---

Vartmagata Roga - Complete Guide

(Diseases of the Eyelids - Netra Shalakya Tantra)

---

What are Vartmagata Roga?

---

MNEMONIC to Remember All 21 Vartmagata Roga

Utsangini - Kumbhika - Pothaki - Vartma Sharkara | Arsho Vartma - Bahala Vartma - Vartma Bandhaka | Klishta Vartma - Kardama Vartma - Klinna/Shyava Vartma | Praklinna Vartma - Aparaklinna Vartma - Vatahata Vartma - Arbuda | Nimesha - Shonita Arsha - Lagana - Visa Vartma - Pakshma Kopa

"Uncle Kumbha Poked Vartma; Arsha Baked Very Boldly; Kard Kard Klinna Shyaava; Praklin Apar Vaata Arbu; Nimesha Shon Lag Visa Pack"

---

The 21 Vartmagata Roga - Complete Table with Dosha, Modern Correlation, Ayurvedic Chikitsa & Modern Treatment

---

1. UTSANGINI (उत्संगिनी)

• Lekhana Karma (scraping) - primary treatment
• Bhedana if suppurated
• Pratisarana with Triphala churna or Trikatu
• Nasya with tikshna dravyas

• Hot fomentation (warm compresses) - 10-15 min, 4x daily
• Topical antibiotics + anti-inflammatory drops
• Intralesional steroid injection (triamcinolone)
• Incision and curettage (I&C) for large chalazion

---

2. KUMBHIKA (कुम्भिका)

• Swedana (hot fomentation) first
• Bhedana (incision) to drain pus
• Nishpeedana (expression of pus)
• Pratisarana with Manahshila, Ela, Tagara, Saindhava + honey
• Raktamokshana (bloodletting) if needed

• Hot compresses
• Epilation of involved cilia (to drain pus)
• Topical antibiotics (chloramphenicol/tobramycin eye drops)
• Oral antibiotics if spreading cellulitis (amoxicillin-clavulanate)
• Surgical incision for large abscess

---

3. POTHAKI (पोथकी)

• Raktamokshana (blood-letting)
• Lekhana (scraping)
• Pratisarana with Shunthi + Saindhava + Pippali
• Prakshaalana with Ushnambu (warm water wash)

• Identify and treat underlying cause (viral, chlamydial, toxic)
• Topical antivirals for viral etiology
• Doxycycline for chlamydial follicles
• Cold compresses, antihistamines

---

4. VARTMA SHARKARA (वर्त्म शर्करा) / SIKATA VARTMA

• Lekhana Karma (first choice)
• Excision of pidakas by shastra
• Shodhana for tridoshic involvement
• Netra Kriyakalpa (local eye therapies)

• Azithromycin (single dose 1g oral) - WHO SAFE strategy for trachoma
• Tetracycline eye ointment 1% for 6 weeks
• For VKC: topical mast cell stabilizers (sodium cromoglycate), antihistamines, steroid drops
• Tarsal conjunctival surgery if trichiasis present

---

5. ARSHO VARTMA (अर्शोवर्त्म)

• Kshara Karma (caustic application)
• Agni Karma (thermal cautery)
• Chedana (excision) if needed
• Arshoghna dravyas locally

• Surgical excision
• Cryotherapy
• Laser ablation
• Electrocautery for papillomas

---

6. SHUSHKA ARSHA (शुष्कार्श)

• Snehana (local oleation) first
• Chedana (excision)
• Agni/Kshara Karma
• Vata-pacifying treatment

• Surgical excision
• Electrodesiccation

---

7. ANJANA NAMIKA (अञ्जनानामिका)

• Swedana (fomentation)
• Bhedana (incision to let out pus)
• Nishpeedana (expression of pus)
• Pratisarana with Manahshila + Ela + Tagara + Saindhava + honey

• Hot compresses (warm packs)
• Oral antibiotics (amoxicillin-clavulanate, clindamycin)
• Topical antibiotics
• Incision and drainage from conjunctival side for internal hordeolum

---

8. BAHALA VARTMA (बहलवर्त्म)

• Lekhana Karma
• Kapha-hara chikitsa (Vamana, Virechana)
• Ushna dravya anjana

• Treat underlying cause
• Lid surgery (blepharoplasty) if severe
• Anti-inflammatory therapy

