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Vartmagat Roga (वर्त्मगत रोग) - Diseases of the Eyelids

Definition & Introduction

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Samanya Nidana (General Etiology)

• Exposure to hot water while pitta is aggravated (Ushnabhitaptasya jala-pravesha)
• Excessive lacrimation or straining of eyes
• Suppression of natural urges (Vega-vinigraha)
• Exposure to smoke (Dhumana)
• Excessive sexual activity
• Anger, grief, and excessive exertion
• Diets heavy in sour, salty, pungent foods (Amla-kulatha-masha-nisevana)

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Classification of 21 Vartmagat Roga (Sushruta)

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Mnemonics to Remember All 21 Vartmagat Roga

Mnemonic 1 - "UK PVA-SA-BVK-PSV-NA-SL-BP"

"Uthta Kumbh Pothaki Vartma-Sharkara, Arsha-Shushka Anjana, Bahala Vartma-Kopa, Praklinna-Shyav-Klishta, Vatahata-Nimesha-Arbuda, Shonit-Lagana, Bisavartma-Pakshmakopa"

Mnemonic 2 - By 4 Groups (easier to recall)

Mnemonic 3 - First-letter mnemonic for all 21 (in Sushruta's order):

"Ugly King Puts Velvet Armour, Squash And Bother, Very Kindly Correct, Shy People Always Vote, No Support, Look Better, Please"

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Detailed Description of Key Conditions with Images

1. Anjananamika = Hordeolum Externum (Stye)

• Dosha: Rakta (blood vitiation with Pitta)
• Copper-colored (tamravarna), painful, pustular swelling on lid margin
• Samprapti: Nidan sevan → Rakta vitiation → through siras → Vartma → vitiates Mamsa and Rakta = Anjananamika

1. Swedana (hot fomentation)
2. Bhedana (incision to drain pus)
3. Nishpeedana (complete extraction of pus)
4. Pratisarana with Manahshila + Ela + Tagara + Saindhava + honey

• Hot compresses (4x/day, 10 minutes)
• Epilation of involved cilia to drain pus
• Topical antibiotics (chloramphenicol/tobramycin eye drops or ointment)
• Systemic antibiotics if cellulitis present
• Incision and drainage for large abscess

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2. Kumbhika / Lagana = Chalazion (Meibomian Cyst)

• Kumbhika: Tridoshaja, painless, rounded swelling
• Lagana: Kaphaja, cystic swelling of lid
• Both are Sadhya (curable) via Bhedana/Lekhana

• Rooksha Sweda (dry heat fomentation)
• Lekhana Anjana (astringent collyrium)
• Lekhana Prati-sarana
• Bhedana (incision) from the inner/conjunctival side

• Conservative: Warm compresses (lid hygiene)
• Intralesional steroid injection (triamcinolone acetonide)
• Surgical: Incision and curettage (I&C) from conjunctival side (this exactly parallels Ayurvedic Bhedana from inner side)

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3. Pothaki & Vartmasharkara = Trachoma

• Pothaki: Kaphaja; pidakas resembling red mustard seeds; itching, discharge, hard and painful - classified as a Pilla roga
• Vartmasharkara: Sugar granule-like deposits on inner lid surface

1. Raktamokshana (bloodletting - Jalaukavacharana/leech therapy)
2. Lekhana (scraping of the follicles)
3. Pratisarana with Triphala churna
4. Prakshalaana with ushna-ambu (warm water wash)

• Surgery (for trichiasis/entropion)
• Antibiotics: Oral Azithromycin 1g single dose OR Tetracycline eye ointment 6 weeks
• Facial cleanliness
• Environmental improvement

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4. Bisavartma = Entropion

• Tridoshaja; inward turning of lid margin
• Sadhya Vyadhi (curable)
• Bhedana Sadhya

• Incision (Bhedana) and repositioning of lid margin
• Local Lepa with astringent herbs

• Topical lubricants (temporary)
• Definitive: Surgical correction
  • Involutional: Everting sutures / wedge resection
  • Cicatricial (post-trachoma): Posterior lamellar rotation (Trabut procedure)

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5. Praklinna Vartma = Ectropion

• Involutional ectropion: Horizontal lid tightening surgery
• Cicatricial: Skin grafting

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6. Vatahat Vartma = Ptosis

• Congenital ptosis: Frontalis sling surgery
• Acquired (nerve palsy): Treat underlying cause; surgical correction if persistent

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7. Arshovartma / Shushkarsha = Papilloma / Benign Lid Tumour

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8. Pakshma Kopa = Trichiasis / Distichiasis

• Epilation (temporary)
• Electrolysis of lash follicles
• Argon laser ablation
• Surgical: Tarsal rotation / bilamellar tarsal rotation

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Samanya Chikitsa (General Treatment Principles)

Ayurvedic Shastra Kriya (Surgical Procedures Used)

Ayurvedic Medicines Commonly Used

• Triphala churna - eye washes, Pratisarana
• Manahshila (realgar) + Saindhava (rock salt) - antimicrobial Pratisarana
• Trikatu - for Kapha-dominant conditions
• Nimba (neem) - anti-inflammatory
• Haridra (turmeric) - antibacterial
• Rasanjana - astringent collyrium
• Kshar karma - chemical cauterization for growths

Modern Ophthalmological Surgical Toolkit for Lid Diseases

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Quick Reference: Sadhyasadhyata (Prognosis)

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Samanya Pathology (Common Mechanism - Modern Interpretation)

• Augmentation of blood (vasodilation, hyperaemia)
• Growth of flesh (inflammatory infiltration/hyperplasia)

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Images Reference

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Summary Table: Ayurvedic-Modern Correlation at a Glance

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