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Background: Dry eye disease is a common, multifactorial disorder of the ocular surface characterised by loss of tear film homeostasis, causing discomfort, visual disturbance and reduced quality of life. Its prevalence is rising with ageing, screen use and environmental factors. Ayurveda describes a similar condition, Shushkakshipaka, and treats it with Kriyakalpa, a group of local ocular procedures, of which Tarpana (retention of medicated ghee over the eyes) is the most characteristic. Objective: To review the modern understanding of dry eye disease, the classical description of Shushkakshipaka and Tarpana, and the clinical evidence for Tarpana in dry eye. Methods: Narrative review of Sushruta Samhita, international consensus reports on dry eye disease, and Ayurvedic clinical studies. Results: Shushkakshipaka is described as dryness, roughness, burning and difficulty in opening the eyes due to Vata and Pitta, closely matching dry eye symptoms. Tarpana involves building a dough wall around the eye and retaining lukewarm medicated ghee for a specified time. An open-label randomised comparative trial of Triphala Ghrita and Goghrita Manda Tarpana and several uncontrolled studies and case reports report improvements in symptoms, Schirmer test and tear film break-up time. No sham-controlled or masked trials have been published. Conclusion: Tarpana is a plausible lipid-based ocular surface therapy for dry eye, consistent with the importance of the tear film lipid layer. Masked, controlled trials using standard dry eye outcome measures are needed before firm conclusions can be drawn.

KEYWORDS: Tarpana; Kriyakalpa; Shushkakshipaka; dry eye disease; tear film; Triphala Ghrita; Shalakya Tantra; ocular surface