TRIPHALA IN OPHTHALMOLOGY: CLASSICAL USES, PRECLINICAL EVIDENCE AND CLINICAL STUDIES
Background: Triphala, a combination of the fruits of Terminalia chebula (Haritaki), Terminalia bellirica (Bibhitaki) and Phyllanthus emblica (Amalaki), is among the most widely used Ayurvedic formulations. Classical texts describe it as Chakshushya, beneficial to the eyes, and prescribe it orally and locally, as eye washes, drops, collyria and medicated ghee, for a range of eye diseases. Objective: To review the classical ophthalmic uses of Triphala, its phytochemistry and pharmacology relevant to the eye, and the preclinical and clinical evidence for its use in eye diseases. Methods: Narrative review of classical Ayurvedic texts and of experimental and clinical studies of Triphala and its constituents in ocular conditions. Results: Triphala is rich in polyphenols, including gallic acid, ellagic acid and chebulagic acid, with antioxidant, anti-inflammatory and antimicrobial activity. In a rat model of selenite-induced cataract, Triphala reduced cataract formation and restored lens antioxidant enzymes. Phyllanthus emblica and its tannoids delayed diabetic cataract in rats. Clinical studies, mostly small and open-label, have evaluated Triphala eye drops in computer vision syndrome, Triphala Ghrita as Ashchyotana in allergic conjunctivitis and as Tarpana in dry eye, and oral Triphala preparations with Tarpana in myopia, reporting symptomatic improvement. Conclusion: Triphala has a strong classical basis and plausible pharmacology for eye health, with encouraging preclinical results. Clinical evidence is limited by small samples, lack of masking and inconsistent outcome measures. Standardised formulations, sterile ophthalmic preparations and rigorous trials are needed.
KEYWORDS: Triphala; Chakshushya; Shalakya Tantra; cataract; computer vision syndrome; conjunctivitis; Triphala Ghrita; antioxidant