Inflammation of conjunctiva causing redness of the eye is conjunctivitis. Conjunctiva is a thin, transparent mucous membrane covering the under surface of the eye lids and it extends from the eye lids to cover the anterior part of the eyeball up to the margin of the cornea.

Common symptoms of conjunctivitis are redness, itching, stickiness, foreign body sensation, irritation, watering from the eyes and sometimes intolerance to light. Vision is generally normal but a slight blurring may occur if excess secretions form a film over the cornea. Conjunctivitis may begin in one eye but often spreads to involve both eyes.

Conjunctivitis is most commonly due to viral and sometimes bacterial infections. But it can also result from allergic reactions or from chemical irritants, air pollution, smoke, shampoos, dirt, swimming pool chlorine or noxious fumes. Rarely, underlying chronic inflammatory conditions can also cause a persistent conjunctivitis. The infectious form of conjunctivitis is very common in children and is highly contagious.

Traditionally, home remedies have been successfully used for soothing inflamed eyes with uncomplicated symptoms, minor infections, or allergies. Treatment consists primarily of cleansing the eyes and preventing the condition from spreading. Daruharidra decoction is a popular traditional formulation mentioned in Ayurvedic texts for the management of uncomplicated conjunctivitis.

Daruharidra (Berberis aristata D.C.)

Daruharidra (Indian berberry) is a shrub or small tree, distributed in the temperate and subtropical parts of Asia, Europe and America. Daruharidra has been in use (as eye drops/ointment) for centuries for prophylactic as well as curative purposes in common eye ailments like conjunctivitis. It is an important ingredient of many traditionally used formulations meant for local ophthalmic use, commonly as decoction and solidified water extract called Rasanjana. These drug forms are used orally, locally as well as for topical ocular preparation. Antimicrobial activity of B. aristata is well demonstrated against a variety of bacteria, fungi, protozoas, helminths, chlamydia and viruses. The alkaloid berberine is known to possess anti-microbial properties against gram positive and gram negative bacteria.

Composition

The formulation consists of the decoction or solidified water extract of the stem or root of Daruharidra (Berberis aristata D.C.) termed as Rasanjana.

English name	Indian berberry
Latin name	Berberis aristata D.C.
Family	Berberidaceae
Part used	Stem and root.

Main chemical constituents

Alkaloids like berberine, berbamine, aromoline, karachine, palmitine, oxyacanthine and oxyberberine.

Quality standards:

Foreign matter	Not more than 2%
Total ash	Not more than 14%
Acid-insoluble ash	Not more than 5%
Alcohol-soluble extractive	Not less than 6%
Water-soluble extractive	Not less than 8%

Method of preparation

• (1) Soak overnight 5 grams of coarse powder of Daruharidra in 100 ml of water.
• (2) Boil the mixture till half of the water remains and filter it.
• (3) Use the filtrate at room temperature to irrigate the inflamed eye(s).

Dosage form: Yellowish coloured liquid.

Therapeutic properties

Anti-inflammatory, antimicrobial, anti-diarrhoeal, anti-trachoma activity, and antipyretic.

Indications and uses

Conjunctivitis, trachoma and eye infection resulting from Chlamydia trachomatis, and chronic ophthalmic inflammation.

Dose and mode of administration

• (1) Patient is made to lie down on the back with the neck slightly extended. Daruharidra is poured on the eye as thin stream with undine or with syringe without injection needle or canula. This procedure can be repeated twice or thrice in a day depending upon the severity of the symptoms.
• (2) Generally the eye should be kept closed but in case of eye discharge, pulling the lids apart and irrigating the eye may be required.
• (3) In cases where redness and burning sensation in the eye are prominent, irrigating fluid should be cold. When pain and discharge are prominent, then lukewarm decoction should be used.
• (4) Daruharidra decoction can also be applied in the form of eye drops in conjunctivitis. For this purpose keep 2 ml of the filtered decoction mixed with equal quantity of pure honey in an eye dropper vial and use this mixture within 12 hours by instilling 1 to 2 drops in each affected eye 4 to 6 times a day at regular intervals.

Precaution and safety aspects

• (1) Decoction and eye drops solution must be prepared fresh daily and kept in a sterile vessel.
• (2) Infection can be easily transmitted by touching or rubbing your eyes, make an effort to avoid it.
• (3) Protect the eyes from dirt, sunlight, other irritating substances and from repeated rubbing.
• (4) Avoid the use of cosmetics while suffering from conjunctivitis.
• (5) Remove contact lens, if it is worn.
• (6) For cleansing and soothing the eyes dip a clean cloth in warm water, wring it out and place it on the eye till it becomes cool. Then apply another cloth in the same way.
• (7) Avoid prolonged work under artificial light and excessive use of the eyes.
• (8) If eye symptoms aggravate or are not relieved within two-three days, seek doctor’s advice for necessary treatment.
• (9) Strictly avoid sharing clothes, handkerchiefs and towels and wash such items separately.
• (10) On coming in contact with a person suffering from conjunctivitis, wash your hands with soap and water properly.

References

• (1) Sharma PC, Yelne MB, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 1. New Delhi: Central Council for Research in Ayurveda & Siddha, 2000. p. 121.
• (2) India, Ministry of Health and Family Welfare. The Ayurvedic pharmacopoeia of India. Part I. Vol. II. New Delhi: Department of Indian Systems of Medicine & Homeopathy, 2001. p. 34.
• (3) Sharma PC, Yelne MB, Dennis TJ. Database on medicinal plants used in Ayurveda. Vol. 1. New Delhi: Central Council for Research in Ayurveda & Siddha, 2000. p. 120-123.

Further reading

• (1) The Wealth of India. Raw materials. New Delhi: Public Information Department, Council of Scientific & Industrial Research, 1988.
• (2) Chunekar KC. Bhavaprakasha Nighantu. Varanasi: Chaukhambha Bharati Academy, 1982.
• (3) Sabnis Mukund. Chemistry and pharmacology of Ayurvedic medicinal plants. Varanasi: Chaukhambha Surabharati Prakashana, 2006.
• (4) Singhal GD, Sharma KR. Ophthalmic and otorhinolaryngological considerations in ancient Indian surgery. Allahabad: Singhal Publications, 1976.
• (5) Acharya JT. ed. Sushruta samhita. Varanasi: Chaukhamba Orientalia, 1980.

Source: Traditional Herbal Remedies for Primary Health Care - WHO