UNDERSTANDING OF PRAMEHAJANYA TIMIRA BY AN AYUREVDA PERSPECTIVE- A REVIEW
Background: The risk of development of blindness in diabetics increases by 20–25 times as compared to the normal population. Globally the number of people with Diabetic Retinopathy will grow from 126.6 million in 2010 to 191.0 million in 2030. 80% blindness in Diabetic Retinopathy is due to Diabetic macular edema (DME). Evidence are available in all Ayurvedic text that validates Timira can be a complication of Madhumeha. Material and method: For this review study, basic concepts of Ayurveda were analysed from all relevant classical texts of Ayurveda including Bruhatrayi, Laghutrayi and other relevant sources. Internet sources were searched for recent advances to find out the probable etiopathogenesis and management of diabetic macular edema. Observations: -In Sushruta Samhita while describing Upadravas(complications) of Prameha, Pratishyaya (rhinosinusitis) and Pandu are Upadravas. Pratishyaya in complication stage causes serious ocular problems. Pandu also leads to Hatendriya Lakshana in its progressive stage. Upadravas according to Doshika predominance of Prameha, Pita Vinamutranetrata is categorized under Upadrava of Pittaja Prameha by Acharya Sushruta, which reflects towards ischaemia of retina. Thus all these references give a clue towards involvement of eyes as a complication of Prameha. In Sushruta Samhita while describing the treatment of Prameha Pidika it is said that in the Poorvaroopa Avastha of Vyadhi, treatment should be Apatarpana, Vanaspati Kashaya and Vasta mutra. If this treatment is not followed then there is increased Maadhurya in Mutra, Sweda and Sleshma which leads to development of Roopa Avastha i.e Prameha Vyadhi. In this stage of Vyadhi Ubhaya Samshodhana should be done, if it is not performed the doshas vitiate more and cause Dushti of Mamsa and Rakta Dhatus, due to which Shopha and other complications of Prameha eg Prameha Pidika occur. Conclusion: Though there is no direct reference for Prameha causing Netra Vikaras in any of our treatises. But there are many references which indirectly point out that Prameha can cause Netra Rogas as its Upadrava. From all the above description, we can conclude that Ayurveda is a science of life and there are many different principles, drugs and therapies that can be used for management of various forthcoming diseases.
KEYWORDS: Diabetic macular edema (DME), Diabetic Retinopathy, Pramehajanya Timira