Decoding Timira As A Prameha-Upadrava: An Ayurvedic Interpretation Of Diabetic Retinopathy

Netra is considered as Pradhana Indriya, as vision is the prime means of perceiving the external world. Among Dṛiṣṭigata Roga, Timira is described by Acharya Susruta and Acharya Vagbhaṭa as a condition that further leads to blindness. On the other hand, Prameha is enumerated as an Aṣṭa Mahagada by Acharya Charaka, highlighting its chronicity. In modern science it can be correlated with Diabetes Mellitus, whose ocular complication manifests as Diabetic Retinopathy. The Samprapti of Prameha involves mainly Kapha-Meda Dusti, Srotorodha, and gradual vitiation of Rakta and Vata, producing Shareera Shaithilya and Dhatu-Kṣhaya. This pathological process extends to the Netra through Shiro-Srotodusṭi, manifesting as Abhiṣyanda and subsequently Timira. In modern science, this resembles retinal microangiopathy, microaneurysms, haemorrhages, ischemia, and neurodegeneration seen in Diabetic Retinopathy. In this article, an attempt is made to analyse Timira occurring as a complication of Prameha through an Ayurvedic perspective and correlate it with Diabetic Retinopathy. The role of Doṣha, Duṣya, Samprapti, and ocular Kriyakalpa procedures such as Tarpana, Putapaka, Anjana, Seka, and Aschotana in mitigating Kapha-Kleda, Rakta-Pitta, and Vata-Kopa has been discussed. This integrative approach offers a deeper understanding of preventive and therapeutic strategies in managing vision-threatening complications of Prameha.