24

-Ju

l-201

2

1

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

NUTRITIONAL DEFICIENCY

DISORDERS OF EYE 24

-Ju

l-201

2

2

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f Ayu

rved

a

amp H

osp

ital H

assa

n

TOPICS OF INTEREST

Definition of Nutrient amp its Types

Ayurveda view of Nutritional Deficiencies

Contemporary View of Nutritional

Deficiencies related to eye

Prevention of Nutritional Deficiencies

24

-Ju

l-201

2

3

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF NUTRIENT

A nutrient is a chemical that

an organism needs to live and

grow

OR

A substance used in an

organisms metabolism which

must be taken in from its

environment

24

-Ju

l-201

2

4

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of

Nutrients

bullBuild and repair tissues

bullRegulate body processes

bullAs energy

24

-Ju

l-201

2

5

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

6

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Classification of Nutrients

Type I

Organic

Carbohydrates Proteins Fats

Vitamins

Inorganic

Minerals Water Oxygen

Type II

Essential Non

Essential

Produced in the body

Types of Nutrient deficiency

Primary Deficiency

Secondary Deficiency

24

-Ju

l-201

2

7

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

8

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

No direct Classical References

on Individual types of Nutrients

कपोषणजनय नतर वयाधि- Coined Term

Concept of आहार अधि amp िात

पोषण can be taken

24

-Ju

l-201

2

9

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SPECIAL IMPORTANCE FOR NETRA

Most Important among Sense Organs

one among ndash अषट सथान परीकष

रोगाकरानत शरीरसय सथानानयषटौ धनरीकषयत

नाडी मतर मल धजहा शबद शबद सपशश दगाकधत (यो र)

Earlier Days ndash an important diagnostic tool ndash

when modern diagnostic methods were unavailable

24

-Ju

l-201

2

10

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

NUTRITIONAL DEFICIENCY

DISORDERS OF EYE 24

-Ju

l-201

2

2

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f Ayu

rved

a

amp H

osp

ital H

assa

n

TOPICS OF INTEREST

Definition of Nutrient amp its Types

Ayurveda view of Nutritional Deficiencies

Contemporary View of Nutritional

Deficiencies related to eye

Prevention of Nutritional Deficiencies

24

-Ju

l-201

2

3

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF NUTRIENT

A nutrient is a chemical that

an organism needs to live and

grow

OR

A substance used in an

organisms metabolism which

must be taken in from its

environment

24

-Ju

l-201

2

4

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of

Nutrients

bullBuild and repair tissues

bullRegulate body processes

bullAs energy

24

-Ju

l-201

2

5

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

6

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Classification of Nutrients

Type I

Organic

Carbohydrates Proteins Fats

Vitamins

Inorganic

Minerals Water Oxygen

Type II

Essential Non

Essential

Produced in the body

Types of Nutrient deficiency

Primary Deficiency

Secondary Deficiency

24

-Ju

l-201

2

7

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

8

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

No direct Classical References

on Individual types of Nutrients

कपोषणजनय नतर वयाधि- Coined Term

Concept of आहार अधि amp िात

पोषण can be taken

24

-Ju

l-201

2

9

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SPECIAL IMPORTANCE FOR NETRA

Most Important among Sense Organs

one among ndash अषट सथान परीकष

रोगाकरानत शरीरसय सथानानयषटौ धनरीकषयत

नाडी मतर मल धजहा शबद शबद सपशश दगाकधत (यो र)

Earlier Days ndash an important diagnostic tool ndash

when modern diagnostic methods were unavailable

24

-Ju

l-201

2

10

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOPICS OF INTEREST

Definition of Nutrient amp its Types

Ayurveda view of Nutritional Deficiencies

Contemporary View of Nutritional

Deficiencies related to eye

Prevention of Nutritional Deficiencies

24

-Ju

l-201

2

3

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF NUTRIENT

A nutrient is a chemical that

an organism needs to live and

grow

OR

A substance used in an

organisms metabolism which

must be taken in from its

environment

24

-Ju

l-201

2

4

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of

Nutrients

bullBuild and repair tissues

bullRegulate body processes

bullAs energy

24

-Ju

l-201

2

5

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

6

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Classification of Nutrients

Type I

Organic

Carbohydrates Proteins Fats

Vitamins

Inorganic

Minerals Water Oxygen

Type II

Essential Non

Essential

Produced in the body

Types of Nutrient deficiency

Primary Deficiency

Secondary Deficiency

24

-Ju

l-201

2

7

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

8

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

No direct Classical References

on Individual types of Nutrients

कपोषणजनय नतर वयाधि- Coined Term

Concept of आहार अधि amp िात

पोषण can be taken

24

-Ju

l-201

2

9

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SPECIAL IMPORTANCE FOR NETRA

Most Important among Sense Organs

one among ndash अषट सथान परीकष

रोगाकरानत शरीरसय सथानानयषटौ धनरीकषयत

नाडी मतर मल धजहा शबद शबद सपशश दगाकधत (यो र)

