Pothaki, Klishtavartma Eye Disorders – Symptoms, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Pothaki is one of the diseases of eyelids (netra vartma gata roga).

Photaki pathology, signs

Pothaki, definition, meaning, pathogenesis
In this condition, lumps / boils which appear like red mustard seeds in shape and size are formed in the eyelids. They are associated with eye discharges, itching in the eyes, heaviness in the eyes and pain in the eyes / eyelids. This condition is called as Potaki. This condition is caused due to vitiation of kapha dosha. Pothakhi is said to be a curable disease.
Read – Eye Diseases Causes, Pathogenesis, Symptoms, Treatment, Herbs

Signs and Symptoms of Potaki eye disorder

• Rakta sarshapa sannibah pidakah – eruptions / boils / lumps of the size and shape of red coloured mustard seeds
• Sravinyah – discharges from the eyes
• Kandurah – itching in the eyes / eyelids
• Gurvyoh – feel of heaviness in eyes / eyelids
• Rujavatyah – pain in the eyelids / eyeballs
  Read – Kaphaja Upanaha (Netra Roga) – Definition, Symptoms, Treatment

Sanskrit verse, classification, correlation

Classification
Based on the location – Pothaki is a Vartmagata Roga (disease occurring in eyelids).
Based on Predominant Dosha – Pothaki is a Kaphaja Netra Roga i.e. it is caused by vitiation of kapha dosha.
Based on Sadhya Asadhyata (prognosis) – Pothaki is a Sadhya roga (curable disease).
Based on predominant treatment / surgical process – Pothaki eye disorder is a Lekhana Sadhya / Lekhya Netra Roga (curable by scraping method / curettage). 
Read – Classification of Eye Diseases As Per Ayurveda

Modern correlation
Pothaki can be closely correlated with Trachoma / Granular Conjunctivitis / Granular Lids formed in the eyelids. The explanation of the lumps in pothaki vartmagata roga too appears as granules. (read more)

Treatment of Pothaki eye disorder
Pothaki is a Lekhana sadhya vyadhi. It is one of the eye diseases which can be cured by scraping methods. The lumps are removed and destroyed by scraping method.

klishtavartma classification, pathology

Klishtavartma Eye Disorder – Definition, Meaning, Symptoms, Treatment

Klishtavartma is one of the diseases of eyelids (netra vartma gata roga).  Klishta = difficulty / being in difficulty / afflicted / being in a bad condition + Vartma = eyelids = Eyelids in a state of difficulty.
Read – Eye Diseases Causes, Pathogenesis, Symptoms, Treatment, Herbs

Classification
Based on the location – Klistavartma is a Vartmagata Roga (disease occurring in the eyelids).
Based on Predominant Dosha – Klishtavarthma is a Raktaja Netra Roga i.e. it is caused by vitiation of blood tissue.
Based on Sadhya Asadhyata (prognosis) – Klistavarthma is a Sadhya roga (curable disease).
Based on predominant treatment / surgical process used in combating the disease – Klistavartma eye disorder is a Lekhana Sadhya / Lekhya Netra Roga i.e. curable by scraping method / curettage. 
Read – Classification of Eye Diseases As Per Ayurveda

Klishtavartma, definition, meaning, pathogenesis
Klishtavartma is an eye disorder and occurs in the eyelids. In this condition, the eyelids suddenly become smooth and gets associated with mild pain, without any reason. It acquires coppery colour initially and later assumes red colour. This disease of the eyelids in which the eye looks as if troubled and is in a state of difficulty and is caused by vitiated blood, is called klishta varthma.
This condition is caused due to vitiation of blood tissue. Klishta Vartma is said to be a curable disease.
Read – Watery Eyes: Causes, Ayurvedic Treatment, Remedies

Klistavartma sanskrit, signs

Explanation of KlishtaVartma by master Videha –
Master Videha has explained Klishtavartma in a slightly different way. The explanation given by Videha is as described below –

The disease of the eyelids which is caused by contamination of the muscles of the eyelids by the blood contaminated kapha, wherein the eyelids become similar to bandhujiva i.e. as red as the Hibiscus flower called klishtavartma.
Read – Computer Vision Syndrome: Causes, Ayurvedic Remedies, Tips

Signs and Symptoms of Klishtavartma eye disorder

• Akasmat cha mrudu vartma – the eyelids suddenly become smooth, without any reasons
• Alpa vedana – mild pain in the eyelids / eyes
• Tamra samam eva – eyelids / eyes appear coppery in colour
• Bhaved raktam – eyelids / eyes become red in later part of time
• Bandhujiva nibham – eye appears as red as hibiscus flower.
  Read – Alaji Eye Disorder Definition, Location, Symptoms, Treatment

Angioneurotic oedema, treatment

Modern correlation
Klishtavartma can be closely correlated with Angioneurotic oedema of the eyelids.

