Lagana, Nimesha Eye Disorder – Symptoms, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Lagana is one among the diseases of eyelids (netra vartma gata roga).  It is also called as ‘alagana’ and ‘nagana’ by other authors.

Classification

Classification based on the location – Lagana is a Vartmagata Roga (disease occurring in the eyelids).
Classification based on Predominant Dosha – Lagana is a Kaphaja Netra Roga (it is caused by vitiation of kapha). Classification based on Sadhya Asadhyata (prognosis) – Lagana is a Sadhya roga (curable disease).
Classification based on predominant treatment / surgical process used in combating the disease – Lagana eye disorder is a Bhedana Sadhya / Bhedya Netra Roga (curable by administration of incision).
Read – Lacrimal Cyst – Causes, Symptoms, Complications, Prognosis, Treatment

Lagana, definition, meaning, pathogenesis
Lagana is an eye disorder and occurs in the eyelids. In this condition, cysts / lumps resembling large cysts which are hard to touch and of the shape and size of the seed of jujube fruit are formed on the eyelids. They are devoid of pain and suppuration, sticky in nature and associated with itching in the eyelids. This condition is called lagana.
Read – Eye Diseases Causes, Pathogenesis, Symptoms, Treatment, Herbs

This condition is caused by vitiation of kapha and is curable.

Explanation of Lagana eye disorder by master Satyaki
‘A disorder of the eyelids caused by vitiated kapha in which a cyst like growth appears on the eyelids which are hard on touch and doesn’t suppurate and are also devoid of pain are called lagana’.
Read – Classification of Eye Diseases As Per Ayurveda

Lagana signs, treatment, correlation

Signs and Symptoms of Lagana eye disorder

• Vartmabhavo sthoolo kathina granthi – a cystic swelling / lump formed on the eyelids which are large and hard in texture / touch
• Kola pramana – lump appears like a fruit of jujube in its size and shape
• Apakah – lump doesn’t undergo suppuration
• Arujah – lump and eyelids are devoid of pain
• Sa kandu – there is itching in the lump and eyelids
• Pichchilah – lump / cyst is sticky, the eyelids too are sticky

Modern correlation
Lagana looks like an explanation resembling its modern counterpart named Chalazion / Meibomian cyst.
Read – Chalazion – Causes, Pathogenesis, Symptoms, Treatment

Treatment of Lagana eye disorder
As already said, Lagana eye disorder should be treated by incision method of surgical intervention.
Bhedana – initially in Lagana, bhedana i.e. incision should be done on the lump.
Pratisarana – After incising, the lump of lagana, should be rubbed with powders of any one of the below mentioned –

• Honey
• Tuttha – purified copper sulfate
• Kshara – alkali
• Long pepper
• Gorochana – bile of cow etc.
  Read – Kshara Agnikarma Vidhi – Cauterization- Astanga Hridaya Sutrasthana 30

Kshara – Agni karma / Pratisarana – If the lump of lagana is large enough, it should first be incised and later applied with alkali or fire. Alternatively it shall be subjected to alkali or fire cauterization. Later the remnant wounds shall be treated on the lines of managing the burns caused by alkali and fire.
Agni karma – if the lagana lumps are not responding to conventional line of treatment they should be dealt with by administering fire cauterization.
Read – Ayurveda Eye Treatment Types, Methods – Ashtanga Hrudaya Sutrasthana 23

Nimesha eye disease

Nimesha Eye Disorder – Definition, Symptoms, Treatment

Nimesha is one among the diseases of eyelids (netra vartma gata roga)
Nimesha = closing the eyes / blinking the eyes

It is a condition in which there is difficulty in blinking or closing the eyelids.
Read – Blepharitis: Inflamed Eyelids Ayurvedic Treatment, Remedies

Classification
Classification based on the location – Nimesha is a Vartmagata Roga (disease occurring in the eyelids).
Classification based on Predominant Dosha – Nimesha is a Vataja Netra Roga (it is caused by vitiation of vata).
Classification based on Sadhya Asadhyata (prognosis) – Nimesha is an Asadhya roga (incurable disease).
Classification based on predominant treatment / surgical process used in combating the disease – Nimesha is an incurable eye condition. Therefore no medicinal or surgical measures have been enumerated in Ayurveda so as to treat this disorder.
Read – Disorders Affecting Eye Junctions And Eyelids

Nimesha is also called as Nimisha.

