Netra Tarpana Treatment For Eye Care Benefits, How To Do?

Article by Dr Raghuram Y.S. MD (Ay)
Head is said to be the Uttamanga (best organ). It is an abode of all the Indriyas (sense organs). Among all the Indriyas (sense organs) Nayana or Eye, the sense organ of sight or vision is said to be the best and most important. Tarpana treatment is an efficient therapy of Ayurvedic eye care. 

Most of our day to day activities are dependent on our vision. We carry out these activities depending on what we see and understand. The visual information is thus transformed into many activities. This also means that the eye is constantly put under performance pressure and stress.

When the eye health is at its best, we enjoy the colourful manifestation of the world. But when the eye gets clouded by one or the other disease, we fell that we have topped the list of cursed.
Stress and strain related disorders of the eye are common in the present era of computers and gadgets. We are now days witnessing school-going kids wearing spectacles at a tender age because of technology addiction and erratic study postures, wrong choices of food and sleep preferences.
Computer eye syndrome or Computer vision syndrome (CVS) is quiet common in most of the people.
Ayurveda offers the best time tested remedies for eye disorders and eye strain. Netra Tarpana tops the list of Ayurvedic remedies meant for tackling diseases related to eye and vision.

What is Netra Tarpana?

‘Netra Tarpana’ is made up of 2 root words –
Netra – means Eye
Tarpana – means Nourishment
Thus Netra Tarpana means ‘Nourishment of Eye’ or a treatment which nourishes the eye
Other names for Netra Tarpana –
Netra Tarpanam
Akshi Tarpana / Akshi Tarpanam – Same as Netra Tarpana (Akshi synonymous with Netra)
Netra Vasti – Vasti means pooling. Medicated oil or ghee is filled in a flour compartment (vasti) constructed around the eye / eyes and left in place for a fixed duration of time. This procedure nourishes and strengthens the eyes, cures the eye diseases. The procedure is same in Netra Tarpana.
Netra Basti – Same as Netra Vasti (Vasti is synonymous with Basti).
The word Netra Tarpana points towards the utility of the treatment and the terms Netra Vasti / Basti points towards the construction and procedure.
Read related: Ayurveda Eye Treatment Methods – Astanga Hrudaya Sutrasthana 23rd chapter

Benefits

Benefits of Netra Tarpana –
Ref – Ashtanga Hridaya Sutra Sthana Ch 24/ verses 1-3

Tarpana therapy benefits:
Nayane Tamyati – Feeling of darkness in front of eyes (also due to irritation after exposure to light)
Stabdha netra – Feeling of stiffness or rigidity in the eyes
Netra shushkata – Extreme dryness of the eyes
Abhighata – Injury to the eye
Vata pittaja roga – Diseases of the eyes caused due to aggravation of Vata and Pitta
Jihma netram – abnormal deviation of eye ball
Sheerna pakshma – eye lashes falling down
Aavila Akshnam – dirtiness of eyes
Krichra unmilana – Difficulty to open or close the eyes
Siraharsha – A type of cellulitis (Acute orbital cellulitis) occurring in the eyes
Sirotpata – Hyperaemia of conjunctiva
Arjuna – Phlyctenular conjunctivitis
Abhisyanda – Conjunctivitis
Adhimantha – Glaucoma
Anyatovata – Hyperaemia of conjunctiva
Vata paryaya – Atrophy of the cranial nerves
Shukra – Keratitis or inflammation of cornea
Ragadi shantata – After pacification of Redness of eyes, tearing, pain, irritation and dirt

Indications

Indications of Netra Tarpanam –
Ref – Sushruta Uttara Ch18, verse 17

Tamyati – feeling of darkness in front of eyes (also due to irritation after exposure to light)
Ati vishushkam – excessive dryness of the eyes
Ati daruna – eyes appear to have hardened
Sheerna pakshma – eye lashes falling down
Aavila netram – dirtiness of eyes
Jihma netram – abnormal deviation of eye ball
Roga klishtam – eyes which have been constantly and repeatedly afflicted and debilitated due to many diseases