Earlier Days ndash an important diagnostic tool ndash

when modern diagnostic methods were unavailable

24

-Ju

l-201

2

10

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF NUTRIENT

A nutrient is a chemical that

an organism needs to live and

grow

OR

A substance used in an

organisms metabolism which

must be taken in from its

environment

24

-Ju

l-201

2

4

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of

Nutrients

bullBuild and repair tissues

bullRegulate body processes

bullAs energy

24

-Ju

l-201

2

5

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

6

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Classification of Nutrients

Type I

Organic

Carbohydrates Proteins Fats

Vitamins

Inorganic

Minerals Water Oxygen

Type II

Essential Non

Essential

Produced in the body

Types of Nutrient deficiency

Primary Deficiency

Secondary Deficiency

24

-Ju

l-201

2

7

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

8

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

No direct Classical References

on Individual types of Nutrients

कपोषणजनय नतर वयाधि- Coined Term

Concept of आहार अधि amp िात

पोषण can be taken

24

-Ju

l-201

2

9

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SPECIAL IMPORTANCE FOR NETRA

Most Important among Sense Organs

one among ndash अषट सथान परीकष

रोगाकरानत शरीरसय सथानानयषटौ धनरीकषयत

नाडी मतर मल धजहा शबद शबद सपशश दगाकधत (यो र)

Earlier Days ndash an important diagnostic tool ndash

when modern diagnostic methods were unavailable

24

-Ju

l-201

2

10

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of

Nutrients

bullBuild and repair tissues

bullRegulate body processes

bullAs energy

24

-Ju

l-201

2

5

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

6

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Classification of Nutrients

Type I

Organic

Carbohydrates Proteins Fats

Vitamins

Inorganic

Minerals Water Oxygen

Type II

Essential Non

Essential

Produced in the body

Types of Nutrient deficiency

Primary Deficiency

Secondary Deficiency

24

-Ju

l-201

2

7

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

8

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

No direct Classical References

on Individual types of Nutrients

कपोषणजनय नतर वयाधि- Coined Term

Concept of आहार अधि amp िात

पोषण can be taken

24

-Ju

l-201

2

9

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SPECIAL IMPORTANCE FOR NETRA

Most Important among Sense Organs

one among ndash अषट सथान परीकष

रोगाकरानत शरीरसय सथानानयषटौ धनरीकषयत

नाडी मतर मल धजहा शबद शबद सपशश दगाकधत (यो र)

Earlier Days ndash an important diagnostic tool ndash

when modern diagnostic methods were unavailable

24

-Ju

l-201

2

10

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

6

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Classification of Nutrients

Type I

Organic

Carbohydrates Proteins Fats

Vitamins

Inorganic

Minerals Water Oxygen

Type II

Essential Non

Essential

Produced in the body

Types of Nutrient deficiency

Primary Deficiency

Secondary Deficiency

24

-Ju

l-201

2

7

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

8

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

No direct Classical References

on Individual types of Nutrients

कपोषणजनय नतर वयाधि- Coined Term

Concept of आहार अधि amp िात

पोषण can be taken

24

-Ju

l-201

2

9

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SPECIAL IMPORTANCE FOR NETRA

Most Important among Sense Organs

one among ndash अषट सथान परीकष

रोगाकरानत शरीरसय सथानानयषटौ धनरीकषयत

नाडी मतर मल धजहा शबद शबद सपशश दगाकधत (यो र)

Earlier Days ndash an important diagnostic tool ndash

when modern diagnostic methods were unavailable

24

-Ju

l-201

2

10

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Types of Nutrient deficiency

Primary Deficiency

Secondary Deficiency

24

-Ju

l-201

2

7

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

8

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

No direct Classical References

on Individual types of Nutrients

कपोषणजनय नतर वयाधि- Coined Term

Concept of आहार अधि amp िात

पोषण can be taken

24

-Ju

l-201

2

9

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SPECIAL IMPORTANCE FOR NETRA

Most Important among Sense Organs

one among ndash अषट सथान परीकष

रोगाकरानत शरीरसय सथानानयषटौ धनरीकषयत

नाडी मतर मल धजहा शबद शबद सपशश दगाकधत (यो र)

Earlier Days ndash an important diagnostic tool ndash

when modern diagnostic methods were unavailable

24

-Ju

l-201

2

10

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

8

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

No direct Classical References

on Individual types of Nutrients

कपोषणजनय नतर वयाधि- Coined Term

Concept of आहार अधि amp िात

पोषण can be taken

24

-Ju

l-201

2

9

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SPECIAL IMPORTANCE FOR NETRA

Most Important among Sense Organs

one among ndash अषट सथान परीकष

रोगाकरानत शरीरसय सथानानयषटौ धनरीकषयत

नाडी मतर मल धजहा शबद शबद सपशश दगाकधत (यो र)

Earlier Days ndash an important diagnostic tool ndash

when modern diagnostic methods were unavailable

24

-Ju

l-201

2

10

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

No direct Classical References

on Individual types of Nutrients

कपोषणजनय नतर वयाधि- Coined Term

Concept of आहार अधि amp िात

पोषण can be taken

24

-Ju

l-201

2

9

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SPECIAL IMPORTANCE FOR NETRA

