By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Gambhirika is one of the ‘disorders of vision’ explained by Master Sushruta. Gambhira means deep. In this disease the eyes appear as if they have sunk deep into the sockets and look small and shrunken. There is also deep seated severe pain in the eyes. This might be the reason that the disease has been named as Gambhirika.
It is the vitiated Vata that causes these pathological changes in the eyes. This is a vata predominant vision disorder.
Read – Vatahata vartma, Vartmarbuda Eye Disorders – Definition, Symptoms, Treatment
Table of Contents
Pathogenesis of Gambhirika
Gambhirika is a Vata disorder. The aggravated vata gets lodged in the organs of vision and damages them. When this happens the vision gets destroyed. The eyes gets shrunken and becomes small. The eye drowns deep inside the socket. The disease is marked by severe pain in the eyes. Experts call this as ‘Gambirika disorder’.
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Signs and Symptoms of Gambhirika
Crookedness / destruction of vision
Eyes gets shrunken and appear small
The eyes are drawn deep into its sockets
Severe pain in the eyes
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This condition of the eye can happen when the muscles controlling the movements of the eye are damaged. This may happen due to the stiffness, convulsions or paralysis of these muscles or due to damage and paralysis of the nerves supplying these muscles. When this happens the movements of the eyeball are hampered and the eyes look sunk deep in and small in size. The tilting of the eyeball towards a particular side might make the eyeball look crooked as explained in Ayurveda explanation of Gambhirika. It is compared to the ‘paralysis of 6th cranial nerve and its symptoms’.
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Sixth Nerve Palsy
6th cranial nerve supplies lateral rectus muscle of the eye which is responsible for eye movements. Damage of the 6th cranial nerve affects eye movement. Weakness of this muscle makes your eye cross inward towards your nose. One or both eyes may be affected depending on whether a single or both nerves are damaged. Double vision and strabismus / crossed eyes (poor eye alignment) are the common symptoms of gambhirika. Strabismus is the same as crooked eyes caused by vitiated vata as explained in gambhirika vision disorder. Head injury or skull fracture can also cause damage to this nerve and so does the inflammation of the nerve. Stroke, infection, brain tumor, meningitis and brain aneurysm are other causes.
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Prognosis from modern and Ayurveda perspective – 6th nerve palsy caused due to trauma cannot be cured completely. Modern medicine provides medications and substantial relief of symptoms and also measures for correcting the vision and to alleviate double vision and strabismus including eye patch and use of prism glasses. On the other hand, Ayurveda has considered Gambhirika as incurable. Trauma has not been mentioned in the causes. The Gambhirika vision disorder is probably a condition caused due to paralysis and severe damage of the 6th cranial nerve as explained by Master Sushruta, both these cases being incurable. We also need to see that this condition is caused by vitiated vata and includes deformity. Vata conditions are either difficult to cure or incurable.
Read – 6th cranial nerve palsy
3rd Nerve Palsy – Symptoms of 3rd nerve (oculomotor nerve) palsy too closely resemble those of Gambhirika but most of the experts have compared Gambhirika to 6th nerve palsy.
Gambhirika is an incurable disease.