ARMAROGA (PTERYGIUM)

🔺CASE STUDY : ARMA / PTERYGIUM

🔺NIDANAM

• Exposure to dust, smoke, wind, and sunlight

• Excessive eye strain

• Suppression of natural urges, especially tears and sneezing

• Unhygienic habits related to eye care

• Excessive Kapha and Pitta dosha provoking diet and lifestyle
  (Reference: Sushruta Samhita, Uttara Tantra 6/29)

🔺PURVAROOPAM

• Mild irritation and dryness of the eye

• Feeling of a foreign body

• Watering of eyes

• Slight reddish discoloration

• Heaviness or discomfort in the eye region

🔺LAKSHANAM

• Presence of a fleshy growth on the sclera

• Growth may spread towards the cornea, affecting vision

• Irritation, foreign body sensation, and redness

• Vision may be obstructed in progressive stages
  (Reference: Sushruta Samhita, Uttara Tantra 6/29)

🔺GENERAL & SYSTEMIC EXAMINATION OF ARMA

🔺GENERAL EXAMINATION

• History: Prolonged sun exposure, wind, dust, or smoke exposure

• Age group: Commonly seen in adults (30–60 years)

• Occupation: Outdoor workers, farmers, drivers

• Diet & Lifestyle: Kapha-Pitta aggravating factors

• Systemic Health: Check for underlying conditions like:

  • Allergies

  • Chronic conjunctivitis

  • Vitamin A deficiency

🔺SYSTEMIC EXAMINATION

• Check for systemic diseases that may exacerbate eye conditions:

  • Autoimmune disorders

  • Liver dysfunction (can lead to yellowish scleral changes)

  • Metabolic syndrome (associated with oxidative stress and tissue degeneration)

🔺LABORATORY INVESTIGATIONS

• CBC (Complete Blood Count): Rule out infection or inflammation

• Blood Sugar (FBS/PPBS/HbA1c): Check for diabetes mellitus

• Vitamin A levels: Rule out deficiency affecting eye health

• ESR/CRP: If inflammation suspected

• ANA, RF: To rule out autoimmune involvement

• Slit-lamp Examination: To observe the lesion size, vascularity

• Visual Acuity Test: To check for any visual impairment

• Photo Documentation: For monitoring the growth or recurrence

🔺DIFFERENTIAL DIAGNOSIS (DD)

• Pterygium

• Pinguecula

• Conjunctival Nevus

• Conjunctival Papilloma

• Squamous Cell Carcinoma (SCC)

• Limbal Dermoid

🔺SAMPRAPTI (PATHOGENESIS)

• Vitiated Kapha and Pitta doshas localize in the eye

• Leads to abnormal tissue growth (Mamsa Vriddhi) in the conjunctival region

• This growth progresses toward the cornea

• Aggravated by continued exposure to etiological factors

🔺SAMANYA CHIKITSA (GENERAL TREATMENT)

• Avoidance of nidana (causative factors)

• Use of Anjana (collyrium) with Kapha-Pitta hara properties

• Nasya (nasal medication) and Netra Prakshalana (eye wash) with medicated decoctions

• Eye drops with anti-inflammatory and astringent herbs

• Internal medicines to balance Kapha and Pitta

🔺VISESA CHIKITSA (SPECIFIC TREATMENT)

SURGICAL MANAGEMENT

• If Arma is large and obstructing vision:

  • Arma Chedana (Surgical excision) as per Sushruta

  • Application of Kshara or Agni Karma if recurrence occurs

  • Post-surgical application of healing and soothing eye medications
    (Reference: Sushruta Samhita, Uttara Tantra 6/29-30)

POST-OPERATIVE CARE

• Use of Tarpana and Putapaka

• Application of medicated ghee, such as Jeevantyadi Ghrita

• Internal medications like:

  • Triphala Guggulu: 500 mg – 1 g twice daily for 4–6 weeks

  • Kaishora Guggulu: 2 tabs twice daily with warm water or decoction for 4–6 weeks

  • Punarnavadi Kashayam: 15–20 ml twice daily before food for 3–4 weeks

  • Triphala Churna: 3–5 g at bedtime with warm water (long term)

LOCAL / TOPICAL APPLICATIONS (BAHYA CHIKITSA)

• Eye Drops (Aschyotana)

  • Jeevantyadi Ghrita: 1–2 drops twice daily (Lubricates and reduces inflammation)

  • Triphala Ghrita: 1–2 drops daily (Balances Pitta and improves vision)

• Tarpana Therapy

  • Medicated Ghrita: Jeevantyadi Ghrita or Triphala Ghrita

  • Eye retention for 10–15 mins for 5–7 days

PANCHAKARMA PROCEDURES (SHODHANA CHIKITSA)

• Virechana: Purgation with drugs like Trivrit Leha to balance Pitta dosha

• Nasya: Anu Taila or Shadbindu Taila – 4–6 drops in each nostril

• Seka (Irrigation): Decoction of Triphala or Daruharidra – Reduces inflammation and overgrowth

• Arma Chedana: Performed when growth obstructs vision or doesn’t respond to medicines – Followed by Tarpana

SPECIFIC FORMULATIONS FOR ARMA (FROM CLASSICAL TEXTS)

• Triphala Seka: Used for eye washing, reduces abnormal growth

• Jeevantyadi Ghrita (Ref: Ashtanga Hridaya Uttara Tantra): Beneficial for Arma due to anti-inflammatory and soothing properties