Most Important among Sense Organs

one among ndash अषट सथान परीकष

रोगाकरानत शरीरसय सथानानयषटौ धनरीकषयत

नाडी मतर मल धजहा शबद शबद सपशश दगाकधत (यो र)

Earlier Days ndash an important diagnostic tool ndash

when modern diagnostic methods were unavailable

24

-Ju

l-201

2

10

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SPECIAL IMPORTANCE FOR NETRA

Most Important among Sense Organs

one among ndash अषट सथान परीकष

रोगाकरानत शरीरसय सथानानयषटौ धनरीकषयत

नाडी मतर मल धजहा शबद शबद सपशश दगाकधत (यो र)

Earlier Days ndash an important diagnostic tool ndash

when modern diagnostic methods were unavailable

24

-Ju

l-201

2

10

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

तजो भत

आतमज

भा

रसज

भा

ततीय मास

24

-Ju

l-201

2

11

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतरोतपधि

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

12

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर Located in धशरस कफ सथान

नतर धपि सथान

दशशन ात धपि

तपशक कफ

रस रकत िात

सामानय नतर धरण

(दक सपशशन च धपिसय)

(परसाद दशशनधपि)

(अकषाणा पाटन चअनगरहणतयधकत अधनलः)

(अधकष तपशणात तपशकः)

(परीणन जीनhellip)

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RELATION BETWEEN आहार िात पोषण

amp NUTRIENTS आहार सभम सतः

= You are what you eat

24

-Ju

l-201

2

13

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

14

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(योग रतनाकर धनतय परधि परकार 123)

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

महशवर = लोधहताकष =

अधि ie आहार

पचन Individual

himself is the

cause for

metabolism of

the food Proper

पचन leads to

सासय

धषण = धसतधथ ie दह

धसतधथ आहार रस cause

for maintain the body

24

-Ju

l-201

2

15

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

बरहम = सधि ie दह

सधि अनन cause for

development of

body अनन

रस भकता

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ततर य पथक घत कषीर तल मास रस सातमयाः

सश रससातमयाशचा त बलनतः

पनरक रस सातमयाशचा एत परायण अलप बलभधनत

(अ ह शा 1 123)

(अ ह शा 1 123)

24

-Ju

l-201

2

16

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सरायतयधकष (physiological)

कलद धशोषण

दीपन

सरोताधस धणोधत

चकषषय अधकषपरसादन इधनियबलिशन जीन

धष नाशन

कलदोपशोषण

असर

धशोिन

कलद

शोषण

धिगि कफ रकत करोधत ात अनलोमन

अधििशक

धिगि

सघातनाशक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

17

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

समयक िात

पोषण भा

आहार धधि

धिान चकषषय आहार सन

जठराधि

बल समयक पराण

वयानसमान परधि

सरोतो

शधधः

िाताधिबल

24

-Ju

l-201

2

18

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BASIC PROCESS OF DHAATU POSHANA

तनमना उधचत काल षड रसानन सन

कोि पराण अधनलाहत

समानन सदधकषत जठराधिना पाक करोधत

रस िात धनमाशण

धकषपोधचत कमशणः वयानन रसिातरहह सशतः

दह सदा यगपत अजसर धधकषपयत (अ ह शा 3 55 56 68)

24

-Ju

l-201

2

19

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSHANA OF NETRA

वयानन रस िातः ऊरधशजतरगत धसरा

धधकषपयत

ततः नतर गत धसरा परापयधत

अननतर नतर परापयधत

तन नतर पोषयधत

24

-Ju

l-201

2

20

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

22

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर रोग

सपराधि

धकषपयमाणः ख गणयात रस सजजधत यतर सः

तधसमन धकार करत ख षशधम तोयतः

धसरानसाररधभदोषरहगणररधशमागतः

जायनत नतरभागष रोगाः परमदारणः

GENERAL SAMPRAAPTI

SPECIFIC SAMPRAAPTI

(अ ह शा 3 69)

(स स उि 1 123)

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

[Nutrient Deficiency Disorder]

अलप

आहार

अधिमानय

सरोतोरोि

ात

गणय

24

-Ju

l-201

2

23

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सपराधि घटक

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Classification of कपोषणजनय नतर वयाधि Based on धनदानम

जनम बल परि

दौहद अपचारजनय

नतर रोग

दोषबलपरि साभाधक

Physiological (गरहभणी)

दषटः कषीरजनय नतर रोगा

दोष षमयजनय

कपोषणजनय नतर रोग

रसकत

24

-Ju

l-201

2

24

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

25

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION OF कपोषणजनय नतर वयाधि

BASED ON सभा

सतनतर वयाधि

bull अलपाहार

bull जनमबल परि

bull साभाधक

परतनतर वयाधि bullअधिमनय amp सरोतोरोि

bull धमयाहारजनय

bullअमल धदाधह धषटधभ आहार

bullअधतमातर आहारजनय

bullअधतमातरा धतकत कषाय मिरानन सन मय सन

bull धहारजनय

bullमनाधत योग अनय मनो भञजानः

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

साभाधक नतर रोग आतशादशशन आसय ससरन

धशषणhelliphellipचकषरोगलाशधनःगभ पयाशगत रपाधण भधनत

When a नारी conceives

गभश takes रस िात from mother for its nourishment amp

development

रस िात कषय in गरहभणी

(रस रौकषय शरम शोषो गलाधन शबदासधहषणता)

