World Journal of Pharmaceutical Research

Vishnoi et al. SJIF Impact

World Journal of Pharmaceutical Factor 8.084
Research
Volume 10, Issue 6, 410-418. Review Article ISSN 2277– 7105

EMERGING LIFE STYLE DISORDERS IN COVID ERA W.S.R. TO

VISUAL DISPLAY TERMINAL SYNDROME AND AYURVEDA

Dr. Anita Vishnoi*1, Dr. Prabhakar Vardhan2, Dr. Rajendra Kumar Soni3, Dr. Gulab
Chand Pamnani4

1
PG Scholar, Department of Shalakya Tantra, Nia Jaipur, Rajasthan, India.
2
Assistant Professor, Department of Shalakya Tantra, Nia Jaipur, Rajasthan, India.
3
Lecturer, Department of Shalakya Tantra, Nia Jaipur, Rajasthan, India.
4
Associate Professor, Department of Shalakya Tantra, Nia Jaipur, Rajasthan, India.

ABSTRACT
Article Received on
26 March 2021, Covid-19 has resulted in tremendous changes in the life style of
Revised on 15 April 2021, common population who was normally not exposed to visual displays
Accepted on 06 May 2021
DOI: 10.20959/wjpr20216-20488 for long periods. Now they have to endure complications of prolonged
use of visual displays like computers, mobiles, tablets etc. in the form
of blurred vision, decreased visual activity, head ache, eye strain,
*Corresponding Author
watering, double vision, etc. Although visual display terminal
Dr. Anita Vishnoi
syndrome is in vogue since almost three decades. Visual Display
PG Scholar, Department of
Shalakya Tantra, Nia Jaipur, Terminal Syndrome is a condition resulting from focusing the eyes on
Rajasthan, India. a computer screen. It is very common in present Era. According to
Ayurveda, Visual Display Terminal Syndrome is caused by Asatmaya
indriyartha samyoga (Atiyoga and Mithya Yoga of Chakshurendriya). Computer users will
often assume awkward postures in order to position their eyes so that they can perform their
work and develop musculoskeletal symptoms such as neck, back and shoulder pain etc.
Covid-era has multiplied the affected populations by many folds as schooling, studies, office
works have to be done by these devices. Therefore, the need of counter acting these changes
by effective measures as advocated in Ayurveda. For this multi-pronged effort in the form of
Tarpana, Aschyotana, Snehana, Nasya, Murdha taila, Tratak are needed.

KEYWORDS: Visual Display Terminal Syndrome, Covid Era, Ayurveda, Tarpana.

www.wjpr.net │ Vol 10, Issue 6, 2021. │ ISO 9001:2015 Certified Journal │ 410
Vishnoi et al. World Journal of Pharmaceutical Research

INTRODUCTION
According to WHO COVID-19 is an infectious disease caused by a virus known as SARS-
CoV-2. Maximum Individuals infected with the corona will experience mild to moderate
respiratory illness, fever and recover without necessitating special treatment. In severe cases
and Older people and those with problems like cardiovascular diseases, chronic respiratory
illness and cancer are more likely to develop serious illness. As per WHO, worldwide there
have been 137866311 confirmed cases of COVID-19 including 2965707 deaths reported to
WHO till 15 April 2021.It is a communicable disease.[1] In Ayurvedic literature
communicable diseases are described under Janapadodhvamsa. As per Acharya Charaka
Janpadodhavansa literally means demolition of societies, Impairment of Vayu (air),
Udaka(water), Desha(land) and kala(season) are more lethal in their increasing order.The root
cause of all the factors is Adharma.[2]

Effects on Eyes due to Covid-19-It has been shown that ocular symptoms together with dry
eye are quite common among covid-19 patients and can seem before the onset of respiratory
symptomatology.[3]

COVID-19 and Visual Display Terminal Syndrome

Prior to the COVID-19 pandemic, the number of people suffering from VDTS was already on
the rise. In COVID-19 Era the dependence increased on visual displays because of the
compulsion of the work to be done from the households. The use of these devices became
unavoidable due to online classes, office work, even for preschool children it became
necessary. Our eyes are not accustomed according to see moving objects for long periods.
When we work on the computers, our eyes have to focus and refocus all the time our eyes
react to images continuously moving and changing. shifting focus causes eye strain. Due to
COVID-19 the number of persons reporting symptom of CVS increased exponentially.
COVID-19 has resulted in tremendous changes in the life style of common population who
was not exposed to visual displays for long periods, now they have to endure complications
of prolonged use of computer displays like computer, tablet, mobile phone, etc. in the form of
blurred vision, decreased visual acuity, headache, eyestrain, watering, double vision etc.
Spending long hours in front of these devices can lead to various ocular problems in
individuals. Due to limitations on outdoor activities for children, which has led to an increase
in the time spent by these children in playing videogames on smartphones. Although these
changes are reversible in early stages by following Dos and Don’ts, yet if refractive errors

