Helloo chopra ,
For someone who is 91, with CKD-4 and hypertension, the priority is always comfort, safety, and avoiding anything harsh or invasive.
Eye pressure of 45 mmHg is quite high. The allopathic drops (like timolol, dorzolamide, latanoprost etc.) are the most effective and safest way to keep that pressure under control and prevent pain or sudden vision loss. Ayurveda can help as supportive care, but not as a complete replacement at this age.
Ayurvedic treatment:
Nothing strong, only safe options that don’t stress kidneys or blood pressure:
Netra Tarpana–
– Cow’s ghee (a drop warmed to body temperature, very pure and sterile) can sometimes be used under guidance of an Ayurvedic doctor, but only if there is no infection risk.
Safer way: taking a very small amount of cow’s ghee internally (½ tsp daily, if digestion allows).
Triphala eyewash :
– A very light filtered Triphala decoction, cooled and strained well, can be used for washing the eyes externally. This helps reduce burning, dryness, and supports eye health. – At this age, it should be very gentle, and only if there is no risk of contamination. – Punarnava Mandur (very mild dose) can support water balance, but should only be given after checking with her nephrologist, since she is CKD-4. – Instead, dietary measures like avoiding excess salt, very spicy food, late-night strain are safer.
Please do not stop the allopathic eye drops they are crucial in keeping the pressure from damaging her optic nerve further. Ayurveda here can only support, not replace.
Investigations & Monitoring:
Regular IOP (intraocular pressure) check Kidney function monitoring (since she is CKD-4) BP monitoring (since high BP can worsen eye damage)
At 91, the focus should be on making her vision comfortable, preventing further loss, and keeping her life easy and pain-free.
Ayurveda can gently support her eyes and overall strength, but her drops are her main protection against blindness.
Warm regards, Dr. Karthika
Eyewash with triphala water. Akshitarpan with brahmi ghrut. Tab. Punarnava 2-0-2 Follow up after 2weeks
It’s crucial to understand that this should not replace your current allopathic treatment. Allopathic medications for glaucoma are vital for preventing irreversible vision loss by directly controlling eye pressure. Any changes or additions should be made only after a thorough consultation with your allopathic ophthalmologist
Given the patient’s age and chronic conditions (CKD-4, hypertension), any intervention, including Ayurvedic ones, must be carefully considered to avoid potential interactions or adverse effects.
Herbal Remedies and Formulations
Triphala: This is a cornerstone of Ayurvedic eye care. A combination of three fruits (Amalaki, Bibhitaki, and Haritaki), Triphala is rich in antioxidants that help protect the delicate tissues of the eyes and may help lower intraocular pressure. It can be used as an eyewash (after boiling and straining) or consumed orally as a powder or tablet.
Punarnava: Known for its diuretic properties, Punarnava is often used to help drain excess fluid from the body, which can help reduce pressure inside the eyes.
Amla (Indian Gooseberry): Extremely rich in Vitamin C and antioxidants, Amla strengthens eye tissues, protects the optic nerve from damage, and improves blood circulation to the eyes.
Ghee: Medicated ghee, particularly Maha Triphala Ghrita, is used in specific Ayurvedic therapies. When applied topically (under expert supervision), it’s believed to nourish and lubricate the eyes, potentially aiding in fluid drainage.
Therapies and Practices Netra Tarpana: A specialized procedure where a dam made of dough is placed around the eyes and filled with medicated ghee. This therapy is highly nourishing and is meant to strengthen the optic nerve and reduce pressure.
Nasya: Involves administering medicated oil (like Anu Taila) into the nasal passages. This practice is believed to address the root cause of eye issues by clearing channels that connect the nose and eyes.
Lifestyle and Diet: Adopting a balanced diet rich in antioxidants, vitamins, and minerals is crucial.
Foods to include: Leafy greens, carrots, sweet potatoes, nuts, seeds, and fish rich in omega-3 fatty acids (like salmon).
Foods to limit: Processed foods, excessive caffeine, and alcohol, as they can sometimes increase eye pressure.
Yoga and Eye Exercises: Gentle exercises and yoga can improve blood circulation to the eyes and help reduce stress.
Trataka (Candle Gazing): A practice that involves staring at a candle flame to improve focus and strengthen eye muscles.
Palming: Rubbing your palms together to create warmth and then gently cupping them over your closed eyes to relax them. 😌
Important Considerations for a 91-Year-Old Patient
Interactions: It is not safe to mix allopathic and Ayurvedic eye drops . They may have unknown interactions that could harm the eyes or negate the effect of the prescribed medication. Systemic Health: The patient’s CKD-4 and hypertension are major factors. Any herb or treatment that impacts blood pressure or kidney function must be avoided or used with extreme caution. For example, some herbs that lower blood pressure could interact with existing hypertension medication. Punarnava, while beneficial for the eyes, is a diuretic and could affect kidney function and electrolyte balance.
Safety First: Given the irreversible nature of vision loss from high eye pressure, allopathic treatment is the primary and most effective method for controlling the condition. Ayurveda can be a complementary therapy but should never be used as a substitute. The patient’s health and safety must be the top priority.