(अ ह स)

गलाधन

धशषण चकषषोगलाशधन

(च स शा 4 16)

24

-Ju

l-201

2

26

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जनमबल परि

नतर रोग

24

-Ju

l-201

2

27

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MAATU AHAARA AS THE ONE OF THE MAIN

FACTOR FOR DEVELOPMENT OF गभशनतर

बीजतमकः महाभतः सकषमः सतानगशच सः

मातशच आहार रसजः करमात ककषौ धिशत अ ह शा 1-2

required for

नतर is an अय of गभश

Hence

is essential

24

-Ju

l-201

2

28

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रसकत जनमबल परि नतर रोग

सामानय लकषणम

ातलशच भत गभशः कबजा आनरधय जड ामनः

ातल आहार सन by गरहभणी

(धतकतोषण कषाय अलप रकष परधमत भोजनः)

अधि षमय

िात कषय

असमयक नतरोतपधि

अनित

(अ ह शा 1 48)

(अ ह धन 1 48)

24

-Ju

l-201

2

29

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ाराह मास

धनतय रकताकष

24

-Ju

l-201

2

30

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

मतसय मास

धनतय

धचरधनमष

सतबदाकष ा

अमलधनतय रकतधपधिन

अधकषरोधगण ा

धशष लकषणम

रसकत जनमबल परि नतर रोग

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि

दौहद धमाननात धह ायः परकधपतो अनतः शरीर अनचरन गभशसय धनाश रपय ा कयाशत (अ स शा 219)

दौहद धनमन

ात कोप

इधनिय उपघात

धशष लकषणम

दौहद धमाननातधकताकष अनकष ा नारी सत जनयधत (स स शा 318)

धकताकष or अनकष

24

-Ju

l-201

2

31

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दौहद अपचारजनय जनमबल परि नतर रोग

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

गरहभणी पररचयाश परािानय

परथम धितीय ततीय मास

सामानयात

चकषरधनियोतपधि

मिर शीत िवय धहतम

24

-Ju

l-201

2

32

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशषात ततीय मास

चकषरधनियोतपधि

परािानयतम

कषीर + सरहप + मि

धशषसत गरहभणी परथम धितीय ततीय मासष मिर शीत िवय

परायमाहार उपसत स स शा 104

ततीय मास कषीर मि सरहपभयामपससजय च स शा 832

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

दषटः कषीरजनय

नतर रोगा

24

-Ju

l-201

2

33

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Production of नतर रोग in कषीरप

In कषीरप only source of िात पोषण is सतनय

Proper सतनय सपत essential for सासय नतर

कषीर दधषट produces नतर रोग

Classification of कषीर दधषट

Difference of Opinion present between आचायश

Most Significant

ात दषट सतनय पान जनय नतर रोग

कषार सतनय पान जनय नतर रोग

24

-Ju

l-201

2

34

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सामानय सपराधि OF दषटसतनय कषीर पानजनय वयाधि

धमया आहार of िातरी

कषीर दधषट

दषट कषीर पान causes अधि षमय in Child

सरोतोरोि and hence िात पोषणकषय

नतररोग

24

-Ju

l-201

2

35

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष लकषणम

ात दषट सतनय पान जनय नतर रोग hellipातधकाररणाम कतश ातोपसशरषटम कषीर

ात दषट सतनय पान

अधि षमय

िात कषय

ात धकार

धतधमर One among नानातमज ात धकार

24

-Ju

l-201

2

36

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कषार सतनय पान जनय नतर रोग

चकषरोगाशचजायत कषार दगिक (हा स त 547)

कषार सतनय पान

अधि षमय

धपि रकत परकोप

चकष रोग

24

-Ju

l-201

2

37

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

कपोषणजनय नतर रोग 24

-Ju

l-201

2

38

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CLASSIFICATION

38

आहारजनय

कपोषण नतर रोग

धहारजनय

कपोषण नतर रोग

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

आहारजनय कोपोषण नतर रोग 2

4-J

ul-2

01

2

39

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ALPA AHARA JANYA DOSHA

भोजन हीन मातर त न बलोपचायौजस

सषा ातरोगाणा हतता च परचकषत

अलप आहार

अधि षमय

िात कषय

रोगासथा (ाधतक रोग)

(अ ह स 8 3)

24

-Ju

l-201

2

40

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPLICATION OF PROLONGED ALPAAHAARA

आहार पचधत धशखी दोषान आहार रहजतः पचधत

दोषकषय च िातन पचधत च िातकषय पराणान

(यो र धनतय 104)