www.wjpr.net │ Vol 10, Issue 6, 2021. │ ISO 9001:2015 Certified Journal │ 411
Vishnoi et al. World Journal of Pharmaceutical Research

accommodative spasms and musculoskeletal changes take place then it needs proper
evaluation and correcting measures. Another aspect of extra exposure of these devices and
less involvement in social life is that there is an impact on psychology resulting in different
psychological disorders from mild to severe like irritability, anxiety, hyperactivity,
depression etc. Due to extensive use of face mask, most of the ophthalmologists are seeing
more and more patients with dry eyes. The use of facemask significantly decreases the
outward spread of air. However exhaled air still needs to disperse. when a facemask sits
loosely against the face, the likely path of exhaled air is upwards. this forces a stream of air
over the surface of cornea. creating state that accelerates corneal tear film evaporation leading
to dry spots on the ocular surface, irritation and discomfort.[4]

Visual Display Terminal Syndrome

Computers have become an essential equipment of modern life style. Visual display terminal
syndrome is a condition resulting from focusing the eyes on computer or other display device
for work, net surfing, social networking and playing video games and prolonged use of
devices with digital screens include: personal computers, laptops, tablets, smartphones,
television etc. Working for long hours in front of the computer is no longer limited to the
office. Computers are now broadly used in institutes and at home as well. In this techno-age,
children as early as two years of age are given touch screen devices like tablets to play and
learn with. These accessories of modern living may give rise to a number of visual and
ophthalmic strains collectively called the Visual Display Terminal Syndrome According to
American Optometric Association (AOA): computer vision syndrome, also referred to as
digital eye strain, describes a group of eye and vision related problems that result from
prolonged computer, tablet, e-reader and cell phone use.[5]

Ocular Symptoms of VDTS[6]

 Eyestrain
 Headache
 Blurred vision
 Dry Eyes
 Difficulty in focusing
 Double vision

www.wjpr.net │ Vol 10, Issue 6, 2021. │ ISO 9001:2015 Certified Journal │ 412
Vishnoi et al. World Journal of Pharmaceutical Research

VDTS and Ayurveda

One should not be ashamed of one’s inability to name a disease, since all disorders cannot be
given standard name.[7]

According to Ayurveda Visual Display Terminal Syndrome is characterised by

Asatmyaindriyartha Samyoga (Mithya yoga and Atiyoga) of Chakshurendriya. Visual
Display Terminal syndrome has no direct reference in Ayuredic texts; it can be correlated to
some extent with symptoms of shushkakshipaka, a sarvagata netra roga. Shushkakshipaka is
caused by vitiation of vata dosha as per Acharya Sushruta[8] and vata-pitta dosha as per
Acharya Vagbhatta.[9] Acharya Karala has opined vitiated vata and rakta dosha cause result
in this disorder. Shushkakshipaka is characterised by Gharsha(irritation), Kunita vartma
(reduced palpebral aperture due to phptophobia), Avila Darshna (Blurred vision), Toda
(pricking type of pain), Daha (Burning Sensation) and Raktaraji (Congestion).[10]

Causes of Visual Display Terminal Syndrome[11]

 Less operational Distance from computer screen
 Dim lighting in room
 Glare on the Screen
 Reduced blink rate -increased tear evaporation

Diagnosis
VDTS necessitates a comprehensive examination with a proper history and a detailed eye
examination including:
 Visual acuity measurement
 Refraction
 Assessment of convergence and accommodation
 Evaluation for dry eye

Associated symptoms like

 Irritability
 Depression
 Addiction of screen time.

Pathogenesis (samprapati) of Visual Display Terminal Syndrome

www.wjpr.net │ Vol 10, Issue 6, 2021. │ ISO 9001:2015 Certified Journal │ 413
Vishnoi et al. World Journal of Pharmaceutical Research

The main contributory factors behind the disease are Asatmyaindriyartha samyoga and
Pragyaparadha.

