{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:13:39Z","timestamp":1789398819972,"version":"build-2803163510"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Meibomian Gland Dysfunction (MGD) has become increasingly common in community practice, often presenting as dryness, irritation, and ocular fatigue. Factors such as prolonged screen exposure, environmental irritants, and advancing age contribute to its growing burden in primary health settings. Conventional management usually focuses on symptom relief, leaving a need for safer, sustainable options that can be applied easily in routine care. Ayurvedic eye therapies, known for their gentle yet restorative effects, may offer such an alternative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A single-arm, open-label clinical study was conducted on 30 patients with clinically diagnosed Meibomian Gland Dysfunction (MGD). The treatment protocol consisted of daily nasal oil instillation (\n                      <jats:italic>pratimarsha nasya<\/jats:italic>\n                      ) using Anu oil for 30\u202fdays, along with medicated eye drops (\n                      <jats:italic>aschyotana<\/jats:italic>\n                      ) prepared from\n                      <jats:italic>Moringa oleifera<\/jats:italic>\n                      leaves and localized warm ocular fomentation (\n                      <jats:italic>avagundana<\/jats:italic>\n                      ) using a herbal bolus immersed in a Triphala-based decoction for the first 15\u202fdays. Clinical outcomes were assessed using both subjective and objective parameters, including the Ocular Surface Disease Index (OSDI), Tear Film Break-Up Time (TBUT), Schirmer\u2019s Test I, fluorescein staining, and meibomian gland expressibility. Assessments were performed at baseline, immediately after treatment, and during follow-up visits. Data were analyzed using the Friedman test and Wilcoxon Signed-Rank test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients showed marked improvement in all clinical parameters. OSDI, TBUT, and Schirmer\u2019s scores improved significantly (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Fluorescein staining was reduced to nil after treatment and remained stable during follow-ups, while meibomian gland expressibility improved consistently, reflecting better tear film stability and glandular function. No side effects or adverse reactions were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This exploratory study suggests that a simple Ayurvedic care regimen may be associated with improvement in symptoms and ocular surface parameters in individuals with Meibomian Gland Dysfunction. Given its non-invasive nature, ease of administration, and suitability for low-resource settings, this approach may have potential relevance as a supportive strategy within primary eye care. However, these findings are preliminary, and further controlled studies are required to confirm effectiveness and define its role in community-level preventive and promotive eye health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations of the study<\/jats:title>\n                    <jats:p>This was a single-arm exploratory study with a small sample size and limited follow-up. Consequently, the findings are preliminary and require confirmation in controlled trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1732091","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T16:50:57Z","timestamp":1769014257000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Integrating ayurvedic eye care into primary health practice: an exploratory study on the combined effect of pratimarsha nasya, avagundana, and aschyotana in meibomian gland dysfunction"],"prefix":"10.3389","volume":"12","author":[{"given":"Sreelekha","family":"P","sequence":"first","affiliation":[{"name":"Amrita Vishwa Vidyapeetham Amrita School of Ayurveda","place":["Kollam, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushma","family":"Naranappa Salethoor","sequence":"additional","affiliation":[{"name":"Amrita Vishwa Vidyapeetham Amrita School of Ayurveda","place":["Kollam, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanti","family":"K","sequence":"additional","affiliation":[{"name":"Amrita Vishwa Vidyapeetham Amrita School of Ayurveda","place":["Kollam, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1016\/j.ophtha.2022.12.021","article-title":"NOV03 for dry eye disease associated with meibomian gland dysfunction: results of the randomized phase 3 GOBI study","volume":"130","author":"Tauber","year":"2023","journal-title":"Ophthalmology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.survophthal.2019.08.007","article-title":"Management of meibomian gland dysfunction: a review","volume":"65","author":"Sabeti","year":"2020","journal-title":"Surv Ophthalmol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"DES87","DOI":"10.1167\/iovs.17-23553","article-title":"Meibomian gland dysfunction: recent progress worldwide and in Japan","volume":"59","author":"Amano","year":"2018","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e25703","DOI":"10.7759\/cureus.25703","article-title":"Prevalence, severity, and treatment outcomes of meibomian gland dysfunction in patients with dry eye symptoms at a tertiary care center in South India","volume":"14","author":"Singh","year":"2022","journal-title":"Cureus"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"460","DOI":"10.3390\/medicina61030460","article-title":"Overview of dry eye disease for primary care physicians","volume":"61","author":"Kwon","year":"2025","journal-title":"Medicina (Kaunas)"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"114147","DOI":"10.1016\/j.bcp.2020.114147","article-title":"Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: a current perspective","volume":"180","author":"Bindu","year":"2020","journal-title":"Biochem Pharmacol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1007\/s13596-020-00468-0","article-title":"A review of properties, nutritional and pharmaceutical applications of Moringa oleifera: integrative approach on conventional and traditional Asian medicine","volume":"20","author":"Meireles","year":"2020","journal-title":"Adv Tradit Med (ADTM)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1922","DOI":"10.1167\/iovs.10-6997a","article-title":"The international workshop on meibomian gland dysfunction: executive summary","volume":"52","author":"Nichols","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1016\/j.jtos.2020.08.008","article-title":"A randomized, sham-controlled trial of intraductal meibomian gland probing with or without topical antibiotic\/steroid for obstructive meibomian gland dysfunction","volume":"18","author":"Kheirkhah","year":"2020","journal-title":"Ocul Surf"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"194","DOI":"10.3831\/\u039a\u03a1\u0399.2017.20.022","article-title":"Phytochemistry and pharmacology of Moringa oleifera lam","volume":"20","author":"Paikra","year":"2017","journal-title":"J Pharmacopuncture"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"S556","DOI":"10.4103\/0973-1296.172961","article-title":"Bioactive extract from Moringa oleifera inhibits the pro-inflammatory mediators in lipopolysaccharide stimulated macrophages","volume":"11","author":"Fard","year":"2015","journal-title":"Pharmacogn Mag"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2098","DOI":"10.3390\/ijms24032098","article-title":"Moringa oleifera: an updated comprehensive review of its pharmacological activities, ethnomedicinal, phytopharmaceutical formulation, clinical, phytochemical, and toxicological aspects","volume":"24","author":"Pareek","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref13","first-page":"172","article-title":"Ashtanga Hridaya Sutra 20\/32","author":"Gupt","year":"2009"},{"key":"ref14","first-page":"819","volume-title":"AstangaHridaya of Vagbhatta, Sutrasthana (29\/14)","author":"Paradakara","year":"2010"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2481","DOI":"10.1007\/s40123-024-00988-x","article-title":"Evidence-based strategies for warm compress therapy in meibomian gland dysfunction","volume":"13","author":"Lee","year":"2024","journal-title":"Ophthalmol Ther"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1732091\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T16:50:58Z","timestamp":1769014258000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1732091\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":15,"alternative-id":["10.3389\/fmed.2025.1732091"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1732091","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]},"article-number":"1732091"}}