Take triphala ghrita 1tsp bd,apply akshitarpanam,
Namaste Chopra ji,
I understand your concern. At the age of 91 with glaucoma (eye pressure 45 mmHg), CKD stage 4 and hypertension, treatment needs to be gentle, supportive, and non-invasive.
✅SAFE AYURVEDIC MEDICATION
1 Triphala Ghrita (1/4 tsp with warm water at bedtime) nourishes eyes, reduces strain
✅EXTERNAL. EYE CARE
Triphala water wash: Soak 1 tsp Triphala in warm water overnight, filter very well in morning, wash eyes with this cooled filtrate (daily or alternate days). Helps reduce pressure & soothe eyes.
Netra tarpana (ghee eye bath) – only if possible under supervision of an Ayurvedic doctor; very effective for glaucoma but needs clinical setup.
✅DIET MODIFICATION
✅ Eat cooling, light foods – gourds, cucumber, coconut water (if BP allows), leafy greens ✅ Add Triphala powder (½ tsp in warm water at night) if bowels are sluggish ✅ Coriander seed water (soaked overnight) can help reduce heat & mild pressure ❌ Avoid excess salt, sour, fried, spicy foods – they worsen pressure ❌ Avoid late nights, prolonged screen use, and constipation
✅ LIFETSYLE AND GENTLE YOGA
Avoid forward bending postures (they raise eye pressure) Practice Shitali pranayama (cooling breath) & Bhramari (humming bee sound) → calms nerves and reduces strain Keep stress & anger under control – Pitta aggravation worsens glaucoma
Continue allopathic drops (do not stop).
Add Triphala ghrita internally + Triphala water wash externally (most safe in elderly).
Maintain cooling diet, reduce salt/spices, and practice gentle pranayama.
Wishing you a good health😊
Warm Regards Dr Snehal Vidhate
Hello
As you mentioned the patient is elderly so please donot do any experiments to the patient with medication because if the change in medication doesn’t suit he will feel more discomfort and make him concious.
You can add TRIPHALA GHRIT 1-2 tsp in the morning with the allopathy drops.
As the patient is elderly his body has become weak to cope up with the changes made in medication so donot disturb their routine.
Rx
Triphla eye wash early morning regularly… procedure:-take 2 TSP saok with 100mlnof normal water till night… At morning strain with cottan cloth and eye wash early morning…
Eye ghrit gold tab=2-2 tab empty stomach twice daily…
Mahatiphladi ghrit=aksitarpan at night…
Start with Amalaki rasayan 1-0-1 after food with water Saptamritlauh 1-0-1 after food with water With Triphala grith do netra Tarpan at nearby ayurvedic centre
Adv: Triphala Ghrita (external use only): Can be used in Netra Tarpana therapy under expert guidance (Visit a nearby Panchkarma center).
Triphala Eye Wash (Netra Prakshalana) - Soak 1 tsp Triphala powder overnight in warm water. - Strain thoroughly through a fine muslin cloth. - Use the clear liquid to gently rinse eyes in the morning. - Benefits: Reduces inflammation, improves circulation, and may help lower IOP.
Nasya with Anu Tailam (if tolerated) - 2 drops in each nostril twice daily. - Supports ocular circulation and calms Vata.
Eye Palming & Gentle Eye Yoga - Rub palms together and gently cup over closed eyes. - Practice slow blinking, eye rotations, and focusing exercises. - Enhances ocular blood flow and relaxes optic nerves.
Lifestyle & Diet Tips - Reduce salt intake to ease systemic pressure. - Hydrate gently—small sips throughout the day. - Avoid caffeine and alcohol. - Practice guided meditation or Yoga Nidra to reduce stress-induced pressure spikes.
HELLO N CHOPRA,
I hear your concern - managing very high intraocular pressure (IOP ~ 45 mmgHg) in a 91 year old with glaucoma, CKD stage 4, and hypetension is delicate
First, an important safely note -At such a high IOP, there is a risk of rapid optic nerve damage and vision loss. Allopathic glaucoma drops are usually the first line and must not be discontinued without opthalmologist guidance. Ayurvedic and natural approaches can completent, but not replace, urgent glaucoma care.
In Ayurveda, raised eye pressure and optic nerve compromise are seen under tridoshaja eye disorders, with predominance of Vata-pitta imbalance leading to obstruction in the channels (srotas)
GOALS OF AYURVEDIC SUPPORT -Reduce vata-pitta aggravation -Improve Netra dhatus (eye tissue nutrition) -Support circulation and fluid balance -Provide gentle, non invasive measures given advanced age.
INTERNAL MEDICINES
1) TRIPHALA GHRITA= 1/4 tsp with warm water at night, if digestion allows. =nourishes optic nerve and supports eye health
2) PUNARNAVADI KASHAYA= 25ml + warm water after meals =useful in reducing fluid retention and balancing kapha-vata, but must be used cautiously in CKD .
