Irsal e alaq (Hirudo therapy) on Maa e Aksar (glaucoma): a scientic review.

Abstract

Maa e aksar (glaucoma) is caused by either increased production or reduced absorption of rutubat (uid) which makes an accumulation inside the eye ball that produces tanao (tension) and constructs the eyeball hard. It results in zoa'f e basar (weakness of vision) and maidan e basarat (narrowing of visual eld). This condition corresponds with glaucoma in allopathic medicine and is dened as a group of conditions characterized by typical changes in the retinal nerve bers and optic nerve head resulting in reduced visual eld, progressive and irreversible vision loss. Its enormous social and economic impact can be acceptable by the fact that it remains as the second leading cause of blindness globally, after cataracts. In 2013, the number of people aged 40-80 years with glaucoma worldwide was estimated to be 64.3 million, increasing to 76.0 million in 2020 and 111.8 million in 2040. Mostly, glaucoma is asymptomatic; generally patients may have complaints like blurred vision, hardness to see in dark, tearing, soreness / tiredness, pain in the affected eyes or frontal portion of the head, feeling of something in the eye and observing the rainbow halos around the light. The treatment is in contrast to nature and Mizaj (temperament) of the disease. Therefore, the elimination of the root cause is the main treatment modality. Despite the use of numerous newer therapeutic regimens, it has remained confronted because of waning of the sensitive part of the eye. The holistic approach of Unani treatment will have a thriving management of diseases with temperamental afliation and its evidences were found throughout the history. Irsal e Alaq (hirudo / leech therapy) which is one of the most important and widely practiced methods used for local evacuation of morbid (invalidated and waste) matter with the use of medicinal leech, has proven efcacy in Maa e aksar, but lacks scientic evidence for validation. The present literary review was based on Unani classical texts, electronic databases of Google scholar, PubMed and through web search. This review aims at highlighting the concept of glaucoma with special reference to Maa e aksar and its management through Irsal e Alaq.