Efficacy of Darvyadi Aschyotana(Eye drop-Anubhuta)and Shunthyadi Aschyotana(Eye drop) in the management of Shushkaakshipaka(Dry eye disease)-an open labelled randomized comparative clinical trial

Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyper osmolality, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles. Hyper osmolality causes release of chemical substances like inflammatory mediators and proteases which causes histological changes like loss of goblet cells and epithelial cells. The condition gradually progresses to punctuate epitheliopathy and ultimately ocular surface damage. In Ayurveda, On the basis of signs and symptoms it can be correlated with Shushkaakshipaka. Shushkaakshipaka mentioned as Sarvagata Netraroga among all the 76 Netrarogas by Acharya Sushruta and mentioned it as Vata predominant Vyadhi. The mainstay of management of Dry Eye Disease in contemporary medicine is by instillation of artificial tear supplements, preservation of natural tears & excess mucous may be treated by acetyl cystine & in severe cases some ocular surgeries. The tear lubricants mentioned are a failure in reproducing the tears because the natural tears are a complex mixture of lipids, mucin and water. Mainly this has a local effect only and, it can’t break the root cause of pathology which often results in recurrence.Also, the main problem is the cost of these medicines. These are prescribed as lifelong therapy and many of the patients will not be in a position to afford these expensive drops. This has paved way for other medical systems, like Ayurveda, to propose experiments and offer alternative treatments for the Dry eye syndrome. Two Groups A and B will be allocated with 50 patients in each group using Computer Generated Random Sampling Method.  Group A will be  provided with Darvyadi Aschyotana 2 drops 4 times in a day and Group  B with Shunthyadi Aschyotana with the same dosage and time interval for 30 days. Both groups will provide with Mahatriphaladi Ghrita Pana 15ml OD in empty stomach for 30 days and with Anutaila Nasya with 5ml in each nostrils at evening for 14 days.subjective and objective assessment will be done on 15th and 30th day.After completion of the treatment, the patients will be asked for follow up for 1 month at the interval of 15 days.