Contraindications

Contra-indications of Netra Tarpana –
Ref – Sushruta Uttara, Ch18, verse18
Durdina – cloudy day
Atyushna dina – very hot day
Ati sheeta dina – very cold day
Chinta – person who is mentally worried
Aayasa – after physical exhaustion
Bhrama – giddiness
Ashanta upadrava – when complications like inflammation, redness, severe pain etc persists in the eye

Procedure

Procedure of Netra Tarpana –

Purvakarma

Purva Karma (Pre-treatment procedure) –
Preparation of the patient:
The patient is thoroughly examined. The Prakriti (basic constitution) and Vikriti (details of morbidity) are documented in detail. The disease is also examined.
The treatment line-up, materials and medicines which need to be used are enlisted.
The eligibility of the patient to undergo the treatment should be accessed.
Read related: Tarpana Putapaka – Ashtanga Hrudaya Sutrasthana 24th chapter

Preparation for the treatment:
Materials needed for the treatment are collected beforehand. They are:
Ghrita (medicated ghee) or Ghrita Manda (supernatant layer of ghee or medicated ghee) suitable to the disease and diseased are collected and stored beforehand. The same medicaments are used for treatments orienting towards prevention of eye disorders and strengthening the eyes and fortification of vision.
Flour of black gram for the construction of Netra Tarpana socket (ring / cabinet)
Water
Stove, bowls, vessels, spoons etc
Sterile cloth / cotton / tissue papers
Materials for Putapaka (eye pooling with juice extracted from processed meat etc)
Materials for Dhumapana (herbal smoking)
Materials for Anjana (colyrium) and Aschotana (eye drops)

Immediate Purvakarma’s:
Ref – Ashtanga Hridaya Sutra Sthana Ch 24/4-6
Before conducting the Netra Tarpana treatment, the below mentioned treatments shall be done as a part of pre-operative procedure –

Kaya Shuddhi: Body cleansing (purifying, detoxifying) measures including – Vamana – therapeutic emesis (vomiting) and Virechana – therapeutic purgation

Shiro-Shuddhi: Head cleansing measure (treatments meant for purifying and detoxifying head and sense organs) i.e. Nasya or Shiro-virechana (Nasal instillation of medications)

Preparing the flour ring or cabinet – Flour of barley and black gram shall be mixed thoroughly in a sterile vessel by adding water and little quantity of oil. The mixture is made into a bolus. From this, 2 small rings so as to fit around the eye socket are prepared. That means to tell that the inner circumference of the ring will fit on the boundary of the socket of the eye so as to enclose the eye within it. The height of the ring should be of 2 angula’s (1 angula=1.75 cm approximately). Small quantity of prepared flour should be kept in a small bowl. This would be useful to seal the junction of the ring with the socket of the eye so as to prevent leakage of medicaments.

Preparing the medicine – The ghee which would be used for Netra Tarpanam shall be liquefied and kept lukewarm. For this, the required quantity of ghee is put in a small sterile bowl. The small bowl is placed in a big vessel having hot water. After the Ghrita gets melted its temperature should be checked. The medicine should be administered lukewarm.

Fomentation – A gentle fomentation is given to the eyes with cloth dipped in warm water before the treatment. The water shall be wiped off with a sterile cloth or cotton before constructing the Tarpana ring.

Pradhana Karma

Pradhana Karma (Treatment proper – method of conducting Netra Tarpanam therapy) –
Ref – Ashtanga Hridaya Sutra Sthana Ch 24/ verses 4-6

After explaining the method of treatment to the patient in detail, he or she shall be taken to a place devoid of heavy breeze or air to conduct Akshi Tarpana treatment.

Season and Time of Tarpana treatment: The treatment shall be done in ‘Sadharana Kala’ i.e. in a season which is neither too hot nor too cold and when there is no rain or sky enveloped with clouds.
The treatment should be conducted either in the morning time or evening time or at both times if the condition of the disease demands an extra attention

Position of the patient: The patient is made to sleep supine (on the back or facing the roof). He or she shall be given a neck support.

