Dry eye (shushkakshipaka) and menopause � a survey study
Journal name: Ayushdhara
Original article title: Dry eye (shushkakshipaka) and menopause � a survey study
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Prakruthi G*
PG Scholar, Professor, Department of PG studies in Shalakyatantra, Sri Kalabyraweshwaraswamy Ayurvedic Medical College, Hospital and Research Centre, Bangalore
Hamsaveni V,
Professor, Department of PG studies in Shalakyatantra, Sri Kalabyraweshwaraswamy Ayurvedic Medical College, Hospital and Research Centre, Bangalore
Kowsalya R G
PG Scholar, Department of PG studies in Prasootitantra and stree roga tantra, Sri Kalabyraweshwaraswamy Ayurvedic Medical College, Hospital and Research Centre, Bangalore
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: Dry eye (shushkakshipaka) and menopause � a survey study
Year: 2018
Copyright (license): CC BY-NC-SA 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Dry eye disease, known as Shushkakshipaka in Ayurveda, is characterized by inadequate tear volume or function, resulting in an unstable tear film and ocular surface issues. It is particularly prevalent among postmenopausal women, whose incidence of dry eye symptoms can be as high as 20% in adults aged 45 and older. The condition is attributed to hormonal changes during menopause, where a decrease in ovarian function leads to alterations in tear production. In the Ayurvedic context, dry eye is classified under SarvagataRoga, emphasizing the depletion of tears (Ashru) and resulting in dryness of the eyes (Shushkanetra).
Hormonal Influence on Dry Eye
The relationship between sex hormones and dry eye symptoms is crucial in understanding the condition's etiology. Research has demonstrated that androgens play a significant role in maintaining tear stability by regulating lipid production in the meibomian glands. In contrast, estrogen and progesterone can disrupt the normal functioning of the lacrimal and meibomian glands, leading to dry eye symptoms. The findings point towards a biological interplay wherein the loss of androgen support post-menopause can compromise tear film stability, while estrogen might exacerbate inflammation and dysfunction in various ocular tissues. This complex interaction highlights the need for further exploration into how hormonal changes during menopause contribute to dry eye disease.
Aging and Eye Function
Aging significantly impacts the visual system and can worsen dry eye conditions. The study findings reveal that anatomical and physiological changes associated with aging result in decreased ocular function, amplified by the progressive hormonal shifts seen in menopause. As women transition through menopause and experience hormonal fluctuations, there is an aggravation of Vata Dosha, which is linked to the manifestation of symptoms like dryness and discomfort in the eyes. The research supports the view that the aging process, compounded by hormonal decline, leads to increased sensitivity and changes in tear production mechanisms, exacerbating dry eye symptoms.
Conclusion
The study concludes that hormonal changes during menopause have a direct correlation with the onset and severity of dry eye disease among women. The findings indicate that 56% of the surveyed menopausal women exhibited symptoms of dry eye, confirmed by the Schirmer test. This highlights the predominant role of Vata Dosha and the subsequent redness, dryness, and discomfort in the eyes after menopause. Further research is recommended to investigate any associated systemic or ocular diseases that may contribute to dry eye in menopausal women, allowing for more targeted treatment protocols.
FAQ section (important questions/answers):
What is dry eye and its connection to menopause?
Dry eye, or Shushkakshipaka in Ayurveda, is a condition that occurs when there is insufficient tear volume or function. It is common among postmenopausal women due to hormonal changes affecting tear production and stability.
What symptoms are associated with dry eye in menopausal women?
Common symptoms include dryness, grittiness, burning sensations, watering, eye strain, and redness. According to the study, 56% of menopausal women reported experiencing these symptoms, indicating a significant impact.
What methods are used to diagnose dry eye disease?
Diagnosis involves the Schirmer test to measure tear production. Results categorize tear production into normal and grading severity, confirming dry eye's presence and aiding in treatment planning.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Dry eye (shushkakshipaka) and menopause � a survey study�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Disease:
Dry eye is a prevalent disease caused by inadequate tear production or excessive tear evaporation. It's referred to as Shushkakshipaka in Ayurveda, where Vata Dosha aggravation plays a crucial role in the development of this disease, particularly in menopausal women.
2) Vata:
Vata is an Ayurvedic concept representing the air and space elements. Its aggravation leads to dryness and is implicated in the pathophysiology of Shushkakshipaka, affecting tear production and causing dry eye disease.
3) Ruksha (Ruksa):
Ruksha is a quality of Vata characterized by dryness. In the context of Shushkakshipaka or dry eye, increased Ruksha quality leads to symptoms such as dry and rough eyelids and eyes.
4) Netra:
Netra means eyes in Sanskrit. The study discusses dry eye disease, where the Netra or eyes are affected by decreased tear production, predominantly caused by hormonal changes in menopausal women.
