Clinical outcomes of oral administration of Ayurvedic polyherbal formulation (Mahatriphala ghrita) for 90 days compared to the baseline in patients( 50-70 years) with Vitreous floaters at a research hospital in Kerala: A case series

Vitreous floaters are prevalent in 76 percent of the general population. Floaters are resulted from vitreous degeneration caused due to oxidative stress. It is perceived by patients as mobile spots, threads, or cobweb-like structures in the visual field. Primary vitreous floaters are those arising from structures endogenous to the vitreous and attributed to vitreous degeneration, posterior vitreous detachment (PVD), or pathological myopia. Secondary floaters are due to inflammation, hemorrhage and asteroid hyalosis. In most cases of primary floaters, symptoms may subside in three months. However, in some others symptoms may not subside and greatly affect the patient’s vision. It may even cause substantial level of psychological distress. In contemporary biomedical practice, management strategies depend on the underlying etiology. In most cases of floaters,while invasive procedures like pars plana vitrectomy or Nd:YAG laser vitreolysis may be employed in severe cases of persistent floaters, there remains no widely accepted or effective treatment for less severe cases. The conventional treatment mostly offered to such case is watchful waiting, after ophthalmologists have successfully ruled out the possibilities of retinal complications after the onset of floaters. In that, patients are only monitored after they have been either reassured that their floaters will resolve with time and counseled to adapt to their new visual experience. This therapeutic gap presents an opportunity to evaluate Ayurvedic interventions for their potential to produce meaningful, patient-perceived improvements in floater symptoms and vision-related quality of life.In Ayurvedic literature, the condition in which a patient perceives floaters is described as Dvitiya Patala Dosa (a disorder affecting the second ocular layer), classified under the National AYUSH Morbidity Code HG-1.2.A case report has documented that oral administration of an Ayurvedic polyherbal formulation (triphala yashti churna) for a duration of 90 days resulted in 50 % improvement of floater symptoms and is safe. It is an ayurvedic polyherbal formulation containing 5 gm of triphala churna (powder of Terminalia chebula Retz., Terminalia bellerica Gaertn., and Emblica officinalis Gaertn.,) and 2 gm of yashtimadhu churna (Glycerrhiza glabra Linn.). The formulation will be administered with 10 ml of Mahatriphala ghrita which is indicated for general wellbeing of ocular structures. Despite encouraging anecdotal and observational reports, robust clinical evidence validating the efficacy of Ayurvedic management for vitreous floaters remains scarce.

To address this evidence gap, the present study proposes  a case series to determine the clinical outcomes of oral administration of Mahatriphala Ghrita for 90 days compared to baseline, in patients (50-70 years) with vitreous floaters, at an ayurvedic research hospital in Kerala.