Myopia and Prathama Patalagata Timira: An Integrative Review from Ophthalmology and Ayurveda

Myopia, or nearsightedness, is one of the most prevalent refractive errors worldwide and is emerging as a global public health concern due to its rapidly increasing incidence and long-term complications. Defined clinically as a spherical equivalent refractive error of > –0.50 diopters, myopia results when parallel light rays focus anterior to the retina, producing blurred distance vision while near vision remains clear. Epidemiological projections indicate that nearly half of the global population may be affected by 2050, with especially high prevalence in East and Southeast Asia. Modern research highlights multifactorial etiologies, including genetic susceptibility, excessive near work, limited outdoor exposure, and urbanized lifestyles. Classification is typically based on refractive error (low versus high myopia) or structural causes (axial versus refractive). Management ranges from optical correction with spectacles and contact lenses to interventions aimed at slowing progression, such as low-dose atropine, orthokeratology, and specialized multifocal lenses, alongside lifestyle modifications. Ayurveda offers a parallel understanding of myopia under the broad category of Drishti Roga, specifically described as Timira. Among its graded stages, Prathama Patalagata Timira—where vitiated Doshas disturb the outermost ocular layer—is correlated with simple myopia. The hallmark feature is Avyakta Darshana (indistinct vision), corresponding closely to the blurred distant vision of modern myopia. Classical texts emphasize causative factors such as excessive close or distant gazing, exposure to dust and smoke, and improper visual habits, which mirror modern risk factors. Ayurvedic management prioritizes Dosha pacification and ocular rejuvenation through therapies such as Akshi Tarpana (retention of medicated ghee over the eyes), Aschyotana (herbal eye drops), Nasya (nasal instillation of oils), and lifestyle modifications. Recent clinical studies demonstrate beneficial outcomes of such therapies in improving visual acuity and reducing symptoms in myopic patients, supporting their relevance in integrative care. This review highlights the striking convergence between modern ophthalmology and Ayurvedic thought: both recognize blurred distance vision as the cardinal symptom, emphasize the importance of lifestyle in etiology and prevention, and advocate for early intervention to prevent progression. Integrating Ayurvedic ocular therapies with evidence-based modern interventions may offer a holistic approach to managing myopia.