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Introduction

Tarpana is usually practiced Kriya in Netra Chikitsa which is Brimhana (nourishing) in nature. It is also commonly known as Netra Basti or Akshitarpana. Netra refers to eyes and Basti stands for means to hold (compartment which holds) or retaining something inside, in this case mainly medicated ghee. The literary meaning of Tarpana is to nourish the eye by fatty materials. Netra Tarpana is a procedure in which comfortably warm medicated ghee is kept over the eyes for a certain period of time with the help of a specially formed frame ring prepared from black gram powder or similar material that help to retain medicated ghee for certain duration. Tarpana is useful both in healthy as well as diseased persons. In healthy persons it is carried out to protect the eyes from degeneration due to aging process and to improve the eyesight. Tarpana is a Snigdha Kriya indicated in Vata Dusta ophthalmic conditions mainly in Dristigata Rogas. It is commonly indicated in macular degeneration, computer eye strain, degenerative conditions, 7th-6th nevre palsies, myasthenia gravis, drooping of eyelid. This Review study was performed with the aim to study the concept of Netra Tarpana, understand the standard procedure of Netra Tarpana and its efficacy.

INDICATIONS FOR TARPANA KARMA:

1. When a patient sees darkness in front of eyes

2. Dryness of the eyes

3. Roughness of the eyes

4. Stiffness of eyelids

5. Falling of eyelashes

6. Dirtiness of the eyes

7. Deviated eyeball or squint

8. In extreme aggravation of the diseases of the eye

9. Injury/traumatic condition of eye

10. Vata –pitta predominant diseases

Vagbhatta has further added a list of diseases

specifically selected for tarpan karma.

They are Kricchronmilana (difficultyin opening eyes), Siraharsha (congestion

of conjunctival blood vessel), Sirotpata (episcleritis), Tama (blackout), Arjuna (subconjunctival haemorrhage), Syanda (conjunctivitis), Adhimantha (glaucoma),

CONTRAINDICATIONS FOR TARPANA KARMA:

According to Acharya Sushruta tarpana is not indicated:

1. On a cloudy day

2. Extreme hot or cold seasons

3. In conditions of worries and anxiety

4. In conditions of tiredness and giddiness of eyes

5. In complications of eyes

6. In the condition of acute pain, inflammation, redness etc.

 

MATERIALS AND METHODS

References regarding Netra Tarpana were collected from various classical and Ayurveda published works, published research papers from Pub Med, Google Scholar, previous work done and compilation was done. Concept of Tarpana in Netra roga Chikitsa was studied in detail.

 

Pre procedure: Collection of materials required for procedure is done. The patient is thoroughly examined. The Prakriti (basic constitution) and Vikriti (details of morbidity) are documented in detail. Patient is advised to pass natural urges of urine stool if present. Susruta Samhita & Astanga Sangraha have mentioned that previously taken meals should be well digested before the procedure which signifies that procedure should be carried out before taking meals and when previous meal is digested. Normal season (Sadharana Kala) is mentioned in Astanga Hridaya Commentator Arundatta describes Sadharana Kala as Basantadaya, meaning thereby procedure should not be performed in extreme climatic conditions. Procedure must be auspicious with good astral combinations (subhe dine). Morning and evening time has been advocated in Susruta Samhita and Astang Hridaya but it has been further clarified in Astanga Sangraha that procedure should be done when eighth part of the day is over or eighth part is still left; meaning thereby approximately three hours after sunrise or three hours before sunset Room should be free from direct air, Sunlight or dust as mentioned in Susruta Samhita and Sarngadhara Samhita Commentator Aadhmalla further states that it should be without smoke too. In Astanga Sangraha, it is mentioned that room should have curtains of blue, yellow or some other colour Supine position for the procedure is mentioned in SusrutaSamhita and Sarngadhara Samhita. Further, commentator Adhmalla explains this position as physically relaxed position with no movements and the subject should also be mentally relaxed, i.e. without anger or fear etc. Swedana has been mentioned before the procedure with clothwithout anger or fear etc. Swedana has been mentioned before the procedure with cloth soaked in lukewarm water in Susruta Samhita. Preparation of Dough of Black gram powder is mixed with sufficient quantity of water to make a thick paste (dough). It is then rolled into a flat slab like structure. Then the eyes are encircled with firm, compact leak proof wall made up of rolled flat slab like structure of the dough. In Astanga Hridaya ring is made up of mixture of black gram and barley flour.Ring should be strong, without joint 2 Angula in height, circular, even boundary. Commentator Adhmalla - 2 Angula in height and 1/2 Angula in thickness In Susruta Samhita, only Ghrita Manda is indicated. Astanga Sangraha has mentioned medicated milk, Ghrita and Ghrita Manda,[26] whereas Astanga Hridaya has mentioned medicated Ghrita in general and Vasa for certain specific conditions.The chosen medicated ghee is heated up to warmness over the water bath passively.

Pradhana Karma:

Netra tarpana should be carried out in the forenoon or in the afternoon on an auspicious day after the food (taken by the patient) has been digested and after the head and the whole body of the patient have

been treated with purification measures properly. Patient is made to lay supine position in a good lighted, ventilated room free from dust & smoke. Than the eyes are encircle with firm, compact leak proof pali(wall) made up of paste of powdered masha. According to Vagbhatta pali is made upto a height of two angulas. The patient is asked to close the eyes and over the

closed eyes, ghrita processed with appropriate drugs and liquefied in lukewarm water should be poured to the orbit, till the level of tip of eyelashes. Patient is asked to open & close the eye intermittently &

steadily.

 

 

Paschata Karma:

After retaining of ghrita for a stipulated period, the ghrita is drained out through a hole made at the bottom of dough wall, near the outer canthus of the eye and the eye is irrigated with lukewarm water fomentation.

The kapha which has already been stimulated by the potency of  ghrita should be eliminated by shirovirechan (nasya), and fumigation (dhoompana) with the kapha-suppresive drugs. Patient is instructed to keep away from exposure to bright lights, wind, sky, mirrors and luminous bodies.

Discussion

SNEHADHARANKALA OR PERIODOF RETENTION OF GHRITA:

Snehadharanakala is implimented considering Adhishtana of diseases & Severity of dosha prakopa.

SAMYAKA TARPITA LAKSHANA
a) Sukhaswapana - good (sound) sleep
b) Avbodhatva - blissful awakening
c) Vaishadhya - clearness of the eyes
d) Varnapatava - discernment of
individual colours
e) Nivriti - feeling of comfort
f) Vyadhividhvansa -cure of the disease
g) Kriya laghvama - easiness in closing
and opening the eyes
h) Prakash kshamta - ability to withstand
bright light

Conclusion

human beings. An individual who is blind, day and
night are the same and this beautiful world is of
no use to him even if he possesses a lot of wealth,
so sincere efforts should be made by every
individual to preserve his / her vision till the
last breath of life. Inspite of remarkable progress
and advances in the field of modern
ophthalmology, there is some
limitations.Ayurveda, the ancient system of
medicine gives valuable guide lines not only in
treatment aspects but also in preventive line.

Netra Tarpana karma is one of the local
therapeutic procedure which if promptly used
shows objective evidencesof excellent responses.