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Ayurved Darpan
Journal of Indian Medicine An International Quarterly Publishing Peer Reviewed Journal
Conceptual study of Kukunaka with special reference to Ophthalmia
Neonatorum in Neonates
Assistant professor1, Associate professor2
Kalyani P. Aher1,*, Gajanan A. Cheke2
1,2Department of Kaumarbhritya
Conceptual Study
ABSTRACT:
Ophthalmia Neonatorum is one of the diseases of neonates. In Ayurveda Kukunaka vyadhi was explained in
samhita has similar features like Ophthalmia Neonatorum, so Kukunaka can be related to Ophthalmia
Neonatorum. It is the conjunctivitis of newborns occurring during first month of life. It may be infectious or non
infectious. It causes pain & tenderness in eyeball, purulent, mucoid/ mucopurulant discharge, hyperaemia,
photophobia and blindness if left untreared. Hence I decided to address Kukunaka (Ophthalmia Neonatorum) as
it may lead to blindness, if left untreated.
In Ayurveda, Acharya Sushruta, Vagbhata & Kashyapa
have described similar features as that of Ophthalmia
Neonatorum under the disease named ‘Kukunaka’.
Sushruta says that it is caused due to ingestion of
breast milk vitiated by vata, pitta and kapha & rakta
while Vagbhata says that the disease is due to eruption
of teeth.
The bacterial conjunctivitis caused in newborns
during passage through infected birth canal. The risk
of infections in neonates increases due to inadequate
maternal care & lack of widespread use of
prophylactic treatment to prevent infections following
birth
An eye can perceive forms, it adorns the face. It is a
source of direct knowledge, it is a guide for right and
wrong deeds and hence eye is most important of all
sense organs.
Neonatal period is initiation of life. To have healthy
child, parents must look after the neonate, as it may
get diseased soon due to immaturity (Apakvdhatu).
A neonate is fully dependant on mother and is prone
for many diseases due to negligence.
xÉuÉïÇ ÌlÉuÉÉrÉïiÉå oÉÉsÉå xiÉlrÉÇ lÉãuÉ ÌlÉuÉÉrÉïiÉå | rÉÉå. U. oÉÉsÉUÉåaÉÉÍkÉMüÉU
Though it is a dushta stanya janit vyadhi i.e. caused
due to vitiated breast milk, one can not stop breast
feeding of the baby. Aacharyas also stated that mother
is responsible for wellness of a child. Thus the
importance of eye among all sensory organs has
provoked me to select a subject related to eye.
Conceptual Study of Kukunaka:
Literature review of the topic is done from Kashyap
Samhita, Charak Samhita, Sushruta Samhita, Ashtanga
Sangraha and Hridaya, Madhava Nidana,
Bhavaprakasha, Sharangadhara Samhita and Modern
Textbook of Pediatrics.
Ayurvedic Concept
MÑüMÑühÉMü MüÉåjÉ CÌiÉ ZrÉÉiÉ: | ´ÉÏMühPû
Kukunaka is an eye disease, hence anatomy is
described first.
Chakshu – ‘Chaksha’ i.e. Darashan meaning which is
responsible for sight.
Netrabudabuda – meaning bubble floating in water
which explains glossy appearance of eye ball which is
soft in consistency and floating in orbit.
28
KEY WORDS: Kukunaka, Ophthalmia neonatorum, Dhatri, Netra, Stanya, Dushti, Dhatus Infection
INTRODUCTION:
* Corresponding Author: Dr. Kalyani P. Aher, E-mail: [email protected]
Article Received on: 07/12/2019 Accepted on: 26/12/2019 Published on: 31/12/2019
1Ashtang Ayurved College, Pune-411030, 2Tilak Ayurved College, Pune-411011, Maharashtra, India.
