Balasagrathita, Siraajala, Sirajapidaka Eye Disorder – Definition, Symptoms, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Balasagrathita is one of the diseases of the sclera / white of the eye (netra shukla gata roga).

Balasagrathita

Balasagrathita is an eye disorder wherein swelling / lump occurs on the white of the eye, caused by kapha. The lump appears to be a swelling solidified or hardened by vitiated kapha.
Read – Lacrimal Cyst – Causes, Symptoms, Complications, Prognosis, Treatment

Balasa = kapha
Grathita = hardened

Classifications
Classification based on location – Balasagrathita is a Netra Shuklagata Roga i.e. disease occurring in sclera part of the eye.
Classification based on Predominant Dosha – Balasagrathita is a Pitaja Netra Roga i.e. it is caused by vitiated Kapha dosha.
Classification based on Sadhya Asadhyata (prognosis) – Balasagrathita is a Sadhya roga i.e. curable disease.
Classification based on predominant treatment process – Balasagrathita is one of the eye disorders which have been included in the list of disorders wherein surgical interventions are contraindicated i.e. Ashastra krutya rogas. Balasagrathita is an aushadha sadhya vyadhi i.e. treatable through medicines.
Read – Classification of Eye Diseases As Per Ayurveda

Balasagrathita, definition, meaning, pathogenesis
Balasagrathita is an eye disorder and occurs in the white of the eye i.e. sclera. It is named based on the description of a swelling probably hardened by vitiated kapha. In this condition, small eruptions appearing white / transparent like a bubble of water or appearing dirty with a coppery tinge, which are hard on touch and associated with mild pain manifest on the white of the eye. This condition is called as balasagrathita.

This condition is caused by vitiation of kapha dosha. It is a curable condition.
Read – Utsangini, Vartma Sharkara Eye Disorders – Symptoms, Treatment

Description of Balasagrathita by Master Videha –
Master Videha is of the opinion that Balasagrathita eye disorder is caused due to simultaneous vitiation of kapha and vata. He describes this condition as – ‘The kapha disturbed and pressed by vitiated vata gets settled in the white portion of the eye giving rise to a swelling which appears like a drop / bubble of water. This condition is called Balasagrathita’.
Read – Klinna vartma, Aklinna vartma Eye Disorder: Symptoms, Treatment

Signs, Correlation

Signs and Symptoms of Balasagrathita eye disorder

• Kamsyabho bhavati site ambu bindu tulyah – a swelling / lump which appears like a drop / bubble of water or dirty with a coppery tinge appears on the white of the eye
• Amrudu – hard in consistency and on touch
• Aruja – associated with mild pain
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Modern correlation
Balasagrathita eye disorder can be closely compared to a condition named ‘Parinaud’s conjunctiva’ explained in the modern medicine. (read here)

It is a condition known as ‘Parinaud’s oculo-glandular syndrome’. It is a combination of granulomatous conjunctivitis in one eye and swollen lymph nodes in front of the ear on the same side. There may also be submandibular adenopathy. It is also known as cat scratch disease. Cat scratch is usually associated with a scratch from a young kitten. Although a cat bite and perhaps even touching the eye with a hand that has been licked by an infected kitten is likely to cause this condition. The ear condition i.e. involvement of ear has not been mentioned in Ayurveda, but this is the closest condition which can be compared with balasagrathita. (read more here)

Treatment of Balasagrathita

As already said, surgical measures are not used to treat balasagrathita sclera disorder. This condition can be treated with medicines.

The line of treatment of balasagrathita eye disorder is as below mentioned – Shodhana – Initially the body should be purified following administration of cleansing treatments like therapeutic emesis, therapeutic purgation, head cleansing errhines and bloodletting.
Ksharanjana – The physician who has expertise in administering collyrium should take nila yava i.e. blue barley – the barley which has not yet ripened and triturate it with milk of cow for seven days. They should later be dried.
Read – Ayurveda Eye Treatment Types, Methods – Ashtanga Hrudaya Sutrasthana 23

Equal parts of the below mentioned herbs are taken and burnt along with barley. They are –

• Arjaka – A variety of basil tree
• Asphotaka – Aleurites moluccanus
• Kapittha – wood apple
• Bael fruit (read more)
• Nirgundi patra – leaves of Vitex negundo and
• Jati pushpa – jasmine flowers

