Timir to Myopia: An Ayurvedic Modern Correlation and Scope of Preventive Ophthalmology

Abstract

Background: Myopia is becoming more prevalent worldwide and is expected to affect 50% of the world’s population by 2050, and high myopia could lead to irreversible vision loss. The progressive visual impairment described in Ayurveda is called Timira and has stages (Patalas) that could be associated with the severity of myopia.

Objective: To establish a correlation between the classical stages of Timira and the contemporary classification of myopia, discuss the clinical evidence for Ayurvedic interventions, and suggest an integrated model for ophthalmology that is preventive in nature.

Methods: A narrative review was conducted on the PubMed, Scopus, Google Scholar, and Clinical Trials Registry India (CTRI) databases from January 1, 2000, to May 10, 2026, following the SANRA guidelines. Keywords: "myopia", "axial elongation", "Timira", "Ayurveda", "preventive ophthalmology". Authentic translations of the Sushruta Samhita, Ashtanga Hridaya, and Charaka Samhita were consulted. Clinical trials and observational studies of Ayurvedic interventions for myopia were included.

Results: Patalagata Timira was divided into four categories based on the refractive error of the eye: simple myopia (0 to –3.00 D), moderate myopia (–3.25 to –6.00 D), high myopia (> –6.00 D), and pathological myopia (Chaturtha Patalagata Timira). Triphala Rasayana led to a decrease in axial length, Netra Tarpana (case report) led to a decrease in axial length, Padabhyanga showed significant improvement in eyesight (p<0.01) and Pathyadi Varti Anjana showed decrease in spherical and cylindrical refractive errors.

Conclusion: Ayurvedic interventions show promising clinical evidence in myopia control. It is worthwhile to conduct large-scale integrative trials with axial length as the primary outcome.