An Integrative Ayurvedic Approach to Chronic Dacryocystitis

Abstract

Chronic dacryocystitis is the most common disorder of the lacrimal drainage system, resulting from a long-standing obstruction of the nasolacrimal duct that leads to tear stagnation, secondary infection, and chronic inflammation of the lacrimal sac. It commonly presents with insidious epiphora, painless medial canthal swelling, and mucoid or purulent regurgitation, progressing through catarrhal, mucocele, suppurative, and fibrotic stages, with potential complications such as corneal ulceration, lacrimal abscess, fistula, and orbital cellulitis. This case reports a 56-year-old diabetic male with chronic right-sided epiphora and lacrimal sac swelling of four months’ duration, with positive regurgitation test and Munk score grade 1. While conventional management includes syringing, probing, and dacryocystorhinostomy, the condition in Ayurveda is correlated with Pooyalasa, a Sannipātika sandhigata roga of the Kaninaka sandhi, described as a two-stage pathology progressing from swelling to Vrana and potentially Pilla roga if left untreated. An integrative Ayurvedic approach using internal medications such as Patoladi Kashaya for Kleda-meda Visoshana, Shothahara, and Ropana effects; Triphala Guggulu for Shothaprasamana, Krimighna, Rasayana, and tissue-healing actions; and Guggulu Panchapala Churna for Srotoshodhana, Lekhana, and Vranashodhana was employed, along with local therapy using Ilaneer Kuzhambu Anjana for effective debris clearance and ocular tissue preservation, and Tulasi arka with Saindhava for enhanced antibacterial, anti-inflammatory action and deeper drug penetration. This highlights the relevance of Ayurvedic management in chronic dacryocystitis for reducing inflammation, preventing recurrence, and offering a non-surgical, holistic therapeutic alternative.