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Kukunaka Nidan or Causes
Hetu (causes of Kukunaka) –
xiÉlrÉmÉëMüÉåmÉ MüÄTüqÉÉÂiÉÌmɨÉU£ü oÉÉsÉÉͤÉuÉiqÉï pÉuÉ LuÉ MÑüMÔühÉMüÉålrÉ:|
xÉÑ. E. 19/9
MÑüMÔühÉMüÈ ÍzÉzÉÉåUåuÉ SliÉÉåimĘ́ÉÌlÉÍqɨÉeÉÈ || uÉÉ. E. 8/19-20
rÉSÉ qÉÉiÉÉ MÑüqÉÉUxrÉ qÉkÉÑUÉÍhÉ ÌlÉwÉåuÉiÉå |
qÉixrÉÇ qÉÉÇxÉÇ mÉrÉÈ zÉÉMÇü iÉjÉÉ SÍkÉ ||
xÉÑUÉxÉuÉÇ ÌmɹqÉrÉÇ ÌiÉsÉÌmɹÉqsÉMüÉÇÎeÉMüqÉ |
AÍpÉwrÉlSÏÌlÉ xÉuÉÉïÍhÉ MüÉsÉå MüÉsÉå ÌlÉwÉåuÉiÉå ||
pÉÑYiuÉÉ pÉÑYiuÉÉ ÌSuÉÉ zÉåiÉå ÌuÉxÉÉ¥ÉèæÈÇcÉ ÌuÉoÉÑkrÉiÉå |
iÉxrÉ SÉåwÉÉÈ mÉëMÑüÌmÉiÉÉ SÕUÇ aÉiuÉÉ cÉ ÌiɸiÉå ||
SÉåwÉåhÉÉuÉ×iÉqÉÉaÉÉïrÉÉxiÉiÉÈ xiÉlrÉÇ cÉ SÒwrÉiÉå || MüÉ.ÎZÉsÉ. 13/3-5
There are two thoughts regarding the concepts of
etiological factors. Sushruta, Kashyapa and Madhava
have considered it as a disorder of vitiated milk, while
Vagbhata says it as a complication of dentition.
Kashyapa has listed the factors responsible for
vitiation of breast milk and ultimately for
development of Kukunaka.
1. Aaharaj (Diet):
a. Consumption of too much sweet articles –
Causes diseases due to vitiation of kapha dosha
like netra roga and abhishyanda etc.
(cÉ. xÉÑ. 26/42)
b. Leafy vegetables
c. Fish and meat –
Mansahar have gunas like ushna, tikshna and
abhishyandi which causes aggrevation of pitta
dosha and rakta dhatu.
d. Milk & milk products like butter, ghee –
Dugdhahar causes abhishyand which is responsi-
ble for vitiation of kapha & rakta.
e. Products of flour
f. Grinded tila.
g. Sour articles like kanji.-
Among six rasas, amla is more prone to eye dis-
eases. Vidahi items also leads to eye diseases.
h. All abhishyandi articles.
Ahara is the basis of all functions of the body. The
doshas and dhatus of the body are created,
maintained and destroyed mainly by ahara. These all
dietary factors are Achakshushya. Dietary items
having ushna veerya always vitiate pitta, pitta being
the functional factor for eye, any vitiation of pitta,
always lead to eye diseases.
2. Viharaj (Mode of life):
Sleeping in day, after taking meal –
Sleep in day time and keeping up late hours in the
night, Eyes are modified organs to work in presence
of sunlight and to rest in absence of light. Also,
Divaswap is said to be trishokar.
All the above causes are tridoshkar and raktdushtikar.
Doshas get vitiated, following above causes and
spread in whole of the body, thus blocking milk
carrying channels. On consuming such vitiated milk
for long time, the vitiated dosha enters the body of
child, producing this eye disorder by vitiating kapha
and rakta.