5) Burning sensation:
Burning sensation is one of the symptoms of dry eye (Shushkakshipaka). It occurs due to the lack of adequate tear film and the exposure of ocular surfaces, leading to irritation and discomfort.
6) Siddha:
[see source text or glossary: Siddha]
7) Vataja (Vata-ja):
Vataja refers to conditions caused by the imbalance of Vata Dosha. Shushkakshipaka is described as a Vataja Sarvagata Netra Roga, wherein Vata imbalance results in dry eye syndrome.
8) India:
The study on Shushkakshipaka and menopause was conducted at Sri Kalabyraweshwaraswamy Ayurvedic Medical College in Bangalore, India, to understand the relationship between menopause and dry eye.
9) Roga:
Roga means disease in Sanskrit. Shushkakshipaka is categorized as a Sarvagata Roga in Ayurveda, affecting the entire eye due to an imbalance of Vata and depletion of Ashru (tears).
10) Shalakyatantra (Salakyatantra, Shalakya-tantra, Shalakyatamtra):
Shalakyatantra is an Ayurvedic branch specializing in ENT and Ophthalmology. The research on dry eye (Shushkakshipaka) was carried out by scholars from this department at an Ayurvedic college in Bangalore, India.
11) Irritation:
Irritation is another symptom associated with dry eye. It results from the instability of the tear film and exposure of the ocular surface due to inadequate tear production.
12) Saindhava (Saimdhava):
Saindhava, or rock salt, is used in various Ayurvedic treatments. It’s mentioned in treatments like Seka (pouring of medicated liquids) and Aschyotana (eye drops) to relieve dryness in Shushkakshipaka.
13) Darshana (Darsana):
Darshana refers to vision. In Shushkakshipaka or dry eye, symptoms include Avila Darshana (blurred vision) due to the instability of the tear film and insufficient tear production.
14) Draksha (Draksa):
[see source text or glossary: Draksha]
15) Gharsha (Gharsa):
Gharsha means a foreign body or gritty sensation. This is a common symptom in dry eye disease, resulting from the roughness and dryness caused by insufficient tear film stability.
16) Vriddhi (Vrddhi):
Vriddhi means increase. Vata Vriddhi or increase in Vata Dosha is a critical factor in Shushkakshipaka, leading to symptoms like dryness, irritation, and other ocular discomforts.
17) Dravya:
[see source text or glossary: Dravya]
18) Ghrita (Ghrta):
Ghrita, or ghee, is used in Ayurvedic treatments such as Snehapana (internal administration) and Tarpana (ocular nourishment) to balance increased Vata and alleviate dryness in Shushkakshipaka.
19) Lodhra:
[see source text or glossary: Lodhra]
20) Sariva (Shariva):
[see source text or glossary: Sariva]
21) Artava:
Artava means menstruation. The cessation of Artava (menstruation) at menopause leads to hormonal changes, causing Vata increase and resulting in conditions like Shushkakshipaka, or dry eye.
22) Kshaya (Ksaya):
Kshaya refers to depletion. In menopausal women, Rasakshaya (depletion of bodily fluids) leads to Vata Vriddhi, contributing to the development of dry eye disease or Shushkakshipaka.
23) Daruna:
[see source text or glossary: Daruna]
24) Khara:
[see source text or glossary: Khara]
25) Laghu:
[see source text or glossary: Laghu]
26) Basti:
Basti, an Ayurvedic enema treatment, is used to balance Vata Dosha. For dry eye treatment, medicated oils or ghritas are administered to alleviate increased dryness in Shushkakshipaka.
27) Avila:
[see source text or glossary: Avila]
28) Shiras (Siras, Siro, Shirash):
[see source text or glossary: Siras]
29) Sira (Shira):
[see source text or glossary: Sira]
30) Guna:
[see source text or glossary: Guna]
31) Gana:
[see source text or glossary: Gana]
32) Pain:
Pain is a common symptom in Shushkakshipaka, including types like Toda (pricking sensation) and Bheda (splitting pain), stemming from Vata aggravation and dryness in the eyes.
33) Pushpanjana (Puspanjana, Pushpa-anjana, Pushpamjana):
[see source text or glossary: Pushpa-anjana]
34) Dhatukshaya (Dhatuksaya, Dhatu-kshaya):
[see source text or glossary: Dhatukshaya]
35) Inflammation:
Inflammation plays a role in dry eye disease by disrupting tear production. Estrogen may exacerbate inflammation in the ocular surface, contributing to Shushkakshipaka in postmenopausal women.
36) Yashtimadhu (Yastimadhu, Yashti-madhu):
[see source text or glossary: Yashtimadhu]
37) Atarushaka (Atarusaka):
[see source text or glossary: Atarushaka]
38) Netraroga (Netra-roga):
Netra-roga refers to eye diseases. Shushkakshipaka is a Netra-roga characterized by dry eye symptoms caused by Vata aggravation, especially prevalent in menopausal women.