Construction of Netra Tarpana cabinet (ring) around the eye: The rings of flour which were kept ready in the Purvakarma are inserted over the eye sockets, (one on each eye) such that the eyes are enclosed within their respective rings. The junctions of the rings with eye sockets are sealed with wet flour so that the medicament doesn’t leak or escape during the process of the treatment.

Filling the Tarpana Ring with medicine – The medicated ghee (ghrita) which was melted and kept warm in the Purvakarma is gently poured in the Netra Tarpana cabinets such that the eyes are dipped within the medicine. The patient is advised to close the eyes while dropping the medicine in the ring. Later he or she is instructed to open and close the eyes repeatedly so that the interior of eyes come into the contact of the medicines intermittently. The medicaments are left in place for a fixed duration of time. The patient might experience burning sensation during the process of the treatment but he or she should be intimated that it is quiet natural to happen. The irritation will come down once the medicines are removed.

Duration of Tarpana

The period for which the medicines should be retained in the Tarpana ring will vary for different diseases and conditions. They are as specified below –

• Vartma roga’s (diseases afflicting the eyelids) – 100 matra kala (approximately 30 – 32 seconds)
• Sandhi Roga’s (diseases afflicting the junction areas of the eye like the junction between eyelashes and eyelids, sclera-corneal junction etc) – 300 matra kala (approximately 90-95 seconds)
• Sita Roga’s (diseases afflicting sclera or white of the eye) – 500 matra kala (approximately 3 ½ minutes)
• Aasita Roga’s (diseases afflicting cornea, choroid, iris and middle layers of the eye) – 700 matra kala (approximately 4 minutes)
• Drishtigata Roga (diseases afflicting the retina and vision) – 800 matra kala (approximately 4 ½ minutes)
• Adhimantha (glaucoma) – 1000 matra kala (approximately 5 minutes & 4 seconds)
• Vata Roga (diseases caused due to morbid Vata) – 100 Matra Kala
• Pitta Roga (diseases caused due to morbid Pitta) – 600 Matra Kala
• Kapha Roga (diseases caused due to morbid Kapha) – 600 Matra Kala
• Swastha (Healthy people) – 600 Matra Kala
• In Vata Roga’s – Tarpana shall be done on a daily basis
• In Pitta Roga’s – Tarpana shall be done on alternate days
• In Kapha Roga’s and Swastha purusha (healthy) – Tarpana shall be done on every 4th day, i.e. after a space of 2 days between 2 sittings

Note: Matra Kala is the time required to count the mentioned number ex. 100 Matra Kala is the time needed to count the numbers 1-100. 1 matra kala is also explained as time required for spelling or pronouncing a guru akshara (difficult alphabet). It is also the time taken to draw a circle in air around the knee and making a click sound with the help of thumb and middle finger.
In all cases, it is preferable to do Tarpana until Samyak Trupta Lakshana’s are obtained (signs of properly administered Tarpana)

Samyak trupta lakshana

Samyak Trupta (Tarpana) Lakshana (Signs of properly done Tarpana):
Ref – Ashtanga Hridaya Sutra Sthana Ch 24/ verse 11; Sushruta Uttara Ch18/verse13

Prakasha Kshamata – Tolerance to light (eye can tolerate light falling on it)
Vishada lochanam – clarity of vision
Laghu lochanam – feeling of lightness in the eyes
Sukha svapna – good sleep
Sukha avabodhatvam – good awakening
Varna patavam – proper perception of all the colours from the eye and proper establishment of normal colours in the mandala’s of the eye (layers) like the white of the eye (sclera) regains its white colour etc.
Nirvritti – establishment of pleasure and health in the eye
Vyadhi vidhwamsa – destruction of eye diseases
Kriya laghava – activities of the eye like closure and opening of lids etc take place easily
Atrupta Lakshana (Signs of improperly or deficiently done Tarpana): Signs of improperly conducted Netra-Tarpana are opposite of those of properly done. They are –
Prakasha Akshamata – Intolerance to light
Avishada lochana – Lack of clarity of eye and vision, feeling as if the vision has been clouded
Guru lochana – heaviness of the eye
Svapna nashanam – loss of sleep
Varna patava akshamata – inability to perceive colours
Anivritti – sick eyes

