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Introduction

in human body. Eyes are the only organ in the body which receives separate treatment modality like Kriyakalpa as a Bahyaparimarjan Chikitsa & no other organ individually receives the treatment. Shalakya Tantra is one among 8 specialties of Astanga Ayurveda, which deals with the diseases occurring above the clavicle (Urdhwajatrugata Sthana).1 Kriyakalpa is the main therapeutic process for ophthalmology in Shalakya tantra, as the Panchkarma is the bases of Kayachikitsha. The word kriyakalpa is made up of two words. kriya means therapeutic procedures useful for curing diseases & kalpa means practical. So Kriyakalpa means specific formulation used for therapy in Ayurvedic Ophthalmology. It includes selection of specific procedure, preparation of special drug form and finally its proper application to the eyes. 2 Kriyakalpa procedures need a modern scientific base to develop the add on tolls in the branch of Ophthalmology. The application of Ayurvedic ocular therapeutics seems makeshift in the light of modern Ophthalmology.

Objectives:

1. To review the Kriyakalpa in Shalakya
2. To interpret the importance of Kriyakalpa in Ophthalmic disorders on the basis its applied aspect.

Methodology:

Source of Data:

Literary and conceptual study was on the data compilation from the Brihatrayees, and other classical books including journals, presented papers in international journals.

Methodology:

Source of Data:

Literary and conceptual study was on the data compilation from the Brihatrayees, and other classical books including journals, presented papers in international journals.

Kriyakalpa:

Acharya Charak has mentioned three kriyakalpas in chikitsa sthan i.e Aschyotana, Anjana & Bidalaka. 3 Acharya Sushruta has mentioned five kriyakalpas i.e Tarpana, Putapaka, Seka, Aschyotana & Anjana.4 Acharya Sharangdhara has mentioned seven kriyakalpas i.e five of Sushruta & two added

Pindi & Bidalaka.5         

Etymology:

Kriyakalpa is formed by two words as Kriya and Kalpa. Word Kriya refers here to therapeutic procedures, which cures the disease without causing any adverse effects while the word Kalpa indicates the specific formulations adopted for the therapeutic procedures. Hence, the word Kriyakalpa literally means to perform proper treatment. 6

Classification of Kriyakalpa:

According to Sushruta there are 5 types of Kriyakalpa: 7

1. Tarpana
2. Putapaka
3. Seka
4. Ascyotana
5. Anjana

According to Charaka there are 3 types. 8

1. Bidalaka
2. Ascyotana
3. Anjana

According to Sharangdhara there are 7 types of Kriyakalpa: 9

1. Seka
2. Ascyotana
3. Pindi
4. Vidalaka
5. Tarpana
6. Putapaka
7. Anjana

1.Tarpana-

This is one of the Kriyakalpa which gives nourishment to the eyes & cures Vata- Pitta predominant diseases. In this procedure the unctuous substances like Medicated ghee, vasa, majja, ghrita manda is kept in the eye for a specific time by special arrangement made around eyes with Mashapali or Tarpana goggle. 10

According to Dosha- i. Vata- 1000 Matra ii. Pitta- 800 Matra iii. Kapha- 600 Matra b) According to Adhisthana- i. Vartma- 100 Matra ii. Sandhi300 Matra iii. Shukla- 500 Matra iv. Krisna- 700 Matra v. Drishti- 800 Matra vi. Sarvagata- 1000 Matra. 11

Mode of action:- in this process  the  oily (ghee) substance is kept in eye for specific time by special arrangement .simple ghee or oil is used as a medicine which is in form of suspen- sion .so its particles do not leave eyes and con- tact time is more and more drug is absorbed. It   will cross corneal epithelium barrier easily due to its lipophilic property It gives nourishment to the eyes and cures the vata pitta vikara It is indicated mainly in Tamiyati, Rukshta, Sushka Netra, Ati darana, Pakshmpat & Ati Rugonta.

2. Aschyotana: It is indicated as first procedure in all eye diseases. Instilling medicated Ghee / Drops to eyes for specific frequency. This is useful in Dry eyes, myopia, and allergic and inflammatory eye disorders. Aschyotana is Adya upakrama in which medicated drops are instilled into open eye from do Angula (approximate 2”) height at Kanineeka Sandhi. Most commonly used medicated drop for Aschyotana is Triphala Kwath containing Amalaki (Emblica officinalis), Bibhitaki (Terminalia bellirica) and Haritaki (Terminalia chebula). Indications: Initial stage of eye disease when Doshas are not severely vitiated specially Pitta Dosha. It is used in eye condition like mild pain, redness, watering, foreign body sensation, itching, burning sensation, congestion of vessels etc. It is contraindicated in night. 12 Classification and Doses: a. Lekhana (8 drops) - Kapha Roga b. Ropana (12 drops)- Pitta and Rakta Roga c. Snehana (10 drops)- Vata Roga. 13

Mode of action:-The medicated drops put into eye from the height of two inches on open eye decoctions of raw drugs are used as medicine so it tissue contact time is very less and it get diluted with tears and drains in to NLD. It is indicated as first procedure in all eye diseases

3.Seka:

Seka is defined medicated solution poured as stream from 4 Angula on closed eye continuously for specific time according to Doshas. It is more beneficial in those conditions which are strong and cannot cure with Aschyotana. In this process “medicine is poured on closed eye (on eye lids) continuously from four inches height fir a specific time according to Dosha” so the medicine is absorbed through skin of lids. Classification and doses a) Lekhna (200 Matra)- Kapha Roga b) Ropana (600 Matra)- Pitta and Rakta Roga c) Snehana (400 Matra)- Vata Roga. 14

Mode of action:- in this process medicine is poured on closed eye(on eye lid)continuously from four inches height fit specific time according to dosha so the medicine is absorbed through skin of lids. It is indicated in acute condition.