Angioneurotic oedema
Angioedema is an area of swelling of lower skin layers and tissue just under the skin and mucus membrane. Swelling may occur in the face, tongue, larynx, abdomen or arms and legs. Many times it is associated with hives. Hives are swelling within the upper skin. The onset is typically sudden and occurs over minutes and hours. The cause may be involvement of bradykinin if it is an inherited problem and histamine if it is an allergic reaction.
Read – Edema – Ayurvedic Understanding, Treatment, Home Remedies

Angioneurotic edema is a type of genetic form of angioedema. People having this problem are born lacking an inhibitor protein known as C1 esterase inhibitor. This inhibitor protein normally prevents activation of a cascade of proteins leading to the swelling of angioedema.

In this condition, patients may get recurrent attacks of swollen tissues, abdominal pain and swelling of larynx which can interfere with breathing. The diagnosis is suspected with a history of recurrent angioedema.
Read – Types Of Swelling – Ayurveda Diagnosis Charak Samhita Sutrasthan-18

But when we see the symptoms of Klishta Vartma, it just looks like a disorder limited to the eyelid. And it doesn’t even have other systemic symptoms as in angioedema or angioneurotic edema. If we consider that ancient Ayurvedic masters would have written about the eye related symptoms of a systemic disease, we can correlate klishtavartma with angioneurotic edema. Even in that case, the swelling in face should have been explained. Sudden and recurrent appearance of swelling is common in both conditions.
Read – How To Make Prognosis Of Disease According To Ayurveda?

Angioedema or Angioneurotic edema occurring only in the eyes or eyelids is a rare condition, but might have been available in the ancient days.

We have references wherein angioedema, which is a systemic allergy, is considered as one of the most common cause of eyelid swelling. (read more)

A publication by ncbi has reported couple of cases of unilateral eyelid angioedema with congestion of the right bulbar conjunctiva, but that was related with intake of Ioxoprofen Sodium. (read more)

Seeing the above said explanations, though klishtavartma doesn’t exactly fit into the category of angioedema or angioneurotic edema, we can compare the conditions since no other close comparisons are available. I have also compared these two conditions since these two have been closely compared by many Ayurvedic scholars since ages.
Read – Tested Remedies For Eye, Ear, Nose, Throat Problems: Ramdas Pai

I personally feel that klishtavartma may be an allergic reaction, and not of a serious order, because treatment has been mentioned for the same and also it has been said that it is curable disorder.

Since contaminated blood is said to be the causative factor according to Ayurveda, congestion of eyelids leading to swelling and edema along with mild inflammation can be considered. Eye symptoms of a systemic disease (not mentioned in Ayurveda) can be considered, if angioneurotic edema is to be removed out of the equation and a parallel thinking needs to be entertained. Since the treatment is scraping therapy i.e. lekhana, and it is curable with scraping therapy, and since systemic medications haven’t been mentioned to treat this condition, klishtavartma is moreover a local disease of an eyelid.
Read – Chaturvidha Netra Srava – 4 types of eye discharges, symptoms, treatment

Treatment of Klishtavartma eye disorder
Klishtavartma is a Lekhana sadhya vyadhi. It is one of the eye diseases which can be cured by scraping methods. The lumps are removed and destroyed by scraping method.

Formulations for Netra Roga from Sahasra Yoga
Asanabilwadi Taila
Manjishtadi Taila
Bhringamalakadi Taila
Bala Dhatryadi Taila
Tungadrumadi Taila
Kacchuradi Choorna(Brihat)
Parpataka Kashaya
Villampahotyadi Taila
Kayyonyadi Taila
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