Ref – Sushruta Uttara, Ch18, verse 15
Other symptoms:
Ruksham – dryness of the eye increases
Aavilam – increase of dirtiness of the eye
Asraadyam – excess of tearing of eye
Rupa darshanam asaham – inability of perceiving the objects of vision
Roga vriddhi – increase in disease and their symptoms

Ati trupta lakshana

Ati Trupta Lakshana (Signs of overly-done Tarpana):
Ref – Sushruta Uttara, Ch18, verse15
Guru netrata – heaviness of eye
Avimalam – dirtiness of eye
Atisnigdham – excessive unctuousness or oiliness of eye
Ashru – excessive lacrimation (tearing of eyes)
Kandu – itching of eyes
Upadeha – coating in the eyes
Dosha samutklishtam – aggravation of vata etc doshas
When Tarpana is done out of proportions, for longer duration or more number of days, Kapha Vyadhi’s or disturbing symptoms of Kapha vitiation are manifested.
Vasa (shudda mamsa sneha – muscle fat) should be used for Netra Tarpana in conditions of Naktandhya (night blindness), Vata Timira (blindness or partial blindness caused due to Vata aggravation or cataract) and Krichra-bodhaka (difficulty to open eyes)

Medicines used for Netra Tarpana:
Triphala Ghritam – It is widely used as medicine and also in preparatory procedure called snehakarma for the treatment of tumors, early stage of cataract, Erysipelas, Excessive discharge in women, eye pain with itching and discharge, cough, oedema, hair fall, intermittent fever, pterygium and such other eye and eye lid related diseases.
Jeevantyadi Ghritam
Ghrita Manda (Supernatant layer of Ghee or medicated ghee) etc

Paschat Karma

Paschat Karma (post treatment procedures) –
Removing the medicine – The medicine is removed by creating a small hole in the lower portion of the wall of the flour ring at the outer angle of the eye and draining the contents in a bowl. Alternately, the wall of the ring is broken at the outer canthus (outer angle of the eye) and the contents are drained in a bowl.

Wiping the eyes and the surrounding area – The medicines sticking to the eye and the sockets are swabbed out by wiping them off with the help of a sterile cotton pad or a tissue paper. Later the eyes can be wiped off gently with a sterile cloth dipped in warm water or the same cloth is used to give a gentle fomentation to the eyes.

Dhumapana – Herbal Smoking should be given to eliminate the Kapha which has been exaggerated due to the administration of Ghrita and or Ghrita Manda in Netra Tarpana

Virechana Nasya or Shiro-virechana – Purgatory / strong and intense nasal medications are instilled and it serves the same purpose of Dhumapana. Nasya can be altered with Dhumapana (used purely on the decision of the doctor)

Putapaka – After the Netra Tarpana, a procedure called Putapaka is done. The eyes get tired after Tarpana. Putapaka is done to ward off the tiredness. The method of treatment is similar to that of Netra Tarpana. Mamsarasa (meat-soup), Dugdha (medicated milk), Ghrita (medicated ghee), Vasa (muscle fat) etc extracted by the process of Putapaka is used as fill up.

Putapaka

Ref – Sushruta Uttara, Ch18, verses 19-20
Putapaka can be done in all those conditions in which Tarpana is done. Those in whom Nasya (nasal instillation of medications), Tarpana and Snehapana (treatment in which medicated oils or ghee is given for intake in metered doses either everyday or as a part of pre-treatment procedure for Shodhana vis-à-vis cleansing procedures) are contraindicated are not eligible to take Putapaka. Putapaka can be done for those eligible to take the treatment after the aggravation of Dosha’s has been subsided.