Management
VDTS may include a variety of approaches as follows
Correction of any refractive errors and use of occupational glasses as required. Treatment of
dry eyes. Proper lighting at the workplace: reflected glare from windows and lighting should
be avoided. Anti-glare screens may help Proper positioning of the monitor: it should not be
too high. Ideally, the centre of the screen should be about 6 inches below the straight-ahead
gaze. Monitor display quality: High resolution LCD monitors with matte finish reduce eye
strain. Older CRT monitors should be set to their highest refresh rates to minimize flicker.
Advice to blink frequently: this re-wet the cornea and helps prevent dryness and irritation.
Rest breaks: 20/20/20 rule - after every 20 minutes of computer viewing, one should look into

www.wjpr.net │ Vol 10, Issue 6, 2021. │ ISO 9001:2015 Certified Journal │ 414
Vishnoi et al. World Journal of Pharmaceutical Research

the distance 20 feet away for 20 seconds to allow the eyes to refocus. The American
Optometric Association suggests a break of 15 minutes after 2 hours of continuous computer
use.[12]

Ayurvedic Management
Acharya Sushruta mentioned following treatment of Shushkakshipaka in sarvagata netra
roga chikitsa adhyaya-
Avoid the causative factor of Shushkakshipaka[13]
Anjana should be done, made up of saindhava lavana, powder of daruharidra, sunthi along
with lemon juice and mixed with ghrita. this anjana should be applied with stanaya and
small amount of water.[14]
Nasya with medicated Anu taila.[15]
Akshi Tarpana with Jivaniya Ghrita and jivaniya ghrita paan should also done.[16]
Parisheka with cold water mixed with saindhava lavana should be done.
Rajanayadi ghrita also can use for anjana.[17]

Acharya Vagbhatta also mentioned treatment of Shushkakshipaka almost similar yogas

As ghrita paan, jivaniya ghrita tarpana, anu taila nasya, netra parisheka etc. In addition to
above treatment Vagbhatta mentioned use of Keshanjana in Shushkakshipaka.[18]

Showing Pathya and Apthya:[19]

Food/Activities Pathya(Do) Apthya (Don’ts)
Lohitakashali(red variety of rice),
Shukadhanya Germinated cereals
Sashtika, Yava(barley)
Shimbidhanya Mudga(green gram) Kulattha, masha
Flesh of animals living in
Mamsa Flesh of birds, tortoise flesh
semi-arid tropics
Jeevanti, Karvellaka, Solanum nigrum,
Shaka Kalingakapatrasaka
Aloevera, Patola, Abhaya
Dadima, Draksha, amalaka, vibhitaka,
Fruits
abhaya
Milk obtained in morning
Dugdha Milk obtained in evening time
time
Ghrita Ghee prepared from cow and Goat milk
Oils Tilataila Atasi
Salt Saindhava Other salts
Foodhabit Light food Excessive intake of food
Drinks Liquid drink Excessive alcohol
Diva swapana, ratri
Sleep Ratri swapana
jagarana

www.wjpr.net │ Vol 10, Issue 6, 2021. │ ISO 9001:2015 Certified Journal │ 415
Vishnoi et al. World Journal of Pharmaceutical Research

Scope of Ayurveda in the field of these type of diseases

DISCUSSION
In this modern Era and due to Covid pandemic excessive use of computers, tablets, smart
phones etc and not following proper life style leads to many life styles disorders. To prevent
and treat life style disorders related to eye disorders through enlightenment of Pathya
Apathya and Dincharyas which are practices are not being followed these days which leads to
many netra rogas. In Ayurveda Pathyas (Chakshushya varga) and Apathyas (Achakshushya
varga) have been explained by different Acharyas. Dincharya described according to
Acharya can be adopted in our daily activities and maintain Netra Swasthya and improve the
vision.

Maintaining Eye health with Dincharya

All the Acharyas have mentioned the mandatory practice of Dincharya for health
maintenance.
Anjana (collyrium)- There are two type of Anjana Sauviranjana and Rasanjana. The
sauviranjana type of collyrium can applied every day and Rasanjana is used once at interval
of five or eight nights.[20]
Nasya -In this procedure medication are instilled into nostris in a specified manner to nourish
the organ above clavicle known as Nasya. Due to anatomically communication the medicine
applied through nostrils reaches to Sringataka Marma.[21]
Shiro abhyanga-It acts as Indriya prasadana and preventive measure for Eye disorders.[22]
Padabhyanga- Massage of oil over the soles maintains vision and reduces Vata Dosha.[23]
Snana(Bathing)-Bathing with cold water from the head is indicated Chakshushya.[24]
Padatra dharana –Use of footwear is benefitial for preventive approaches in eye
disorders.[25]
Padaprakshalana- washing of feet with clean water helps in ChakshuPrasadana.[26]
Chatraa dharana- Use of umbrella prevents dust, and excessive light to eyes acts as
Chakshushya.[27]
Trataka