39) Rasadhatu (Rasa-dhatu):
[see source text or glossary: Rasa-dhatu]
40) Kalanusari (Kala-anusari):
[see source text or glossary: Kalanusari]
41) Vatadosha (Vatadosa, Vata-dosha):
Vatadosha's imbalance is central to Shushkakshipaka. An increase in Vata attributes to dryness and a range of symptoms affecting eye health in both Ayurveda and allopathic medicine.
42) Discussion:
The discussion section of the study links the increase in Vata Dosha with the prevalence of dry eye in menopausal women and outlines Ayurvedic treatment modalities for the condition.
43) Pravritti (Pravrtti):
[see source text or glossary: Pravritti]
44) Splitting:
Splitting pain, or Bheda, is a symptom of Shushkakshipaka linked to Vata aggravation. It signifies severe discomfort in the ocular region due to dryness.
45) Ayurveda (Ayus-veda):
Ayurveda, the ancient Indian system of medicine, provides detailed insights and therapeutic interventions for conditions like Shushkakshipaka (dry eye) based on Dosha imbalances, particularly Vata.
46) Devadaru (Deva-daru):
[see source text or glossary: Devadaru]
47) Lakshana (Laksana):
Lakshana means symptoms in Ayurveda. The symptoms of Shushkakshipaka include dryness, irritation, and pain, akin to modern descriptions of dry eye disease.
48) Putapaka (Puta-paka):
[see source text or glossary: Putapaka]
49) Anutaila (Anu-taila):
[see source text or glossary: Anutaila]
50) Snigdha:
[see source text or glossary: Snigdha]
51) Upadeha:
Upadeha refers to discharge, a symptom of Shushkakshipaka (dry eye) indicating an inflammatory response in the eyes due to compromised tear production.
52) Haridra:
[see source text or glossary: Haridra]
53) Tantra (Tamtra, Tantrism):
[see source text or glossary: Tantra]
54) Kamala (Kama-la):
[see source text or glossary: Kamala]
55) Laksha (Laksa):
[see source text or glossary: Laksha]
56) Stanya:
[see source text or glossary: Stanya]
57) Yashti (Yasti):
[see source text or glossary: Yashti]
58) Anjana (Amjana):
Anjana, a collyrium, is used in Ayurvedic therapy to treat eye disorders like Shushkakshipaka, reducing symptoms of dryness and irritation by balancing Vata Dosha.
59) Bengal (Bemgal):
Rose Bengal staining is used in diagnosing dry eye (Shushkakshipaka) to assess damage to the ocular surface, helping in quantifying the dryness and formulating treatment.
60) Vartma (Vatrma):
[see source text or glossary: Vartma]
61) Pushpa (Puspa):
[see source text or glossary: Pushpa]
62) Vidari (Vidarin):
[see source text or glossary: Vidari]
63) Animal:
Animal studies reveal hormonal impacts on ocular structures. These studies indicate that estrogen may exacerbate dry eye, while androgen deficiency affects tear production.
64) Desire:
Desire for cold comfort is a symptom of Shushkakshipaka, arising from increased Vata. This indicates the patient's relief in cool environments or treatments.
65) Dosha (Dosa):
Dosha refers to the three fundamental bio-elements in Ayurveda: Vata, Pitta, and Kapha. Imbalance in these Doshas, especially Vata, is central to the development of Shushkakshipaka.
66) Nasya (Nashya):
Nasya, the nasal administration of medicated drops, is a treatment for Shushkakshipaka. It helps alleviate dry eye symptoms by balancing elevated Vata Dosha.
67) Kalka:
[see source text or glossary: Kalka]
68) Ashru (Asru):
Ashru means tears. Insufficient Ashru or tear production results in dry eye disease (Shushkakshipaka), underscoring the importance of balanced tear production for ocular health.
69) Dhatu:
[see source text or glossary: Dhatu]
70) Manda (Mamda):
[see source text or glossary: Manda]
71) Shula (Sula):
[see source text or glossary: Shula]
72) Bheda:
Bheda, or splitting pain, is part of the symptom profile of Shushkakshipaka. This severe pain type is linked to the Vata Dosha imbalance in dry eye disease.
73) Ayus (Ayush):
[see source text or glossary: Ayush]
74) Honey:
[see source text or glossary: Honey]
75) Blood:
Sex hormones, influenced by blood levels, impact ocular tissues. Androgens decline and affect tear production, while estrogen can increase inflammation, leading to dry eye disease.
[Note: The above list is limited to 75. Total glossary definitions available: 85]
Other Science Concepts:
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Shushkakshipaka, Vatadosha, Burning sensation, Symptoms of dry eye, Aging impact, Dry eye, Sex hormone, Menopause, Tear film, Schirmer test, Rasa Dhatu Kshaya, Pro-inflammatory cytokine, Vision-threatening complications, Hormonal impact, Ocular surface damage.