4.Bidalaka-

Bidalaka is the application of medicated paste on the outer surface of eyes i.e eyelids. Bidalaka are of three types according to thickness of paste as Uttam, Madhyam & Heena. Bidalaka relieves burning, discharge, excessive tears, swelling, redness, itching. 15

5.Anjana- Application of medicine to the internal surface of lid margin from Kaninika sandhi to Apanga sandhi with Anjana Shalaka is called as Anjana. Types of Anjana according to action of drugs are as; 16

1. Lekhanajana- Used in Kapha predominant diseases of eyes

· In vata predominant diseases- Amla- Lavana Rasa

· In Pitta predominant diseases- Tikta-Kashay rasa

· In Rakta Predominant diseases-Kashaya- Tikta Rasa

1. Ropananjana- Drug is oily & it gives strength & complexion to the eyes

Prasadanjana- It is prepared with Madhura & Snigdha medicines. 17

Mode of Action:-

In this application of medicine to the internal surface of lid margin from kaneenika sandi to apanga sandi with the anjana saalaka. So its bioavailability is more due to more tissue con- tact time. Sourveeranjan or darvi rasa kriya can be mixed with honey can be applied in the eye for kapha sodhana as eye is pitta predominant in nature and should be protected from kapha dosha. So daily practice of anjana as Dinacharya is best simple ophthalmic medication to prevent eye diseases.6

6.Putapaka : 18, 19

The procedure of Putapaka is similar to Tarpana, but the ingredients, preparation of medicine and durations are different. It can be done after Tarpana or independently. Indications and contraindications of Tarpana are also applicable to Putapaka. There are 3 types of Putapaka mentioned in classics like Snehana, Lekhana and Ropana, but Vagbhata has mentioned Prasadana  in the place of Ropana. Retention time of Putapaka is 100 Matrakala in Lekhana , 200 in Snehana, 300 in Ropana Putapaka.

Mode of action:-Procedure is same as tarpana but medicine preparation is swarasa extracted by putpaka vidhi. Contact time is same as tar- pan but absorption is more than tarpana because it is suspension of fat water soluble con- tents so having both lipophilic and hydrophilic property to penetrate cornea. Its indication is same as tarpana.

7.Pindi-

Pindi is the modified procedure of Bidalaka. Instead of direct application of drug paste on eyes, it is kept in cotton or Doshghna leaves & is kept tightly over the eyelids. Pindi relieves the symptoms of Netrabhishyanda, Adhimantha, Sotha, Netrakandu, Kaphaja Netraroga.20

Discussion

Kriyakalpas are the boon to Ayurvedic ophthalmology and forms the basis of ocular therapeutics in Ayurveda. In Kriyakalpa, various drugs can be selected as per vitiated dosa and types of diseases for the procedures. In Anjana, Bioavailability is more due to more tissue contact time. In Putpaka, medicine preparation is different as swarasa is extracted by put pakavidhi. Contact time is same as tarpana but absorption is more than tarpana because it is a suspension of fat- and water-soluble contents so having both lipophilic and hydrophilic property to penetrate cornea. In Parisek, in this process medicine is poured on closed eye, this medicine is absorbed through the skin of eye lids. The active principle is aqueous extract so tissue contact time is very less as it get diluted with tears and drained to naso lacrimal duct. In Pindi process, Medicine is absorbed through skin of eye lid and due to heat of poultice local temperature is increased resulting in local vasodilatation. In Bidalak, Medicine is absorbed through skin as in Pindi and Seka. Mechanical effect of pressure helps in reducing IOP by vasodilatation and aqueous drainage.

Usefulness of Kriyakapla: 21

These Kriyakalpa method are mostly useful in the following eye symptoms and disease:

When a patient sees darkness / blackouts in front of eyes, Roughness of the eyes, In severe dryness of the eyes, Stiffness of the eyelids, Falling of eye lashes / Madrosis, Dirtiness of the eyes, eye starin, burning sensation, Deviated eye ball / Squint, In extreme aggravation of the diseases of the eye, Injured eyes due to Abhighata, Falling of eye sights

Eye Disease.

1. Kricchronmeelana
2. Siraharsha
3. Sirotapata
4. Arjuna
5. Shukra
6. Timira
7. Abhishyanda
8. Adhimantha
9. Anyatovata
10. Vataparyaya
11. Vatika and Paitika diseases of eyes

Conclusion

Kriyakalpas would add on benefits  to Ayurvedic ophthalmology which can be further studied through the route of drug administration, absorption, solubility & bio-availability of drug. In practice, therapeutic effect is found in all types of Kriyakalpa. As per Ayurveda, various drugs can be selected according to the doshas, type and severity  of disease as kriya kalpas. Kriya kalpa plays an important role in Netra roga chikitsa.