24

-Ju

l-201

2

41

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MITHYA AHARA JANYA DOSHA धमय आहारा अलपमातरा amp अकसमातndash Chances of

diseases in less

धमय आहार अधतमातरा amp धनतय ndash Chances of disease

in more

धदाधह आहार (Mainly Causes धपि परकोप)

यतो अमल धपाककत ताद धदाधहताद असयोकत

धषटधभ आहार (Mainly Causes ात परकोप)

धषटभीनी रकषाकद गण यकता च

धरध आहार

षाणय आनरधय ीसशप दकोदराणhellip

(अरणदि)

(च स स 2 123)

24

-Ju

l-201

2

42

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(अरणदि)

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धदाधह आहार धषटधभ आहार amp धरध आहार

अधि षमय

धतरदोष रकत परकोप

रोगासथा

चकषवयाशधिः (धशषण धतधमर)

24

-Ju

l-201

2

43

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SAMPRAAPTI

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धशष नतररोगकर आहार

शकतारानालामल कलतथ माष धनष णhellip

Shuktam

रकतधपिकफ़ोतकलकद शकत ातानलोमनम

Aranala

िानयामल भकद तीकषणॊषण धपिकत सपशशशीतलम

Amla rasa

अमलोऽधिदीिीकत धिगिो हध पाचनरोचन

उषणीयो धहमसपशश परीणनो भदनो लघ

करोधत कफधपिासतर मढातानलोमनम

सोऽतयभयसतसतनो कयाशत शधथलय धतधमर भरमम

(अ ह स 5 81)

(अ ह स 5 84)

(अ ह स 10 11)

24

-Ju

l-201

2

44

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Kulattha

उषणा कलतथा पाकऽमला शकराशम शवास पीनसान

कासाशश कफाताशच घनधनत धपिासतरदा परम

Masa माष धिगिो बलशलषमलधपिकर सर

(अ ह स 6 18)

(अ ह स 6 20)

24

-Ju

l-201

2

45

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातर

अननपान

असमयक

पचन

अधि

षमय

आम नतरह सरोतो

पराधि सरोतो रोि

िात कषय नतर धकार

24

-Ju

l-201

2

46

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमातरा जनय नतर रोग सतपशयधतhelliphelliphellipइधनिय सरोतसा लपोhelliphellip

(च स स 23 7)

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

इधनिय

बल कषय

मद कफज रोग अधिसाद

िातकषय

अधनलवयाधि

धषटधभ

सरोतोरोि

अचकषषय धतधमरकर तनो शधथलय

इधनियबलनाशन

अधकषपाक

षड

रसः

अमल

लण

कट

मिर

धतकत

कषाय

24

-Ju

l-201

2

47

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधतमय पानाज नतर वयाधि तीकषणोषण रकष सकषमामल वयााधय आशकर लघ

धकाधष धशद मय ओजो असमात धपयशयः

(अ ह धन 61)

अधतमय पान धतरदोष + रकत परकोप

ओज कषय अधि षमय

चकषरधनिय वयाधि

24

-Ju

l-201

2

48

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अधत िमपान जनय नतर रोग

तीकषणादयो धष अपयकताhellip(अ ह धन 62)

Especially seen with

िमपान with धष िवय

like Tobacco

24

-Ju

l-201

2

49

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

िम

गण मय

गण

धष गण

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF EXCESS िमपान

Hence िमाधत योग वयापत almost similar

to अधत मय वयापत 24

-Ju

l-201

2

50

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

रकतधपि आनरधय बाधियश तणमरचाश मद मोह कत

िमो अकाल अधतपीतो ाhelliphellip(अ ह स 214)

अधतिमपान अधत मयपान समान सपराधि

आनरधय

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

धहारजनय कपोषण नतर वयाधि मनाधतयोग ndash (As a नतररोग धनदान mentioned by ङगसन)

मनाधतयोग

िात कषय

ात धध

इधनिय पोषण षमय

नतर वयाधि

24

-Ju

l-201

2

51

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

अनयमनसो भञजानः

अनय मनसो भञजानः अधि षमय

आम उतपधि असमयक पचन

सरोतोरोि िातकषया

नतर रोग

24

-Ju

l-201

2

52

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONTEMPORARY

VIEW

24

-Ju

l-201

2

53

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

SCENARIOhellip Malnutrition as a cause of blindness

has been and still is much

underestimated In many countries

it is the chief cause of blindness in

young children The onset is

insidious and difficult to

diagnose and the later stages

proceed rapidly to irreversible

damage

24

-Ju

l-201

2

54

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

NUTRITIONAL DEFICIENCY DISORDERS

OF EYE

Xeropthalmia

Glaucoma amp

ARMD

Cataract

Optic Atrophy

Anemic Retinopathy

24

-Ju

l-201

2

55

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A

24

-Ju

l-201

2

56

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as Retinol

Two Forms of Retinol

Retinaldehyde ndash required for normal vision

Retinoic acid

Normal Requirement

1800 IUday

Dietary Source

Liver fish and eggs

24

-Ju

l-201

2

57

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Functions of Vitamin A

Retinal - prosthetic group of photosensitive pigments

Needed in Lysosomal membrane stability

Plays a role in Keratinization Cornification cell growth

24

-Ju

l-201

2

58

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Role of Vitamin A in Vision

11-cis-retinal

ISOMERISATION REACTION

(11-cis-retinal all-trans form)

