Ayurvedic Management of Recurrent Diffuse Episcleritis: A Case Report
DOI:
https://doi.org/10.70066/jahm.v14i7.2847Keywords:
Case report, Diffuse episcleritis, sirajala, jaloukavacharana, seka, vidalakaAbstract
Background: Episcleritis, an acute inflammation of the episclera, is often managed with topical steroids and systemic anti-inflammatory drugs in conventional medicine, yet recurrence remains a challenge. The incidence of episcleritis is approximately 15.39 per 100,000 persons per year, with diffuse type being the most common. Ayurveda correlates episcleritis with Sirajala. Clinical findings: This case report describes the successful management of diffuse episcleritis in a 43-year-old female, presented with recurrent redness, mild pain, swelling, and tearing of the left eye since 2019, with increasing episode frequency. Slit-lamp bio microscopy revealed diffuse congestion of superficial episcleral vessels involving the entire visible sclera with chemosis. Key lab findings: Erythrocyte sedimentation rate (ESR) of 85 mm/hr, immunoglobulin E (IgE) at 380 IU/mL, and immunoglobulin G (IgG) at 22 g/L, antistreptolysin O (ASO) titers at 342.4 IU/mL. Intervention: Ayurvedic intervention included internal (Guduchyadi kashayam, Sudarshana gutika and Haridra khandam) and external therapies (Seka, Vidalaka, and Jaloukavacharana). The treatment was rationally designed to pacify aggravated Pitta- Kapha, regulate Vata, normalize Rasa-Rakta Dhatus and address the root cause of recurrent Sirajala (episcleritis). Outcome: Following the interventions, redness, pain, tearing, and chemosis/swelling resolved completely, with no recurrence observed during a 20-month follow-up period. Visual acuity and intraocular pressure, remained stable. Visual Analogue Scale (VAS) score for pain reduced from 4 to 0 and vision, inflammation, strabismus, appearance (VISA) score for chemosis reduced from 1 to 0 by discharge. Redness (Efron scale) and tearing (Munk scale) also became zero. Conclusion: This case highlights the efficacy of Ayurvedic interventions in addressing the root cause of episcleritis (correlated with Sirajala in Ayurveda), offering a potential alternative for recurrent cases. The therapies rationally pacified aggravated Pitta-Kapha, regulated Vata and normalized Rasa-Rakta dhatus. Internal medicines reduced inflammation, while external therapies helped prevent recurrence by pacifying local and systemic Dosha-Dhatu imbalance.
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