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Background: Glaucoma is the leading cause of irreversible blindness worldwide. It is a group of optic neuropathies characterised by progressive loss of retinal ganglion cells and visual field, with raised intraocular pressure as the main modifiable risk factor. Sushruta describes Adhimantha, a severe eye disease with intense pain in the eye and head that can lead to blindness within days, which Ayurvedic scholars correlate with glaucoma, particularly acute angle-closure glaucoma. Objective: To review the classical description of Adhimantha, its correlation with types of glaucoma, the evidence base for modern glaucoma management, and the available Ayurvedic evidence, and to define the safe role of Ayurveda in glaucoma care. Methods: Narrative review of Sushruta Samhita and Ashtanga Hridaya, landmark glaucoma trials, and Ayurvedic clinical literature. Results: Adhimantha is described as a Sarvagata (whole-eye) disease, with four types according to Dosha, and the classical prognosis of blindness within a few days in untreated cases closely resembles acute angle-closure glaucoma. Chronic open-angle glaucoma, which is painless and slowly progressive, corresponds less clearly. Lowering intraocular pressure with medication, laser or surgery has been shown in randomised trials to slow glaucoma progression. Ayurvedic evidence consists of small clinical studies, case reports and an ongoing randomised add-on trial of a Rasayana formulation and Shigru eye drops. Conclusion: Adhimantha offers a historically important description of glaucoma-like disease. Ayurvedic treatment must not replace intraocular pressure-lowering therapy. Its possible roles are as an adjunct for neuroprotection and quality of life, which require controlled trials.

KEYWORDS: Adhimantha; glaucoma; intraocular pressure; Shalakya Tantra; angle-closure glaucoma; open-angle glaucoma; neuroprotection; integrative ophthalmology