Ayurvedic treatment for Stargardt Disease

Stargardt disease (also known as Stargardt macular dystrophy, Stargardt macular degeneration, Juvenile macular degeneration, Fundus Flavimaculatus) is a peculiar type of eye disease which causes progressive vision loss. It is a genetic disorder, and it affects the macula. Before talking about a disease that affects the macula, we have to understand the importance of the macular area.

The macula is the most sensitive part of the retina. The light rays reflected from an object passes through the eyeball. The light refracts to focus on a particular point on the retina during this passage. This point is the macula. After the light rays converge on the macula, a series of reactions occur on retinal cells such as photochemical, electrical, nervous, etc. As a result of these reactions, a nerve impulse develops.

The light rays reflected from the object carry all the object’s details, such as colour, size, shape, etc. So, when the impulse forms, it will hold all the particular object’s attributes. This object conducts to the brain through the optic nerve. In the brain, this impulse gets transformed into the actual visual sense. So, we can see that the reactions initiating in the macular area become the first step of your eyesight. So, any defect or pathology in this area will cause severe defects in vision. Stargardt disease is such a disease. Since the pathology is only on the eye’s nerve cells, improving vision with spectacles is not possible.

Stargardt disease often starts in childhood. The main symptoms are 

• Slow loss of central vision, most often in both eyes
• Grey, black or hazy spots in the visual field, especially in the centre
• Hypersensitivity towards light and light sources
• Requires more time to get adapted between light and dark places
• Colour blindness
• Distorted or wavy vision
• Blurriness of vision

If analyzed based on ayurvedic principles, we can say that Pitta is the most crucial factor. The macula is the seat of Pitta, especially one particular fraction of Pitta known as Alochakapitta. Suppose the Alochakapitta gets vitiated by any means (genetic factors, dietary factors, other habitual factors etc.) and also gets confined to the macular area. Due to this, macula cannot perform their properties and functions correctly.

Vitiation of Alochakapitta may happen for various reasons. In the case of Stargardt disease, being a genetic disorder, inheritance is the main reason. Besides inheritance, there are many contributing factors, and these are of two types.

1. Ahara (Dietary factors) – Ayurveda classifies the dietary factors responsible for this condition as Achakshushsa Pittaja Aharas. That means it is Not suitable for the functioning of Pitta in the eyes. e.g., food items with too much sour taste, deep-fried food items, hot and spicy items, unscientific fasting habits, and not taking an adequate quantity of water.
2. Viharas (Habitual factors) – These are Achakshushya Pittaja viharas. These factors are capable of vitiating the Alochakapitta inside the eye, and it is not suitable for the proper functioning of the Pitta such as:

• Exposure to bright light and light sources without protective measures
• Lack of adequate sleep at night
• Excessive works on illuminating screens – e.g., mobiles, laptops etc
• Too much travel, especially exposed to sun and wind
  Stress, strain and tension
• Not taking head wash regularly

Stargardt disease is an eye condition primarily affecting the macula, the most sensitive area of the retina. The retina, composed of nerve-endings, lines the innermost layer of the eyeball. When diseases like Stargardt affect the retina, particularly the macula, visual impairment becomes a significant symptom.

The disease involves the accumulation of unwanted materials in the macular area, leading to its dysfunction. As the macula is responsible for converting light rays into impulses for vision, its impairment results in visual defects. Stargardt disease, also known as macular degeneration, is named after the German doctor who first described it.

Unlike other tissues in the body, nerve cells, especially those in the retina, do not regenerate. Once cells in the macular region degenerate, the defect becomes permanent. Treatment aims to improve the health and stability of existing cells and tissues to enhance their functioning.

Stargardt disease is genetically inherited, making it incurable but treatable. Early diagnosis and treatment are crucial as symptoms typically manifest in childhood. Visual impairments associated with Stargardt disease include central field vision loss, peripheral vision clarity, dark or invisible areas in the visual field, and distorted vision.

Treatment in Ayurveda focuses on normalizing the pitta dosha, which dominates the site of the macula. Medications selected for treatment aim to control pitta vitiation while considering the role of vata. Ghee preparations are often used, both internally and externally, along with specific treatment procedures like Tarpana to penetrate deeper layers of the eye.

The treatment plan varies based on individual constitution and disease severity. Lifestyle modifications, such as dietary adjustments and avoiding bright lights, are essential for managing the condition. Medications should be selected based on the patient’s dosha dominance, with an emphasis on pitta-shamana properties.

Patients with a pitta-dominant constitution may require stricter control of pitta-vitiating factors in their diet and habits. Selecting fruits and vegetables with antioxidant properties and avoiding citrus fruits is recommended. Regular oil application on the head before bathing with pitta-controlling oils can also be beneficial.

While Stargardt disease cannot be cured, its progression can be managed with medication and lifestyle adjustments. Educating patients about factors that worsen the condition and emphasizing adherence to treatment and lifestyle modifications can significantly improve their quality of life.