PHOTO-BLEACHING

(all-trans retinal dissociates from the opsin)

Nerve Impulse Generated and Transmitted

24

-Ju

l-201

2

59

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN A DEFICIENCY

Prevalence

1st = PEM

2nd = Vitamin A Deficiency d

Commonest Single Cause of Blindness in Children

Vitamin A Deficiency on Eye

Xeropthalmia

24

-Ju

l-201

2

60

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XEROPTHALMIA

24

-Ju

l-201

2

61

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION

Xerophthalmia is defined as a dry

thickened lusterless condition of the

eyeball resulting especially from a

severe deficiency of vitamin A

24

-Ju

l-201

2

62

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

XN

Night Blindness

X1B Bitotrsquos Spot

X3A (13rd)

Corneal Ulceration

XS

Corneal scar

X3B (23rd)

Corneal Ulceration

X2

Corneal Xerosis

X1A

Conjunctival Xerosis

XFC

Xerophthalmic Fundus

WHO Classification of Xerophthalmia 2

4-J

ul-2

01

2

63

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Retina

Deficient reserves of Retinaldehyde

Decreased recycling of Retinaldehyde to

form Rhodopsin

Slow dark adaptation

When severely increased

Night blindness

24

-Ju

l-201

2

64

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Conjunctiva

Loss of goblet cells

Conjunctival Xerosis

Yellow-gray foamy patches of keratinized

cells

Bitotrsquos Spots

24

-Ju

l-201

2

65

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology in Cornea

Dryness of Cornea Wrinkling and

Thickening

Lusterless Cornea - Xerophthalmia

Punctuate epithelial erosions

Corneal ulceration

Keratomalacia

24

-Ju

l-201

2

66

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Xerophthalmia

Corneal Keratinization

Corneal Residual Scarring

Anterior Staphyloma

Irreversible Blindness

24

-Ju

l-201

2

67

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

COMPARISON आयद मत Contemporary view

अधतकाल अलपाहार सन

दोष कषय

िात पाक

इधनिय नाशन

Vitamin A deficiency

Night blindness

Xerosis

Xerophthalmia

Keratomalacia

Anterior staphyloma

24

-Ju

l-201

2

68

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT THROUGH AYURVEDA

Night blindness

नकतानरधय

Xerosis

Xerophthalmia

Keratomalacia शषकाधकषपाक

दोष involved ात धपि रकत

24

-Ju

l-201

2

69

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Management Methodology

शमन धचककतस ndash ात धपि शमन िवय ndash अलप दोष

Commonly Used Medicines

Drakshaadi ghrita Vidaaryaadi ghrita

Aswagandhaadi Ghrita

Kooshmaanda Rasyana

Triphala Ghrita etc

शोिन धचककतस ndash धरचन रकतमोकषण ndash बह दोष

Other treatment can be Done according to

yukti

24

-Ju

l-201

2

70

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E

24

-Ju

l-201

2

71

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Is a group of 8 compounds that includes

tocopherols and tocotrienols

Normal Daily Requirement

15 mg per day

Dietary Source

Wheat germ oil sunflower oil leafy vegetables

Normal Functions of Vitamin E

Is an Anti-Oxidant

Helps in Neurological function

24

-Ju

l-201

2

72

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN E DEFICIENCY

Prevalence

Vitamin E deficiency Rare

Vitamin E Deficiency

Squint

Retinopathy

Early Onset of Cataract

24

-Ju

l-201

2

73

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Retina

Vitamin E deficiency

Axonal degeneration

(cause not known)

Degeneration of Optic Nerve Head

Retinopathy

24

-Ju

l-201

2

74

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Ocular Adnexa

Vitamin E deficiency

Axonal degeneration

CN 4 CN 6 CN 3 defect

Reduced function of

affected muscle

Squint Opthalmoplegia

24

-Ju

l-201

2

75

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Vitamin E

Deficiency in Lens

Vitamin E deficiency

Decreased anti-oxidation in lens

Accumulation of Large Protein

Molecule

Early cataract formation

24

-Ju

l-201

2

76

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C

24

-Ju

l-201

2

77

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Also called as L-Ascorbic acid or L-