Nimesha, definition, meaning, pathogenesis
Nimisha is an eye disorder and occurs in the eyelids. In this condition, the nimeshini siras i.e. the nerves responsible for closure of eyes, located in the eyelids are afflicted by vitiated vata. Consequently, the vitiated vata causes excessive movements in the eyelids. This can be understood in terms of the eyelids become weak leading to repeated flapping or winking of eyes. This condition is called nimesha eye disorder in which the phenomenon / function of normal closure of the eye is afflicted to a greater extent.
Read – Tarpana Putapaka – Ayurveda Eye Care – Ashtanga Hrudaya Sutrasthana 24

This condition is caused by vitiation of vata and is incurable.

Read – Stye – Causes, Symptoms, Remedies, Treatment

Nimesha symptoms, correlation, treatment

Explanation of Nimesha eye disorder by master Chakshushya According to this reference – ‘the nerves which have the capacity (cause) to make the eyes close and open are called nimeshini siras’.

The pathogenesis of nimesha disorder will occur when these nerves are afflicted by the vitiated vata. ‘The vitiated vata, on getting lodged in the nimeshini siras located in the eyelids will cause excessive movements in the eyelids. This is called nimesha eye disorder’.
Read – Kumbhika – Anjananamika Eye Disorders – Symptoms, Treatment

Explanation of Nimesha eye disorder by master Videha
Master Videha too has explained the nimesha disorder in the same way as Sushruta but he has mentioned the name of the nerve as ‘unmeshini’ instead of ‘nimeshini’. He has also mentioned that this disorder cannot be treated i.e. nimisha eye disorder is incurable.

According to master Vagbhata – ‘Nimesha is an eye disorder in which the eyelids afflicted by vitiated vata cause closure and opening of the eyelids frequently and there is absence of pain in the eyelids’. Sarvangasundari commentary of Ashtanga Hridaya too explains the condition in same terms as that of Vagbhata.
Read – Computer Vision Syndrome: Causes, Ayurvedic Remedies, Tips

Signs and Symptoms of Nimesha eye disorder

• Chalayati ati vartmani (Vartmani chalayed, Atyartha chalayed vartma) – excessive movements in the eyelids as caused by vitiated vata
• Nimesho unmeshanah muhuh – repeated closure and opening of the eyelids
• Aruk / peeda rahitam – absence of pain in the eyelids / eyes
  Read – Vartmakardama, Shyavavartma Eye Disorders – Symptoms, Treatment

Modern correlation
Nimesha eye disorder can be compared to the ‘affliction of the third cranial nerve supplying the Levator Palpabrae muscle’. This eye condition can also occur due to the affections of the 7^th cranial nerve.

A muscle named Levator palpebral superioris helps in lifting the eyelid, i.e. in opening the lid. Another muscle orbicularis palpabrum enables the lid to drop down and close. These both muscles are related with the opening and closure of the eyelids i.e. movements of the eyelids.
Read – Anatomy of Eye: Netra Rachana: Ayurveda Perspective

The third cranial nerve i.e. Oculomotor nerve supplies the upper eyelid muscle i.e. levator palpebrae superioris. The branches of the seventh cranial nerve i.e. facial nerve supply orbicularis palpabrum / orbicularis oculi muscle. These two nerves and their branches control the eye movements / eyelid movements via their supply to these eye muscles. Affections of these nerves lead to weakness of the muscles controlling the closure and opening of the eyelids and would manifest with symptoms resembling those of nimesha eye disorder.
(Read more)

Treatment of Nimesha eye disorder
As already said, Nimesha eye disorder is incurable condition. Therefore no medicinal or surgical treatments have been mentioned for the treatment of Nimisha eye disorder in the Ayurvedic treatises.

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