Many Acharyas have mentioned that, the baby
receives milk (stanya) which is a part of mother’s
ahar rasa. So her diet is very important in transfer-
ring vyadhis to baby.
xÉpÉÇuÉÎliÉ qÉWûÉUÉåaÉÉ AzÉÑkS¤ÉÏUxÉåuÉlÉÉiÉç | MüÉ.xÉÇ.xÉÑ.19/27
SÒwÉrÉÌiÉ mÉrÉxiÉålÉ zÉÉËUUÉ urÉÉkÉrÉ: ÍzÉzÉÉå: | xÉÑ.xÉÇ.zÉÉ. 10/33
ͤÉUÇ ÌWû rÉjÉÉå£æüSÉåïwÉMüÉåmÉlÉæUÉWûÉUÌuÉWûÉkÉÉï§rÉÉ urÉÉmɳÉÇ ÌuÉÌuÉkÉÉqÉrÉÉåSrÉÉcÉ
oÉÉsÉxrÉ mÉëMüsmÉiÉå | A.xÉÇ.E. 2/3
aÉÑÂÍpÉÌuÉïÌuÉkÉæUlÉæSÒï¹æSÉåïwÉæ: mÉëSÒÌwÉiÉqÉç |
¤ÉÏUÇ qÉÉiÉÑ: MÑüqÉÉUxrÉ lÉÉlÉÉ UÉåaÉÉrÉ MüsmÉiÉå || qÉÉ.ÌlÉ. 67/5
kÉɧrÉÉ aÉÑÂÍpÉÌuÉïÌuÉkÉæU³ÉæSÒï¹æSÉåïwÉsÉæxiÉjÉÉ |
SåWåû SÉåwÉÉ: mÉëMÑümrÉÎliÉ iÉiÉ: xiÉlrÉÇ mÉëSÒwrÉÌiÉ ||
ÍqÉjrÉÉWûÉU ÌuÉWûÉËUhÄrÉÉ SÒ¹É uÉÉiÉÉSrÉ: Îx§ÉrÉÉ: |
SÒwÉrÉÎliÉ mÉrÉxiÉålÉ zÉËUUÇ urÉÉkÉrÉ: ÍzÉzÉÉå: || pÉÉ.mÉë.mÉÔ. 4/16,17
Thus mithya ahara vihar by mother causes
stanyadushti or vitiation of milk by doshas, causing
many vyadhis in child.
Poorva Roop – Prodromes:
Prodromes of Kukunaka are not described in the text.
Roop - Symptoms and Signs:
ApÉϤhÉÇqÉx§ÉÇ x§ÉuÉiÉå lÉ cÉ ¤ÉÏuÉÌiÉ SÒqÉïlÉÉ: |
lÉÉÍxÉMüÉÇ mÉËUqÉ×SèlÉÉÌiÉ MühÉïÇ uÉÉÇNûÌiÉ SÒ:ÎZÉiÉ: ||
sÉsÉÉOûqÉͤÉMÑüOÇû cÉ lÉÉxÉÉÇ cÉ mÉËUqÉSïÌiÉ |
lÉå§Éå MühQÒûrÉiÉåÅpÉϤhÉÇ mÉÉÍhÉlÉÉ cÉÉmrÉiÉÏuÉ iÉÑ |
xÉ mÉëMüÉzÉÇ lÉ xÉWûiÉå A´ÉÑ cÉÉxrÉ mÉëuÉiÉïiÉå |
uÉiqÉïÌlÉ µÉrÉjÉѶÉÉxrÉ eÉÉlÉÏrÉɨÉÇ MÑü‚ÑühÉMüqÉ || MüÉ. ÎZÉsÉ. 13
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qÉ×SèlÉÌiÉ lÉå§ÉqÉÌiÉMühQÒûqÉjÉÉͤÉMÔüOÇû lÉÉxÉÉsÉsÉÉOûqÉÌmÉ iÉålÉ ÍzÉzÉÑÈ
ÌlÉirÉqÉ| xÉÔÄrÉïmÉëpÉÉ lÉ xÉWûiÉå xÉëuÉÌiÉ mÉëoÉkSÇ..... xÉÑ. E. 19/9
xrÉɨÉålÉ ÍzÉzÉÑÂcNÕûlÉiÉÉqÉëɤÉÉå uÉϤÉhÉÉxÉqÉÈ |
xÉuÉiqÉïzÉÔsÉmÉãÎcNûsrÉÈ MühÉïlÉÉxÉÉͤÉqÉSïlÉÈ || uÉÉ. E. 8/19-20
eÉÉrÉiÉå iÉålÉ iɳÉå§ÉÇ MühQÒûUÇ cÉ x§ÉuÉålqÉÑWÒû: |
ÍzÉzÉÑ: MÑürÉÉïssÉsÉÉOûÉͤÉMühPûlÉÉxÉÉuÉbÉwÉïhÉqÉ ||
zÉ£üÉå lÉÉMïümÉëpÉÉÇSì¹ÒÇ lÉ uÉiqÉÉåïlqÉÏsÉlɤÉqÉ: | rÉÉå. U. oÉÉsÉUÉåaÉÉÍkÉMüÉU
Clinical Features:
The child suffering from Kukunaka may have
following features-