Ascorbate

Normal Daily Requirements

30 to 100 mg day

Dietary Sources

Citrus fruits green vegetables

(especially broccoli) tomatoes and

potatoes

24

-Ju

l-201

2

78

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Helps in Collagen formation

Connective tissue metabolism and cross-linking

Normal Functions

24

-Ju

l-201

2

79

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN C DEFICIENCY

No Direct Deficiency Diseases

Vitamin C Deficiency

May Cause Early Onset of Cataract

24

-Ju

l-201

2

80

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Glaucoma

Due to the neuro-

protective effect

Conjunctival amp Retinal

Hemorraghe

Due to defective collagen

formation

Keratomalacia

In association

with Vitamin A

Other Ocular Diseases of Vitamin C deficiency 2

4-J

ul-2

01

2

81

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CATARACT

24

-Ju

l-201

2

82

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

DEFINITION OF CATARACT A cataract is defined as an

opacification of the crystalline

lenshellip

24

-Ju

l-201

2

83

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Double Vision Cloudy vision

Halos

Glare

24

-Ju

l-201

2

84

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

BIOCHEMICAL CHANGES

As age advances

Decreased in soluble protein

Increase in insoluble protein

De-naturation of lens proteins

Leads to unfolding of protein molecules

Aggregation of proteins

Large molecules

24

-Ju

l-201

2

85

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ROLE OF FREE RADICALS

Free radicals

Produces Oxidation

Denaturation of proteins

24

-Ju

l-201

2

86

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTIOXIDANTS Studies have shown antioxidants have a

significant role in preventing and are

also thought to slow the progression of

cataracts

Vitamins C E are main among them

24

-Ju

l-201

2

87

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANTI-OXIDANT EFFECT OF TRIPHALA

Triphala exhibits antioxidant

activity The Polyphenolic

content in Triphala reduce

oxidative stress by converting

the reactive oxygen free radicals to

non-reactive products thereby

exhibiting anti-oxidant property

24

-Ju

l-201

2

88

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Phytother Res 2005 Jul19(7)582-6

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCH FINDINGS

Dietary intake of Protein and

Carotene Niacin Riboflavin and

Thiamine

Vitamin C supplements for more than

10 years

Dietary intake of vitamins A

C E

24

-Ju

l-201

2

89

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B

COMPLEX

24

-Ju

l-201

2

90

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Vitamin B complex includes Vitamin

B1 B2 B3 B6 amp B12

Normal Dietary Intake

11 to 12 mg per day

Dietary Sources

Meat liver yeast eggs potatoes milk

Peanut beans cereals like corn amp

millet

24

-Ju

l-201

2

91

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

VITAMIN B COMPLEX DEFICIENCY

Prevalence

Primary Vitamin B Complex Deficiency

ndash RARE

Secondary Deficiency ndash Common

Almost always more than one B complex

vitamin deficiency will be present

In eye Deficiency Symptom Mainly

resulted from Vitamin B1 amp B12

24

-Ju

l-201

2

92

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

93

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bullCauses

bullAlcohol Excess

bullLeads to

bullWernickersquos Encephalopathy

Excess Vitamin B1 deficiency

bullNutritional Optic Atrophy

bullTobacco-Alcoholic Amblyopia

Excess Vitamin

B12

Deficiency

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS

ENCEPHALOPATHY

24

-Ju

l-201

2

94

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

WERNICKErsquoS ENCEPHALOPATHY 2

4-J

ul-2

01

2

95

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

A neurological disorder caused by

Thiamine deficiency typically from

terminal stages of Chronic Alcoholism

Characterized by triad of lsquoGOArsquo

G ndash Global confusion

O ndash Opthalmoplegia

A ndash Ataxia

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

96

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Complication of Prolonged Vitamin B1 Deficiency

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

97

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Basic Patho-Physiology

Vitamin B Complex deficiency

Demyelination of nerves (Cause Unknown)

Degeneration amp Functional deficit

Delayed pattern of

Visual evoked potential

24

-Ju

l-201

2

98

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

TOBACCO-ALCOHOL AMBLYOPIA

Heavy Alcohol Intake Excess Smoking

Destruction of Vitamin B12 Absorption

Vitamin B12 Deficiency

Peripheral Neuropathy

Nutritional Optic Atrophy

24

-Ju

l-201

2

99

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Identical Symptomatology and Pathological changes

in Chronic Alcoholism amp Tobacco Addiction (Victor

Mancall and Dreyfus1960)

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

आय द मत Contemporary

Science

सपराधि of अधत मयपान amp

अधत िमपान similar due

to तीकषणाकद गण

Hence धष समाना

Creates अधि षमय

िात कषय amp ओजो कषय

इधनिय नाशनम

Identical Symptomatology

and Pathological changes in

Chronic Alcoholism amp

Tobacco Addiction

Vit B12 absorption

Peripheral Neuronal

Degeneration

Nutritional Optic Atrophy

24

-Ju

l-201

2

100

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MANAGEMENT OF TOBACCO-ALCOHOL AMBLYOPIA

धचककतसा तत

ततर शीतो धधिरहहतः (अ ह स 215)

शीत ीयश धष शमन धचककतसा amp ओजो िशक

धचककतसा

Hence Use

धतकत रस परिान िवय

(धतकत is धपि शमन धष नाशक)

In घत medium (रस शकरौजसा धहतम)

Ghrita is धशषण धष नाशक धपि शमन amp चकषषय

24

-Ju

l-201

2

101

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Practically

Tiktaka Ghrita

Maha Tiktaka Ghrita

Patolaadi ghrita etc can be

given

24

-Ju

l-201

2

102

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF OTHER VITAMINS IN EYE Role of Vitamins In ARMD

