Ayurvedic Management of Toxic Nutritional Optic Neuropathy: A Case Report

Abstract

Toxic/nutritional optic neuropathy (TNON) is a condition caused by chronic exposure to toxins or nutritional deficiencies, particularly involving B-complex vitamins. It commonly presents with bilateral, painless visual impairment, color vision defects, and central or centrocaecal scotomas. This study reports a case of 47-year-old male with a history of chronic alcohol and tobacco use who developed Toxic nutritional optic neuropathy with severely reduced vision in the right eye. He was managed with therapies including Virechana with Trivrut lehya(70gms) preceded by Snehapana with Mahatriphaladya ghrita in arohana matra, Nasya with Bhringaraja taila(10drops) for 7days, Tarpana with Mahatriphaladya ghrita for 7 days once daily, Anjana with Neelotpaladi anjana for 30 days, and internal medicines for 30days which included Saptamruta Louha 2 Tab with 10ml ghee and 5ml honey at night after food  and Triphala kashaya 30ml mixed with 5ml of Mahatriphaladya ghrita at bed time. Post-treatment, the patient showed notable visual improvement in the right eye (from HM+ to 4/60) along with partial recovery in color vision. Ayurvedic treatments focusing on detoxification, ocular rejuvenation, and dosha balance played a critical role in cessation of pathology and enhancing vision. This case highlights the potential of classical Ayurvedic management in improving outcomes in toxic nutritional optic neuropathy when applied early and appropriately.