Types

Types of Putapaka:
Putapaka is of 3 types:
Snehana Putapaka (putapaka having or admixed with fats or prepared with unctuous or fat-rich drugs) –
It is preferred to be done in a person having rukshata (excessive dryness in the body) or ruksha netra (dryness in the eye)
It is preferred to be done in Vata disorders of the eye
The below mentioned are used for Snehana Putapaka:
Sneha – ghee or oil
Mamsa – meat
Vasa – meat soup
Majja – bone marrow
Meda – fat
Madhura aushadha – medicines or drugs having sweet taste
Duration – It is done for 200 matra kala
Lekhaneeya Putapaka (putapaka prepared using drugs having a scraping nature i.e. capacity to scrap off the kapha and fat) –
It is preferred to be done in a person having snigdhata (oily body or excessive unctuousness of the body) or snigdha netra (very unctuous eyes)
It is preferred to be done in Kapha-Vata conditions or Kapha-Vata disorders of the eye

The below mentioned drugs are mixed together and used for Lekhaneeya Putapaka:
Jangala yakrit mamsa – flesh or meat of the liver of animals and birds living in dry and desert regions
Shunti – Ginger
Maricha – Pepper
Pippali – Long pepper
Krishna or Kanta loha bhasma – Ash or calx of magnetic iron
Tamra bhasma – Calx or ash of Copper
Shankha Bhasma – Ash or calx of conch
Pravala bhasma – Calx or ash of Coral
Saindhava lavana – Rock salt
Dadhi – curds etc
Duration: It is done for time duration of 100 matra kala

Ropaneeya Putapaka –
It is preferred for bringing strength and lustre in the eye or in eyes afflicted by morbid Pitta, Rakta or Vata or eyes afflicted with Vrana (ulcers)
Acharya Vagbhata names it as Prasadana Putapaka (Putapaka prepared with nourishing drugs) and indicates its usage in Drishti Roga’s (Vision related disorders)

Procedure

How is Putapaka done?
Putapaka is made up of 2 words – Puta, meaning concealed heating, Paka means preparing or processing. In this method, the medicaments are wrapped in a mud ball which is processed after having been kept amidst burning charcoal (gained after burning woods of medicinal trees).
Meat slices (2 numbers) weighing 1 pala (48grams approximately) each are taken and grinded to make a smooth paste. All the drugs which are to be added and mixed with the meat also should be in same quantity
The liquids which are to be mixed are taken in a quantity of 8 pala (384 grams approximately). For Snehana Putapaka decoction prepared from sweet tasting Kakolyadi group of drugs and milk, for Lekhana Putapaka – honey and decoction of Triphala, for Ropana Putapaka – drugs which taste bitter and their decoction should be taken in prescribed quantity.
These liquids should be grinded with the meat and a bolus is prepared.
The meat bolus is wrapped in leaves of castor, plantain etc. Over this a coat of wet mud is applied.
The wrapped boluses are kept amidst burning woods of either of Khadira (Acasia catechu), Eranda (Ricinus communis), Vata (Banyan tree) etc and processed.
Once the bolus is properly processed and gets cooled, the layer of mud and the enveloping leaf layer are removed. The bolus is squeezed so as to obtain its juice. This is used for filling in the ring or cabinet constructed around the eye sockets (pooling). The method is same as in Netra Tarpana.

Anjana (colyrium), Aschotana (eye drops) and Swedana (sweating or fomentation to eyes) – when some diseases are manifested due to wrong administration of Tarpana or Putapaka

Discharge: The treatment can be done with patient as in-patient or as out-patient. In the 2nd case, we discharge the patient on daily basis (after each sitting) with proper instructions.