Vitamins A C amp E + Zn

Reduce the risk of ARMD

amp its associated visual loss

Role of Vitamins In Glaucoma

Vitamins E C B1 B12 amp Mg

Provides a neuro-protective effect

24

-Ju

l-201

2

103

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(Am J Clin Nutr January 2007 vol 85 no 1 304S-307S)

(Altern Med Rev 2001 6141-66)

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Still Under Researchhelliphellip

Effects of deficiencies of Vitamins K amp D on eye are only under research

Few research findings claim that vitamin D deficiency may cause myopia

24

-Ju

l-201

2

104

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

105

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON

24

-Ju

l-201

2

106

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Introduction

Iron plays and important role in forming

complexes with molecular oxygen in hemoglobin

and myoglobin which helps in oxygen transport

Normal Daily Requirement

8 mg day

Dietary Sources

Meat soyabeans cereals leafy vegetables milk

Functions

For function and synthesis of Hemoglobin

Production of certain neuro-transmitters

24

-Ju

l-201

2

107

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

IRON DEFICIENCY

Prevalence

Most common nutritional deficiency in Children

24

-Ju

l-201

2

108

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Anemic Retinopathy

Anemia Iron

Deficiency

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ANEMIC

RETINOPATHY

24

-Ju

l-201

2

109

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Patho-Physiology of Anemic Retinopathy

Exact Patho-Physiology is not Known

24

-Ju

l-201

2

110

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

May be Due to

Retinal hypoxia

Venous stasis Angiospasm

Increased capillary

Permeability

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Clinical Findings

POSTERIOR SEGMENT CHANGES

Haemorrhages

Rothrsquos spots

Exudates

Cotton wool spots

Retinal oedema

Venous tortuosity

24

-Ju

l-201

2

111

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

bull Causes Vitamin A deficiency Symptoms

bull Zinc deficiency interfere with vitamin A

metabolism in several ways

Decreases synthesis of retinol binding

protein which transports retinol to tissues

Decreases activity of enzyme Retinyl

Palmitate which is necessary for release of

retinol from the liver

Zn is needed for the enzyme that convert

retinol into retinal

24

-Ju

l-201

2

112

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ZINC

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

MODERN FOOD HABIT

RELATED

NUTRITIONAL

DEFICIENCY

24

-Ju

l-201

2

113

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

EFFECT OF JUNK FOOD ON EYE 2

4-J

ul-2

01

2

114

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

JUNK FOOD

(Pediatr Clin North A 2009 Oct 56(5)1105-21)

influence the storage amp

availability of some

nutrients

decreased consumption

of fruits amp vegetables

increased intake of

high-calorie

nutritionally poor-quality

foods

increased adiposity

Nutritional deficiencies in overweight and obesity

24

-Ju

l-201

2

115

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

RESEARCHES HAVE SHOWN THAThelliphellip

Greater consumption of

carbohydrates amp soft drinks

was associated with retinal

arteriolar narrowing

amp

venular widening

24

-Ju

l-201

2

116

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Am J Clin Nutr May 2012 vol 95 no 5 1215-1222

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POINT TO NOTE

In comparison with other organs

of the body the eye appears to

be remarkably well protected

against the adverse effects of

general under nutrition

24

-Ju

l-201

2

117

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

POSTGRAD MED J (1964) 40 711

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

नतर

सरकषणोपाय

24

-Ju

l-201

2

118

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

सशदा च धनष त ससथो अधप नयनधपरयः

पराण य गोिम शाली षधषटक कोिान

मदगादीन कफ धपिघनान भरर सरहपः पररपलतान

शाक च धि मास जाङगल दाधडम धसत

सनि धतरफला िाकषा ारी पान च नाभस

(अ ह उि )

धतकताधन साशधण लघधन च

(यो र)

धतरफला मि सरहपभया धनधश नतर बलाया च

(अ ह स)

24

-Ju

l-201

2

119

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

ON ANALYSIS

धतकत रस मिर रस

लघ धिगि गण

शीत ीयश

मिर धपाक

धशषण चकषषय कमश

24

-Ju

l-201

2

120

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

121

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

Special Emphasis

नयन धपरयः

ससथो अधप

सशदा च धनषत

चकषषय

कफ धपि शमन

भरर सरहपः पररपलतान

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

24

-Ju

l-201

2

122

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

CONCLUSION In present era unwholesome diet is the

main cause leading to nutritional

deficiency

Nutritional deficiencies leads to िात कषय

Hence दीपन पाचन सरोतो शोिन amp िात पोषण

is main line of management

िवय which are चकषषय can be used to

improve the Eye Health

24

-Ju

l-201

2

123

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

(ध चाणकय)

24

-Ju

l-201

2

124

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

जल अनन

सभाधषत

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n

THANK YOU

24

-Ju

l-201

2

125

By D

rMa

nju

sree R

P S

DM

Colle

ge o

f

Ayu

rved

a amp

Hosp

ital H

assa

n