• Dr A A Mundewadi

Age Related Macular Degeneration (ARMD) – Modern (Allopathic) Versus Ayurvedic Herbal Treatment

One of the leading causes of blindness is a medical condition known as age related macular degeneration; known in short as AMD or ARMD. As the name suggests, this condition causes degeneration of the macula, the most important and functional part of the retina, usually leading to diminished central vision. There are multiple risk factors associated with this condition and include ageing, female gender, genetics, faulty diet, excessive sun exposure, smoking, cardiovascular disease, high blood pressure and obesity.

This disease is classified as either wet type or dry type. The dry type aka non-exudative or non-neovascular AMD, involves a gradual process of drusen (yellowish spots) deposits within the layers of the retina, causing a gradual thinning and leading to diminished central vision. Though the dry AMD affects nearly 90 % of affected individuals, this causes limited vision loss, as the process usually stabilizes after some time.

The same does not hold true for the wet type of AMD, which causes more than 80 % of the vision loss encountered in AMD patients, though it affects only about 10 % of affected individuals. Also known as exudative or neovascular AMD, it involves growth of abnormal blood vessels beneath the retina, leading to leakage of fluid and blood. Vision loss may be sudden, dramatic and progressive, often within a few days or weeks.

The symptoms of dry AMD may be prevented or slowed down with the help of food and diet supplements such as fish, dark green leafy vegetables, garlic and onion, soy, yellow fruits and vegetables, blueberries, grapes, wine, nuts, extra virgin olive oil, zinc, copper, magnesium, selenium, fatty acids, lutein, zeaxanthin, carotinoids, vitamins A, B, C, and D, glutathione, flavinoids, amino acids, gingko biloba, sage, bilberry and milk thistle.

Treatment for wet AMD includes injection of antivascular endothelial growth factor (anti VEGF) drugs, laser photocoagulation, photodynamic therapy, and use of low vision devices. The anti VEGF intra-ocular injections are currently believed to be the most effective treatment for wet AMD; however, this treatment may have potentially serious short and long term side effects.

Dry AMD can be treated with Ayurvedic medicines using oral Rasayan (rejuvenating) herbs along with Triphala or Mahatriphala Ghrut (clarified butter) both orally and locally, especially in the form of a Panchkarma procedure known as Netra-Tarpan (eye lubrication). After Ayurvedic treatment, most affected individuals have been known to retain a decent vision since more than three decades.

To avert sudden and drastic vision loss in the wet type of AMD, the use of leeches on the forehead area - just outward of the eye margins – is a useful and effective treatment measure. Mild and repeated purgation helps in reducing fluid build-up beneath the retina. Medicines can then be given to remove toxic collection from the eyes, as well as to help reduce the abnormal vessel growth and frequent leakages. Alternating courses of Netra-Tarpan and Netra-anjan (application of herbomineral wet powders in the eyes) are required to reverse the process of neo-vascularization. For patients who still do not respond, additional treatment is given in the form of shiro-dhara (liquid medicine drip aimed at the forehead) and courses of basti (medicated enemas). In this way, vision can be gradually restored fully or partially (depending upon the stage at which treatment has been commenced), and further loss of vision can be prevented. The standard treatment time for this is usually 4-6 months.

Ayurvedic herbal treatment can thus be judiciously used to effectively treat both the dry and wet types of AMD, without the risk of serious long-term side effects.

Age Related Macular Degeneration, ARMD, AMD, Ayurvedic treatment, herbal medicines, wet AMD, dry AMD

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