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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 14  |  Issue : 6  |  Page : 78-82

The effect of eye exercise, triphala kwath eyewash, and instillation of distilled water on computer vision syndrome


Department of Shalakyatantra, Mahatma Gandhi Ayurved College Hospital and Research Center, Wardha, Maharashtra, India

Date of Submission01-Dec-2019
Date of Decision07-Dec-2019
Date of Acceptance27-Dec-2019
Date of Web Publication30-Sep-2020

Correspondence Address:
Dr. Roshna Sukhdevji Bhutada
Department of Shalakyatantra, Mahatma Gandhi Ayurved College Hospital and Research Center, Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_202_19

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  Abstract 


Background: Computer vision syndrome (CVS) is a serious problem for the millions of people who spend hours in front of a computer. In modern lifestyle, every person is getting affected to the radiations caused by video display terminals, computer, television, and CFL lamp, mobile etc. The catastrophic effect of CVS has resulted in low performance and extreme discomfort to the sufferer. Being a disease of modern era,”it is difficult to get the nearest resembling disease in Ayurveda, but relief can be obtained by following Dinacharya, Rutucharya and basic principles of Ayurveda . So this study includes Eye exercise, Triphala kwath Eye Wash and distilled water eyewash. Aims & Objectives: The present study aimed to compare the efficacy of Eye exercise Triphala Kwath eyewash and instillation of distilled water in the management of CVS and To provide easily available, efficient, and cheaper medicine. Materials and Methods:The total sample size was 80. Each group consist of 40 sample size. Group I treated with eye exercise and Triphala Kwath eyewash and Group II treated with eye exercise and distilled water eyewash. Clinical Eye Examination done before treatment (D0), Follow up every 7th day upto 42 days .The effect of intervention was assure. Result:The results of the study revealed average 55% relief for group I for most of the subjective criteria and objective criteria. Conclusion:Eye exercise and Triphala Kwath eyewash is more significant than eye exercise and instillation of distilled water.

Keywords: Computer vision syndrome, dinacharya, rasayana, Triphala Kwath


How to cite this article:
Bhutada RS. The effect of eye exercise, triphala kwath eyewash, and instillation of distilled water on computer vision syndrome. J Datta Meghe Inst Med Sci Univ 2019;14, Suppl S2:78-82

How to cite this URL:
Bhutada RS. The effect of eye exercise, triphala kwath eyewash, and instillation of distilled water on computer vision syndrome. J Datta Meghe Inst Med Sci Univ [serial online] 2019 [cited 2022 Jun 30];14, Suppl S2:78-82. Available from: http://www.journaldmims.com/text.asp?2019/14/6/78/296810




  Introduction Top


Studies have shown, however, that eye-related symptoms are the most frequently occurring health problems among video display terminals (VDTs) users.[1] The main visual symptoms reported by VDT users include eye strain, tired eye, eye irritation, burning sensation, redness, blurred vision, and double vision thus term the phrase “computer vision syndrome” (CVS). It is estimated according to some reports that the diagnosis treatment of their symptom costs almost US$2 billion each year. As computer users become marked aware of CVS, it is important that ophthalmologists should be attentive to this rapidly evolving disorder Triphala Kwath once in 7 days intervals up to 42 days and compare the results with placebo group installation of distilled water.

Much study had shown that approximately 50%–90% of computer users became the victim of CVS at some point of their life. Hence, there is an urgent need to understand the dynamics of this problem and prevent it from assuming epidemic proportions.[2] The prime importance has been given to the eye in ancient Ayurveda. Acharyas mentioned urdhangachikitsa separately among Astanga Ayurveda for the treatment of the organ situated in urdha jatru (above clavicle). Acharya Charaka[3] elaborated Dinacharya starting with Anjana karma quotes that day and night are one and the same for the blind person, and value of life goes vain without eye. Hence, it is the duty of every individual to accept and adopt all the measures which help to protect our vision.[4] CVS becomes the disease of 21st centuries; there are no direct references of this disease in Ayurveda text. However, it is possible to understand the disease through the fundamental of Ayurveda and it is expected that effective results may obtain through Ayurveda regimen. The process of understanding a disease has been mentioned in astangasamgraha 22nd chapter named as rogabhediyoadhyaya, and following this, one can nominate CVS as “Vata Pitta vyadhi”.

Objectives

  1. To select the patients having CVS as well as not having CVS but doing computer more than 3 h
  2. To compare the efficacy of Triphal Kwath eyewash and instillation with distilled water drop in the management of CVS
  3. To provide easily available, efficient, and cheaper medicine.



  Materials and Methods Top


The two group of clinical study over 40 samples of CVS patient was done with the trial drug Triphala Kwath eyewash for 42 days decided for a treatment period of 6 weeks). Triphala Kwath preparation procedure is as follows: Triphala Kwath 5 g coarse powder is added to 16 parts of water of water, i.e., 80 ml, boiled and reduced to the 1/4th part 20 ml, and filtered using filter paper and this filter paper used wash both eyes.