1. lÉå§Éå MühQÒûrÉiÉåÅpÉϤhÉÇ - Excessive itching of eyes
2. sÉsÉÉOûqÉͤÉMÑüOÇû cÉ lÉÉxÉÉÇ cÉ mÉËUqÉSïÌiÉ - The child rubs
eye balls, nose & forehead area
3. xÉ mÉëMüÉzÉÇ lÉ xÉWûiÉå - Photophobia
4. ApÉϤhÉÇx§ÉÇ xÉëuÉiÉå - Excessive lacrimation
5. uÉiqÉïÌlÉ µÉrÉjÉÑ - Swelling of eyelids
6. lÉ uÉiqÉÉåïlqÉÏsÉlɤÉqÉ: - Pain & heaviness in eye lids.
Sadhyasadhytva:
All the types of Kukunaka are curable by medicine. All
Acharya have mentioned medicinal treatment for
Kukunaka.
Samprapti of Kukunaka:
Samanya Samprapati – Pathogenesis of eye
diseases –
Samprapati can be explained as pathological changes
evoked by etiological factors, leading to manifestation
of sign and symptoms of diseases.
ÍxÉUÉÅlÉÑxÉÉËUÍpÉSÉåïwÉãÌuÉïaÉÑhÉãÂkuÉïqÉÉaÉiÉã: |
eÉÉrÉliÉå lÉå§ÉpÉÉaÉåwÉÑ UÉåaÉÉ: mÉUqÉSÉÂhÉÉ: | xÉÑ. E. 1/20-21
The vitiated doshas, as they course through the
vessels and reach upward, produces excessively
formidable diseases in different parts of the eye.
mÉëSÒ¹SÉåwÉxÉÇ iÉÑ rÉSÉ ÌmÉoÉÌiÉ SÉUMüÈ ||
sÉuÉhÉÉqsÉÌlÉwÉåÌuÉiuÉÉlqÉÉiÉÉmÉѧÉÉã UxÉÉÌSWû |
AÉWûÉUSÉåwÉɨÉxrÉÉxiÉÑ oÉÉsÉÉxrÉÉlɳÉpÉÉåÎeÉlÉÈ ||
AlÉÑmÉëuÉåzÉÉSɤÉåmÉÉSÒwhÉxÉiuÉÉuÉlÉÉSÌmÉ |
eÉÉrÉiÉå lÉrÉlÉurÉÉÍkÉÈ zsÉåwqÉsÉÉåÌWûiÉxÉÇpÉuÉÈ || MüÉ. ÎZÉ. 13/6-8
When the breast milk vitiated by doshas & also due to
consumption of salty & sour rasas by mother is
consumed by the infant, the abnormalities caused by
her diet enter the child who is totally dependent on
her milk. Then by action of throwing/ convulsing,
being of hot character & also due to desire (of god)
the disease of eye due to kapha & rakta develops.
The description given by other authors is very short.
Sushruta & Vagbhata accepts that Kukunaka (acute
conjunctivitis) develops to the children. Sushruta says
that it is caused due to ingestion of breast milk
vitiated by kapha, vata, pitta, & rakta while Vagbhata
say that the disease is due to eruption of teeth.
Chikitsa of Kukunaka:
Kashyapa extensively described about treatment of
Kukunaka.
