A case study on Ayurveda management of Krimigranthi (~Seborrheic blepharitis)

Krimigranthi (~Chronic/Seborrheic blepharitis) is a Kapha pradhana (~ Kapha dosha predominant) Bhedana sadhya (~curable by therapeutic incision) Sandhigataroga (~disease occurring at junctions of the eye). The signs and symptoms of Krimigranthi can be correlated with Seborrheic blepharitis, one of the most commonly encountered diseases in the ophthalmic outpatient department. The treatment of Krimigranthi includes Swedana (~therapeutic sudation) , Bhedana (~therapeutic incision), and Pratisarana (~external application by mild rubbing). A 23-year-old female patient presented with the complaints of the presence of white flaky material, itching, and swelling over the upper lid margin in both eyes, and recurrent redness in both eyes for the last one year. The slit lamp examination reveals the presence of white flakes on the upper lid margin, swelling, and plugging of meibomian gland orifices in both eyes. The conjunctiva of both eyes was congested, and mucus strands were present. Changes observed in the signs and symptoms before and after the intervention were assessed by the Blepharitis Symptom (BLepharItIS) scale and slit lamp examination. The Ayurveda treatment protocol adopted in the case included Deepana - Pachana (~enhancing digestion and metabolism), Dosha anulomana (~regularizing physiological movement of regulatory functional factors of the body) along with Krimihara (~anti-microbial), and Shothahara chikitsa (~anti-inflammatory). There was mild relief in itching, congestion, swelling, and the presence of flakes on the lid margins in both eyes after the third visit. However, the patient came to know about her pregnancy during her fourth visit, and treatment was stopped but only Netra parisheka (~ocular therapy by streaming) was continued. Meibomian gland orifices were clear in both eyes on the fourth visit. There was a reduction in the BLISS score from 13 to 3 after treatment and follow-up. There was mild improvement in the Schirmer test reading and tear break-up time along with complete resolution of symptoms and no recurrence on follow-up.