The method of selection of patients for data: patients were selected randomly irrespective of sex, religion, and socialeconomic status. The case sheet was prepared initially as per the details required pertaining to the disorder along with vital data for the statistics to be collected. All the cases were recorded in these sheets and finally data were drawn based on the information furnished in the sheets. Charts were prepared based on the data wherever necessary and represented in the form of bar diagrams and graphs as per the requirement.

Inclusion criteria

  1. Computer users between the age group of 18–35 years
  2. Daily computer users for 3 h continuously per day or more
  3. Eye- and or vision-related symptoms discomfort subjectively attributed to VDT/computer use.


Exclusion criteria

Patients other than inclusion criteria.

Study design

Type of study (method of study)

The open controlled randomized comparative clinical observation study method was used.

Clinical presentation of VDT user/computer clinical per forma will be based on questionnaire. Discontinuation criteria: If any adverse effect of therapy is seen or patient suffering severe illness or not willing to continue the treatment then patient drug Schedule stop & consider as dropout patient.

Sample size

The total sample size was 80. Each group consisted of 40 points.

Sampling technique

Eighty patients of CVS were treated by randomly dividing them into two groups:

  • Triphala Kwath 10 ml in BT (Morning and Evening) for 42 day Treatment advice for 6Week, Clinical Eye Examination Duration Before Treatment (D0), Follow up 7th, 14th, 21st, 28th, 35th, and 42nd days after the completion of treatment period.
  • Group II: A group of Clinical Study over 40 Non Dropout samples of CVS was done with the trial of instillation of distilled (demineralized and sterilized) water BT (Morning and Evening) or eye wash for 42 day decided for a treatment period of 6 weeks).


Selection of sample

The study was conducted in SRC Ayuved College Chikhli, which is the center for studies.

Patients attending the OPD of SRC Ayurvedic College and Hospital Chikhli were included for studies.

Collection of the trial drug

All materials were collected from the authorized dealer.

Assessment criteria

Self-gradation was given to symptoms assessment done at an interval of 7 days on the basis of pre- and post-observation found on this scale after completion of the treatment 42nd day and 6 month to see the long-term effect. The sample size was 80 (40 in one group) which were with 80 patients were selected for treatment and randomly distributed in two group without consideration any factor. Patients were not allowed to compare their treatment or made aware of the complete study, but only consent was obtained for the treatment. Diagnosis of clinical presentation: VDT users/computer users clinical per forma was based on questionnaire. Complete eye examination: Clinical examination of follow-up was repeated at the selected intervals of the treatment. Clinical examination include questionnaire. Observations were made during the treatment and also during followup period recording of the conditions on Clinical Eye exam will be done before treatment (D0), 7th, 14th, 21st, 28th, 35th, 42nd, completion of the treatment. Clinical presentations of sign and symptoms were graded as:

mild+ (1), moderate++ (2), severe +++ (3), and absent (0).

Schirmer's test was done to check the lubrication of the eye. All the findings were compared and analysis was done accordingly. Adverse events were classified as mild, moderate, and severe. Mild mean causing, no limitation of usual activity although the patient may experience slight discomfort. Moderate mean Causing some limitation of usual activity and patient may experience annoying discomfort. Severe mean causing inability to carry out usual activity the patient may experience intolerable discomfort, burning sensation, eye strain, and loss of a focus. All the adverse events findings were probably recommended.

Subjective parameters for the assessment of the result

Result assessment

The clinical efficacy of the drug was assessed objectively as well as subjectively.

Subjective assessment

Gradation:

The symptoms' gradation was in the four groups.

  • Grade I – Normal – mark given 0
  • Grade II – Mild – mark given 1
  • Grade II – Moderate – mark given 2
  • Grade II – Severe – mark given 3.


Statistics

Q.1 Is there significant difference in symptom of CVS before the treatment and after the follow-up of treatment? (comparison within the same group on different days of follow-ups).

Hypothesis for research question (methods)

Hypothesis testing in was performed in two ways:

