Vol. 2, Issue 2, Part A (2025)

Background: Dry eye disease (DED), corresponding to śuṣka netraroga in Ayurveda, is increasingly prevalent in digitally active populations and is associated with significant visual discomfort and impaired quality of life. Conventional management with artificial tears, particularly hyaluronic acid preparations, often provides incomplete or short-lived relief. Classical Ayurvedic texts advocate netratarpaṇa (retention of medicated ghṛita over the eyes) as a localized nourishing therapy for dry ocular conditions, but high-quality comparative clinical data are limited.
Objectives: To evaluate the efficacy and safety of ghṛita-based netratarpaṇa compared with preservative-free sodium hyaluronate eye drops in the management of mild-to-moderate dry eye syndrome (śuṣka netraroga) in adults with significant digital screen exposure.
Methods: In this prospective, randomized, parallel-group controlled trial, 60 adults (18-65 years) with TFOS DEWS II-defined dry eye, Ocular Surface Disease Index (OSDI) ≥13, TBUT <10 s and/or Schirmer I ≤10 mm/5 min were randomized (1:1) to a ghṛita-netratarpaṇa group (Group A) or a sodium hyaluronate group (Group B). Group A received a standardized medicated ghṛita tarpana regimen (daily for 7 days, then weekly for 4 weeks), while Group B received preservative-free 0.15% sodium hyaluronate four times daily for 6 weeks. Both groups received uniform lifestyle counselling related to digital device use and environmental modification. Primary outcome was change in OSDI from baseline to week 6. Secondary outcomes included TBUT, Schirmer I, Oxford corneal fluorescein staining, functional vision/quality-of-life indices and safety. Data were analyzed on an intention-to-treat basis.
Results: Baseline demographic and clinical characteristics were comparable between groups. At week 6, mean OSDI decreased from 44.8±11.9 to 15.3±9.6 in Group A and from 45.6±12.3 to 23.9±10.8 in Group B, with a significantly greater mean reduction in Group A (−29.5±11.2 vs −21.7±10.6; p<0.05). A higher proportion of patients in Group A achieved ≥20-point OSDI reduction and OSDI <13. TBUT improved from 6.1±1.5 s to 10.2±2.1 s in Group A and from 6.0±1.6 s to 8.3±1.9 s in Group B, with a significantly larger gain in the intervention group. Schirmer I values and Oxford staining grades also showed significantly greater improvement with netratarpaṇa, with more eyes reaching grade 0-1 staining by week 6. Both treatments were well tolerated; adverse events were mild and transient, with no serious ocular or systemic complications.
Conclusion: Ghṛita-based netratarpaṇa produced superior improvements in symptoms, tear film stability, tear secretion and ocular surface integrity compared with sodium hyaluronate alone, with an acceptable safety profile in mild-to-moderate dry eye among digitally active adults. These findings support the incorporation of standardized ghṛita netratarpaṇa as a viable integrative therapy within contemporary dry eye management, particularly in patients with lifestyle- and screen-related śuṣka netraroga. Larger, multicenter and longer-term studies are warranted to confirm durability of benefit and to refine its role in stepwise ocular surface care.