Measures to be applied on Dhatri –
iÉxrÉ ÍcÉÌMüÎixÉiÉÇ ´Éå¸Ç urÉÉZrÉÉxrÉÉÍqÉ rÉjÉÉ iÉjÉÉ |
kÉɧÉÏÇ iÉÑ iÉxrÉ uÉÉqÉrÉåiÉ cÉãuÉ ÌuÉmÉÉcÉrÉåiÉ ||
iÉxrÉÉ uÉÉliÉÌuÉËU£ürÉÉ ÌlÉSÒï½ cÉ xiÉlÉÉuÉÑpÉÉã |
pÉÉåeÉlÉÉÌlÉ cÉ xÉuÉÉïÍhÉ rÉjÉÉrÉÑ£Çü mÉëSÉmÉrÉåiÉ ||
mÉjrÉÇ pÉÑÇeÉÏiÉ ZÉÉSåiÉ ÌuÉmÉËUiÉÇ cÉ uÉerÉïrÉåiÉ |
mÉërÉiÉÉ zÉÑkSuÉx§ÉÉ xrÉÉSÎYsɹÉÅqÉÍsÉlÉÉ iÉjÉÉ || MüÉ. xÉÇ. ÎZÉ. 13
Dhatri of affected child should be given emetics.
MÑü‚ÔühÉå ZÉÌSU´Éå¸É ÌlÉqoÉmɧÉãÈ zÉ×iÉÇ bÉ×iÉÇ |
mÉÏiuÉÉ kÉɧÉÏ uÉqÉåiM×üwhÉÉrÉ¹Ï xÉwÉïmÉxÉãlkÉuÉãÈ || uÉÉ. E 9/24
After performing emesis & purgation properly,
her breast milk should be expressed out and she
should be advised to take congenial diet.
Vagbhata advised medicated ghrita for dhatri.
Breasts should be pasted with Haridra, Pippali,
Nagarmotha & fumigated with ghrita & sarsapa.
Dhatri should remain clean. It may provide
further spread to other children.
Measures applicable to child –
Eyes of the children should be washed with water
very thoroughly, after expressing out impure
blood from the lids. This process may help in
relieving the congestion.
After performing above procedures, drugs are
applied in the eyes through Parisheka,
Aaschotana and application of Lepas & Vartis.
Expression of impure blood using Jalauka, madhu
& trikatu pratisaran. And treatment to Dhatri.
iÉxrÉÉWûUåS ÂÍkÉUqÉÉzÉÑ ÌuÉÌlÉÍsÉïZÉåŠ|
¤ÉÉæSìÉrÉÑiÉåÈ MüOÒûÍpÉÈ mÉëÌiÉxÉÉUrÉå¨ÉÑ
qÉÉiÉÑÈ ÍzÉzÉÉåUÍpÉÌWûiÉÇ cÉ ÌuÉÍkÉÇ ÌuÉSkrÉÉiÉ || xÉÑ. E. 19/10
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Instillation of medicated ghrita.
AɶrÉÉåiÉlÉå cÉ ÌWûiÉqÉ§É bÉ×iÉÇ aÉÑQÒûcÉÏÍxÉkSÇ iÉjÉÉÅÅWÒûUÌmÉ cÉ
̧ÉTüsÉÉÌuÉmÉYuÉqÉ ÿ xÉÑ. E. 19/13
Instillation of Triphala Ghrita or Guduchi Ghrita.
Pratisaran:
̲ÌlÉzÉÉUÉåkÉërÉwšÉuWûUÉåÌWûhÉÏÌlÉqoÉmÉssÉuÉãÈ |
MÑüMÑühÉMåü ÌWûiÉÉ uÉÌiÉïÈ ÌmɹãxiÉÉqÉëUeÉÉåÎluÉiÉãÈ ||
ͤÉU¤ÉÉãSìbÉ×iÉÉåmÉåiÉÇ SakÉÇ uÉÉ sÉÉåWûeÉÇ UeÉÈ | uÉÉ. E. 9/32
Modern Literature:
Ophthalmia Neonatorum
Introduction-
Ophthalmia Neonatorum i.e conjunctivitis in
newborns is inflammation of surface or covering of
the eye. Eye infection in 1st month of life, as a result
of carelessness at the time of birth can be classified as
Ophthalmia neonatorum.