---

9. VARTMA BANDHAKA (वर्त्मबन्धक)

• Sneha-swedana first
• Surgical separation
• Lekhana of adhesions
• Pratisarana with kapha-pitta hara dravyas

• Surgical division of adhesions
• Amniotic membrane transplantation
• Scleral contact lenses
• Prevent re-adhesion with eye drops

---

10. KLISHTA VARTMA (क्लिष्टवर्त्म)

• Lekhana Karma
• Raktamokshana
• Cooling/Pitta-rakta-hara treatment

• Topical antihistamines
• Topical NSAIDs
• Cold compresses
• Mild topical steroids for severe cases

---

11. KARDAMA VARTMA (कर्दमवर्त्म)

• Shodhana (cleansing) procedures
• Lekhana
• Pratisarana with tikshna dravyas
• Nasya

• Lid hygiene (warm compresses + lid scrubbing)
• Topical antibiotics (bacitracin, erythromycin ointment)
• Artificial tears
• Oral doxycycline for Meibomian gland dysfunction

---

12. SHYAVA VARTMA / SRAVA VARTMA (श्यावावर्त्म)

• Vata-hara chikitsa
• Snehana + Swedana
• Careful epilation of misdirected cilia

• Epilation (temporary)
• Electrolysis / radiofrequency ablation (permanent)
• Cryotherapy (most effective for multiple lashes)
• Lid-splitting surgery for distichiasis

---

13. PRAKLINNA VARTMA (प्रक्लिन्नवर्त्म)

• Kapha-hara chikitsa
• Swedana to lids
• Lekhana
• Vamana (therapeutic emesis)
• Anjana with Kasisadya anjana

• Identify triggers/allergens
• Topical antihistamines + mast cell stabilizers
• Lid hygiene
• Omega-3 supplements for MGD

---

14. APARIKLINNA VARTMA (अपरिक्लिन्नवर्त्म)

• Tridosha-hara chikitsa
• Swedana to lids (gentle)
• Snehana + lekhana
• Shodhana procedures

• Warm compresses + Lid massage
• Preservative-free artificial tears
• Azithromycin drops (off-label for blepharitis)
• Intense pulsed light (IPL) therapy for rosacea-associated MGD

---

15. VATAHATA VARTMA (वातहतवर्त्म)

• Being Asadhya, no curative treatment indicated
• Palliative: Vata-hara measures
• Snehana (oil instillation), Nasya with Vata-hara oils
• Basti (enema with vata-pacifying formulations)

• For ptosis: Frontalis sling surgery, levator resection
• For lagophthalmos (Bell's palsy): Lubricating eye drops, taping lid at night, moisture chambers, gold weight implant
• Treat underlying cause (nerve palsy)

---

16. ARBUDA / VARTMARBUDA (वर्त्मार्बुद)

• Chedana (surgical excision) - primary treatment
• Agni/Kshara Karma post-excision
• Shodhana + Ropana for wound healing

• Surgical excision with histopathology
• Cryotherapy / laser for benign tumors
• Radiotherapy if malignant
• Electrocautery / diathermy

---

17. NIMESHA (निमेष)

• Being Asadhya, symptomatic management only
• Vata-hara: Snehana, Swedana, Shirobasti
• Nasya with Vata-hara oils (Anu Taila, Shadbindu Taila)

• Botulinum toxin (Botox) injection into orbicularis oculi - gold standard
• Oral medications: clonazepam, baclofen, trihexyphenidyl
• Deep brain stimulation (DBS) in refractory cases
• Myectomy (surgical removal of orbicularis) in severe cases

---

18. SHONITA ARSHA (शोणितार्श)

• Raktamokshana (blood-letting) - Leech therapy
• Chedana if discrete lesion
• Rakta-pitta hara treatment
• Cooling herbs: Chandana, Ushira applications

• Capillary hemangiomas: Propranolol (oral/topical) - first line
• Laser therapy (pulsed dye laser, Nd:YAG)
• Surgical excision
• Intralesional corticosteroids