The alkali water prepared from the ash of the above said ingredients should be taken in a big pan and added with rock salt, copper sulphate and turmeric or cow bezoar and boiled together and made dry after evaporation of all liquid portions. This dried product which is obtained is called ksharanjana, it is rich in alkali property and can be readily used as collyrium in treatment of balasagrathita eye disorder. It should be stored in a glass container. While applying the collyrium, it needs to be applied using an iron or glass collyrium rod.
Read – Anjana – Collyrium Types, Method, Uses, Side Effects, Contra Indications

Anjana & parisheka – The powder of the below mentioned ingredients should be mixed in ghee of cow and stored. This should be used as collyrium. This has a strong and caustic action on the lesion. It should be applied by a sterile collyrium rod (anjana shalaka). Following this the eye should be stream poured by medicated liquids like decoctions and rinsed. Colyrium will destroy the swelling and the stream pouring of medicaments will heal the wound.

The patient should be kept on nutritious food and made to rest in a clean and sterile place having good illumination.
Read – Netra Tarpana Treatment For Eye Care Benefits, How To Do?

Sirajala

Sirajala Eye Disorder – Definition and meaning, location, symptoms, treatment

Sirajala is one of the diseases of the sclera of the eye (netra shukla gata roga). 

Siraa jaala is a condition of the eye wherein red coloured network of blood vessels are formed over the white of the eye
Siraa = veins, blood vessels
Jaala = network
Read – Chalazion – Causes, Pathogenesis, Symptoms, Treatment

Classification
Classification based on the location – Sirajaal is a Netra Shuklagata Roga i.e. disease occurring in the sclera part of the eye.
Classification based on Predominant Dosha – Sirajaala is a Pitaja Netra Roga i.e. it is caused by vitiated pitta dosha.
Classification based on prognosis – Sirajaala is a Sadhya roga i.e. curable disease.
Classification based on predominant treatment process – Siraajaala is one among those sclera disorders which have been classified as Chedhya or Chedana Sadhya Vyadhis i.e. diseases which can be cured by excision method. Therefore, excision is the treatment of choice in Sira jal eye disorder.
Read – Stye – Causes, Symptoms, Remedies, Treatment

Siraajaala, definition, meaning, pathogenesis
Siraajaala is an eye disorder occurring in the sclera of the eye. It is named based on its resemblance with network of blood vessels. In this condition a network of red, hard and large blood vessels are formed and spread out unevenly all over the white of the eye i.e. on the bulbar conjunctiva. This condition is called Siraajaal. This condition is caused by vitiation of blood. It is a curable condition.
Read – Alaji Eye Disorder Definition, Location, Symptoms, Treatment

Signs and Symptoms of Siraajala eye disorder

• Jaalaabhah kathina siro mahaan saraktah santaanah – a network of red, hard and large blood vessels are formed out on the sclera part / bulbar conjunctiva of the eye. Their branches are unevenly spread out all over the white of the eye.
  Read – Arshovartma, Shushkarsha Eye Disorders – Symptoms, Treatment

Modern correlation
Siraajaala can be closely compared to a condition called ‘Scleritis’ explained in the modern medicine. Scleritis is an inflammatory condition wherein there is inflammation of the sclera including the bulbar conjunctiva.

It is of two types i.e. Episcleritis when it is superficial and Deep Scleritis when the inflammation is deep. (read more)

Treatment of Siraajaala eye disorder
Siraa jaala eye disorder is treated using excision method.

Chedana – The hard and large blood vessels of the Sirajaala eye disorders should be held using badisha i.e. hooks and lifted up from their position. After lifting the blood vessels, they have to be excised using mandalagra shastra i.e. knife with round edge.
Read – Tested Remedies For Eye, Ear, Nose, Throat Problems: Ramdas Pai

Armokta chikitsa – After excision, the lesions should be treated on the lines of treating another sclera disorder i.e. arma which is often compared to pterygium. The medicines said in arma treatment should be used for rubbing over the wound of siraajaala. Example – the lesion should be gently rubbed with the powder of alkali obtained by burning barley plant and three pungent herbs i.e. long pepper, black pepper and ginger.

Abhishyandi chikitsa – The sira jaala eye disorder should further be treated on the lines of conjunctivitis. While doing so, the dosha predominance need to be seen and treated accordingly as said in vataja conjunctivitis, pittaja conjunctivitis etc. Medicaments mentioned in the treatment of conjunctivitis shall be used in combination with scraping medicines in treatment of siraajaala eye disorder.
Read – Pakshmakopa (Trichiasis) Eye Disorder – Definition, Symptoms, Treatment

Master Vagbhata advocates the line of treatment of raktaja abhishyanda i.e. conjunctivitis caused by vitiation of blood in the treatment of siraajaala eye disorder.

