaka (blended paste of herbs is applied over eyes), Akshi-tarpan (pool of medicated ghee around eyes), Anjana (collyrium), etc. are used in this. Rakta-Mokshana (bloodletting) is done by Jaloukavcharan (leech therapy) to reduce the pain and edema. For Akshi-tarpan (instillation of herbal eye drops) use of medicated oils and ghee like Mahatriphala ghrita, Phala Ghrita, Jeevantiyadhi Ghrita are done as they are known for their Chakshushya (beneficial for eyes) properties.
Bilvadhi eye drops and punarnava swaras (freshly squeezed juice of leaves of Boerhavia diffusa) are used in Aschyotana. It is helpful in relieving redness, itching and burning sensation. Also use of “Matru-stanya” (milk of a lactating mother) is done in Rakta and Pittaj Adhimantha.
Triphala kashayam [decoction made using Haritaki (Terminalia chebula) + Vibhitaki (Terminalia bellirica) + Amalaki (Emblica officinalis)] is used for washing eyes. It removes any impurities in eyes which might trigger watering of eyes.
To improve the focus of eyes, “Jyoti-trataka” is also indicated. In this, the patient has to steadily gaze at a certain point or the tip of the flame of a candle. Acharya’s have also mentioned about “Pada-Abhyanga” i.e., foot massage with oils. It is known to strengthen vision and improve focus.
Ayurvedic Herbs Beneficial In Glaucoma
1. Amla / Emblica officinalis
Commonly known as Indian Gooseberry, this powerhouse of nutrients is known to balance all your tridoshas. It has high levels of vitamin C which is essential for collagen production and maintaining the health of blood vessels in the eyes. It has various alkaloids, flavonoids, polyphenols & tannins to protect the eyes from the oxidative stress and damage caused by free radicals. Amla boosts the natural repair mechanism of eyes and helps in faster recovery from eye infections or injuries.
2. Brahmi / Bacopa monnieri
This herb is a powerpack source of antioxidants. It is rich in alkaloids like bacosides. It is known to improve visual focus and cognitive functions. It improves blood flow in the retina as it is a rich source of nitric oxide. Brahmi is helpful in reversing damage caused by free radicals.
Herbal Remedies For Glaucoma By Planet Ayurveda
Planet Ayurveda provides a combination of ayurvedic herbs for the management of Glaucoma. With the use of above-mentioned herbs, planet Ayurveda has compiled few medicines which are efficient in treating Glaucoma. These are Angel eye vitale capsules, Bilberry capsules, Amalaki Rasayan capsules, and Green Essential capsules. All the Planet Ayurveda medicines are 100% natural, vegetarian, additive free, chemical & preservative free and without any side effects. With ayurvedic intervention, the Glaucoma can be managed efficiently and thus, increasing the quality of life.
- Angel Eye Vitale Capsules
- Bilberry Capsules
- Amalaki Rasayan Capsules
- Green Essential Capsules
Herbal Remedies for Glaucoma
Products Description
1. Angel Eye vitale Capsules
These capsules are prepared from the standardized extract derived from Amla (Emblica officinalis), Gotu-kola (Centella asiatica), and Bhringraj (Eclipta alba). These herbs altogether are “Chakshushya” i.e., beneficial for eyesight. The extract from Gotu-kola (Centella asiatica) improves sight as it causes production of “Rhodopsin” in the retina. It is also helpful in improving retinal blood circulation.
Dosage: 1-2 Capsules once or twice daily.
2. Bilberry Capsules
These capsules are prepared from the standardized extract of Bilberry (Vaccinium myrtillus). Bilberry is a natural and richest source of anthocyanins. These potent bioactives are known worldwide for improving eye sight, particularly night vision. They protect cells against oxidative damage. These are also anti-microbial and anti-inflammatory.
Dosage: 1-2 Capsules once or twice daily.
3. Amalaki Rasayan Capsules
These capsules are prepared from the standardized extract of Amla (Emblica officinalis). Along with it, Cow’s ghee, honey and Pippali (Piper longum) churna is used in these capsules. They are a rich source of vitamin c, vitamin A and carotenoids which enhances vision. Their regular consumption is beneficial for maintaining healthy vision throughout your life.
Dosage: 1-2 Capsules twice daily, with plain water, after meals.
4. Green Essential Capsules
These capsules are prepared from the standardized extract of Grape seed (Vitis vinifera), Wheat grass (Triticusm sativum), Spirulina (Arthrospira platensis), Green tea (Camellia Sinensis) and Amla (Emblica officinalis). These Green Essential capsules are a rich source of nitrates. These nitrates in the body get converted to nitrous oxide on digestion and this nitrous oxide is helpful in clearing out each and every minute blood vessel. Therefore, it is helpful in improving blood circulation in the retina, thus improving sight.
Dosage: 1-2 Capsules twice daily, with plain water, after meals.
Conclusion
Glaucoma is a serious and potentially debilitating eye condition that requires early detection, timely treatment, and ongoing management. While it cannot be cured, the progression of glaucoma can be slowed or halted with appropriate interventions. Regular eye exams are necessary to keep watch at the progress of the disease. Ayurvedic treatment offers a holistic perspective on managing glaucoma by focusing on restoring balance to the body, particularly through natural remedies that target the root causes of the disease. Herbs like Triphala (Amalaki + Haritaki + Bibhitaki), Amla (Emblica officinalis), and Mandukaparni (Centella asiatica), along with specialized therapies such as Netra Tarpana, Putpaka etc. are used to help reduce intraocular pressure, improve blood circulation to the eyes, and promote overall eye health.
Although Ayurveda cannot reverse damage already done to the optic nerve, it can slow the progression of the disease and improve the quality of life for patients. By addressing both the physical and emotional aspects of the condition, Ayurvedic treatments offer a comprehensive solution that supports the body’s healing process. Regular monitoring and early intervention are still critical in preventing further complications. In combination with conventional medical care, Ayurveda can be a valuable complementary approach, providing a natural and personalized path to manage glaucoma and maintaining eye health for the long term.