REFERENCES
1. Covid19.who.int.
2. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy edition 2014,Vimanasthana chapter3/6

www.wjpr.net │ Vol 10, Issue 6, 2021. │ ISO 9001:2015 Certified Journal │ 416
Vishnoi et al. World Journal of Pharmaceutical Research

3. Hong N, Yu W, Xia J, Shen Y, Yap M, Han W (2020) Evaluation of ocular symptoms

and tropism of SARS-CoV-2 in patients confirmed with COVID-19. Acta Ophthalmol.
10.1111/aos.14445 - PMC - PubMed
1
4. Giannaccare G, Vaccaro S, Mancini A, Scorcia V. Dry eye in the COVID-19 era: how
the measures for controlling pandemic might harm ocular surface. Graefes Arch Clin Exp
Ophthalmol, Nov, 2020; 258(11): 2567-2568. doi: 10.1007/s00417-020-04808-3. Epub
2020 Jun 19. PMID: 32561978; PMCID: PMC7304378.
5. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome
6. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome
7. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy edition 2014, Sutra sthana 18/44.
8. Shastri Ambika Dutta, Sushruta Samhita of Sushruta with Ayurveda Tatva Sandeepika
Hindi commentary, Uttar Tantra, Chaukhambha Sanskrit Sansthana, Varanasi, Reprint,
2018; Chapter 6, Shloka 3-4: 33.
9. Tripathi Bramhanand, Ashtanga Hrudayam with Nirmala Hindi commentary, Uttar
Sthana, Chaukhambha Sanskrit Sansthana, Varanasi, Reprint, 2014; 15(16): 986.
10. Shastri Ambika Dutta, Sushruta Samhita of Sushruta with Ayurveda Tatva Sandeepika
Hindi commentary, Uttar Tantra, Chaukhambha Sanskrit Sansthana, Varanasi, Reprint
2018; 6(26): 39.
11. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome
12. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/computer-vision-syndrome
13. Shastri Ambika Dutta, Sushruta Samhita of Sushruta with Ayurveda Tatva Sandeepika
Hindi commentary, Uttar Tantra, Chaukhambha Sanskrit Sansthana, Varanasi, Reprint,
2018; 1(25): 14.
14. Shastri Ambika Dutta, Sushruta Samhita of Sushruta with Ayurveda Tatva Sandeepika
Hindi commentary, Uttar Tantra, Chaukhambha Sanskrit Sansthana, Varanasi, Reprint,
2018; 9(20): 53.
15. Shastri Ambika Dutta, Sushruta Samhita of Sushruta with Ayurveda Tatva Sandeepika
Hindi commentary, Uttar Tantra, Chaukhambha Sanskrit Sansthana, Varanasi, Reprint,
2018; 9(22): 53.
16. Shastri Ambika Dutta, Sushruta Samhita of Sushruta with Ayurveda Tatva Sandeepika
Hindi commentary, Uttar Tantra, Chaukhambha Sanskrit Sansthana, Varanasi, Reprint,
2018; 9(21): 53.

www.wjpr.net │ Vol 10, Issue 6, 2021. │ ISO 9001:2015 Certified Journal │ 417
Vishnoi et al. World Journal of Pharmaceutical Research

17. Shastri Ambika Dutta, Sushruta Samhita of Sushruta with Ayurveda Tatva Sandeepika
Hindi commentary, Uttar Tantra, Chaukhambha Sanskrit Sansthana, Varanasi, Reprint,
2018; 9(23): 53.
18. Vagbhatta virachita Asthanga Samgraha with hindi commentary by kaviraj atridev gupta,
chowkhambha krishanadas academy, Varanasi, edition, 2011; 259.
19. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy edition, Sutra, 2014; 25(38): 466.
20. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy, 2014; 5(15): 113.
21. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy edition, Sutra sthana, 2014; 58: 123.
22. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy edition, Sutra sthana, 2014; 83: 127.
23. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy edition, Sutra sthana, 2014; 91: 129.
24. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy edition, Sutra sthana, 2014; 94: 130.
25. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy edition, Sutra sthana, 2014; 100: 131.
26. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy edition, Sutra sthana, 2014; 98: 131.
27. Agnivesha, Charaka Samhita revised by charaka and Dridhabala, Chowkhambha Bharati
Academy edition, Sutra sthana, 2014; 101: 131.

www.wjpr.net │ Vol 10, Issue 6, 2021. │ ISO 9001:2015 Certified Journal │ 418