Instructions –
The patient is instructed not to open the eye immediately.
He or she is advised to open and close the eye a few times after a couple of minutes.
They are also advised not to rub their eyes in case irritation persists and told that it will naturally come down after a few minutes.
Patients can use spectacles when they are discharged to protect their eyes from sunlight, dust and breeze
Eye should not be suddenly exposed to extremes of sunlight, breeze or dust and pollutants
Eye shall not be washed off immediately
Seeing towards the sky, irritants like welding etc should be avoided
Head-bath shall be avoided as far as possible during the treatment
Dosha balancing diet should be instructed. Vata-Pitta and Rakta aggravating diet and lifestyle practices should be avoided.
Proper rest to eye should be advised
The same instructions are applicable to in-patients also.
The patient should be advised to undergo Netra Tarpana at least twice in a year (curative). For preventive and relaxation purposes it can be taken for 1 or 2 sittings in a period of 1 month or 1 ½ months.

Shamana aushadhas

Shamana Aushadha’s – Palliative medicines:
Some of the best medicines for eye which can be taken for cure and prevention of eye diseases during the follow up are –
Triphala ghrita
Mahatraiphaladi Ghritam
Brahmi ghritam
Ghrita mandam
Jeevantyadi Ghritam
Patoladi ghritam
Saptamrita lauha
Triphaladi guggulu
Lauhadi guggulu
Pathyakshadhatryadi kashayam
Varadi kashayam
Shatavaryadi churnam
Triphala churnam
Drakshadi leham
Chyavanaprasham
Amalaki rasayanam etc

Ayurvedic perspective of eye health –
According to Ayurveda, the functioning of eye is under the control of Alochaka Pitta (a subtype of Pitta located in eye). Pitta is one of the governing elements of the body (Dosha’s) which represents all the functions of fire. This Pitta is governed by Pachaka Pitta (pitta located in the gut). This also means that the eye and its functioning is under the direct control and influence of the gut fire (how good is our feel of hunger and digestion related functions).
Ayurveda tells that Alochaka Pitta is most often pathologically influenced and disturbed by morbid Kapha. This also indicates that the balance in Kapha is essential for balance of Alochaka pitta (or any subtype of Pitta to function properly), the eye and eyesight.

Likewise, since the eye is located in the head it is also affected by imbalances of Vayu, mainly Prana Vayu.
The other subtypes of Vata, Pitta and Kapha can also influence in the manifestation of eye disorders.
Generally degenerative disorders of the eye and nerve related diseases are caused due to morbid Vata whereas inflammatory and vision related disorders are caused due to morbid Pitta. Netra Tarpana is handy in these cases.
Netra Tarpana soothes the nerves, wards off inflammation, degeneration, dryness etc of the eye, establishes eye health and rejuvenates the eye and vision. It also helps in preventing many eye related diseases by enhancing eye immunity.

To sum up –
As in any other disease, Ayurveda has in its core many unparalleled remedies for preservation and fortification of eye health and to eradicate eye diseases. Netra Tarpana has proved its worth time and again as the best rejuvenating therapy for eye. You can experience this treatment even if you have healthy eyes. It will prevent many eye related diseases.
So whenever you think of eye health, think of Netra Tarpanam
Click to Consult Dr Raghuram Y.S. MD (Ayu)

Research

In Computer vision syndrome, Triphala ghrith efficacy was evaluated in 30 patients for 7 days. The duration was 15-20 minutes per day. The controlled clinical trial concluded that the therapy was beneficial in significantly relieve the symptoms of CVS.
Depak P. Sawant, Gajanan R. Parlikar, Sandeep V. Binorkar. Efficacy of Triphala Ghrita netratarpan in computer vision syndrome, International journal of Res. Ayurveda Pharm 2013, 4(2):244-248 (1)

Tarpana in children

Can netra tarpana treatment be done in children?
Netra Tarpana is a form of treatment where medicated liquids are pooled on the eyes. It can be done in children. Usually milder and soothing liquids like Triphala Triphala ghritham – herbal ghee with Triphala is used in children to correct refractive errors. 
Yes, but with milder liquids like Triphala ghritham, herbal ghee with Triphala.