Epidemiology –
It affects 1-2% newborns in western white, while
23% are affected in developing countries.
Predisposing factors –
Organisms in vagina shed during delivery
PROM
Prolonged delivery
Few tears & low levels of IgA.
Trauma to epithelial barrier.
Prophylaxis (silver nitrate , antibiotics)
Causative factors of Ophthalmia Neonatorum:
Causes of Ophthalmia Neonatorum are infectious or
non-infectious in origin.
1. Infections –
Most common types of bacteria that cause
infection in infant’s eye come from mother’s birth
canal, passed to infant during delivery. These
infections can include:
STDs- if untreated many of these infections can
cause serious damage to infant’s eye.
Chlamadia trachomatis – most common in vagi-
nally transmitted diseases.
Neisseria gonorrohae – is rare now-a-days, but it
is the most serious.
Staphylococcus aureus
Streptococcus pneumonia
Herpes simplex – less oftnely.
Risk factors- The biggest risk factor is maternal
infection or STD at the time of delivery. Mother may
not have any symptom during delivery & still be able
to transmit the infection.
2. Non infectious –
It is due to irritation in eye. It is due to reaction to
chemical irritants like silver nitrate.
It is a self limiting condition lasting no more than
24-36 hrs. It can be distinguished from infectious
conjunctivitis.
The cases of chemical conjunctivitis are
decreasing as silver nitrate prophylaxis is being
replaced by other agents, which in turn have
reduced the incidence of gonoccocal
conjunctivitis.
Clinical features –
Most common symptoms of Ophthalmia Neonatorum
are thick & pus like discharge from eyes, redness &
swelling of conjunctiva, and swollen eyelids. The dis-
charge may be purulent, mucopurulant or mucoid
from one or both eyes.
Bacterial conjunctivitis – depending upon pathogen,
there may be mixed picture of red eye with lid swell-
ing, & varying amount of purulent discharge.
A. Chlamydial infection –
Commonest infectious cause. Infants whose mothers have untreated
chlamydial infections antepartum have 30-40%
chances of developing chlamydial neonatal
conjunctivitis. In addition 10-20% of these children develop
pneumonia related to Chlamydia. Perinatal chlamydial infection may also cause
localized infection in nasopharynx, middle ear,
vagina and rectum. It affects in 5-14 days after birth. Unilateral or bilateral watery discharge which
becomes copious & purulent later on. There may be associated pre-septal cellulitis, and
less commonly rhinitis, otitis.
31
Sr. No. Aetiology Manifestation 1. Chemicals In Hours
(Antibiotic, Detergent) 2. Gonoccocal 1-3 Days 3. (Other) Bacterial 4-5 Days 4. Chlamydial 5-10 Days
Table No. 1: Causative factors and their manifestations
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B. Gonorrheal infection –
Occurs typically 1-5 days after birth, but may
occur later. Hyperacute conjunctival infection & chemosis, lid
oedema, severe purulent discharge. There may be associated corneal ulceration &
perforation.
C. Viral conjunctivitis –
Acute onset.
1-14 days after birth.
Unilateral/bilateral serosanguinous discharge
with/without vesicular skin lesions.
Other ocular features include –keratitis, uveitis,
cataract and retinitis.
Uncommonly systemic infections can cause
jaundice, hepato-spleenomegaly, pneumonitis
Prevention –
Antibiotic eye ointment given to the infant after
birth.
Treating the mother for any STDs prior to labour
& delivery.
A caesarean section for mother with active geni-
tal herpes lesions.
Investigations -
History of previous or concurrent STD in mother
& results of any cervical cultures obtained during
pregnancy.
Ocular examination- penlight & fluorescein
examination.
Microbiological- conjunctival swb culture.
Mother – cervical swab for gonorrhoea, Chlamy-
dia & viral infection.
Treatment:
Since the potential for serious eye damage to the
infant is so great, its standard treatment is to give the
infant antibiotic eye drop right after birth. This helps
to prevent the development of infection.