Siraja pidaka

Siraja pidaka – Definition, Symptoms, Treatment

Siraja pidaka is also one of the diseases of the sclera (Netra Shukla Gata Roga).

Siraa pidaka / Siraaja pidaka is a condition of the eye wherein white coloured boils / lumps are formed on the white of the eye surrounded by blood vessels
Siraa = veins, blood vessels
Pidaka / pidika = boil / lump / swelling / eruption
Read – Eyelash Falling Out (Madarosis) – Ayurvedic Treatment And Therapies

Classifications
Classification based on the location – Siraaja Pidaka is a Netra Shuklagata Roga i.e. disease occurring in the sclera part of the eye.
Classification based on Predominant Dosha – Siraaja Pidaka is a Sannipataja Netra Roga i.e. it is caused by simultaneous vitiation of all the three doshas. Classification based on prognosis – Siraajapidaka is a Sadhya roga i.e. curable disease.
Classification based on predominant treatment process – It is classified as Chedhya or Chedana Sadhya Vyadhis i.e. diseases which can be cured by excision method. Therefore, excision is the treatment of choice in Sira pidika eye disorder.
Read – Vatahata vartma, Vartmarbuda Eye Disorders – Definition, Symptoms, Treatment

Siraa Pidaka, definition, meaning, pathogenesis
Siraaja Pidaka is an eye disorder occurring in the sclera. It is named based on the eruptions covered by blood vessels. In this case, it is called siraa pidaka.

These lumps appear as if arising from blood vessels. Therefore they are also called siraaja pidaka. In this condition white coloured eruptions arise on the white of the eye, near the margin of the black of the eye (corneal junction of sclera). These lumps are encircled by network of blood vessels. This condition is called Siraa pidakaa / Siraaja pidakaa.

This condition is caused by simultaneous vitiation of all the three doshas. It is a curable condition.
Read – Anatomy of Eye: Netra Rachana: Ayurveda Perspective

Signs and Symptoms of Siraaja pidaka eye disorder

• Shuklasthaah sitaa pidakaah siraa avrutaa, asita sameepajah – white colored eruptions are formed on white of the eye, i.e. the meeting place of white (sclera) and black (iris / cornea) of the eye and are surrounded by network of blood vessels.

Modern correlation
Siraaja pidaka is often compared to two conditions explained in the modern medicine. They are –

Phlyctenular conjunctivitis / Phlyctenular Keratoconjunctivitis – It is an eye condition in which there is an immune reaction of the bulbar conjunctiva and cornea to the bacteria. On the white of the eye, small yellow-gray eruptions called phlyctenules are formed in this condition. Phlyctenules occur at the limbus i.e. meeting place of the conjunctiva and cornea or on the conjunctiva covering the sclera. (read more)

Deep Scleritis – Scleritis is the inflammation in the episcleral and sclera tissues with injection in both superficial and deep episcleral blood vessels. At times, it may involve the cornea, adjacent episclera and uvea. Deep scleritis is a condition wherein there is severe inflammation of the sclera, with involvement of the underlying uvea. (read more)

Treatment of Siraja Pidaka eye disorder
Sirapidika is treated using excision method.

Chedana – Master Sushruta has mentioned that – ‘if the siraja pidakas cannot be successfully treated with medicines, then they need to be excised using mandalagra shastra i.e. round edged knife, just as explained in the excision of arma eye disorder’.
Arma is often compared to pterygium. This means to tell that the initial condition of sira pidika should be treated with medicines and if the condition does not respond to the medications or in chronic conditions, it shall be treated through excision method.
Read – Triphala Home Remedy For Eye Care

Armokta chikitsa – After excision, lesions should be treated on the lines of treating another sclera disorder i.e. arma. The medicines said in arma treatment should be gently rubbed over the wound of siraja pidika. Example – the lesion should be gently rubbed with the powder of alkali obtained by burning barley plant and three pungent herbs i.e. long pepper, black pepper and ginger.

Abhishyandi chikitsa – The siraajaa pidaka eye disorder should further be treated on the lines of conjunctivitis while considering the dosha predominance. The medicaments mentioned in the treatment of conjunctivitis shall be used in combination with scraping medicines in treatment of siraa pidika eye disorder.
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