3) TRIPHALA CHOORNA EYE WASH= soak 1/2 tsp triphala powder in water overnight, filter very well, use strained water for gentle eyewash in the morning (if tolerated)
LOCAL/ OCULAR THERAPIES
-NETRA TARPANA= (gentle ghee/oil pooling therapy) -=usually done in Ayurvedic clinics, but at advanced age and high IOP, only mild lubrication with medicated ghee (e.g- Mahatriphal ghrita eye drops, 1 drop once daily) may be considered
-ANJANA (collyrium)= avoid strong rasanjana or irritant collyriums in elderly
DIET AND LIFESTYLE SUPPORT -Favour cooling, light, sattvik diet= boiled vegetables, gourds, leafy vegetables (spinach, kela), barley, and moong dal -Avoid=excess salt, fermented foods, spicy/oily food, heavy curd, excessive tea/coffee -Stay hydrated, but follow fluid restriction as per CKD management -Gentle breathing= sheetali pranayam, Anulom-vilom- helps reduce stress and regulate intraocular pressure
SIMPLE HOME EYE CARE -cold compress with clean cloth dipped in cool water- soothes burning and reduces strain -Gentle palming (rubbing palms, placing over eyes - relaxes optic nerves) -Adequate rest, avoid bright glare, excessive TV/ Phone
KEY CONSIDERATIONS -At IOP= 45, vision loss can progress rapidly-> do not stop allopathic drops -Ayurvedic measures here are supportive, not curative at this stage
DO FOLLOW
HOPE THIS MIGHT BE HELPFUL
THANK YOU
DR. MAITRI ACHARYA
Hello, There is a special eye care hospital called Sreedhareeyam ayurvedic eye hospital. They will be best people to take care of such cases as he is 91 years old with CKD and hypertension. Take care, Kind regards.
Managing eye pressure in conditions like glaucoma is crucial, and while the treatments you’re already using are indispensable, certain Ayurvedic methods may complement them. First, it’s important to note that the priority is always safety. Given the patient’s age and condition, consulting a healthcare provider before starting any new treatments is essential.
In Ayurveda, eye health can be supported through holistic approaches, aiming at balancing Pitta dosha, which is often linked with eye issues. Diet plays a significant role here. Incorporating foods that pacify Pitta like cucumber, cilantro, and zucchini can be beneficial. Encourage moderate consumption of ghee, known for its nourishing properties, particularly a few drops of pure ghee in each eye—however, this should be done cautiously so please consult with a healthcare professional, to avoid any complications.
Triphala, a revered Ayurvedic formulation, can be helpful here — it is known to support eye health. Using Triphala eye wash can be done by soaking Triphala powder in warm water, straining it, and using the liquid once cooled. This should not be done without supervision to ensure no contamination or sensitivity occurs. Furthermore, Triphala can also be taken internally, usually at bedtime, but the dosage must be tailored to the patient’s constitution.
Practices like Trataka (candle-gazing) are traditionally recommended for eye health. However, this should be approached with caution, given the patient’s age. Gentle eye exercises such as palming (covering closed eyes with the palms) can relieve strain.
Stress management is another angle that should be considered, as stress can exacerbate eye conditions. Techniques like meditation or slow, rhythmic breathing exercises like Anulom Vilom (alternate nostril breathing) might help in calming the mind and reducing stress-induced pressure fluctuations.
Lifestyle adjustments are vital. Adequate rest, proper hydration, and avoiding strain, such as reading for extended periods or exposure to bright screens, are advisable. Regular eye check-ups to monitor eye pressure remain crucial, and integrating these Ayurvedic practices should be viewed as complementary to the prescribed allopathic treatments.
Reducing eye pressure, especially in elderly patients with a history of glaucoma, should be managed carefully. While you’re using allopathic drops which are essential, integrating Siddha-Ayurvedic practices cautiously can complement the ongoing treatment. Always consult with a healthcare professional, but here’s a starting point:
First, consider the role of diet and lifestyle. A balanced diet that supports the liver and helps maintain healthy blood pressure can indirectly relieve eye pressure. Incorporate foods high in omega-3 fatty acids like flaxseeds and try to increase the intake of leafy green vegetables. These foods are gentle on digestion yet support the overall eye health and circulation.
Practicing gentle eye exercises twice a day could be beneficial. Encourage blinking exercises and rolling the eyes slowly in clockwise and anti-clockwise directions. Each set should last about two minutes.
Herbal formulations might also offer support. Triphala is often mentioned in Ayurvedic texts for its potential to aid eye-related concerns. Prepare Triphala water: Soak one teaspoon of Triphala powder in a glass of water overnight, strain in the morning, and use it to gently wash the eyes. This should be done under careful observation and confirming safety with the practitioner’s advice.
Manage dosha imbalances by ensuring the eyes are not exposed to direct wind, bright screens, or extreme temperatures, which might aggravate the Pitta dosha.
Controlling stress is vital. Encourage practices like meditation or pranayama, specifically Anulom Vilom breathing exercises. These can be calming and help in regulating both pressure and circulation naturally.
Lastly, regular follow-up with an eye specialist is crucial to monitor the pressure levels. If there are any signs of discomfort or sudden changes in vision, assure that immediate attention by a healthcare practitioner is sought.
