Ayurvedic Management of Idiopathic Full-Thickness Macular Hole with Anatomical Closure on OCT: A Case Report

Authors

  • Nelliakkattu Narayanan
  • Nelliakattu N P Sreekala
  • Sreekanth N Parameswaran
  • Chintuja J Parayil
  • Sumesh Soman
  • Krishnendu Sukumaran

DOI:

https://doi.org/10.70066/jahm.v14i4.2691

Keywords:

Case Report, Full-thickness macular hole, Samana Chikitsa, Shodhana Chikitsa, Vataja Kaca

Abstract

Background: Macular hole (MH) is a vitreoretinal disease characterized by a full-thickness neurosensory retinal defect in the center of the macula. Although there is no direct correlation, based on the symptomatic presentation of the patient, full thickness Macular Hole (FTMH) can be correlated to Vataja Kaca. Case Presentation: A 61-year-old male presented with a four-month history of blurred vision in the right eye (RE), especially with difficulty in reading small letters, with central scotoma (blurry spot in the center of the visual field), with no marked distortion of lines. Optical Coherence Tomography (OCT) confirmed the diagnosis of FTMH. Intervention: The patient underwent a structured Ayurvedic treatment protocol, focusing on Ama pachana, Samana (palliative), Snehana (unctuous therapy), Brmhana (nourishing), and Vatahara line of treatment. Outcome: After five months, the patient reported progressive improvement in visual clarity of the RE with the absence of central scotoma. Visual acuity improved to 6/9 (logMAR 0.176) in the RE from baseline 6/24 (logMAR 0.602), while near vision in RE improved to N12 from baseline N24 and OCT shows complete closure of the hole. Conclusion: This case highlights the potential efficacy of Ayurvedic therapies in the management of a FTMH, necessitating further larger-scale trials and research in this field for validation.

Author Biographies

Nelliakkattu Narayanan

Chief Physican, Sreedhareeyam Ayurvedic Eye Hospital and Research Centre, Sreedhareeyam Ayurvedic Research and Development Institute, Nelliakkattumana, Kizhakombu PO, Koothattukulam-686662. Ernakulam, Kerala, India.

Nelliakattu N P Sreekala

Deputy Chief Physician, Sreedhareeyam Ayurvedic Eye Hospital and Research Centre, Sreedhareeyam Ayurvedic Research and Development Institute, Nelliakkattumana, Kizhakombu PO, Koothattukulam-686662. Ernakulam, Kerala, India.

Sreekanth N Parameswaran

Chief Medical Officer, Sreedhareeyam Ayurvedic Research and Development Institute

Chintuja J Parayil

Research Officer, Sreedhareeyam Ayurvedic Research and Development Institute, Nelliakkattumana, Kizhakombu PO, Koothattukulam-686662. Ernakulam, Kerala, India

Sumesh Soman

Research Coordinator, Sreedhareeyam Ayurvedic Research and Development Institute, Nelliakkattumana, Kizhakombu PO, Koothattukulam-686662. Ernakulam, Kerala, India.

Krishnendu Sukumaran

Research Coordinator, Sreedhareeyam Ayurvedic Research and Development Institute, Nelliakkattumana, Kizhakombu PO, Koothattukulam-686662. Ernakulam, Kerala, India.

References

Majumdar S, Tripathy K. Macular Hole. [Updated 2023 Aug 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559200/

Shaikh N, Kumar V, Salunkhe N, Nayak S, Azad S. Pediatric idiopathic macular hole - A case report and review of literature. Indian J Ophthalmol. 2020 Jan;68(1):241–4. Available from: https://doi.org/10.4103/ijo.IJO_354_19

Flaxel CJ, Adelman RA, Bailey ST, Fawzi A, Lim JI, Vemulakonda GA, et al. Idiopathic Macular Hole Preferred Practice Pattern. Ophthalmology. 2020 Feb;127(2):P184–P222. Available from: https://doi.org/10.1016/j.ophtha.2019.09.026

Achyutha Varrier Cheppattu (editor). Astanga Hrdayam of Vagbhata, Uttaratantra, chapter 12, verse no.10. 17th edition, Vol. 1. Kodungallur; Devi Book Stall; 2016; 171.

Achyutha Varrier Cheppattu (editor). Astanga Hrdayam of Vagbhata, Uttaratantra, chapter 13, verse no.80. 17th edition, Vol. 1. Kodungallur; Devi Book Stall; 2016; 202.

Soundarya N, Vivek Gowda S, Rathi S. An Ayurvedic management of Retinal Pigment Epithelial Detachment - A Case Study. J Ayurveda Integr Med Sci (JAIMS). 2021 Mar-Apr;6(2):265–9. Available from: https://jaims.in/index.php/jaims/article/view/1247

Raghavendra, Acharya RN. A Review on Therapeutic Potentials of "Jivanti" in Ayurveda. Anveshana Ayurveda Medical Journal (AAMJ). 2015 Nov-Dec;1(6):442–9. Available from: https://www.researchgate.net/publication/290946206

Gopinathan G, Dhiman KS. Triphala in Eye Diseases: A Critical Review. Journal of Homeopathy & Ayurvedic Medicine (J Homeop Ayurv Med). 2013 Jul;2(2):123. Available from: https://doi.org/10.4103/2167-1206.1000123

Dhotre Darshana, Mamatha KV, Sujathamma k. Seka -A curtain raiser to ocular therapy in the management of inflammatory diseases of eye. International Journal of Ayurveda and Pharma Research (IJAPR). 2016 Sep;4(9):32–8. Available from: https://ijapr.in/index.php/ijapr/article/view/453

Vaijwade AP, Ramteke RB. Aschyotana Therapy- A Potential Ocular Therapeutics in Ayurveda. International Ayurvedic Medical Journal (IAMJ). 2017 Feb-Mar;1(3):261–4. Available from: http://www.iamj.in/posts/images/upload/261_264.pdf

Jnaneshanayaka MS. Review on Shiro Lepa -A Conceptual Study. International Journal of Pharmaceutical Research and Applications (IJPRA). 2024 Jan-Feb;9(1):340–5. Available from: https://doi.org/10.35629/7781-0901340345

Pradeep Kumar K, Ramesh BN. A Comparative Study on the Efficiency of Patoladi Ghrita Pana and Punarnavadhi Anjana in Timira. Journal of Ayurveda and Holistic Medicine (JAHM). 2019;7(2):1–10. Available from: https://www.jahm.in/index.php/jahm/article/view/154

Kamthe AV, Darunde S. LITERARY REVIEW OF NETRA TARPAN IN NETRA ROGA. World Journal of Pharmaceutical and Medical Research (WJPMR). 2024;10(4):94–7. Available from: https://www.wjpmr.com/abstract_id/2143

Rathi S. An Ayurvedic approach to partial thickness macular hole - A case report. Int J Ayu Pharm Chem. 2020 Jan;12(1):124–129. Available from: https://www.ijapc.com/issue_details.php?issue_id=53

Additional Files

Published

2026-05-24

How to Cite

Narayanan, . N., Sreekala , N. N. P., Parameswaran, S. N., Parayil, C. J., Soman, S. ., & Sukumaran, K. . (2026). Ayurvedic Management of Idiopathic Full-Thickness Macular Hole with Anatomical Closure on OCT: A Case Report. Journal of Ayurveda and Holistic Medicine (JAHM), 14(4), 105-113. https://doi.org/10.70066/jahm.v14i4.2691

Most read articles by the same author(s)