Integrative Management of Dry Eye Syndrome (Sushkakshipaka): Bridging Ayurvedic Netra Kriya Kalpa with Modern Ophthalmology

Abstract

Background: Dry eye syndrome (DES) has an incidence of 5-50 percent of the global population and is characterized by instability and inflammation of the tear film. Modern therapies include artificial tears, cyclosporine, lifitegrast, and device therapies, although many patients still experience symptoms. Ayurveda conceptualizes DES as Sushkakshipaka, which is controlled by Netra Kriya Kalpa, topical eye treatment procedures such as Tarpana, Aschyotana, Seka, and Nasya. Objective: To synthesize the pathophysiological basis and therapeutic evidence of the integration of Ayurvedic Kriya Kalpa with modern ophthalmology. Methods: Narrative literature review of literature (2000225) in PubMed, Scopus, Ayushdhara, and classical texts. Results: TFOS DEWS II diagnostic pathway involves the use of OSDI, TBUT (<10 s), osmolarity (≥308imOsm/L) and staining. NF κB, IL 1 0 IL 6, TNF 0, and MMP 9 are the inflammatory pathways. Level of evidence- Level 1-2- Anti inflammatory and device-based therapies. Netra Tarpana including Triphala Ghrita is significant in the improvement of the Schirmer test, TBUT and symptoms (p<0.05). Aschyotana is delivered directly into the eye, and Nasya is used to treat supraclavicular pathology. Conclusion: A hybrid severity-based algorithm that combines Kriya Kalpa with current therapies can provide the best results. Prospective randomized trials and standardized protocols are needed.