---

19. LAGANA (लगन)

• Chedana (surgical correction)
• Kshara Karma
• Lekhana of redundant tissue
• Local Vata-Kapha hara treatment

• Tarsal fracture procedure (for spastic entropion)
• Everting sutures (Quickert sutures)
• Lid wedge resection
• Jones' repair / Wies procedure
• Vertical lid shortening

---

20. VISA VARTMA (विसवर्त्म)

• Shastra Karma (surgical correction)
• Bandaging techniques
• Medicated lepa to tighten loose skin
• Vata-hara treatment

• Medial conjunctivoplasty (medial ectropion)
• Lateral tarsal strip procedure
• Full-thickness lid shortening
• Cicatricial ectropion: skin grafting
• Treat underlying cause (facial nerve palsy, lid laxity)

---

21. PAKSHMA KOPA (पक्ष्मकोप)

• Rakta-mokshana
• Raktaja-hara chikitsa
• Nasya with Vata-hara dravyas
• Careful, repeated epilation (as it recurs - hence Yapya)
• Tarpana (eye nourishing therapy)

• Epilation (repeated - temporary)
• Electrolysis of aberrant follicles
• Cryotherapy (most effective - destroys follicle)
• Argon laser ablation
• Tarsal rotation surgery for distichiasis
• Lamellar keratectomy if corneal scarring

---

UTKLISHTA VARTMA - The 4 Sub-types (per Ashtanga Sangraha)

• Pittotklishta: Raktamokshana, Virechana, Lekhana, Chandana Ksheerapaka Seka
• Kaphotklishta: Lekhana, Pratisarana, Vamana, Anjana (Kasisadhyanjana)
• Raktotklishta: Pitta-Rakta hara treatment + Lekhana
• Tridoshaja: Combined approach based on predominant symptoms

---

Quick Reference Summary Table

---

Prognosis Classification (Sadhyata)

---

Key Ayurvedic Treatment Modalities in Vartmagata Roga

---

General Nidana (Causes) for Vartmagata Roga

• Prasak sarodhana - suppression of secretions
• Kopa, Shoka, Klesha, Abhighata - anger, grief, strain, trauma
• Atimaithunacha - excessive sexual activity
• Shukta, Aranala, Amla, Kulatha, Masha - fermented, sour foods, horse gram, black gram
• Nishevan - improper eye care
• Vega Vinigrah - suppression of natural urges
• Sweda, Dhooma Nishevana - excessive smoke, steam exposure
• Chardi (vomiting) Vidhata - improper emesis
• Imanathyoga - improper use of eyes
• Vaaspa Graha - suppression of tears
• Sookshma Nireekshana - staring at minute objects
• Ratrau Jagarana - night wakefulness

---

FINAL MNEMONIC CHART

VARTMAGATA ROGA = 21 EYELID DISEASES

U - Utsangini        = Chalazion
K - Kumbhika         = Ext. Stye (H. Externum)
P - Pothaki          = Follicular Conjunctivitis
V - Vartma Sharkara  = Trachoma / VKC
A - Arsho Vartma     = Papillary Hypertrophy
S - Shushka Arsha    = Dry Papilloma
A - Anjana Namika    = Internal Stye (H. Internum)
B - Bahala Vartma    = Lid Hypertrophy
V - Vartma Bandhaka  = Ankyloblepharon
K - Klishta Vartma   = Allergic Conjunctivitis
K - Kardama Vartma   = Mucopurulent Blepharitis
S - Shyava Vartma    = Trichiasis
P - Praklinna Vartma = Wet Blepharitis
A - Apariklinna Vartma = Seborrheic Blepharitis
V - Vatahata Vartma  = Ptosis/Lagophthalmos (ASADHYA)
A - Arbuda           = Eyelid Tumor
N - Nimesha          = Blepharospasm (ASADHYA)
S - Shonita Arsha    = Hemangioma
L - Lagana           = Entropion
V - Visa Vartma      = Ectropion
P - Pakshma Kopa     = Trichiasis+Distichiasis (YAPYA)

Sentence: "Uncle Kumbha Poked Vartma;
          Arsha Said Anjana's Bahala Vision;
          Keep Kard Shyav-ing Prak-Aprak;
          Vata Arbu Nimes Shon Lag Visa Pack"

---