Bacterial infection-
The infants are given antibiotic topical drops/
ointment like gentamicin eye drop. Eye wash is given
to remove discharge. Treatment should be guided by
organism grown in culture. Antibiotic treatment is
very effective and infection resolves quickly.
I. Chlamydial infection –
10% sulfacetamide drop – 4 times daily.
1% tetracycline ointment 2 times daily
Oral erythromycin syrup (50 mg/kg/day qds)
for 14 days.
II. Gonnorheal –
Babies need hospitalization & evaluation for
disseminated disease.
They should receive Ceftriaxone 25-50mg/kg
IV/IM single dose or Cefotaxim 100mg/kg IV/
IM single dose.
Attention should be paid if –
Red conjunctiva,
Sudden & severe onset
Baby is distressed or unwell
Both eyes are affected
Possibility of maternal infection.
In this case prior to results from gram staining it is
appropriate to start with broad spectrum antibiotic.
e. g.: Ofloxocin 0.3% qds for a week.
Chemical conjunctivitis – Ophthalmia Neonatorum
due to irritation usually improves of its own. No
treatment is required although some favour use of
preservative free artificial tears.
Prophylaxis –
Proper antenatal care of mother & any vaginal
discharge should be treated meticulously –
The shedding of some micro organisms from cervix
during 3rd trimester is well documented. e. g. – 7-
20% of women shed CMV12% shed Chlamydia.
Some women shed herpes simplex virus (HSV 2)
during pregnancy even in absence of typical genital
lesions.
If the screening of all pregnant women can not be
accomplished, the WHO has suggested screening
women at high risk for delivering a baby who could
develop neonatal conjunctivitis.
Asepsis & care are to be maintained to protect eye
during delivery
Sulfaceyamide (10%), framycetin, or norfloxacin
eye drop 4 times daily for 7-10 days is advised
following birth.
Crede’s prophylaxis – 1 drop of 1% silver nitrate
is instilled into the eyes of the baby, just after the
birth. It should never be stronger than 1% -
otherwise corneal opacity may result.
Crede’s prophylaxis was used earlier to prevent
gonococcal ophthalmia, which is very rare now-a-
days.
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CONCLUSION:
Neonatal period is initiation of life. A neonate is fully
dependent on mother and is prone for many diseases
due to negligence as well as due to immaturity
(Apakvdhatu)
Ophthalmia neonatorum is conjunctivitis of newborns
occuring during 1st month of life.
In Ayurveda, Acharyas have described it as Kukunaka.
Acharya Sushruta have described 76 types of
netraroga which are observed in adults as well as in
children. But Kukunaka affects only children hence
not included in netraroga.
While Vagbhata included Kukunaka in Vartmagata
vyadhi (disorder of eyelids) and described it as a
disorder of dentition.
Eyes are source of direct knowledge. It is a guide for
right and wrong deeds. Hence, it is important to
prevent a baby from such diseases.
REFERENCES:
[1] Dr. Pandit Hemraj Sharma, Kashyap Samhita,
Chaukhamba Sanskrit Sansthan Varanasi, 2008.
[2] Yadavaji Trikamaji Achyarya, Charak Samhita,
Chaukhamba Sanskrit Sansthan Varanasi, 1984
[3] Yadavaji Trikamaji Achyarya, Susruta Samhita,
Chaukhamba Sanskrit Sansthan Varanasi, 1980
[4] Dr. Ganesh Krishnagarde, Ashtanga Hridaya,
Raghuvanshi Prakashan Pune, 1996
[5] Indradev Tripathi, Yogratnakar, Chaukhamba
Sanskrit Sansthan Varanasi, 1996
[6] Dr. O.P. Ghai, Essential Pediatrics, CBS
Publication, 2013.
[7] www.scholar.google.co.in
Cite this article as:
Kalyani P. Aher, Gajanan A. Cheke, Conceptual study
of Kukunaka with special reference to Ophthalmia
Neonatorum in Neonates, ADJIM 2019: 4(4), p. 28-33.
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