  1. To compare the result within the same treatment group on different days, statistical method paired t- test was used.


Observation

I have studied 103 samples out of which 23 patients is take Dropout and 80 patients take full treatment so. In brief, we have produced the results of 40 patients in each group. In the gender, the study comprised 40 male (50%) patients and 40 female (50%) patients. In the marital status, the study comprised 70 married (87.50%) patients and unmarried 10 (12.50%) patients. In the diet distribution, the study comprised 72 mix (90%) patients and 10 vegetarian (10%) patients. In the Prakruti type, the study comprised 56 Vata-Pittaja (70%) patients, 16 Vata-Kaphaj (20%) patients, and 8 Pittaja Kaphaja (10%) patients. Age-wise distribution study comprised 30 18–23 years age (37.5%) patients, 40 24–29 years age (50%) patients, and 10 30–35 years age (12.5%) patients. Occupation type comprised 64 service (80%) patients and 16 student (14%) patients. Religion of the study comprised 76 Hindu (95%) patients, 4 Baudha (5%) patients, and 0 Muslim (0%) patient. The economical status of the study comprised 10 good (10%) patients and 72 medium (38%) patients. Working hour spend on Computer study comprises 3–4 h spend on computer 24 patient (30%) patient, 5–6 h spend on computer 24 patient (30%) 7–8 h spend on computer 32 patient (40%). In agni/appetite-wise distribution by different modality groups, the study comprised Vishamagni 28 (35%) patients, Tīksnagni 28 (35%) patients, and Mandagni 24 (30%) patients. Dryness Status distribution by Groups. According the Schemer's wet test 60% patient is found dry eye, while 40% patient is wet eye. Duration of diseases 0–6 month 30 patient (37.5%), 6–12 month 30 patient (37.5%) patient and 12–18 month 8 patient (10%), 18–24 month 24 patient (20%).[5] Dryness symptom scored 72 points. Eye strain symptoms had 45 points. Redness of eye symptom had 45 points. Itching of eye symptoms had 32 points. Headache symptom had 48 points for Group II. Blurred vision symptoms had 50 point. Neck, shoulder, or back pain symptom had 50 points as shown in [Figure 1].
Figure 1: In Group I, the effect of Triphala Kwath on computer vision syndrome (42 days) result from table 1

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  Results Top


The results are shown in [Table 1] and [Table 2] and [Figure 2].
Table 1: Group I Triphala Kwath computer vision syndrome (42 day effect) treatment

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Table 2: Group II The effect of instillation distilled (demineralized and sterilized) water or eyewash

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Figure 2: The effect of the mean difference of Triphala Kwath on computer vision syndrome (42 days) resuts from table 1

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The average result of the mean difference was 0.54 and relief in Group I was 55% and [Figure 3]. The value of P was <.05 so the result was statistically significant at 0.05 level; we can compare the result with previous, got the relief after 42 treatment days. Hence, the result was significant in Group I.
Figure 3: The effect of (mean ± standard deviation) Triphala Kwath on computer vision syndrome result from table1

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All symptoms not found any significant 13% and P > 0.05 relief after 42 days in Group II. There was no result for Group II.

Discussion based on the clinical study

The result is significant in Group I (the Effect eye Exercise, Triphala kwath eye Wash) & treatment is more effective than Group II (Instillation of Distilled water). Laying emphasis on the involved doshas, all these causes lead to the vitiation of vata pittapradhan dosa.


  Conclusion Top


CVS is vata-pitta pradhan tridoshaja vyadhi. Aasatmya indriyartha samyoga and pragyaparadhparinam are the three main causative factors behind the pathogenesis, according to Ayurveda. Low distance of screen from the eye, improper room light, and low blinking rate are the main causative factors; dryness of the eye, eye strain, redness of the eye, itching, burning sensation of the eye, blurring of image, and headache and neck/shoulder/back pain were the main symptoms and complaint for majority of the patients. The disease is not related with refractory error, but the intensity of signs and symptoms increase for those persons with incorrect or under correct refractory error. Vata-pitta sharirikprakriti users are the main victim of this disease. Rajasika manasika prakriti persons are more prone to the disease. Young (18–30) educated adults are the main victims of the disease.

In the present study, the effect of Triphala Kwath Eye Wash on CVS, has taken for clinical evolution of different signs and Symptoms. The study drug, Triphala Kwath eyewash, showed a statistically significant result for most of the signs and symptoms.

According to the modern view, CVS is a disorder caused due to nutritional deficiency. In modern science, Vitamin A deficiency causes computer-related eye problem. Mucin is also one important cause of dryness to the Eye which results in normal eye physiology. Triphala Kwath is used for eyewash where chksushya effect of Triphala effect seen locally. The Triphala kwath Eye wash is faster way relive patient can get cheaper medicine easily without admitting inhospital, Eye exercise can be done when the patient at work time also so Ayurvedic medicine recommendation in this study was fulfill.

This study was financially supported by Mahatma Gandhi Ayurved College Hospital and Research Center, Wardha, Maharashtra, India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Available from: http://en.wikipedia.org/wiki/Computer_vision_syndrome.wikipedia.org. 2010. [Last accessed on 2017 Jan 01].  Back to cited text no. 1
    
2.
Becoming a Squinter Nation, Wall St. Journal, August 17, 2010. Available from: https://my2020eyecare.ca/computer-vision-syndrome/”. [Last accessed on 2017].  Back to cited text no. 2
    
3.
Shastri KN, Chaturvedi GN. Chakrapani Ayurveda Deepika, Vidyothaini Commentary: Charaka Samhitha, Chaukhamba Bharati Academy Varanasi, 1991;1:44-7.  Back to cited text no. 3
    
4.
Available from: https://uihc.org/healthlibrary/computervision-syndrome. [Last accessed on 2017 Jan 10].  Back to cited text no. 4
    
5.
Available from: https://www.healthnfitnesscare.com/eye-care-tips-and-exercises-for-tired-eyes.html. [Last accessed on 2017 Jan 10].  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2]



 

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